Long Term Recovery Among Convicted Drunk Drivers

说明（由申请人提供）：此R01拨款申请要求5年的资助，以延长对一批首次酒后驾驶违规者的观察期至15年。受试者首次被观察是在法院强制转介到新墨西哥州阿尔伯克基进行药物滥用评估的筛选项目时（1989-1992）。5年后，对1396名罪犯进行了访谈，确定了他们目前和12个月的药物使用和其他精神障碍诊断。目前的一项二级分析拨款检查了为5年随访研究开发的纵向数据库。对于拟议的研究，我们将在5年随访研究中找到并对整个队列的参与者进行结构化的面对面访谈。据估计，71%的受试者可以找到位置，其中5%已经死亡。一项初步研究显示，参与意愿很高（92%），估计总共有750名受试者（35%非西班牙裔白人；47%西班牙裔；15%美洲印第安人；3%其他种族；56%受试者为女性）。访谈和问卷调查将衡量15年酒精使用和其他精神疾病的进展情况；检查在接受和不接受正式和非正式治疗的情况下获得清醒的受试者的属性；确定驾驶结果的长期比率，包括违规、撞车和酒后驾车被捕；并评估两种替代理论模型（即社会控制模型和认知行为模型）在预测长期、饮酒/驾驶和交通结果方面的作用。最后，通过对罪犯子集的定性研究，我们将评估受试者的自我报告信息和长期保持清醒和复发的变异性。将通过明确规定的诊断标准确定酒精和药物滥用/依赖的流行程度以及心理健康诊断。将比较不同性别之间以及西班牙裔和非西班牙裔白人受试者之间的比率。驱动结果将通过自我报告和使用基于计算机的档案记录数据来确定那些仍然居住在新墨西哥州的人（估计约占受试者的88%）。在美国，酒后驾车是酒精相关死亡的最大单一原因，超过三分之一的酒后驾车事故司机之前曾因酒驾被捕。然而，很少有研究调查被定罪的酒驾司机的长期后果。对这个酒驾样本的长期随访，已经有了丰富的细节描述，可以增加很多关于酒驾司机的知识体系。收集长期随访数据的能力，结合理论发展和综合经验重点，将为女性和男性罪犯的预防和治疗方案的发展提供独特的贡献。

DESCRIPTION (provided by applicant): This R01 grant application requests 5 years of funding to extend the observation period of a cohort of first-time driving while impaired (DWI) offenders to 15 years. Subjects were first observed at the time of court-mandated referral for substance abuse evaluation to a screening program in Albuquerque, NM for a first DWI offense (1989-1992). A subset of 1,396 offenders was interviewed 5 years later where current and 12-month diagnoses of substance use and other psychiatric disorders were ascertained. A current secondary analysis grant examines the longitudinal database developed for the 5-year follow-up study. For the proposed study we will locate, and conduct structured, in-person interviews with the entire cohort of participants in the 5-year follow-up study. An estimated 71% of subjects can be located, with 5% deceased. A pilot study revealed a high (92%) willingness to participate, yielding an estimated total of 750 subjects (35% non-Hispanic White; 47% Hispanic; 15% American Indian; 3% other races; 56% of subjects are females). Interviews and questionnaires will measure the 15-year progression of alcohol use and other psychiatric disorders; examine attributes of subjects who achieved sobriety with and without the aid of formal and informal treatment; determine long-term rates of driving outcomes, including violations, crashes, and DWI arrests; and evaluate two alternative theoretical models (i.e., the Social-Control, and the Cognitive-Behavioral models) in predicting long-term, drinking/driving and traffic outcomes. Finally, through conduct of a qualitative study with a subset of offenders, we will assess subjects' self-report information and variability in long-term maintenance of sobriety and relapse. Prevalence of alcohol and drug abuse/dependence, and mental health diagnoses will be ascertained through well specified diagnostic criteria. Rates will be compared between genders and between Hispanic and non-Hispanic White subjects. Driving outcomes will be ascertained by self-report and using computer-based archival record data for those who still reside in New Mexico (estimated to be about 88% of subjects). Driving after drinking is the largest single cause of alcohol-related deaths in the U.S., and over one third of drivers in alcohol-related crashes have previous drunk-driving arrests. Yet few studies have examined long-term outcomes of convicted drunk drivers. Longer-term follow-up in this DWI sample, already described in rich detail, could add much to the body of knowledge regarding drunk drivers. The ability to collect long-term follow-up data coupled with theory development and an integrated empirical focus will provide a unique contribution to the development of prevention and treatment programs for both female and male offenders.