Naltrexone and CBT for problem drinking

纳曲酮和 CBT 治疗饮酒问题

基本信息

批准号：
7590479
负责人：
JON MORGENSTERN
金额：
$ 56.69万
依托单位：
NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-04-01 至 2011-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7590479
关键词：
AIDS prevention Abstinence Address Adverse effects Advocate Aftercare Alcohol abuse Alcohol consumption Alcohol dependence Alcohols Attenuated Behavior Therapy Behavioral Collection Complex Consumption Coping Skills Counseling Cues Data Data Collection Development Diagnostic and Statistical Manual Early treatment Enrollment Exposure to Failure Frequencies Future Goals HIV HIV Seropositivity Health Heavy Drinking Heterosexuals Individual Intermediate Variables Intervention Mediating Moods Motivation Naltrexone Nature Outcome Participant Patient Self-Report Pharmacotherapy Placebos Population Psychological Factors Psychotherapy Randomized Recruitment Activity Relapse Relative (related person)Reporting Research Research Personnel Risk Risk Behaviors Risk Reduction Sampling Self Efficacy Self-control as a personality trait Sex Behavior Social Network Supportive care Technology Treatment Failure Variant Voice alcohol abstinence alcohol abuse therapy alcohol craving alcoholism therapy base behavior change cognitive behavior therapy coping craving drinking effective therapy efficacy testing experience follow-up high risk meetings men men who have sex with men negative mood problem drinker programs psychologic response sex risk skill acquisition social social cognitive theory success transmission process treatment effect treatment response

项目摘要

Problem drinking MSM are at risk for relapse because their social milieux are often associated with alcohol, and are at elevated risk for HIV because of high base rates of HIV and because drinking is associated with HIV-risk behavior. Although substantial research exists on HIV risk reduction in MSM alone or in combination with alcohol abuse treatment, few studies have examined the impact of alcohol-only treatment on HIV risk. Problem drinkers are most receptive to interventions focused on moderation of drinking rather than abstinence; however moderation-oriented cognitive-behavior therapy (CBT) is limited in that success depends on the successful implementation of new coping strategies for urges to drink and development of self-efficacy for coping. Naltrexone (NTX) is also a well established treatment for problem drinkers with moderated drinking goals, but its effects diminish after treatment is discontinued. The limitations of these treatments suggest that their combination might enhance the efficacy of both. We propose combining moderation-oriented CBT with NTX in the treatment of problem drinking,HIV- positive and -negative MSM, to evaluate their efficacy alone and in combination. We also propose to utilize new data collection technology, Interactive Voice Response, to collect data on daily relations among drinking, sexual behavior and psychological variables thought to mediate treatment response. Our objectives are to: 1) enroll a sample of 240 problem drinking MSM using active and passive recruitment strategies; 2) evaluate the efficacy of 12 weeks of randomly assigned treatment, with 50 mg of NTX or placebo, combined with modified, behavioral self-control therapy or brief supportive therapy; 3) evaluate conditional relationships between heavy drinking and likelihood of HIV risk behavior; 4) evaluate daily associations among mood, craving, self-efficacy, motivation, and drinking. Assessments will include baseline, 3, 6, & 9 month follow-up. This application is of tremendous relevance to alcoholism treatment and HIV prevention. First, we will evaluate established treatments for problem drinking in an under-studied but unique population, namely MSM. Second, we will examine the impact of alcohol-focused treatment on HIV risk behavior in a very high- risk population. Third, we will use new data collection technology to examine complex relationships among drinking, HIV risk, and psychological factors to better inform future interventions.

酗酒问题男男性行为者面临旧病复发的风险，因为他们的社交环境通常与酒精有关，由于艾滋病毒基本感染率高以及饮酒与艾滋病相关，因此感染艾滋病毒的风险较高艾滋病毒风险行为。尽管存在大量关于单独或联合 MSM 降低 HIV 风险的研究对于酒精滥用治疗，很少有研究探讨仅酒精治疗对艾滋病毒风险的影响。有饮酒问题的人最容易接受以适度饮酒为重点的干预措施，而不是节制;然而，以适度为导向的认知行为疗法（CBT）的成功有限取决于新的饮酒冲动应对策略的成功实施和发展应对的自我效能。纳曲酮 (NTX) 也是治疗饮酒问题的一种行之有效的治疗方法适度的饮酒目标，但其效果在治疗停止后减弱。这些的局限性治疗表明，它们的组合可能会增强两者的功效。我们建议将适度导向的 CBT 与 NTX 结合起来治疗饮酒问题、艾滋病毒- 阳性和阴性 MSM，以评估其单独和组合的功效。我们还建议利用新的数据收集技术，交互式语音应答，收集人们日常关系的数据饮酒、性行为和心理变量被认为可以调节治疗反应。我们的目标目标是： 1) 使用主动和被动招募策略招募 240 名有饮酒问题的 MSM 样本； 2）评估 12 周随机分配治疗（联合 50 mg NTX 或安慰剂）的疗效采用改良的行为自我控制疗法或简短的支持疗法； 3）评估条件关系酗酒与艾滋病毒危险行为的可能性之间的关系； 4）评估情绪之间的日常关联，渴望、自我效能、动机和饮酒。评估将包括基线、3、6 和 9 个月的随访。该应用对于酗酒治疗和艾滋病毒预防具有极大的相关性。首先，我们将评估针对未充分研究但独特的人群的饮酒问题的既定治疗方法，即男同性恋者。其次，我们将在非常高的范围内研究以酒精为重点的治疗对艾滋病毒危险行为的影响。危险人群。第三，我们将使用新的数据收集技术来检查之间的复杂关系饮酒、艾滋病毒风险和心理因素，以便更好地为未来的干预措施提供信息。