Understanding Harmful Alcohol Use in Context: Utility of Dynamic Assessment of Behavioral Economic Risk Factors

项目摘要 过度饮酒和酒精使用障碍（AUD）在美国仍然很普遍， 与酒精使用率增加有关。尽管不断发展，许多现有的治疗方法， 有害的酒精使用和AUD只有适度的影响。显然需要进行更有效的干预 战略，这可以通过理论驱动的病因学研究酒精的使用和恢复， 个人的自然环境。行为经济学提出了两个有害的候选过程 酒精使用可能通过以下方式发生：未来结果的快速贬值（延迟折扣，DD）;以及过度使用酒精。 酒精的价值（强化价值，定义为对酒精的需求或偏好）。虽然研究人员 目前掌握了操纵这些过程的方法，它们产生的变化是短暂的; 大多数证据表明，DD和酒精含量在较小程度上在以下方面发挥了病因学作用： 物质使用是从这些措施的特质水平。K99/R 00的科学目标是确定 延迟折扣（Aim 1）和酒精值（Aim 2）的实时状态级测量的预测效用 在维持有害酒精使用期间的实地酒精使用（研究1; K99）;以及随后 确定这些结果是否适用于AUD的自然恢复（研究2，目标3; R 00）。参与者 将是社区居住的成年人过度饮酒（研究1; N = 64）， 近期从AUD中恢复，未接受干预（研究2; N = 64）。两项研究的参与者将在 过度饮酒和AUD发病高峰的年龄范围（21-35岁）。在研究1和2中， 参与者将完成基线会议，为期21天的生态瞬时评估（EMA）期， 研究结束访视。EMA将在一天中随机提供，以评估DD和 酒精值在EMA期间，将使用透皮酒精客观测量酒精使用情况 传感器和自我报告。通过这些目标获得的知识将指导更多的发展， 通过测试理论上- 接地过程;并补充候选人在行为经济学方面的基本实验室专业知识。 研究和培训活动将在佛罗里达大学完成，该大学是中心的所在地， 行为经济健康研究，多个NIH资助的成瘾相关研究中心，以及广泛的 职业发展机会。一个强大的澳元专家指导团队将指导候选人的 发展使用技术先进的评估方法进行实地研究的技能， 过度饮酒和AUD的人群;增强对行为经济学的理解， 申请到AUD;和额外的时间来建立自己在该领域作为一个酒精研究员。最终这 培训将确保候选人成功地获得以研究为重点的机构的教师职位， 授予所需的技能和知识，为减少有害酒精使用和AUD做出实质性贡献。

PROJECT SUMMARY Excessive alcohol use and alcohol use disorder (AUD) remain prevalent in the United States, with the mortality rate associated with alcohol use increasing. Despite ongoing developments, many existing treatments for harmful alcohol use and AUD have only modest effects. There is a clear need for more effective intervention strategies, which could be informed by theoretically-driven etiological research on alcohol use and recovery in individuals’ natural environments. Behavioral economics suggests two candidate processes that harmful alcohol use may occur through: rapid devaluation of future outcomes (delay discounting, DD); and over- valuation of alcohol (reinforcing value, defined as demand or preference for alcohol). While researchers are currently equipped with methods to manipulate these processes, the changes they produce are ephemeral; and the majority of evidence suggesting DD, and to a lesser extent alcohol value, play an etiological role in substance use are from trait levels of these measures. The scientific goals of this K99/R00 are to determine the predictive utility of state-level measures of delay discounting (Aim 1) and alcohol value (Aim 2) for real-time alcohol use in the field during maintenance of harmful alcohol use (Study 1; K99); and to subsequently determine whether these findings generalize to natural recovery from AUD (Study 2, Aim 3; R00). Participants will be community-dwelling adults engaging in excessive alcohol use (Study 1; N = 64), and those who have recently recovered from AUD without intervention (Study 2; N = 64). Participants in both studies will be in the age range at which excessive drinking and onset of AUD peak (21-35 years old). In both Studies 1 and 2, participants will complete baseline sessions, a 21-day ecological momentary assessment (EMA) period, and an end-of-study visit. EMAs will be randomly delivered throughout the day to assess DD and measures of alcohol value. During the EMA period, alcohol use will be both objectively measured using transdermal alcohol sensors and by self-report. The knowledge gained through these aims will guide the development of more effective interventions for excessive alcohol use and AUD by testing the predictive utility of theoretically- grounded processes; and complement the candidate’s basic laboratory expertise in behavioral economics. Research and training activities will be completed at the University of Florida, which is home to the Center for Behavioral Economic Health Research, multiple NIH-funded addiction-related research centers, and extensive career development opportunities. A strong mentoring team of AUD experts will guide the candidate’s development of skills to conduct field-based research using technologically-advanced assessment methods in populations with excessive alcohol use and AUD; an enhanced understanding of behavioral economics as applied to AUD; and additional time to establish herself in the field as an alcohol researcher. Ultimately, this training will ensure the candidate’s success in obtaining a faculty position in a research-focused institution and confer the skills and knowledge needed to substantively contribute to reducing harmful alcohol use and AUD.