Leveraging Ecological Momentary Assessment to Examine Peer Affiliations as a Mechanism of Behavior Change in Youth Alcohol Use Treatment

利用生态瞬时评估来检查同伴关系作为青少年酒精使用治疗中行为改变的机制

基本信息

批准号：
10436234
负责人：
Samuel Noah Meisel
金额：
$ 1.97万
依托单位：
EMMA PENDLETON BRADLEY HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-01 至 2022-08-31
项目状态：
已结题

项目摘要

PROJECT SUMMARY/ABSTRACT BACKGROUND. Alcohol use (AU) and misuse, including the onset of alcohol use disorder (AUD), peak during adolescence and emerging adulthood. Despite the adverse effects of AU among youth, such as increased risk for the development of substance use disorders and increased risk of alcohol-related deaths, the best available psychosocial interventions for AUD yield only modest short term benefits among youth. One way to improve treatments for AUD and reduce the public health burden associated with youth AU is to advance our understanding of how interventions work. Virtually all evidence-based psychosocial interventions emphasize shifting from alcohol using peers to non-using peers because youth AU predominantly occurs in the presence of peers, and affiliating with AU using peers is consistently associated with increased risk for relapse and worse treatment outcomes. To date, AUD treatment research has largely neglected the peer context of adolescents and emerging adults and this is particularly concerning because failure to consider the centrality of peer relationships in adolescent AU interventions leads to diminished and, in some cases, iatrogenic effects. SPECIFIC AIMS. This F32 supports the first study, to our knowledge, to use ecological momentary assessment (EMA) to examine whether daily level shifts from alcohol using to non-using peers over the course of AUD treatment leads to reductions in drinking and identify when these shifts occur. METHODS. Using an existing data set of a clinical trial examining the effects of medication (topiramate) and motivational enhancement and cognitive behavioral therapies (MET-CBT) relative to placebo plus MET-CBT using EMA (N =82; ages 14-24 years), the project will examine 1) the amount of time youth spend with alcohol-using and non-using peers from pre to post intervention in topiramate and placebo conditions, 2) whether topiramate leads to reductions in AU by attenuating the relationship between being in the presence of alcohol using peers and subsequent AU, and 3) whether lower levels of alcohol use, resulting from the attenuated relationship between being in the presence of alcohol-using peers and subsequent AU in the topiramate condition, in turn, leads to greater time spent with non-alcohol using peers. LONG-TERM GOAL. This research plan provides the opportunity for mentored training in identifying mechanisms of behavior change for youth AUD treatments and advanced training in collecting and analyzing complex EMA data. The identified mentorship team includes experts in the fields of adolescent addiction treatment, mechanisms of behavior change research, clinical trials research, and EMA data collection and analysis., and is housed in internationally recognized clinical and addiction research centers. The current F32 project will facilitate a successful transition to research independence and will support future grant applications that will investigate how social and biological processes impact AUD treatment leveraging EMA designs. Thus, this F32 aids the NIAAA's research priorities of identifying mechanisms of action for pharmacotherapy and reducing youth AU.

项目概要/摘要背景。酒精使用 (AU) 和滥用，包括酒精使用障碍 (AUD) 的发作，在青春期和成年初期。尽管 AU 对青少年有不利影响，例如风险增加对于药物滥用障碍的发展和酒精相关死亡风险的增加，最好的方法是 AUD 的社会心理干预只能在青少年中产生有限的短期效益。一种改进方法治疗 AUD 并减少与青少年相关的公共健康负担 AU 旨在推进我们的了解干预措施如何发挥作用。几乎所有基于证据的心理社会干预措施都强调从饮酒的同龄人转向不饮酒的同龄人，因为青年 AU 主要发生在存在的情况下的同龄人，以及利用同龄人加入 AU 始终与旧病复发和复发的风险增加相关。更差的治疗结果。迄今为止，AUD 治疗研究在很大程度上忽略了同龄人的背景青少年和新兴成年人，这一点尤其令人担忧，因为没有考虑到青少年 AU 干预中的同伴关系会减少影响，在某些情况下还会导致医源性影响。具体目标。据我们所知，该 F32 支持第一项使用生态瞬时技术的研究评估（EMA），检查在课程中日常水平是否从饮酒的同伴转变为不饮酒的同伴 AUD 治疗可导致饮酒量减少，并确定这些转变何时发生。方法。使用一项临床试验的现有数据集，检查药物（托吡酯）和动机的影响相对于安慰剂加使用 EMA 的 MET-CBT 的增强和认知行为疗法 (MET-CBT)（N =82；年龄 14-24 岁），该项目将检查 1）青少年花费在饮酒和饮酒上的时间从托吡酯和安慰剂条件干预前到干预后不使用同伴，2) 是否使用托吡酯通过削弱同龄人饮酒之间的关系，导致 AU 减少以及随后的 AU，以及 3) 是否因关系减弱而导致饮酒水平降低反过来，在饮酒的同伴面前和随后处于托吡酯状态的 AU 之间，导致与不酗酒的同伴相处的时间更长。长期目标。该研究计划提供了在确定青少年 AUD 治疗行为改变机制方面进行指导培训的机会收集和分析复杂 EMA 数据的高级培训。确定的导师团队包括青少年成瘾治疗、行为改变机制研究、临床试验领域的专家研究、EMA 数据收集和分析，并位于国际公认的临床和成瘾研究中心。目前的 F32 项目将有助于成功过渡到研究独立性并将支持未来的拨款申请，这些申请将调查社会和生物如何流程影响利用 EMA 设计的 AUD 处理。因此，这款 F32 有助于 NIAAA 的研究重点确定药物治疗的作用机制并减少青少年 AU。

项目成果

期刊论文数量（4）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Parent and Adolescent Reports of Parental Monitoring and Sources of Parental Knowledge are Linked to Cannabis Use and Symptom Development in Adolescents.

家长和青少年的家长监测报告和家长知识来源与青少年大麻使用和症状发展有关。

DOI：
发表时间：
2022-07-11
期刊：
影响因子：
0
作者：
Parlette, Brianna;Padovano, Hayley Treloar;Pielech, Melissa;Meisel, Samuel;Miranda Jr, Robert
通讯作者：
Miranda Jr, Robert

Assessing Parent-Adolescent Substance Use Discussions Using the Continuous Assessment of Interpersonal Dynamics.

使用人际动态的持续评估来评估父母与青少年药物使用的讨论。