Examining the Validity of the Alcohol Use Disorder Recovery Construct Using a Between- and Within-Persons Design

项目总结 越来越多的人达成共识，认为康复不仅仅是缓解，还包括更广泛的生物心理社会 情绪健康和社区融合等领域的改善(Kelly&Hoeppner，2014； 理查森等人，2019年；怀特，2012年)。定性研究(例如，Borkman等人，2016)和定量研究 人与人之间的差异(Garner等人，2014年；Lusczakoski等人，2014年)似乎与更广泛的 恢复定义。然而，这些定义描述了一个过程，研究还没有涉及到 更广泛的恢复结构在人内层面的有效性。这一点至关重要，因为有证据表明 恢复定义中包括的域在人与人之间的级别上收敛并不保证在- 人的变化也有类似的模式。此外，目前还不清楚基于成人的康复概念化是否可以 适用于青年(Finch等人，2020)，或者如果康复在种族/民族、性别、康复方面具有相同的含义 途径，以及无序和规范的使用。我们的长远目标是促进改善经济复苏的工作- 以护理为导向的系统。此R21应用程序的总体目标是评估恢复的有效性 使用探索性的、数据驱动的方法，构建从青春期到成年中期的近25年。 我们的中心假设是，恢复定义中包括的领域在以下两个阶段之间具有适度的相关性： 人的差异水平，在不同的亚群中表现出一些重要的经验意义差异，并且 人与人之间存在显著的相关性。当前项目的基本原理是，它通知业务定义 从青春期到中年的恢复，并为未来R01水平的努力提供了一个比较点 以验证成年后期的康复措施。这项研究使用了来自国家纵向研究的数据 青少年到青壮年健康、纵向测量不变性分析和平行过程潜伏期 建立增长模型以实现以下具体目标：1)确定时间和子组的重要性 在调节恢复分数的含义方面的成员资格。2)确定恢复中是否包含域 定义在人内部是联系在一起的。我们期望这项研究将确定酒精的有效性 使用障碍(AUD)从青春期到成年中期的恢复结构，确定是否恢复 指标在不同群体之间的作用是相同的，并在人内相互关联。这一贡献是 意义重大，因为它通知了捕捉多维和动态性质的措施的发展 澳元的恢复过程。这个项目是创新的，因为它使用了更长期的内部设计， 包括青春期的数据，进行康复的纵向测量不变性分析 主持人，通过人内饮酒来评估标准有效性，并分析国家数据 青春期到中年。这些成果将产生重要的积极影响，促进努力 确定如何更改早期轨迹以改善整个生命周期的健康状况，估计恢复情况 此外，还应评估酒精使用者的流行率，调整服务以适应酒精使用者的亚群，并评估注重康复的护理系统。

PROJECT SUMMARY There is growing consensus that recovery extends beyond remission to broader biopsychosocial improvements in domains such as emotional health and community integration (Kelly & Hoeppner, 2014; Richardson et al., 2019; White, 2012). Qualitative (e.g., Borkman et al., 2016) and quantitative studies of between-persons differences (Garner et al., 2014; Lusczakoski et al., 2014) appear consistent with broader recovery definitions. These definitions describe a process, however, and research has not yet addressed the validity of the broader recovery construct at the within-persons level. This is crucial because evidence that domains included in recovery definitions converge at the between-persons level does not guarantee that within- persons change is similarly patterned. Moreover, it is not clear if adult-based conceptualizations of recovery can be applied to youth (Finch et al., 2020) or if recovery has the same meaning across race/ethnicity, sex, recovery pathways, and disordered vs. normative use. Our long-term goal is to facilitate efforts to improve recovery- oriented systems of care. The overall objective for this R21 application is to evaluate the validity of the recovery construct across nearly 25 years from adolescence to mid-adulthood using an exploratory, data-driven approach. Our central hypothesis is that domains included in recovery definitions are moderately correlated at the between- persons differences level, exhibit some important differences in empirical meaning across subgroups, and are significantly correlated within persons. The rationale for the current project is that it informs operational definition of recovery from adolescence to mid-adulthood and provides a point of comparison for future R01 level efforts to validate recovery measures in late adulthood. This study uses data from the National Longitudinal Study of Adolescent to Young Adult Health, longitudinal measurement invariance analysis, and parallel process latent growth modeling to achieve the following specific aims: 1) Determine the importance of time and subgroup membership in moderating the meaning of recovery scores. 2) Determine whether domains included in recovery definitions are linked within persons. It is our expectation that this study will determine the validity of the alcohol use disorder (AUD) recovery construct from adolescence to mid-adulthood, identifying whether recovery indicators function in the same way across groups and intercorrelate within persons. This contribution is significant because it informs development of measures that capture the multidimensional and dynamic nature of the AUD recovery process. This project is innovative because it uses a longer-term within-persons design, includes data from adolescence, conducts longitudinal measurement invariance analyses of recovery moderators, evaluates criterion validity via alcohol use within persons, and analyzes national data spanning adolescence to mid-adulthood. These results will have an important positive impact by facilitating efforts to determine how early trajectories might be altered to improve health across the lifespan, estimate recovery prevalence, adapt services to subgroups of alcohol users, and evaluate recovery-oriented systems of care.