Daily State-like Distress Tolerance and Alcohol Use Motivation among Hazardous Drinkers with Posttraumatic Stress Disorder

项目总结/摘要 危险饮酒和创伤后应激障碍（PTSD）都是非常普遍和频繁的 导致临床和功能结局比任何一种更严重的共病公共卫生状况 个体障碍12 -17.目前还没有“黄金标准”，基于证据的治疗方法可用于此 18此外，对这一人群最有希望的干预措施的特点是高发病率。 磨损和小的治疗效果大小19，使这一组服务不足，缺乏一个强大的， 重大干预20.一些研究表明，痛苦耐受力（DT）的个体差异是 理论上与危险饮酒和PTSD 21 -25有关。DT反映了感知或客观的能力， 承受消极的情感或身体状态26. DT相对稳定（即，它具有类似特质的品质），但最近 工作表明，它也保持了类似国家的质量27，28。类状态DT是一种心理过程， 29.重复地和持续地随着时间的推移29.过去的工作并没有在创伤后应激障碍和 危险的饮酒习惯。为了填补这一空白，促进机械知识，可以告知未来 为这一人群的治疗发展，拟议的研究将审查以下主要目标， 生态瞬时评估（EMA）框架超过21天的时间采样时期：检查 状态样低DT是否介导基线PTSD症状与饮酒之间的关联 动机;以及状态样DT是否介导基线时PTSD症状与 危险饮酒该项目的主要假设是，较低状态的DT将介导 基线PTSD症状与A.1.a中列出的酒精结局之间的相关性。和A.2.a.在寻求 识别和理解状态样DT作为一种可能导致酒精使用和并发的作用机制 条件（例如，创伤后应激障碍），这项建议涉及国家酒精滥用和酒精中毒研究所 （1）战略规划目标（1a）。该奖项将支持研究方法的重点培训 和统计分析，否则是不可能的，以及提供机会进行 研究以更好地理解状态样DT作为影响PTSD的潜在机制- 危险的酒精使用协会。

PROJECT SUMMARY/ABSTRACT Hazardous drinking and posttraumatic stress disorder (PTSD) are both highly prevalent and frequently comorbid public health conditions that result in more severe clinical and functional outcomes than either individual disorder12-17. There are currently no “gold standard,” evidence-based treatments available for this comorbidity.18 Moreover, the most promising interventions for this population are marked by high rates of attrition and small treatment effect sizes19, leaving this group underserved and lacking a robust and clinically significant intervention20. Some research suggests that individual differences in distress tolerance (DT) are theoretically relevant to both hazardous drinking and PTSD21-25. DT reflects the perceived or objective ability to withstand negative affective or bodily states26. DT is relatively stable (i.e., it has trait-like qualities), but recent work indicates that it also maintains state-like qualities27, 28. State-like DT is a psychological process expressed repeatedly and continuously over time29. Past work has not integrated state-like DT in terms of PTSD and hazardous drinking comorbidity. To fill this gap and facilitate mechanistic knowledge that can inform future treatment development for this population, the proposed research will examine the following primary aims in an ecological momentary assessment (EMA) framework over a 21-day time-sampling epoch: to examine whether state-like lower DT mediates the association between PTSD symptoms at baseline and alcohol use motivation; and whether state-like DT mediates the association between PTSD symptoms at baseline and hazardous drinking. The primary hypothesis of this project is that lower state-like DT will mediate the association between baseline PTSD symptoms and alcohol outcomes listed in A.1.a. and A.2.a. In seeking to identify and understand state-like DT as a mechanism of action that may underly alcohol use and co-occurring conditions (e.g., PTSD), this proposal addresses the National Institute of Alcohol Abuse and Alcoholism (NIAAA) strategic planning goals (Objective 1a). This award will support focused training in research methods and statistical analysis that would not otherwise be possible, as well as provide the opportunity to conduct research to develop a greater understanding of state-like DT as a potential mechanism influencing PTSD- hazardous alcohol use associations.