Behavioral Activation to Reduce Problem Alcohol Use in College Students with ADHD

行为激活可减少多动症大学生的饮酒问题

• 批准号: 9333077
• 负责人: ANDREA CHRONIS-TUSCANO
• 金额: $ 37.6万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-20 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9333077
• 关键词: Accountability; Address; Affect; Age; Alcohol abuse; Alcohol consumption; Attention deficit hyperactivity disorder; Behavior; Behavior Therapy; Behavioral; Characteristics; Collaborations; Comorbidity; Counseling; Data; Dependence; Development; Disease; Drug Compounding; Drug abuse; Drug usage; Ensure; Environment; Executive Dysfunction; Feasibility Studies; Feedback; Focus Groups; Future; General Population; Goals; Heavy Drinking; Hyperactive behavior; Impulsivity; Individual; Informal Social Control; Intention; Intervention; Intervention Studies; Life; Life Style; Manuals; Mental Depression; Methodology; Modification; Mood Disorders; Motivation; Outcome; Participant; Pattern; Pilot Projects; Population; Population Intervention; Populations at Risk; Prevention trial; Procedures; Process; Psychosocial Assessment and Care; Publishing; Randomized; Randomized Controlled Trials; Research; Rewards; Risk Behaviors; Services; Social Functioning; Structure; Students; Supervision; Testing; Time; Training; Universities; Vulnerable Populations; Wolves; alcohol abuse prevention; alcohol availability; alcohol intervention; alcohol related problem; associated symptom; base; behavior change; clinically relevant; college; design; disability; drinking; drinking behavior; experience; high risk population; improved; improved outcome; inattention; mood symptom; negative affect; novel; peer; psychosocial; public health relevance; therapy development; university student

DESCRIPTION (provided by applicant): College students with Attention-Deficit/Hyperactivity Disorder (ADHD) are particularly vulnerable to problematic alcohol use, given their developmentally-inappropriate levels of inattention, hyperactivity and impulsivity, combined with the lifestyle associated with life on a college campus (including increased access to alcohol, decreased structure and parental supervision). Our prior research demonstrates elevated rates of alcohol- related problems and disorders (AUDs) among college students with ADHD; 47% of college students with ADHD meet lifetime criteria for alcohol abuse and 23% meet criteria for dependence, as compared to 12% and 6% of college students from the general population, respectively. There are currently no published randomized controlled studies examining psychosocial interventions for college students with ADHD, and none specifically targeting AUDs in this population at any age, despite the clear indication from emerging research of the need for such interventions. Moreover, brief motivation-based alcohol interventions (BMIs) that generally have been successful for college students show limited benefits among individuals with elevated impulsivity and poor self- regulation, both hallmarks of ADHD, calling for the need to modify BMIs for this vulnerable group. Thus, it is crucial to determine core treatment components that are efficacious for treating AUDs and that are developmentally-appropriate for college students with ADHD and designed in a manner which promotes transportability to the university counseling center setting. Behavioral activation (BA) is a brief behavioral approach that aims to increase individuals' contact with valued environments through systematic efforts to increase rewarding experiences, enjoyment of daily activities, and goal-directed behaviors. We have successfully applied BA to substance users in a range of settings, including college students with problematic drinking patterns. Importantly, BA has clear relevance for addressing ADHD-related executive functioning deficits, which may be associated with an increased propensity for engagement in problematic alcohol use. Further, BA teaches individuals to engage in healthy, goal-directed rewarding behaviors, rather than relying on drinking to provide immediate rewards. Finally, BA is a highly adaptable intervention approach. In the current study, we will develop a BA-based treatment intended to reduce problematic drinking behaviors among college students with ADHD. This treatment will be developed in collaboration with the University Counseling Center, to ensure its applicability within this setting, utilizing focus grou methodology with Center staff. Finalized treatment manuals, altered based on focus group feedback, will be tested in a stage I RCT among 80 college students randomized to 3 sessions of BMI + BA or BMI + supportive counseling (SC). We expect that BMI + BA will be successful with college students with ADHD, in terms of decreasing the escalation of problematic alcohol use behaviors, as compared to BMI + SC. This treatment development study will set the stage for larger-scale RCTs (R01).

描述（由申请人提供）：注意力缺陷/多动症障碍（ADHD）的大学生特别容易受到有问题的饮酒，因为他们的发育不合适的不合适，多动症和冲动性以及与大学校园的生活方式相关联（包括增加酒精，减少酒精，结构和养生监督）的生活方式。我们先前的研究表明，ADHD的大学生中与酒精有关的问题和疾病（AUD）的率升高；有47％的多动症的大学生符合滥用酒精的终身标准，而23％的大学生符合依赖的标准，而普通人群分别为12％和6％的大学生。目前，尚无对ADHD的大学生进行心理心理干预的随机对照研究，尽管有明确的研究表明需要进行此类干预措施，但在任何年龄段的人群中都没有专门针对该人群的AUDS。此外，对于大学生来说，基于简短的基于动机的酒精干预措施（BMI）表现出有限的冲动性和自我调节不良的人的好处，这两种ADHD的标志都呼吁为这个脆弱的群体修改BMIS。因此，确定有效治疗AUDS的核心治疗组件至关重要，这些组件适合ADHD的大学生，并以促进向大学咨询中心环境的可运输性进行设计。行为激活（BA）是一种简短的行为方法，旨在通过系统的努力来增加奖励体验，日常活动和目标指导行为，以增加个人与有价值的环境的接触。我们已成功地将BA应用于各种设置的药物使用者，包括饮酒方式有问题的大学生。重要的是，BA在解决与ADHD相关的执行功能缺陷方面具有明确的相关性，这可能与增加有问题的饮酒倾向有关。此外，BA教会个人从事健康，目标指导的有益行为，而不是依靠喝酒来提供即时奖励。最后，BA是一种高度适应性的干预方法。在当前的研究中，我们将开发一种基于BA的治疗方法，旨在减少ADHD大学生中有问题的饮酒行为。这种治疗方法将与大学咨询中心合作开发，以确保其在这种情况下的适用性，并利用与中心工作人员的Focus Grou方法。根据焦点小组的反馈更改的最终确定治疗手册将在80阶段的I阶段在80阶段的大学生中进行测试，以随机分为BMI + BA或BMI + BMI +支持性咨询（SC）的3次会议。与BMI + SC相比，我们预计BMI + BA将在有问题的饮酒行为升级的情况下成功地与ADHD的大学生一起成功。这项治疗开发研究将为大型RCT奠定阶段（R01）。