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.

抽象的 创伤后应激障碍（PTSD）经常与危险的酒精结果共同出现 大量的公共卫生伯恩斯和挑战传统治疗方法。虽然可以访问 干预措施可以适应个人在自然环境中内部风险的波动是 新兴的这些即时自适应干预措施在很大程度上尚未考虑创伤频道的作用 在酒精中。为此，研究需要确定饮酒的急性风险，因为 个人在日常生活中会出现PTSD症状。定义和运作的迫切需要 与PTSD相关饮酒的急性认知过程（AIM 1），此类认知的可变性 在现实世界中的PTSD症状中（AIM 2），并确定这些急性认知中的哪些是相关的 进行实际的饮酒活动并调节与PTSD相关的饮酒（AIM 3）。在K99阶段，AIM 1组成 使用PTSD的经常饮酒者对急性风险认知进行细粒度的定性检查，使用 焦点小组确定关键的急性认知和认知访谈方法以操作 这种认知的措施。 AIM 2通过检查这些认知评估是否有所不同 在饮酒者的日常生活中，在14天的生态瞬间，在PTSD症状中活跃起来 评估（EMA）研究。在R00阶段，AIM 3大大扩展了此类工作以测试是否 急性认知与实际饮酒事件有关，以及它们是否是PTSD相关的机制 饮用另一个14天的EMA。总的来说，这种混合方法将确定近端 PTSD相关饮酒的认知机制可以在以后的即将到来的干预措施中。作为 K99/R00 NIH独立奖，这些研究工作将支持出现 专门的早期职业研究员（ZASO博士）具有与急性认知创伤有关的独特专业知识 过程。这款K99/R00还可以负担急性PTSD饮酒的Zaso乐器开发 过程，瞬间评估情感酒精认知以及方法论/统计 表征瞬间，现实世界中饮酒过程所需的技术。 Mentalship团队提供 创伤与饮酒的交集方面的专业知识（Jennifer Read博士），每日协作支持 PTSD相关饮酒的过程（Tracy Simpson博士），酒精认知的急性激活（Robert博士 DVorak），优化移动酒精评估和干预措施（Tammy Chung博士）和统计 多级酒精病因的建模（Craig Colder博士）。 Zaso博士的职业发展将发生 加法罗大学心理与临床研究所成瘾研究所， 它包括丰富的知识环境，并具有成瘾的研究人员网络。全面的， 这款K99/R00将推动Zaso博士作为独立创伤相关的酒精研究人员的出现 维持旨在减少酒精危害的临床有影响力的研究计划所需的技能。