Integrating Cognitive Neuroscience Toward Understanding of Mechanisms of CBT for Alcohol Use Disorders

整合认知神经科学以了解 CBT 治疗酒精使用障碍的机制

• 批准号: 10680572
• 负责人: BRIAN D. KILUK
• 金额: $ 14.3万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-20 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10680572
• 关键词: Acceleration; Achievement; Addictive Behavior; Affect; Affective; Alcohol consumption; Ambulatory Care; Area; Back; Behavior; Behavioral; Behavioral Mechanisms; Brain; Characteristics; Client; Clinical; Clinical Trials; Cognition; Cognitive; Cognitive Science; Cognitive Therapy; Collaborations; Computers; Coping Skills; Data; Development; Equipment and supply inventories; Evaluation; Evidence based intervention; Fostering; Functional Magnetic Resonance Imaging; Funding; Goals; Growth; Independent Scientist Award; Individual; Intervention; Interview; Knowledge; Link; Manuals; Measures; Mediating; Mediation; Mediator; Methods; Modeling; Monitor; Motivation; National Institute on Alcohol Abuse and Alcoholism; Neurocognitive; Neuropsychological Tests; Outcome; Play; Principal Investigator; Process; Randomized; Role; Testing; Therapeutic; Therapeutic Intervention; Training; Validation; Work; active method; addiction; alcohol use disorder; behavior change; career; career development; clinical practice; cognitive function; cognitive neuroscience; effective therapy; efficacy evaluation; executive function; follow-up; improved; incentive salience; indexing; medical schools; meetings; negative affect; neuroimaging; neuromechanism; novel; novel strategies; programs; randomized trial; reduced alcohol use; skill acquisition; skills; standard care; timeline; treatment as usual; treatment effect; trial design

PROJECT SUMMARY/ABSTRACT Cognitive Behavioral Therapy (CBT) is an established approach for alcohol use disorders (AUD), yet it is hindered by a number of obstacles to dissemination and effective implementation in clinical practice, which include a limited understanding regarding how it exerts its effects (i.e., mechanisms of behavior change). Improved understanding of mechanisms of behavior change could spur the development of novel interventions that amplify the effect of evidence-based interventions for AUD, potentially transforming addictions treatment and the way we conduct behavior change interventions more broadly. Recent developments in cognitive science and neuroscience hold great promise for accelerating the understanding of mechanisms of behavior change associated with CBT. The proposed Independent Scientist Award will foster Dr. Kiluk's career development in these areas to advance understanding of how CBT changes cognition, behavior, and the brain. The independent clinical trial to be conducted under this proposal (R01AA024122; PI – Kiluk) will evaluate the efficacy of a computer-delivered CBT (CBT4CBT) or clinician-delivered CBT in comparison to standard treatment as usual (TAU) at reducing alcohol use among 180 outpatient treatment seekers. Treatments will be delivered over the course of 8-weeks and will include a 6-month follow-up period to assess durability of treatment effects. Multiple behavioral, experiential, and cognitive measures will be used to develop a more complete understanding of the mechanistic processes by which CBT works to reduce alcohol use. The specific aims of the project are as follows: 1. Evaluate the efficacy of CBT4CBT or clinician-delivered CBT relative to TAU at reducing alcohol use through an 8-week randomized trial, with 6-month follow-up. We expect either form of CBT will be more effective than TAU at increasing the percentage of days abstinent (PDA) during treatment and follow-up. 2. Evaluate the extent to which CBT's putative mechanisms act as a mediator of treatment effect on reducing alcohol use in both forms of CBT relative to TAU. We expect indices reflecting the acquisition and implementation of skills will mediate the effect of CBT on alcohol use (i.e., PDA). This project directly links with Dr. Kiluk's career goals of incorporating cognitive neuroscience approaches to identify mechanisms of evidence-based interventions, with a focus on how CBT interventions affect change in functional domains of addiction such as executive function, negative affect, and incentive salience, consistent with NIAAA's Addictions Neurocognitive Assessment battery. Training in cognitive neuroscience and neuroimaging through collaboration with experts in these areas at Yale School of Medicine will facilitate achievement of these goals.

项目摘要/摘要 认知行为疗法（CBT）是一种既定的酒精使用障碍方法（AUD），但它是 受到许多障碍的阻碍 包括对其施加其效果的有限理解（即行为改变机制）。 对行为变化机制的理解有所改善可能促进新干预的发展 这扩大了基于证据的干预措施对AUD的影响，可能会改变成瘾治疗 以及我们进行行为改变干预措施的方式。认知科学的最新发展 神经科学对加速对行为改变机制的理解有很大的希望 与CBT相关。拟议的独立科学家奖将促进Kiluk博士的职业发展 这些领域以促进对CBT如何改变认知，行为和大脑的理解。独立 根据本提案（R01AA024122; PI - KERUK）进行的临床试验将评估A的效率 与往常 （tau）减少180名门诊治疗者的酒精使用。治疗将通过 8周的课程将包括6个月的随访期，以评估治疗效果的耐用性。多种的 行为，专家和认知措施将被用来对 CBT致力于减少酒精使用的机械过程。 该项目的具体目的如下： 1。评估CBT4CBT或通过临床交付的CBT相对于Tau的效率，以减少通过 为期8周的随机试验，随访了6个月。我们希望两种形式的CBT都比 在治疗和随访期间，tau增加了几天戒酒（PDA）的百分比。 2。评估CBT推定的机制作为减少治疗效应的介体的程度 相对于tau，两种形式的CBT使用酒精。我们期望反映收购的指数和 技能的实施将介导CBT对饮酒的影响（即PDA）。 该项目直接与Kiluk博士的职业目标联系在一起，以结合认知神经科学方法 确定基于证据的干预措施的机制，重点是CBT干预措施如何影响变化 成瘾的功能领域，例如执行功能，负面影响和激励性显着性，一致 随着NIAAA的添加，神经认知评估电池。认知神经科学和 通过与耶鲁大学医学院这些领域的专家合作进行神经影像学会将有助于 实现这些目标。

项目成果

Cognitive-Behavioral Interventions Targeting Alcohol or Other Drug Use and Co-Occurring Mental Health Disorders: A Meta-Analysis.

针对酒精或其他药物使用和同时发生的心理健康障碍的认知行为干预措施：荟萃分析。

• DOI: 10.1093/alcalc/agab016
• 发表时间: 2021
• 期刊: Alcohol and alcoholism (Oxford, Oxfordshire)
• 作者: Mehta,Kahini;Hoadley,Ariel;Ray,LaraA;Kiluk,BrianD;Carroll,KathleenM;Magill,Molly
• 通讯作者: Magill,Molly