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: 10913234
• 负责人: Michelle Josephine Zaso
• 金额: $ 24.9万
• 依托单位: SYRACUSE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-18 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10913234
• 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) 经常与危险的酒精后果同时发生，表现为 巨大的公共卫生负担并对传统治疗方法提出了挑战。虽然可以访问 能够适应个人在自然环境中波动的内部风险的干预措施 这些新兴的适时适应性干预措施在很大程度上尚未考虑创伤后遗症的作用 在酒精使用中。为此，研究需要确定当前饮酒的严重风险： 人们在日常生活中会经历创伤后应激障碍（PTSD）症状。迫切需要定义和实施 PTSD 相关饮酒的急性认知过程（目标 1），检查此类认知的变异性 现实世界中的 PTSD 症状（目标 2），并确定这些急性认知中哪些是相关的 实际饮酒事件并调解与 PTSD 相关的饮酒（目标 3）。在 K99 阶段，目标 1 包括 对患有 PTSD 的经常饮酒者的急性风险认知进行细粒度的定性检查，利用 焦点小组确定关键的敏锐认知和认知访谈方法以实施 此类认知的衡量标准。目标 2 通过检查这些认知评估是否有所不同来对这些认知评估进行现场测试 贯穿饮酒者的日常生活，并在 14 天的生态瞬间内活跃于 PTSD 症状中 评估（EMA）研究。在 R00 阶段，Aim 3 大大扩展了此类工作，以测试这些工作是否 急性认知与实际饮酒事件以及它们是否是 PTSD 相关机制有关 饮酒跨越另一个 14 天 EMA。总的来说，这种混合方法调查将确定近端 PTSD 相关饮酒的认知机制可以作为未来及时干预的目标。作为一个 K99/R00 NIH 独立之路奖，这些研究工作将支持一个 专注的早期职业研究员（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。该 K99/R00 还可以为 Zaso 博士提供用于急性 PTSD 相关饮酒的仪器开发 过程、情感酒精认知的瞬时评估以及方法/统计 描述瞬时的、现实世界的饮酒过程所必需的技术。导师团队提供 创伤和酒精使用交叉方面的专业知识（詹妮弗·里德博士），并提供日常协作支持 PTSD 相关饮酒过程（特雷西·辛普森博士）、酒精认知的急性激活（罗伯特博士） Dvorak）、移动酒精评估和干预的优化（Tammy Chung 博士）以及统计 多层次酒精病因学建模（Craig Colder 博士）。 Zaso 博士的职业发展将发生在 布法罗大学心理学系和成瘾临床与研究所， 其中包括丰富的知识环境和富有成效的成瘾研究人员网络。全面的， K99/R00 将推动 Zaso 博士成为一名独立的创伤相关酒精研究者 维持旨在减少酒精危害的具有临床影响力的研究计划所需的技能。