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Recovery & Help-Seeking Processes in Problem Drinkers

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基本信息

批准号：
7853741
负责人：
JALIE A TUCKER
金额：
$ 16.53万
依托单位：
UNIVERSITY OF ALABAMA AT BIRMINGHAM
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-07-20 至 2011-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7853741
关键词：
Address Alcohol abuse Alcohols Behavior Behavioral Communities Community Services Control Groups Data Drug abuse Economics Equation Event Expenditure Eye Feedback Health Illicit Drugs Individual Intervention Interview Knowledge Lead Life Measures Mediating Mediation Mediator of activation protein Modeling Monitor Nicotine Outcome Participant Pattern Population Process Public Health Randomized Recovery Recruitment Activity Relative (related person)Research Research Support Resolution Resource Allocation Rewards Savings Substance Use Disorder System Testing Time TimeLine Voice Work base brief motivational intervention community based service community setting computerized cost discount discounting drinking economic behavior experience group intervention help-seeking behavior indexing intervention effect motivational enhancement therapy preference problem drinker programs public health priorities response substance abuser theories

项目摘要

DESCRIPTION (provided by applicant): This revised competing renewal application continues research aimed at understanding resolution processes in problem drinkers and promoting resolution efforts in the community. The research is guided by behavioral economics, which provides a powerful framework for understanding substance use disorders, the hallmark of which is a persistent preference for short-term rewards (i.e., drinking) that lead to long-term costs, and a devaluation of delayed alternatives that support positive functioning. Behavioral economic theory and research support new matching hypotheses based on measures of the temporal intervals over which problem drinkers organize their behavior. Substance abusers tend to devalue or "discount" delayed rewards, but those who organize their behavior over longer "time horizons" are more likely to recover, and lengthening time horizons may enhance positive outcomes. The time horizon variable thus may have moderating and mediating effects on natural and intervention-assisted recovery attempts. Two interventions suitable for use in community settings, motivational interviewing (Ml) and extended self-monitoring (SM), appear to reduce problem drinking by shifting behavior allocation away from drinking and toward delayed, non-drinking rewards. But they differ in their timeframe of application, and this may interact with the time horizon variable, such that drinkers with shorter time horizons may benefit most from Ml followed by extended SM. The proposed study will evaluate these hypotheses using untreated problem drinkers (N = 330) who have quit recently or are considering quitting. They will be randomly assigned to 1 of 3 groups (n = 110) (natural resolution control, Ml only, or Ml plus SM for 6 months) and will be followed for 2 years. Structural equation modeling will be used to evaluate the moderation and mediation hypotheses. Support for the hypotheses will yield a new basis for matching based on behavior economic variables that differ than those studied in Project MATCH and will advance knowledge about mechanisms of action of these established but poorly understood interventions. Investigating these questions with an eye toward developing appealing community services for the under-served majority of problem drinkers addresses a public health priority, since this population segment contributes the bulk of harm and cost of drinking problems. The proposed research appropriately models an "open economy" in which drinking problems are developed, maintained, and must be resolved.

描述（由申请人提供）：这一修订后的竞争性续期申请继续研究，旨在了解问题饮酒者的解决过程，并促进社区的解决努力。该研究以行为经济学为指导，该经济学为理解物质使用障碍提供了一个强大的框架，其特征是对短期奖励的持续偏好（即，饮酒）导致长期成本，以及支持积极功能的延迟替代品的贬值。行为经济学理论和研究支持新的匹配假设的基础上的措施的时间间隔问题饮酒者组织他们的行为。物质滥用者倾向于贬低或“折扣”延迟的奖励，但那些在较长的“时间范围”内组织行为的人更有可能恢复，延长时间范围可能会增强积极的结果。因此，时间范围变量可能对自然恢复和干预辅助恢复尝试产生调节和中介作用。两个干预措施，适合在社区环境中使用，动机访谈（MI）和扩展的自我监控（SM），似乎减少问题饮酒的行为分配远离饮酒和延迟，非饮酒奖励。但是它们在应用的时间范围上不同，并且这可能与时间范围变量相互作用，使得具有较短时间范围的饮酒者可能从MI中受益最多，然后是延长的SM。拟议的研究将评估这些假设使用未经治疗的问题饮酒者（N = 330）谁最近退出或正在考虑退出。他们将被随机分配到3组中的1组（n = 110）（自然消退对照组、仅MI组或MI + SM组，持续6个月），并将随访2年。结构方程模型将被用来评估适度和调解的假设。支持的假设将产生一个新的基础上匹配的行为经济变量的基础上，不同于那些在项目匹配研究，并将推进知识的行动机制，这些既定的，但知之甚少的干预措施。调查这些问题，着眼于为服务不足的大多数问题饮酒者开发有吸引力的社区服务，这是一个公共卫生优先事项，因为这一人群造成了大量的伤害和饮酒问题的成本。拟议的研究适当地模拟了一个“开放经济”，在这个经济中，饮酒问题得到了发展、维持，而且必须得到解决。