Examining the Validity of the Alcohol Use Disorder Recovery Construct Using a Between- and Within-Persons Design

使用人间和人内设计检查酒精使用障碍恢复结构的有效性

• 批准号: 10592189
• 负责人: George B. Richardson
• 金额: $ 21.03万
• 依托单位: UNIVERSITY OF CINCINNATI
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-20 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10592189
• 关键词: Address; Adolescence; Adolescent; Adolescent and Young Adult; Adult; African American; Age; Alcohol consumption; Alcohols; Area; Asian Pacific Islander; Black race; Clinical; Community Integration; Consensus; Data; Development; Dimensions; Disease; Disease remission; Education; Emotional; Ethnic Origin; Etiology; Exhibits; Female; Finches; Future; Goals; Growth; Health; Health Personnel; Heavy Drinking; Individual; Knowledge; Life; Link; Longevity; Longitudinal Studies; Measurement; Measures; Mental Health; Mission; Modeling; National Institute on Alcohol Abuse and Alcoholism; National Longitudinal Survey of Adolescent to Adult Health; Native Americans; Nature; Participant; Pathway interactions; Pattern; Personal Satisfaction; Persons; Prevalence; Process; Psychometrics; Public Health; Quality of life; Race; Recovery; Religion and Spirituality; Reporting; Research; Resources; Risk-Taking; Services; Social support; Spirituality; Structure; Subgroup; Testing; Time; United States National Institutes of Health; Work; Youth; alcohol use disorder; base; biopsychosocial; care systems; design; disability; emerging adult; expectation; improved; innovation; physical conditioning; sex; stem; substance use; treatment services; young adult

PROJECT SUMMARY There is growing consensus that recovery extends beyond remission to broader biopsychosocial improvements in domains such as emotional health and community integration (Kelly & Hoeppner, 2014; Richardson et al., 2019; White, 2012). Qualitative (e.g., Borkman et al., 2016) and quantitative studies of between-persons differences (Garner et al., 2014; Lusczakoski et al., 2014) appear consistent with broader recovery definitions. These definitions describe a process, however, and research has not yet addressed the validity of the broader recovery construct at the within-persons level. This is crucial because evidence that domains included in recovery definitions converge at the between-persons level does not guarantee that within- persons change is similarly patterned. Moreover, it is not clear if adult-based conceptualizations of recovery can be applied to youth (Finch et al., 2020) or if recovery has the same meaning across race/ethnicity, sex, recovery pathways, and disordered vs. normative use. Our long-term goal is to facilitate efforts to improve recovery- oriented systems of care. The overall objective for this R21 application is to evaluate the validity of the recovery construct across nearly 25 years from adolescence to mid-adulthood using an exploratory, data-driven approach. Our central hypothesis is that domains included in recovery definitions are moderately correlated at the between- persons differences level, exhibit some important differences in empirical meaning across subgroups, and are significantly correlated within persons. The rationale for the current project is that it informs operational definition of recovery from adolescence to mid-adulthood and provides a point of comparison for future R01 level efforts to validate recovery measures in late adulthood. This study uses data from the National Longitudinal Study of Adolescent to Young Adult Health, longitudinal measurement invariance analysis, and parallel process latent growth modeling to achieve the following specific aims: 1) Determine the importance of time and subgroup membership in moderating the meaning of recovery scores. 2) Determine whether domains included in recovery definitions are linked within persons. It is our expectation that this study will determine the validity of the alcohol use disorder (AUD) recovery construct from adolescence to mid-adulthood, identifying whether recovery indicators function in the same way across groups and intercorrelate within persons. This contribution is significant because it informs development of measures that capture the multidimensional and dynamic nature of the AUD recovery process. This project is innovative because it uses a longer-term within-persons design, includes data from adolescence, conducts longitudinal measurement invariance analyses of recovery moderators, evaluates criterion validity via alcohol use within persons, and analyzes national data spanning adolescence to mid-adulthood. These results will have an important positive impact by facilitating efforts to determine how early trajectories might be altered to improve health across the lifespan, estimate recovery prevalence, adapt services to subgroups of alcohol users, and evaluate recovery-oriented systems of care.

项目概要 人们越来越多地一致认为，康复不仅限于缓解，还包括更广泛的生物心理社会 情绪健康和社区融合等领域的改善（Kelly & Hoeppner，2014； 理查森等人，2019；怀特，2012）。定性（例如，Borkman 等人，2016）和定量研究 人与人之间的差异（Garner et al., 2014; Lusczakoski et al., 2014）似乎与更广泛的差异一致 恢复定义。然而，这些定义描述了一个过程，并且研究尚未解决这个问题 更广泛的恢复结构在人员内部的有效性。这一点至关重要，因为有证据表明 恢复定义中包含的域在人与人之间的层面上收敛并不能保证内部- 人的变化也有类似的模式。此外，尚不清楚基于成人的康复概念是否可以 适用于青少年（Finch et al., 2020），或者恢复在不同种族/民族、性别、恢复中具有相同的含义 途径，以及无序与规范使用。我们的长期目标是促进改善康复的努力- 定向护理系统。此 R21 应用程序的总体目标是评估恢复的有效性 使用探索性、数据驱动的方法构建从青春期到中年的近 25 年。 我们的中心假设是，恢复定义中包含的域在两者之间适度相关： 人的差异水平，在不同亚组的经验意义上表现出一些重要的差异，并且是 人与人之间显着相关。当前项目的基本原理是它提供了操作定义 从青春期到中年的恢复，并为未来 R01 级别的努力提供比较点 验证成年后期的恢复措施。本研究使用的数据来自国家纵向研究 青少年到青年健康、纵向测量不变性分析和并行过程潜伏 增长建模以实现以下具体目标：1）确定时间和子组的重要性 成员资格在调节恢复分数方面的意义。 2) 确定域是否包含在恢复中 定义在人体内是相互联系的。我们期望这项研究能够确定酒精的有效性 从青春期到中年的使用障碍（AUD）恢复构造，确定是否恢复 指标在不同群体中以相同的方式发挥作用，并在个人内部相互关联。这个贡献是 意义重大，因为它有助于制定捕捉多维和动态性质的措施 澳元复苏过程。这个项目是创新的，因为它使用了长期的内部设计， 包括青春期的数据，进行恢复的纵向测量不变性分析 主持人，通过人体内酒精使用情况评估标准有效性，并分析跨度的国家数据 青春期至中年。这些成果将通过促进以下努力产生重要的积极影响： 确定如何改变早期轨迹以改善整个生命周期的健康，估计恢复情况 患病率，调整服务以适应酒精使用者的亚群体，并评估以康复为导向的护理系统。