High-Intensity Drinking and Alcohol-Induced Blackouts among Young Adult Drinkers: An Event-level Analysis

项目摘要 过去，三分之一的年轻人从事高强度饮酒（HID;女性8+饮料/男性10+饮料） 一年，使他们处于严重的急性后果的风险，酒精使用（例如，严重伤害、过量）。 此外，三分之一至一半的年轻成年饮酒者报告酒精诱导的停电（AIB），结果 与HID事件不同。迄今为止，大多数关于HID和AIB的研究都是横断面的，回顾性的， 这项研究仅在大学生中进行，几乎没有揭示导致HID或AIB的特定饮酒事件。 还需要在这些活动中客观地反映饮酒情况，这是可行的， 生物传感器技术了解更多关于饮酒模式，近因和后果 对于继续发展和完善有效的干预措施， 最危险的饮酒者本研究的具体目的是：（1）阐明饮酒的地形图 事件水平在自然发生的饮酒事件的特点是HID和/或AIB，使用自我报告 通过生态瞬时评估（EMA）和客观的生物传感器数据捕获的饮用水;（2）确定 事件水平的行为前因（游戏前、饮酒游戏、保护性行为策略）， 心理社会前因（饮酒动机，意愿，意图，影响，社会背景），以及积极的 和HID事件的负面后果;（3）隔离事件水平的因素，增加AIB的风险超过 中毒（同时使用其他药物，睡眠不足，意愿，意图）;（4）检查 在三个年度中，HID，AIB和相关负面后果之间的频率和关联 评估。首先，将使用关键知情人访谈（n=20-28）来收集关于以下内容的相关性的数据： 基于理论的认知和行为因素，社会背景，情感和其他因素在HID的预测， 以及确定HID对年轻人的影响。接下来，在测量突发设计中，200名年轻人 成人将在12个月时完成面对面评估和3次30天的每日EMA评估 间隔，结合使用生物传感器技术客观测量酒精消费量。我们 寻求区分HID和AIB相对于所有其他饮酒的事件水平预测因素和结果 事件，并相对于大量的间歇性饮酒（4+/5+饮料），以隔离什么地方的个人在 这是一种独特的风险，尤其是与结果有关的风险。将使用多水平模型来确定预测因子 以及作为每个饮酒事件是以HID还是AIB为特征的函数的结果。的结果 拟议中的研究将为这两个公共卫生问题的近端预测因素提供新的信息 在年轻人中。这项创新研究将有助于确定干预措施的激励目标， 为制定预防性干预措施，减少HID、AIB和 其他与酒精有关的严重后果。

PROJECT SUMMARY One in three young adults engage in high intensity drinking (HID; 8+ drinks for women/10+ for men) in the past year, placing them at risk for serious acute consequences of alcohol use (e.g., severe injury, overdose). Further, one third to one half of young adult drinkers report alcohol-induced blackouts (AIB), an outcome distinct from HID episodes. Most research to date on HID and AIB has been cross-sectional, retrospective, and conducted exclusively in college students, revealing little about specific drinking events leading to HID or AIB. Needed also are objective indicators of the topography of drinking during these events, which is feasible with biosensor technology. Understanding more about drinking patterns, proximal antecedents and consequences of HID and AIB is imperative to the continued development and refinement of effective interventions for the most at-risk drinkers. The specific aims of this study are to: (1) elucidate the topography of drinking at the event-level during naturally occurring drinking events characterized by HID and/or AIB, using both self-reported drinking captured via ecological momentary assessment (EMA) and objective biosensor data; (2) determine event-level behavioral antecedents (pregaming, drinking games, protective behavioral strategies) and psychosocial antecedents (drinking motives, willingness, intentions, affect, social context), as well as positive and negative consequences of HID events; (3) isolate event-level factors that increase AIB risk beyond level of intoxication (co-use of other drugs, inadequate sleep, willingness, intentions); and (4) examine changes in frequency of and associations among HID, AIB, and related negative consequences across three annual assessments. First, key informant interviews (n=20-28) will be used to gather data on the relevance of theoretically-based cognitive and behavioral factors, social context, affect and other factors in the prediction of HID, as well as to identify consequences of HID for young adults. Next, in a measurement burst design, 200 young adults will complete in-person assessments and three 30-day bursts of daily EMA assessments at 12-month intervals, in combination with objective measurement of alcohol consumption using biosensor technology. We seek to differentiate the event-level predictors and outcomes of HID and AIB relative to all other drinking events, and relative to heavy episodic drinking (4+/5+ drinks), in order to isolate what places an individual at unique risk for these particularly concerning outcomes. Multilevel models will be used to determine predictors and outcomes as a function of whether each drinking event is characterized by HID or AIB. The results of the proposed research will provide novel information on proximal predictors of these two public health concerns among young adults. This innovative study will help to determine motivational targets for interventions, and in doing so, provide theoretical and empirical bases for designing preventive interventions to reduce HID, AIB and other severe alcohol-related consequences.