Contextual Influences on Alcohol Response and its Relation to Drinking Outcomes

描述（由申请人提供）：酒精反应（AR）的个体差异是长达25年的酒精相关问题的可靠预测因素。然而，很少有人努力将这些关于AR高风险模式的知识应用于预防/干预计划。这与针对其他众所周知的风险标志（如酗酒家族史）的协同努力形成了直接对比。为了将AR的高风险模式应用于经验支持的干预措施，我们必须解决文献中的重要空白。首先，AR的具体模式带来的最大风险仍然没有得到很好的理解。虽然有明确的证据表明，对酒精的负面影响（如困倦、头晕）的低水平反应与后期问题的风险增加有关，但对AR的其他方面知之甚少。迄今为止，只有一项研究调查了高唤醒的积极影响（如兴奋、健谈）与后期饮酒结果之间的关系，没有关于低唤醒的积极影响（如放松、平静）对后期问题风险的影响的研究。这是一个关键问题，因为饮酒的负强化动机是饮酒问题的有力预测因素。其次，先前的纵向研究评估了AR在不具有典型饮酒环境代表性的情况下（例如，在实验室单独饮酒）。因此，我们对AR在更“现实世界”的饮酒环境中与后来的负面结果风险之间的关系知之甚少。[这些信息是至关重要的，因为AR的高风险模式不能推广到更多的现实环境中，可能具有有限的实际效用。拟议的研究将描述AR的特定模式，预测随后的酒精相关问题，从而允许将AR相关风险信息直接应用于预防和干预工作。参与者（n = 360； 50%为女性）将被随机分配到三种饮酒环境中的一种（单独实验室，小组实验室或小组模拟酒吧），每种环境中都有饮料条件（n = 70酒精；n = 50安慰剂）。这三组设计将允许我们检查社会（单独vs.群体）和物理（实验室vs.模拟酒吧）环境对AR的影响。]我们将使用多方法方法（显式，内隐，行为和生物测量）来评估AR的全部范围，包括先前纵向研究中未检查的影响（例如低唤醒的积极影响和高唤醒的消极影响）。在安慰剂控制的酒精挑战之后；我们将使用两年一次的调查（共4次评估）跟踪随后的饮酒行为和酒精相关问题。[这项研究设计将使我们能够全面检查酒精作为未来饮酒和问题预测因素的影响，并确定AR与后来饮酒结果之间的关系是否依赖于环境。][建议的研究结果将为传播关于AR的特定高风险模式的更详细信息提供基础，特别是个人在典型饮酒环境中容易辨别的AR模式（例如群体饮酒或在酒吧环境中饮酒）。]

DESCRIPTION (provided by applicant): Individual differences in alcohol response (AR) are robust predictors of later alcohol-related problems over periods as long as 25 years. [Yet, there has been little effort to apply this knowledge about high risk patterns of AR to prevention/intervention programs. This is in direct contrast to concerted efforts to target other well- known markers of risk (e.g. family history of alcoholism). In order to move toward the application of high-risk patterns of AR to empirically supported interventions, we must address important gaps in the literature.] First, the specific pattern of AR that confers greatest risk is till not well understood. Although there is clear evidence that a low level of response to negative alcohol effects (e.g. drowsy, dizzy) is associated with increased risk for later problems, much less is known about other aspects of AR. To date, only one study has examined the relation between high arousal positive effects (e.g. excited, talkative) and later drinking outcomes, and there are no studies on the effects of low arousal positive effects (e.g. relaxed, calm) on risk fo later problems. This is a critical issue as stronger negative reinforcement motives for drinking are robust predictors of drinking problems. Second, prior longitudinal studies have evaluated AR in settings that are not representative of typical drinking contexts (e.g. solitary drinking in a laboratory). Thus, we know little about relations between AR in more "real world" drinking contexts and later risk for negative outcomes. [This information is vital as high risk patterns of AR that do not generalize to more real-world settings may have limited practical utility. The proposed study will characterize specific patterns of AR that predict subsequent alcohol-related problems, thereby allowing the direct application of information about AR-related risks to prevention and intervention efforts. Participants (n = 360; 50% female) will be randomly assigned to one of three drinking contexts (solitary lab, group lab, or group simulated bar) with beverage condition nested within each context (n = 70 alcohol; n = 50 placebo). This three group design will allow us to examine the impact of both social (solitary vs. group) and physical (lab vs. simulated bar) context on AR.] We will use a multi-method approach (explicit, implicit, behavioral, and biological measures) to assess the full range of AR, including effects that have not been examined in prior longitudinal studies (e.g. low arousal positive and high arousal negative effects). Following the placebo controlled alcohol challenge; we will track subsequent drinking behavior and alcohol-related problems using bi-annual surveys over a two year period (4 total assessments). [This study design will allow us to examine the full range of alcohol effects as predictors of future drinking and problems, and determine if relations between AR and later drinking outcomes are dependent on context.] Findings of the proposed study will provide the basis for disseminating more detailed information about specific high-risk patterns of AR, particularly patterns of AR that individuals are readily able to discern in typical drinking contexs (e.g. group drinking or drinking in a bar setting).]