Testing explicit theoretical models of drinking/driving

描述（由申请人提供）：本R 03提案寻求两年的资金，对一个重要的纵向数据集进行二次分析，该数据集在选定的DWI罪犯样本（N=1396）中检查高风险饮酒和驾驶的预测因素。二次分析提供了一种富有成效和成本效益高的检验和完善理论的手段，并可利用最近开发的创新统计技术来扩充现有知识。先前的工作研究酒精亚型和高风险饮酒者的分类强调了人格因素和驾驶相关态度作为有效的近端预测因子的作用。 然而，这一知识体系忽视了检查认知过程和精神症状的病因作用，因为它们有助于脆弱性。基于与酒精有关的前瞻性研究积累的经验证据突出表明，认知和精神因素在饮酒的早期阶段起着突出的生成作用，并导致严重和更有问题的滥用。然而，需要更详细的研究来澄清特定的风险因素是否会缓和或介导高风险饮酒和驾驶。本申请以几种方式扩展了先前的经验发现和理论知识：（1）通过包括更广泛的一组人口统计学、认知、行为、态度和心理学特征。（包括诊断性）预测因子;（2）通过使用被定罪的DWI罪犯的高风险样本，并在妇女和少数民族中有足够的代表性，这提供了一个独特的机会，以了解更多的病因和后果的问题，酒精使用的罪犯人口;（3）通过检查5年的历史，物质滥用治疗及其关系的进展，酒精和药物依赖症状;（4）运用验证性因素分析和结构方程模型（SEM）等多元统计分析方法，对高危饮酒的理论模型进行检验。参与者是被定罪的酒后驾车者，他们被转介到新墨西哥州伯纳利托县的市法院系统的洛夫莱斯综合筛查项目，在转介筛查五年后进行了联系和采访。数据收集协议包括结构化的面对面访谈，加上酒精和药物的研究诊断标准，以及其他精神疾病。这项研究有可能阐明在第一次DWI定罪后的五年内导致高风险饮酒和驾驶以及精神症状存在的重要风险机制，并阐明理论上一致的基础，以构建临床有用的筛查方法，开发有效的预防方法，并设计有效的治疗方法。

DESCRIPTION (provided by applicant): This R03 proposal seeks two years of funding to conduct secondary analyses on an important longitudinal dataset examining predictors of high-risk drinking and driving in a select sample of DWI offenders (N=1396). Secondary analyses provide a fruitful and cost-effective means of testing and refining theory and can augment existing knowledge using recently developed and innovative statistical techniques. Prior work examining alcoholic subtypes and classification of high-risk drinkers has emphasized the role of personality factors and driving-related attitudes as efficient proximal predictors. However, this body of knowledge has neglected examining the etiologic role of cognitive processes and psychiatric symptoms as they contribute to vulnerability. An accumulation of empirical evidence based on prospective alcohol-related studies highlights that cognitive and psychiatric factors play a prominent generative role in the early stages of drinking and contribute to heavy and more problematic abuse. However, more detailed studies are required that clarify whether specific risk factors moderate or mediate high-risk drinking and driving. The present application extends previous empirical findings and theoretical knowledge in several ways: (1) by including a wider set of demographic, cognitive, behavioral, attitudinal, and psychological (including diagnostic) predictors than previously considered; (2) by using a high-risk sample of convicted DWI offenders, with adequate representation of women and minorities, which provides a unique opportunity to learn more about etiology and consequences of problematic alcohol use in an offender population; (3) by examining 5-year histories of substance abuse treatment and its relation to the progression of alcohol and drug dependence symptoms; and (4) by implementing state-of-the-art multivariate statistical analysis methods including confirmatory factor analysis and structural equation modeling (SEM) to examine theoretical models of high-risk drinking. Participants were convicted drunk drivers referred to the Lovelace Comprehensive Screening Program from the municipal court system in Bernalilto County, New Mexico, contacted and interviewed five years after referral for screening. Data collection protocols included structured in-person interviews coupled with research diagnostic criteria for alcohol and drug, and other psychiatric disorders. This study has the potential to elucidate important risk mechanisms that contribute to high-risk drinking and driving and presence of psychiatric symptoms in the five years following a first DWI conviction, as well as elucidate a theoretically consistent foundation on which to construct clinically useful screening methods, develop valid prevention approaches, and design efficient treatment approaches.