A Mobile-Based Intervention to Address Heavy Drinking and Binge Eating in College Students

项目摘要/摘要 据报道，在过去的一个月里，超过5200万美国成年人酗酒。酗酒是错综复杂的 与酒精使用障碍--一种有害的疾病--的发展有关，并呈指数级增加风险 与严重的医疗和精神疾病有关的疾病，死亡率上升，以及对常规药物的抵抗 治疗。与此同时，多达4300万美国人参与了暴饮暴食的事件，其特点是 大量食用食物，再加上失控。暴饮暴食与 暴饮暴食障碍，最普遍的饮食障碍表型，以及肥胖，这是 这是全球可预防死亡的主要原因之一。最重要的是，经常暴饮暴食 同时发生的，稳健的数据说明了一种狂欢类型的行为对 另一种的严重程度和频率，表明有共同的基本机制。虽然共享的 狂饮和暴饮暴食的机制已经被很好地解释了，很少有治疗方法 已经开发了针对这些跨诊断维持因素的数据。解决这些机制 早期通过使用可获得的预防方法对以下方面具有重要的公共卫生影响 防止发展有害的和难以治疗的疾病。重要的是，这两种狂欢的风险 饮酒和暴饮暴食在年轻人中大大增加，特别是在大学生中， 矛盾的是，为这些有问题的行为寻求治疗的比率确实很低。因为这两个 酒精使用障碍和暴饮暴食障碍通常出现在青春期晚期，精确的方法来 在大多数人群中，在这些症状行为转变为完全阈值障碍之前，将其作为目标 处于危险之中，是至关重要的。此外，由于大学求诊率确实很低， 学生们，开发个性化和大规模可用的精确方法是 尤其是有理由这样做。在这项研究中，我们建议利用我们团队在开发移动设备方面的经验 基于电话的行为健康干预，开发一种移动干预，以双重减少共生 通过瞄准它们共同的潜在机制来狂饮和狂饮。这项分两阶段进行的研究将 首先寻求开发和进行干预的系统Beta测试，由以下组件组成 专家对20名有酗酒行为的男女大学生进行了循证治疗 边吃边喝。随后，我们将在一项随机对照试验中对改进的干预措施进行试点测试 300名两种行为的大学生以及谁将接受干预(N=150)或标准 接受资源(对照；N=150)，以确定减少酗酒频率和相关的干预效果 有问题。结果将提供与可扩展和跨诊断方法相关的第一个已知数据 减少高风险和有限求医人群的暴饮暴食频率。

Project Summary/Abstract More than 52 million American adults report binge drinking in the past month. Binge drinking is intricately linked to, and exponentially increases the risk for, the development of an alcohol use disorder - a pernicious illness linked to severe medical and psychiatric morbidity, elevated mortality, and a resistance to conventional treatments. In tandem, up to 43 million Americans engage in episodes of binge eating, characterized by the consumption of a large amount of food coupled with a loss of control. Binge eating is inherently linked to the development of binge eating disorder, the most prevalent eating disorder phenotype, and obesity, which is among the leading causes of global preventable death. Crucially, binge drinking and binge eating frequently co-occur, with robust data illustrating a bidirectional antagonistic effect of one binge type behavior upon the severity and frequency of the other, indicative of shared underlying mechanisms. Although the shared mechanisms underpinning both binge drinking and binge eating have been well-explicated, few treatments to date have been developed to target these transdiagnostic maintaining factors. Addressing these mechanisms early through the use of accessible prevention approaches has important public health implications for preventing the development of harmful and difficult-to-treat disorders. Importantly, the risk for both binge drinking and binge eating are substantially elevated in young adults, and particularly among college students, where paradoxically, rates of treatment seeking for these problematic behaviors are reliably low. Since both alcohol use disorder and binge eating disorder most typically onset in late adolescence, precision methods to target these symptomatic behaviors prior to their conversion to full threshold disorders, in the populations most at-risk, is of critical importance. Moreover, and owing to the reliably low rates of treatment seeking in college students, the development of precision approaches that are personalized and accessible on a large scale are especially warranted. In this study, we propose to leverage our group’s experience in developing mobile phone-based behavioral health interventions, to develop a mobile intervention to dually reduce co-occurring binge drinking and binge eating by targeting their shared underlying mechanisms. This two-phase study will first seek to develop and conduct a systematic beta test of the intervention, comprised of components of evidence-based treatments vetted with experts, in 20 male and female college students who engage in binge drinking and eating. Subsequently, we will pilot test the refined intervention in a randomized controlled trial of 300 college students who engage in both behaviors, and who will receive the intervention (N=150) or standard receipt of resources (control; N=150), to ascertain intervention efficacy in reducing binge frequency and related problems. Results will provide the first known data relating to a scalable and transdiagnostic approach to reducing binge drinking and eating frequency in a population at heightened risk and limited treatment-seeking.