Alcohol Response, Cognitive Impairment, and Alcohol-Related Negative Consequences

描述(申请人提供)：在新兴成年人中，饮酒的公共卫生成本在很大程度上归因于酒精对其他行为风险的影响，如攻击性、不安全的性行为和酒后驾车。越来越多的研究文献表明，酒精中毒会降低执行认知控制，特别是削弱抑制优势行为反应的能力，这些影响可能导致参与行为风险的倾向增加。另一篇文献表明，随着人们越来越多地认识到酒精反应反映了稳定的、受遗传影响的个体差异，整个人群对酒精影响的急性生理和主观反应存在差异。然而，关于酒精反应的研究主要集中在它们在酒精使用障碍发展中的作用，而忽视了它们对急性酒精中毒相关行为结果的贡献。这项拟议的研究将测试酒精反应在预测自然环境中与酒精相关的行为风险方面的作用。在第一个研究阶段，中度到重度饮酒的新兴成年人将在模拟的酒吧环境中完成受试者内的安慰剂控制的酒精挑战，以评估主观和生理酒精反应以及酒精引起的抑制损害。更大的酒精反应预计与更大的酒精诱导的抑制优势反应的损害有关。在第二阶段，相同的参与者将使用基于网络的日常日记报告他们的酒精使用、主观酒精反应和其他行为风险。实验室中更大的酒精反应将前瞻性地预测事件级每日日记中评估的醉酒行为风险，控制事件级酒精反应和估计的血液酒精浓度。最后，更大的酒精诱导的抑制性损伤有望在基于实验室的酒精反应和事件级行为风险之间起到中介作用。这一发现有望确定更大的酒精反应对事件级别的行为影响。这个项目将整合两个不同的研究方向，证明更大的酒精反应会加剧酒精对行为风险的抑制作用。这些结果将允许将酒精反应纳入酒精对行为影响的理论模型中，并将有助于解释为什么一些新兴成年人在醉酒时比其他成年人更有可能从事有害行为。 与公共健康相关：酒精使用和精神障碍在新兴成年人中最为普遍，酒精使用对公共健康的不利影响主要归因于酒精对其他行为风险(例如，身体攻击、不安全的性行为、酒后驾车)的影响。然而，重要的是，并不是所有的新兴成年人都会在醉酒时做出这些有害的行为，我们对酒精对行为的影响的理解仍然不完整。这项申请建议进行研究，以确定作为酒精反应函数的行为风险倾向存在个体差异的机制，最终目标是提高干预措施的针对性和效率，以降低新兴成年人饮酒的公共卫生成本。

DESCRIPTION (provided by applicant): Among emerging adults, the public health costs of alcohol use are attributable in no small part to the effects of alcohol on other behavioral risks such as aggression, unsafe sex, and driving after drinking. A growing research literature demonstrates that alcohol intoxication decreases executive cognitive control, in particular impairing the ability to inhibit prepotent behavioral responses, and these effects may contribute to an increased propensity to engage in behavioral risks. A separate literature demonstrates that there is variability across the population in acute physiological and subjective responses to the effects of alcohol, with increasing recognition that alcohol responses reflect stable, genetically influenced individual differences. Research on alcohol responses, however, has largely focused on their role in the development of alcohol use disorders at the expense of examining their contributions to behavioral outcomes associated with acute alcohol intoxication. The proposed research will test the role of alcohol responses in predicting alcohol-related behavioral risks in the natural environment. In a first study phase, moderate-to-heavy drinking emerging adults will complete a within-subject, placebo-controlled alcohol challenge in a simulated bar environment to assess subjective and physiological alcohol responses and alcohol-induced inhibitory impairment. Greater alcohol responses are expected to be associated with greater alcohol-induced impairment in the inhibition of prepotent responses. In a second phase, the same participants will report on their alcohol use, subjective alcohol responses, and other behavioral risks using Web-based daily diaries. Greater alcohol responses in the lab will prospectively predict intoxicated behavioral risks as assessed in the event-level daily diaries, controlling for event-level alcohol responses and estimated blood alcohol concentration. Finally, greater alcohol-induced inhibitory impairment is expected to mediate the association between lab-based alcohol responses and event-level behavioral risks. The findings are expected to identify the event-level behavioral effects of greater alcohol responses. This project will integrate two separate lines of research by demonstrating that greater alcohol responses exacerbate the disinhibiting effects of alcohol on behavioral risks. These results will permit the incorporation of alcohol responses into theoretical models of the effects of alcohol on behavior and will help explain why some emerging adults are more likely to engage in harmful behaviors while intoxicated relative to others. PUBLIC HEALTH RELEVANCE: Alcohol use and disorders are most prevalent among emerging adults, and the adverse public health impact of alcohol use is largely attributable to alcohol's effects on other behavioral risks (e.g., physical aggression, unsafe sexual behaviors, driving after drinking). Importantly, however, not all emerging adults engage in these harmful behaviors when intoxicated, and our understanding of the effects of alcohol on behavior remains incomplete. This application proposes research to identify a mechanism underlying individual differences in the propensity to engage in behavioral risks as a function of alcohol responses, with the ultimate goal of improving the targeting and efficiency of interventions to reduce the public health costs of emerging-adult alcohol use.