Identification and characterization of in-the-moment cognitive antecedents to alcohol use among drinkers with PTSD

患有创伤后应激障碍 (PTSD) 的饮酒者饮酒的即时认知前因的识别和特征描述

• 批准号: 10624771
• 负责人: Michelle Josephine Zaso
• 金额: $ 16.87万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-06-01 至 2023-09-17
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10624771
• 关键词: Acute; Acute Post Traumatic Stress Disorder; Address; Affective; Alcohol abuse; Alcohol consumption; Alcohols; Area; Award; Clinical; Cognition; Cognitive; Collaborations; Data; Dedications; Development; Distress; Ecological momentary assessment; Emotional; Emotions; Environment; Etiology; Event; Focus Groups; Frequencies; Future; Grain; Group Interviews; Harm Reduction; Hour; Individual; Intervention; Investigation; Knowledge; Laboratories; Link; Maps; Measurement; Measures; Mediating; Mentorship; Methodology; Methods; Modeling; Outcome; Pathway interactions; Patient Self-Report; Phase; Post-Traumatic Stress Disorders; Process; Productivity; Psychology; Public Health; Reporting; Research; Research Institute; Research Personnel; Risk; Role; Schedule; Source; Statistical Models; Survivors; Symptoms; Techniques; Testing; Time; Translations; Trauma; Treatment outcome; United States National Institutes of Health; Universities; Work; adaptive intervention; addiction; alcohol abuse therapy; alcohol expectancy; alcohol measurement; alcohol use disorder; career; career development; cognitive interview; cognitive process; cognitive testing; coping; design; distress tolerance; drinking; evidence base; experience; field study; innovation; multilevel analysis; negative affect; neglect; novel; programs; skills

Abstract Posttraumatic stress disorder (PTSD) co-occurs frequently with hazardous alcohol outcomes, presenting considerable public health burdens and challenging traditional treatment approaches. Although accessible interventions able to adapt to individuals’ fluctuating internal risks within their natural environments are emerging, these just-in-time adaptive interventions have largely not yet considered the role of trauma sequalae in alcohol use. To do so, research needs to identify the acute risks for drinking operating in-the-moment as individuals experience PTSD symptoms in their daily lives. There is a critical need to define and operationalize acute cognitive processes underlying PTSD-related drinking (Aim 1), examine variability in such cognitions amid PTSD symptoms in real-world settings (Aim 2), and establish which of these acute cognitions are linked to actual drinking events and mediate PTSD-related drinking (Aim 3). During the K99 phase, Aim 1 comprises a fine-grained qualitative examination into acute risk cognitions among frequent drinkers with PTSD, utilizing focus groups to identify key acute cognitions and cognitive interviewing approaches to operationalize measures of such cognitions. Aim 2 field-tests these cognitive assessments by examining whether they vary across drinkers’ daily lives and are active amid PTSD symptoms within a 14-day ecological momentary assessment (EMA) study. During the R00 phase, Aim 3 considerably extends such work to test whether these acute cognitions are linked to actual drinking events as well as whether they are mechanisms of PTSD-related drinking across another 14-day EMA. Collectively, this mixed methods investigation will identify proximal cognitive mechanisms of PTSD-related drinking that can be targeted in future just-in-time interventions. As a K99/R00 NIH Pathway to Independence Award, these research efforts would support the emergence of a dedicated early career researcher (Dr. Zaso) with unique expertise in acute cognitive trauma-related drinking processes. This K99/R00 also would afford Dr. Zaso instrumental development in acute PTSD-related drinking processes, momentary assessment of affective alcohol cognitions, and the methodological/statistical techniques necessary to characterize momentary, real-world drinking processes. The mentorship team offers expertise in the intersection of trauma and alcohol use (Dr. Jennifer Read), with collaboration support on daily processes in PTSD-related drinking (Dr. Tracy Simpson), acute activation of alcohol cognitions (Dr. Robert Dvorak), optimization of mobile alcohol assessment and intervention (Dr. Tammy Chung), and statistical modeling of multilevel alcohol etiologies (Dr. Craig Colder). Dr. Zaso’s career development will occur within the Department of Psychology and Clinical and Research Institute on Addictions at the University at Buffalo, which comprise a rich intellectual environment with a network of productive addictions researchers. Overall, this K99/R00 will propel Dr. Zaso’s emergence as an independent trauma-related alcohol researcher with the skills necessary to maintain a clinically impactful research program aimed at curtailing alcohol harms.

摘要 创伤后应激障碍(PTSD)经常与危险的酒精后果并存，表现为 相当大的公共卫生负担和挑战传统的治疗方法。虽然可以访问 能够适应个人在其自然环境中波动的内部风险的干预措施是 新兴的，这些及时的适应性干预在很大程度上还没有考虑创伤后遗症的作用 在饮酒方面。要做到这一点，研究需要确定在瞬间饮酒的严重风险如下 个人在日常生活中经历创伤后应激障碍症状。迫切需要定义和实施 与创伤后应激障碍相关的饮酒的急性认知过程(目标1)，检查此类认知的可变性 在真实世界环境中的创伤后应激障碍症状中(目标2)，并确定这些敏锐认知中的哪些与之相关 与实际饮酒事件相关，并调解与创伤后应激障碍有关的饮酒(目标3)。在K99阶段，目标1包括 经常饮酒的创伤后应激障碍患者急性风险认知的细粒度定性检测 焦点小组确定关键的敏锐认知和认知面谈方法以实现操作 这种认知的衡量标准。Aim 2通过检查这些认知评估是否不同来对它们进行实地测试 在14天的生态瞬间内，饮酒者的日常生活中，在创伤后应激障碍症状中表现活跃 评估(EMA)研究。在R00阶段，Aim 3极大地扩展了这类工作，以测试这些 敏锐的认知与实际的饮酒事件有关，以及它们是否与创伤后应激障碍相关 在另一个为期14天的均线上喝酒。总体而言，这种混合方法的调查将确定近端 创伤后应激障碍相关饮酒的认知机制，可在未来的即时干预中进行针对性的研究。作为一名 K99/R00 NIH独立之路奖，这些研究努力将支持一个 专注的早期职业研究人员(Zaso博士)，在急性认知创伤相关饮酒方面拥有独特的专业知识 流程。这款K99/R00还将为扎索博士开发与急性创伤后应激障碍相关的饮酒工具提供资金 过程、情感性酒精认知的瞬时评估以及方法学/统计学 描述瞬间、真实世界饮酒过程所需的技术。导师团队提供 创伤和酒精使用交叉领域的专业知识(Jennifer Read博士)，并在日常工作中提供协作支持 与创伤后应激障碍有关的饮酒过程(特雷西·辛普森博士)，酒精认知的急性激活(罗伯特博士 流动酒精评估和干预的优化(Tammy Chung博士)，以及统计 多层次酒精病因的建模(克雷格·科尔德博士)扎索博士的职业发展将在 布法罗大学心理学、临床和成瘾研究所， 其中包括一个丰富的智力环境，以及一个富有成效的成瘾研究人员网络。总的来说， 这款K99/R00将推动扎索博士成为一名独立的创伤相关酒精研究人员 保持旨在减少酒精危害的临床有效研究计划所需的技能。