Quantifying Exposure to Illicit Drugs & Psychosocial Stress in Real Time

量化非法药物的暴露程度

• 批准号: 8553260
• 负责人: Kenzie Preston
• 金额: $ 150.98万
• 依托单位: NATIONAL INSTITUTE ON DRUG ABUSE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8553260
• 关键词: Algorithms; Ambulatory Monitoring; Baltimore; Behavior; Behavioral; Biological; Clinical; Cocaine; Data; Data Analyses; Development; Drug usage; Effectiveness; Electronics; Environment; Environmental Exposure; Event; Exposure to; Galvanic Skin Response; General Population; Genetic; Geographic Locations; Goals; Happiness; Heroin Abuse; Illicit Drugs; Intervention; Knowledge; Laboratory Procedures; Location; Measures; Methods; Nature; Neighborhoods; Noise; Outpatients; Participant; Patient Self-Report; Pharmaceutical Preparations; Physiological; Positioning Attribute; Psychosocial Stress; Publications; Records; Reporting; Research Personnel; Resolution; Respiration; Signal Transduction; Social Sciences; Specimen; Stress; System; Time; Training; Urine; Workplace; addiction; diaries; drug craving; environmental intervention; heart rate variability; interest; meter; response; trait

Assessment of exposure to drug use and psychosocial stress is complicated by the fact that each is often transient and difficult to recall accurately. Assessment of their causal connections with one another, and of their genetic and environmental determinants, is complicated by the complexity of the causal connections and by the elusive nature of what constitutes the environment. In this project, we are assessing drug use and psychosocial stress in near-real time through Ecological Momentary Assessment (EMA), in which participants use handheld electronic diaries to record events as they occur and to report recent or ongoing events in response to randomly timed prompts throughout the day. We are also maintaining real-time records of where the reported events occur by having participants carry Global Positioning System (GPS) loggers to track their whereabouts with a spatial resolution of several meters. We use these data collectively in a method we are calling Geographical Momentary Assessment (GMA). Our goal with GMA has little to do with knowing the specific Baltimore locations where drug-related behaviors occur, and everything to do with gaining generalizable knowledge about how activity spaces (the spaces in which daily activities occur) are associated with such behaviors and their precipitants. To that end, we score neighborhood environments in terms of objective statistical data andmore innovativelyin terms of objective ratings by trained observers. For many addiction researchers, such as behavioral geneticists and pharmacological clinical trialists, these environmental measures will constitute noise to be controlled for, so the benefit of GMA to them will be to help isolate the biological measures of interest. For addiction researchers with a social-science focus, the environmental measures will be signal rather than noise, so the benefit of GMA will be to make a case for environmental interventions and to provide a rigorous way of assessing the interventions implementation and effectiveness. To increase the objectivity of our field methods, we have added ambulatory monitoring of physiological functions such as respiration, heart-rate variability, and galvanic skin response. Our goals for these measures include the development of algorithms that can automatically detect behavioral events (such as episodes of drug use or stress) without requiring self-report. To help validate our field methods, we are collecting thrice-weekly urine specimens from all our participants and assessing their trait stress reactivity through standardized laboratory procedures. Our six publications from this set of projects have all used data from the first such project we completed, which was an EMA study that did not incorporate GPS. In the most recent of those publications, we showed that our cocaine- and heroin-abusing outpatients reported less stress and greater happiness (and less drug craving) at the workplace than in any other setting. This was a surprising result, precisely opposite to what has been reliably found in the general population. We do not facilely draw causal conclusions from this non-experimental finding, but we do conclude that experimental interventions are warranted. We continue to analyze data from our first EMA study, but our focus is on completing a larger study that incorporates GPS along with additional EMA measures of stress.

吸毒暴露和社会心理压力的评估很复杂，因为它们往往是短暂的且难以准确回忆。由于因果关系的复杂性和环境构成的难以捉摸的性质，对它们之间的因果关系以及它们的遗传和环境决定因素的评估变得复杂。 在这个项目中，我们通过生态瞬时评估（EMA）近乎实时地评估药物使用和社会心理压力，其中参与者使用手持式电子日记记录发生的事件，并报告最近或正在进行的事件以响应随机定时的事件。全天提示。我们还通过让参与者携带全球定位系统 (GPS) 记录器以几米的空间分辨率跟踪他们的行踪，来维护所报告事件发生地点的实时记录。我们在称为地理瞬时评估 (GMA) 的方法中集体使用这些数据。我们 GMA 的目标与了解发生毒品相关行为的巴尔的摩的具体地点无关，而与获得关于活动空间（发生日常活动的空间）如何与此类行为及其诱因相关的一般性知识有关。为此，我们根据客观统计数据以及更创新的方式根据训练有素的观察员的客观评级对邻里环境进行评分。对于许多成瘾研究人员，例如行为遗传学家和药理学临床试验人员来说，这些环境措施将构成需要控制的噪音，因此 GMA 对他们的好处将是帮助分离出感兴趣的生物措施。对于关注社会科学的成瘾研究人员来说，环境措施将是信号而不是噪音，因此 GMA 的好处将是为环境干预提供理由，并提供严格的方法来评估干预措施的实施和有效性。 为了提高现场方法的客观性，我们增加了对呼吸、心率变异性和皮肤电反应等生理功能的动态监测。我们对这些措施的目标包括开发可以自动检测行为事件（例如吸毒或压力事件）而无需自我报告的算法。 为了帮助验证我们的现场方法，我们每周三次从所有参与者那里收集尿液样本，并通过标准化实验室程序评估他们的性状应激反应性。 我们这组项目的六篇出版物均使用了我们完成的第一个此类项目的数据，该项目是一项未纳入 GPS 的 EMA 研究。在最近的这些出版物中，我们表明，与其他任何环境相比，滥用可卡因和海洛因的门诊患者在工作场所的压力更小，幸福感更高（以及对毒品的渴望更少）。这是一个令人惊讶的结果，与在普通人群中可靠发现的结果完全相反。我们不会轻易地从这一非实验发现中得出因果结论，但我们确实得出结论，实验干预是有必要的。我们继续分析第一个 EMA 研究的数据，但我们的重点是完成一项更大规模的研究，其中包含 GPS 以及其他 EMA 压力测量方法。