Natural environment assessment of alcohol responses in risky drinkers

项目摘要 实验室酒精挑战提供了关于个体对酒精的反应的重要知识， 与饮酒有关的问题。然而，这种方法需要大量时间和资源， 捕捉真实世界的酒精反应。因此，MPI提出了一种方法的开发工作， 评估流动酒精反应，结合基于智能手机的高分辨率生态 使用新一代腕戴式酒精生物传感器（BACTrack Skyn™）进行瞬时评估（HR-EMA）， 提供酒精使用的客观验证。这一发展性R21提案的首要目标是 比较HR-EMA衍生的实时反应，在典型的大量饮酒事件，在自然 环境中的个人跨越酒精使用连续体，包括酒精使用障碍（AUD）饮酒者， 这些人在很大程度上被排除在此类研究之外，还有大量社交饮酒者（HD）和轻度饮酒者。 对照组（LD）。拟议的研究将包括在典型的饮酒过程中进行智能手机评估 在参与者的自然环境中以及在比较非酒精饮料期间的发作 在大致相同的时间但在不同的日期评估消耗发作。参与者将 在他们饮酒期间的多个时间点完成简短的1分钟智能手机调查， 评估他们的消费量、主观反应和背景事件。他们还将完成简短的 每日情绪调查和饮酒事件后第二天的调查，以评估遗留影响， 后果这种非侵入性的腕戴式传感器将在每次饮酒期间和之后的12小时内使用 作为自我报告行为的客观验证。本研究将入组105例受试者（每个亚组35例） 年龄在21-55岁之间，参与时间约为一周。我们保守估计 15%的退出率，以便最终有N=90名参与者。我们的第一个目标是比较急性主观 在自然环境中饮酒者亚组的饮酒事件期间的反应。我们预测 酒精会在AUD和HD中产生更高的刺激，喜欢和想要，而不是LD，特别是在早期。 饮酒事件（即，第一个小时），AUD与HD和LD相比，焦虑和压力的减少更大， 在控制了饮酒量和非酒精性饮酒发作反应后。我们还预测， 可穿戴生物传感器将是可接受的（≥85%的使用率，很少损失或损坏），并显示出良好的灵敏度， 特异性检测>90%发作中酒精使用与不使用。我们的第二个目标是检查个人 急性酒精反应的差异作为饮酒速度的函数。我们预测快速饮酒 消耗将与刺激和欲望正相关，与镇静负相关， 这些效应在AUD与LD中最为明显，HD为中间值。总之，拟议的研究 将通过扩展HR-EMA方法来评估自然环境，从而推进酒精研究领域 急性饮酒行为、主观反应和饮酒相关结果， 饮酒者亚群。

PROJECT SUMMARY ABSTRACT Laboratory alcohol challenges have provided important knowledge about individual responses to alcohol and risk for drinking-related problems. However, this approach is time- and resource-intensive and cannot fully capture real-world alcohol responses. Therefore, the MPI propose developmental work on a method for assessing ambulatory alcohol responses that combines smartphone-based high-resolution ecological momentary assessment (HR-EMA) with new-generation, wrist-worn alcohol biosensors (BACTrack Skyn™) to provide objective verification of alcohol use. The over-arching goal of this developmental R21 proposal is to compare HR-EMA-derived real-time responses during typical heavy drinking episodes in the natural environment in individuals across the alcohol use continuum, including alcohol use disorder (AUD) drinkers, who have largely been excluded from such research, as well as heavy social drinkers (HD) and light drinker controls (LD). The proposed research will include smartphone assessments throughout a typical drinking episode in participants’ natural environment as well during a comparison non-alcohol drinking beverage consumption episode assessed at approximately the same time but on a different day. Participants will complete brief 1-minute smartphone-based surveys at multiple time points during their drinking episodes to assess their quantity consumed, subjective responses, and contextual events. They will also complete brief daily mood surveys and next-day surveys after the drinking episodes to assess carry-over effects and consequences. The noninvasive wrist-worn sensor will be used during, and for 12 hours after, each drinking episode as objective verification of self-report behavior. The study will enroll 105 participants (35/per subgroup) between ages 21-55 for participation over an approximate one-week interval. We conservatively anticipate up to a 15% drop-out rate in order to have a final N=90 participants. Our first aim is to compare acute subjective responses during alcohol drinking episodes in the natural environment across drinker subgroups. We predict that alcohol will produce higher stimulation, liking, and wanting in AUD and HD than in LD, particularly early in the drinking episode (i.e., first hour) and greater reduction in anxiety and stress in AUD versus HD and LD, after controlling for amount consumed and non-alcohol drinking episode responses. We also predict that wearable biosensors will be acceptable (≥85% use, few losses or damage) and show good sensitivity and specificity detect alcohol use vs. non-use in >90% of episodes. Our second aim is to examine individual differences in acute alcohol responses as a function of drinking pace. We predict that faster-paced alcohol consumption will be positively associated with stimulation and wanting and inversely associated with sedation, and these effects will be most pronounced in AUD vs LD, with HD intermediate. In sum, the proposed research will advance the alcohol research field by expanding HR-EMA methodologies to assess natural environment acute drinking behavior, subjective response, and drinking-related outcomes in diverse, clinically-relevant drinker subgroups.