Modeling Individual Heterogeneity in the Alcohol Relapse Process

描述(由申请人提供)：大约1760万美国人符合酒精滥用或依赖的标准，12.5%符合酒精滥用或依赖标准的个人(220万美国人)将接受酒精问题的治疗。在接受治疗的人中，大多数人将在治疗后的头12个月内至少喝一杯酒。这项拟议的研究旨在描绘在酒精治疗后的第一年内治疗后饮酒的模式。由NIAAA赞助的酒精治疗多点调查Project Match的数据将被用来检验这一假设，即个人之间和个人内部的饮酒行为随着时间的推移存在显著差异。对项目匹配数据的二级数据分析将用于三个不同的目的。这项拟议研究的第一个目标将是复制之前的研究，使用潜在生长混合物建模来调查在最初的治疗后饮酒后饮酒轨迹的常见模式和个体差异。第二个目标是使用复发风险因素的生物心理社会模型来描述饮酒轨迹的差异。第三个目标是通过扩展潜在增长混合模型来分析进入和退出禁欲的个人的行为，从而量化复发过程的复杂性。这些分析的目标是了解为什么以及何时个人会随着时间的推移经历饮酒的重大变化。拟议研究的主要目的是提供一个经验驱动的复吸模型，该模型结合了复吸过程的个体变异性和突发性、间断性，如理论和定性报告所示。这项调查的最终目的是为临床医生及其客户提供更高的认识，使他们认识到可能使个人倾向于大量饮酒的风险因素，以及那些在治疗后增加从轻度饮酒过渡到重度饮酒的可能性的因素。

DESCRIPTION (provided by applicant): Approximately 17.6 million Americans meet criteria for alcohol abuse or dependence, and 12.5 percent of individuals who meet criteria for alcohol abuse or dependence (2.2 million Americans) will receive treatment for an alcohol problem. Of those who receive treatment, the majority of individuals will have at least one drink in the first 12-months following treatment. The proposed study aims to delineate patterns in post-treatment drinking during the first year following alcohol treatment. Data from Project MATCH, a multi-site investigation of alcohol treatment sponsored by the NIAAA, will be used to test the hypothesis that there is significant variability in the drinking behavior between individuals and within individuals across time. Secondary data analyses of the Project MATCH data will be conducted for three distinct purposes. The first goal of the proposed study will be to replicate previous research using latent growth mixture modeling to investigate common patterns and individual differences in trajectories of drinking after the initial post- treatment drink. The second goal is to describe the differences in drinking trajectories using a biopsychosocial model of relapse risk factors. The third goal is to quantify the complexity of the relapse process by extending the latent growth mixture models to analyze the behavior of individuals who transition in-and-out of abstinence. The goal of these analyses is to understand why and when individuals experience major shifts in drinking over time. The major aim of the proposed research is to provide an empirically-driven model of relapse that incorporates the individual variability and abrupt, discontinuous nature of the relapse process, as illustrated in theoretical and qualitative reports. The ultimate goal of this inquiry is to provide clinicians and their clients with a heightened awareness of risk factors that may predispose an individual to heavy drinking and those factors that increase the probability of transitioning from light-to-heavy drinking following treatment.