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）：患有注意力缺陷/多动症（ADHD）的大学生特别容易出现酗酒问题，因为他们的注意力不集中、多动和冲动的程度与发育不相适应，再加上与大学生活相关的生活方式校园（包括增加获取酒精的机会、减少结构和家长监督）。我们之前的研究表明，患有 ADHD 的大学生中与酒精相关的问题和障碍 (AUD) 的比例较高； 47% 患有 ADHD 的大学生符合终生酗酒标准，23% 符合酒精依赖标准，而普通人群中这一比例分别为 12% 和 6%。目前还没有发表的随机对照研究对患有多动症的大学生进行心理社会干预，也没有专门针对该人群任何年龄段的 AUD，尽管新兴研究明确表明需要进行此类干预。此外，对大学生普遍有效的短暂的基于动机的酒精干预（BMI）显示，对于冲动性高和自我调节能力差的个体来说，效果有限，这两者都是多动症的标志，因此需要针对这一弱势群体修改BMI。因此，确定对治疗 AUD 有效、适合患有 ADHD 的大学生的发展并以促进可转移到大学咨询中心环境的方式设计的核心治疗成分至关重要。行为激活（BA）是一种简短的行为方法，旨在通过系统性的努力来增加奖励体验、日常活动的享受和目标导向的行为，从而增加个人与有价值的环境的接触。我们已成功地将 BA 应用于各种环境中的物质使用者，包括有饮酒习惯问题的大学生。重要的是，BA 对于解决 ADHD 相关的执行功能缺陷具有明显的相关性，这可能与有问题的饮酒倾向增加有关。此外，BA 教导个人进行健康的、有目标的奖励行为，而不是依靠饮酒来提供即时奖励。最后，BA是一种适应性很强的干预方法。在当前的研究中，我们将开发一种基于文学学士的治疗方法，旨在减少患有多动症的大学生中存在问题的饮酒行为。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，并与中心工作人员一起利用焦点小组方法。根据焦点小组反馈进行修改的最终治疗手册将在 I 期随机对照试验中进行测试，其中 80 名大学生被随机分配到 3 次 BMI + BA 或 BMI + 支持咨询 (SC) 课程。我们预计，与 BMI + SC 相比，BMI + BA 将在减少有问题的饮酒行为的升级方面对患有 ADHD 的大学生取得成功。这项治疗开发研究将为更大规模的随机对照试验 (R01) 奠定基础。