Novel Mechanisms of Behavior Change in Alcoholism Treatment

描述（由申请人提供）：目前对酒精使用障碍的治疗在理论基础和方法上各不相同，但对临床特征有很大差异的患者往往同样有效。基于我们目前对行为改变机制（MOBC）的理解，在客户治疗匹配方面的有限进展强烈要求基础到临床科学的转化研究提供创新（Willenbring, 2005）。更好地理解支持行为灵活性的机制对于开发更有效的治疗方法至关重要。它将通过帮助分类具有不同潜在行为改变能力的客户来促进客户-治疗匹配，阐明由当前治疗激活的基本变化过程，并提出潜在的新治疗目标。本次K02竞争性续期申请旨在建立在申请人在前一个奖励期间获得的知识、研究技能和定量培训的基础上，以进一步了解服务于情绪调节的神经生物学和神经认知过程，并可以支持或阻碍适应性行为改变。

DESCRIPTION (provided by applicant): Current treatments for alcohol use disorders vary in theoretical foundation and approach, yet are often equally effective across clients who differ substantially in clinical features. Limited progress in client treatment matching, based on our current understanding of mechanisms of behavior change (MOBC), argues strongly for basic to clinical science translation research to provide innovation (Willenbring, 2005). Better understanding of mechanisms that support behavioral flexibility is essential for progress in developing more effective treatments. It would facilitate client-treatment matching by helping to classify clients with different underlying capacities for behavior change, clarify fundamental change processes ctivated by current treatments, and suggest potentially new treatment targets. This K02 competitive renewal application seeks to build upon the knowledge, research skills, and quantitative training the applicant gained during the previous award period to further understand neurobiological and neurocognitive processes that subserve emotional regulation and can act to support or hinder adaptive behavioral change. The overarching goal is to gain expertise in methods that promote translation between basic and clinical science to characterize novel MOBC. Structured, multidisciplinary collaborative expertise and new quantitative skills will be applied to data from the applicant's ongoing research program. NIAAA supported experiments focus on alcohol and placebo challenge effects on implicit memory for, and autonomic nervous system reactivity to, neutral, emotionally valenced and alcohol-related cues in young adult drinkers who are not alcohol dependent. The NIDA supported study focuses on memory and reactivity to the same stimuli, and to drug-related cues, in clinical and high risk samples, and examines the relation of implicit memory and autonomic regulatory processes to intervention outcomes. Skills will also be applied to data from pilot fMRI and genetic studies that recruit participants from these NIH projects to characterize cognitive control processes that operate in bidirectional feedback loops with autonomic reactivity during cue exposure and memory tasks, and test for genetic markers of intermediary phenotypes related to regulatory processes. Support of this application will allow the PI to cross-fertilize theories and methods needed to conduct productive translation research to improve understanding of MOBC in alcoholism treatment, and maximize her contributions to the field.