Long-Term Alcohol Use Effects of a Training Intervention for ADHD

项目摘要/摘要 拟议研究的长期目标是确定一种假定的干预机制 改变高危人群中酒精使用问题的发展轨迹。要达到 为了达到这个目标，申请者将接受关于酒精使用危险因素的高级培训，多方法数据设计 和收集，以及通过课程作业、实验室轮换、研讨会和咨询获得的量化技能。这是一个 重要的研究领域，因为患有ADHD的青少年有经历与酒精有关的问题的风险5，6 并在3、4岁时出现酒精使用障碍。申请人的团队之前实施了 对患有ADHD的青少年进行培训干预，初步调查显示，这种干预是 首次对青少年ADHD患者的干预与酒精使用方面的积极治疗相关 问题7.这些差异的大小随着时间的推移而增长，与其他结果的结果一致 这种干预14.因此，这种干预可能改变酒精使用问题的发展轨迹 患有多动症的青少年。ADHD和ADHD之间联系的领先发育生物心理社会模型 酒精使用问题10突出了情绪失调(ED)在催化酒精风险中的关键作用 ADHD患者中的使用问题。因此，当前研究的目标是检查耐久性 随着年轻人进入成年阶段，与酒精有关的问题得到改善，这一时期 酒精使用高峰2，并检查勃起功能障碍是导致问题途径改变的可能机制 酗酒。将努力保留患有ADHD的青少年(n=171)的原始样本 之前在高中时参加了一项训练干预的随机对照试验。 参与者提供了在过去3到5年中的3个时间点的酒精使用行为和ED的自我报告。在……里面 在这项拟议的研究中，参与者将报告他们目前的酒精使用模式和相关问题。至 加深我们对ED的复杂结构的理解，ED将通过多个分析单元进行测量 (即自我报告、生理、行为)。将使用结构方程建模来解决 目的：(1)考察对酒精使用问题的干预效果；(2)考察对酒精使用问题的干预效果 以及(3)研究勃起功能障碍与酒精使用问题之间的联系，并在探索性目标中， 通过ED检查干预是否对酒精使用问题有效果。性爱将作为一种 这些目标的主持人给出了潜在的性别特定路径的证据，在患有 ADHD 55-58。拟议的研究有可能确定变化的干预机制 在未来的干预措施中有针对性地减少高危青少年所经历的有害后果 酒精使用问题。此外，通过该奖学金向申请人提供的培训将增强她的能力。 能够进行作为独立研究人员职业生涯所必需的基础性和机械性研究 能够对高危青少年进行干预开发和评估研究。

Project Summary/Abstract The long-term objective of the proposed study is to identify a putative intervention mechanism of change for altering the developmental trajectory of alcohol use problems among an at-risk population. To attain this goal, the applicant will receive advanced training in risk factors of alcohol use, multi-method data design and collection, and quantitative skills via coursework, lab rotations, workshops, and consultation. This is an important area of research as adolescents with ADHD are at-risk for experiencing alcohol-related problems 5,6 and developing alcohol use disorders as emerging adults 3, 4. The applicant’s team previously implemented a training intervention for adolescents with ADHD, and preliminary investigations revealed this intervention was the first intervention for youth with ADHD to be associated with positive treatment-related gains in alcohol use problems 7. The magnitude of these differences grew over time, consistent with findings of other outcomes from this intervention 14. Thus, this intervention may alter the developmental trajectory of alcohol use problems for adolescents with ADHD. A leading developmental biopsychosocial model of the link between ADHD and alcohol use problems 10 highlights the critical role of emotion dysregulation (ED) in catalyzing risk for alcohol use problems among individuals with ADHD. Thus, the goals of the current study are to examine the durability of improvements in alcohol-related problems as the youth transition into emerging adulthood, a time when alcohol use peaks 2, and to examine ED as a putative mechanism of change in the pathway to problematic alcohol use. Efforts will be made to retain the original sample of adolescents with ADHD (n = 171) who previously participated in a randomized controlled trial of a training intervention while in high school. Participants provided self-report of alcohol use behaviors and ED at 3 points over the previous 3 to 5 years. In the proposed study, participants will report their current patterns of alcohol use and associated problems. To enhance our understanding of the complex construct of ED, ED will be measured via multiple units of analysis (i.e., self-report, physiological, behavior). Structural equation modeling will be employed to address the following aims: (1) examine intervention effects on alcohol use problems; (2) examine intervention effects on ED; and (3) examine the association between ED and alcohol use problems, and, in an exploratory aim, examine whether intervention has an effect on alcohol use problems via ED. Sex will be explored as a moderator across these aims given evidence of potential sex-specific pathways to use among individuals with ADHD 55-58. The proposed study has the potential to identify an intervention mechanism of change to be targeted in future interventions that may reduce the detrimental outcomes experienced by youth at-risk of alcohol use problems. Further, the training afforded to the applicant through this fellowship will enhance her ability to conduct basic and mechanistic research necessary for a career as an independent researcher capable of conducting intervention development and evaluation research for at-risk youth.