Evaluating Alcohol Expectancies and their Salience During Real-World Drinking Occasions as Risk Factors for Young Adult Alcohol Misuse

摘要 对于大多数人来说，酒精在整个生命过程中的使用在青壮年达到顶峰，并在此期间使用 发展阶段伴随着许多后果和社会代价。年轻人饮酒 考虑到年轻人经常饮酒的方式，这是一个严重的公共卫生负担；也就是年轻人 成年人比其他年龄段的人更容易酗酒(一次饮酒五次或五次以上 和极端狂饮(连续饮酒十次或以上)。借助新兴技术，我们现在可以提供 在实际饮酒前或饮酒期间对年轻人进行流动干预，目的是减少 在这一事件中饮酒的总量并减少了负面后果。然而，有一个 理论、研究和实时干预开发之间的差距达到理论很少的程度 预测什么时候干预可能最有效，或者酒精本身如何影响特定的风险因素。 拟议的研究旨在通过测量酒精预期及其显著程度来解决这一差距(即， 对特定潜在酒精相关结果的关注程度)在年轻人的自然 环境，检查预期及其对酒精的反应的显著变化的程度 消费和现实世界的背景因素，并检查这些变化是否与 随后的饮酒行为。为此，该研究利用了生态瞬时评估(EMA)。 方法：240名年轻成年酗酒者将完成一项为期24天的EMA研究，研究对象包括四名 周末，并将自我报告饮酒预期及其在每日、之前和期间的突出程度 在自然环境中饮酒。EMA将最大限度地提高生态有效性并允许对 酒精预期及其显著程度如何随着酒精消费本身以及实际情况的变化而发生变化 世界背景因素。我们还将评估酒精的急性影响，如在饮酒场合和 检查这些影响是否与饮酒期望值及其重要性有关。最后， 对人级主持人的检查将允许确定谁可能经历最大的变化 酒精预期及其显着性，以及对谁来说，这些变化与酒精最密切相关 消费。研究结果将弥合理论、研究和干预之间的鸿沟 通过评估酒精预期及其作为潜在干预目标的显着性来发展，而 饮酒或处于高危环境时。拟议的申请与NIAAA的战略计划保持一致，并已 对公共卫生的重大影响，包括确定何时干预、以什么机制为目标 (例如，酒精预期和/或其突出程度)，以及目标是谁。

ABSTRACT Alcohol use across the life course peaks for most individuals in young adulthood, and use during this developmental period is associated with numerous consequences and societal costs. Young adult alcohol use is a serious public health burden when considering the way in which young adults often drink; that is, young adults are more likely than individuals of other age groups to engage in binge drinking (five or more drinks in a row) and extreme binge drinking (ten or more drinks in a row). With emerging technology, we can now deliver mobile interventions to young adults before or during an actual drinking episode with the intent of reducing the overall amount of alcohol consumed in that episode and reducing negative consequences. However, there is a gap between theory, research, and the development of real-time interventions to the extent that theories rarely predict when an intervention might be most effective or how alcohol itself may influence specific risk factors. The proposed research aims to address this gap by measuring alcohol expectancies and their salience (i.e., the amount of attention paid to specific potential alcohol-related outcomes) in young adults’ natural environments, examining the extent to which expectancies and their salience shift in response to alcohol consumption and across real-world contextual factors, and examining whether these shifts are associated with subsequent alcohol consumption. To do so, the research utilizes ecological momentary assessment (EMA) methodologies: 240 young adult heavy drinkers will complete a 24-day EMA study spanning across four weekends, and will self-report alcohol expectancies and their salience at the daily level and before and during drink episodes in the natural environment. EMA will maximize ecological validity and allow for examination of how alcohol expectancies and their salience shift as a function of alcohol consumption itself as well as real- world contextual factors. We will also assess alcohol’s acute effects as reported during drinking occasions and examine whether these effects are associated with alcohol expectancies and their salience. Finally, examination of person-level moderators will allow for identification of who may experience the greatest shifts in alcohol expectancies and their salience and for whom these shifts are most strongly associated with alcohol consumption. The research findings will bridge the gap between theory, research, and intervention development by evaluating alcohol expectancies and their salience as potential intervention targets while drinking or when in high risk contexts. The proposed application is aligned with NIAAA’s strategic plan and has significant implications for public health, including identifying when to intervene, what mechanisms to target (e.g., alcohol expectancies and/or their salience), and who to target.