Changing impulsivity with mindful breathing therapy to reduce problem drinking

通过正念呼吸疗法改变冲动，减少饮酒问题

基本信息

批准号：
8702417
负责人：
KEVIN W CHEN
金额：
$ 33.22万
依托单位：
UNIVERSITY OF MARYLAND BALTIMORE
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-25 至 2016-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8702417
关键词：
Address Affect Alcohol abuse Alcohol consumption Alcohol or Other Drugs use Alcohols Anxiety Area Awareness Behavior Behavior Therapy Behavioral Breathing Clinical Counseling Development Dimensions Elements Emotions Frequencies Future Heavy Drinking Impairment Impulsive Behavior Impulsivity Individual Intervention Learning Life Link Manuals Measures Mediating Mediator of activation protein Mental Depression Modeling Muscle relaxation phase Outcome Outcome Measure Participant Patient Self-Report Pattern Personality Personality Development Personality Traits Pharmaceutical Preparations Phase Pilot Projects Problem behavior Public Health Quality of life Randomized Controlled Trials Reaction Relapse Research Resistance Risk Risk Behaviors Risk Factors Role Sampling Self Destructive Behavior Solutions Staging Stress Students Symptoms Techniques Testing Therapeutic Effect Thinking Training Work Youth alcohol related problem base clinical effect college college drinker college drinking college student alcohol abuse dosage drinking drinking behavior effective therapy experience follow-up innovation interest mindfulness mindfulness meditation novel novel strategies open label problem drinker programs psychologic psychological orientation public health relevance response screening social stigma sound student drinker therapy development trait trial comparing university student

项目摘要

DESCRIPTION (provided by applicant): An efficacious strategy for addressing problem substance use among college student drinkers is to target core risk factors. Arguably one of the most clearly documented risk factors for problem drinking among college students is impulsivity, with the relationship holding across various dimensions of impulsivity. Available evidence supports the importance of intervening with impulsivity to limit problem drinking among college students, but there are few proven treatments for any dimension of impulsivity. This notable lack may be due to the traditional view of impulsivity as an unchangeable personality trait. However, recent research suggests personality can change and is sensitive to behavior manipulation. As a result there is clear need for novel approaches targeted at core changes in the individual and their behavior patterns. Mindfulness meditation (MM) is a unique option in this direction as MM is especially useful in reducing impulsive behaviors including problem drinking, but its exact role in affecting different dimensions of impulsivity and in effecting change in problem drinking has yet to be explored. Based on evidence from recent studies, as well as our own pilot work, we hypothesize that one of the mechanisms by which MM reduces problem drinking among college students is by lessening impulsivity - moreover, the focus on changing college student problem drinking is done without any explicit focus on drinking behavior itself. The specific aims of this Stage 1 therapy development study are to: 1) modify and further develop a breathing-based mindfulness therapy (BBMT) for reducing impulsivity and problem drinking among college youth; 2) investigate the feasibility and preliminary efficacy of applying BBMT for reducing problem drinking with a pilot randomized controlled trial (RCT); 3) examine changes in impulsivity, as measured by both behavioral and self-report assessments, as one of possible mediators in the observed effect of BBMT on problem drinking. These aims will be achieved in two phases. In Phase 1 we will expand and fully develop the existing BBMT program with manuals to determine the effective treatment dosage for both problem drinking and impulsivity in an open label trial (n = 10). Using the modified treatment materials from Phase 1, in Phase 2 we will conduct a RCT comparing the effects of modified BBMT to a Supportive Counseling + Progressive Muscle Relaxation (SC + PMR) control condition (n = 36 each) on problem drinking, assessed at baseline, weeks 4 and 8, and a 3-month follow-up. Other potential mediators such as perceived stress and anxiety also will be examined in the final model. This study has great implications for reaching student drinkers who are less willing to acknowledge their drinking problems since it addresses core vulnerability (impulsivity) among at-risk students in a manner that limits stigma and may reduce resistance to change. A diverse team experienced in mindfulness, impulsivity and behavior therapy development has been assembled to conduct the proposed R34 project and prepare for a full therapy development study in the future.

描述（由申请人提供）：解决大学生饮酒者物质使用问题的有效策略是针对核心风险因素。可以说，大学生饮酒问题最明确的风险因素之一是冲动，这种关系贯穿于冲动的各个方面。现有证据支持干预冲动以限制大学生饮酒问题的重要性，但针对任何方面的冲动，几乎没有经过验证的治疗方法。这种显着的缺乏可能是由于传统观点认为冲动是一种不可改变的人格特质。然而，最近的研究表明，性格是可以改变的，并且对行为操纵很敏感。因此，显然需要针对个人及其行为模式的核心变化的新方法。正念冥想 (MM) 是这个方向上的一个独特选择，因为 MM 在减少冲动行为（包括酗酒）方面特别有用，但其确切作用影响不同维度的冲动以及影响饮酒问题的改变还有待探索。根据最近研究的证据以及我们自己的试点工作，我们假设 MM 减少大学生饮酒问题的机制之一是减少冲动——而且，改变大学生饮酒问题的重点是在没有任何帮助的情况下完成的。明确关注饮酒行为本身。第一阶段治疗开发研究的具体目标是：1）修改并进一步开发基于呼吸的正念疗法（BBMT），以减少大学生的冲动和酗酒问题； 2) 通过随机对照试验（RCT）研究应用 BBMT 减少饮酒问题的可行性和初步效果； 3）检查冲动的变化，通过行为和自我报告评估来衡量，作为观察到的 BBMT 对问题饮酒的影响的可能中介之一。这些目标将分两个阶段实现。在第一阶段，我们将扩展并全面开发现有的 BBMT 计划，并附有手册，以确定在开放标签试验（n = 10）中针对饮酒问题和冲动的有效治疗剂量。使用第一阶段改进的治疗材料，在第二阶段，我们将进行一项随机对照试验，比较改进的 BBMT 与支持性咨询 + 渐进式肌肉放松 (SC + PMR) 控制条件（各 n = 36）对饮酒问题的影响，评估时间为基线、第 4 周和第 8 周以及 3 个月的随访。其他潜在的中介因素，例如感知压力和焦虑，也将在最终模型中进行检查。这项研究对于接触那些不太愿意承认自己饮酒问题的学生饮酒者具有重大意义，因为它以限制耻辱并可能减少对变革的抵制的方式解决了高危学生的核心脆弱性（冲动）。一支在正念、冲动和行为疗法开发方面经验丰富的多元化团队已经组建起来，以开展拟议的 R34 项目，并为未来的全面治疗开发研究做好准备。