Research and Mentoring in AA-related Mechanisms of Change

描述(由申请人提供)：戒酒互助会(AA)对许多药物滥用者有帮助，但不是全部。现在已经有八项研究报告说，增加精神修行在一定程度上可以解释与再生障碍性贫血相关的好处。我们的研究表明，更多的祈祷和冥想“驱动”精神修行的有益行为，尽管产生这种效果的潜在原因 都还有待调查。这项修订后的申请响应了PA-11-195，以患者为中心的研究(K24)职业中期奖，并寻求50%的保护时间，为期5年，让Tonigan博士启动一项新的AA研究，调查自我报告的精神实践的增加是否能减少直接奖励偏差(BoetTiger等人，2007)，这是一种认知行为效应，将提供深远的保护益处，防止复发。这项拟议的研究具有非常重要的意义，因为它代表了第一批理论驱动的努力之一，即整合自我报告和行为数据，以了解AA潜在的变化过程。职业发展计划的总体目标(25%全时当量)是向托尼根博士提供必要的知识和技能，以启动对高管和 基于冲动的决策系统是直接奖励偏差的基础(Bickel等人，2011)。为此，建议在神经认知测量、执行功能受损和冲动性以及大脑-行为神经联系领域开展课程工作。有组织的合作将巩固和深化这些知识的增长，除了提供管理和行为衡量分析方面的“实践”培训，这是研究直接奖励偏差的核心。还建议举办统计研讨会，以加强托尼根博士在不平衡纵向设计中使用绝对结果的能力。建议对早期AA成员(N=100)进行单组纵向研究。前瞻性假设由神经行为决策过程的经验支持模型(Bickel等人，2001)指导，并将使用在12个月内收集五次的自我报告的祈祷实践、停止信号反应时间、冲动性和延迟贴现率的测量来进行测试。还要求有保护时间来指导四名专注于酒精相关变化机制研究的杰出未来科学家(25%FTE)。指导计划包括每周与指导对象举行会议，明确指导目标，以及为指导对象召开年度会议，向当地NIH调查人员介绍他们目前的工作和未来计划。职业发展活动、先导研究和指导目标紧密结合，相辅相成。修订后的K24目标的实现将(1)为四名杰出的未来调查人员的职业发展轨迹增加显著的动力，以及(2)将为托尼根博士提供 有了必要的基础和试点数据，启动了一系列基于再生障碍性疾病的研究，大大推进了再生障碍性疾病中变化过程的研究。

DESCRIPTION (provided by applicant): Alcoholics Anonymous (AA) is helpful to many, but not all, substance abusers. Eight studies have now reported that increased spiritual practices account, in part, for AA-related benefit. Our work indicates that increased prayer and meditation "drive" the salutary actions of spiritual practices although the underlying reasons for this effect have yet to be investigated. This revised application responds to PA-11-195, Mid-Career Award in Patient-Oriented Research (K24), and seeks 50% protected time for 5 years for Dr.Tonigan to initiate a new line of AA research that investigates whether self-reported increases in spiritual practices mobilize reductions in immediate reward bias (Boettiger et al., 2007), a cognitive-behavioral effect that would provide far-reaching protective benefit against relapse. The proposed research is highly significant because it represents one of the first theory-driven efforts to integrate self-report and behavioral data to understand underlying change processes in AA. The overall objective of the career development plan (25% FTE) is to provide Dr. Tonigan with the knowledge and skills that are necessary to initiate the investigation of the executive and impulsive-based decision-making systems underlying immediate reward bias (Bickel et al., 2011).To this end, coursework is proposed in the areas of neurocognitive measurement, impaired executive functioning and impulsivity, and brain-behavior neural linkages. Structured collaborations will consolidate and deepen these knowledge gains in addition to providing "hands-on" training in the administration and analysis of behavioral measures that are central to study immediate reward bias. Statistical workshops are also proposed to strengthen Dr. Tonigan's ability to use categorical outcomes in unbalanced longitudinal designs. A single- group longitudinal study of early AA members (N = 100) is proposed. Prospective hypotheses are guided by an empirically supported model of neurobehavioral decision-making processes (Bickel, et al., 2001), and will be tested using measures of self-reported prayer practices, stop-signal reaction time, impulsivity, and delay discounting rates collected five-times over 12-months. Protected time is also requested to mentor four outstanding prospective scientists focused on alcohol-related change mechanism research (25% FTE). The mentoring plan includes weekly meetings with mentees, clear mentoring objectives, and an annual conference for mentees to present their current work and future plans to local NIH investigators. The career development activities, pilot research, and mentoring aims are tightly integrated and mutually reinforcing. Achievement of the revised K24 aims will (1) add significant momentum to the career trajectories of four outstanding prospective investigators, and (2) will provide Dr. Tonigan with the necessary foundation and pilot data to launch a line of AA-based research that significantly advances how processes of change are studied in AA.