Recovery & Help-Seeking Processes in Problem Drinkers

恢复

• 批准号: 7343262
• 负责人: JALIE A TUCKER
• 金额: $ 48.1万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 1992
• 资助国家: 美国
• 起止时间: 1992-09-01 至 2010-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7343262
• 关键词: Address; Alcohol abuse; Alcohols; Behavior; Behavioral; Communities; Community Services; Condition; Control Groups; Data; Drug abuse; Economics; Effectiveness of Interventions; Equation; Event; Expenditure; Eye; Feedback; Health; Health Priorities; Illicit Drugs; Individual; Intervention; Interview; Knowledge; Lead; Life; Measures; Mediating; Mediation; Mediator of activation protein; Modeling; Monitor; Nicotine; Outcome; Participant; Pattern; Personal Satisfaction; Population; Process; Public Health; Randomized; Rate; Recovery; Recruitment Activity; Relative (related person); Research; Research Support; Resolution; Resource Allocation; Rewards; Savings; Substance Use Disorder; System; Testing; Time; TimeLine; Voice; Work; base; community based service; computerized; cost; discount; discounting; drinking; economic behavior; experience; help-seeking behavior; indexing; motivational enhancement therapy; motivational intervention; preference; problem drinker; programs; response; substance abuser; theories

DESCRIPTION (provided by applicant): This revised competing renewal application continues research aimed at understanding resolution processes in problem drinkers and promoting resolution efforts in the community. The research is guided by behavioral economics, which provides a powerful framework for understanding substance use disorders, the hallmark of which is a persistent preference for short-term rewards (i.e., drinking) that lead to long-term costs, and a devaluation of delayed alternatives that support positive functioning. Behavioral economic theory and research support new matching hypotheses based on measures of the temporal intervals over which problem drinkers organize their behavior. Substance abusers tend to devalue or "discount" delayed rewards, but those who organize their behavior over longer "time horizons" are more likely to recover, and lengthening time horizons may enhance positive outcomes. The time horizon variable thus may have moderating and mediating effects on natural and intervention-assisted recovery attempts. Two interventions suitable for use in community settings, motivational interviewing (Ml) and extended self-monitoring (SM), appear to reduce problem drinking by shifting behavior allocation away from drinking and toward delayed, non-drinking rewards. But they differ in their timeframe of application, and this may interact with the time horizon variable, such that drinkers with shorter time horizons may benefit most from Ml followed by extended SM. The proposed study will evaluate these hypotheses using untreated problem drinkers (N = 330) who have quit recently or are considering quitting. They will be randomly assigned to 1 of 3 groups (n = 110) (natural resolution control, Ml only, or Ml plus SM for 6 months) and will be followed for 2 years. Structural equation modeling will be used to evaluate the moderation and mediation hypotheses. Support for the hypotheses will yield a new basis for matching based on behavior economic variables that differ than those studied in Project MATCH and will advance knowledge about mechanisms of action of these established but poorly understood interventions. Investigating these questions with an eye toward developing appealing community services for the under-served majority of problem drinkers addresses a public health priority, since this population segment contributes the bulk of harm and cost of drinking problems. The proposed research appropriately models an "open economy" in which drinking problems are developed, maintained, and must be resolved.

描述（由申请人提供）：此修订的竞争性更新申请继续进行研究，旨在了解问题饮酒者的解决过程并促进社区中的解决方案。这项研究以行为经济学为指导，该行为经济学为理解物质使用障碍提供了有力的框架，其标志是对短期奖励（即饮酒）的持续偏爱，导致长期成本，以及支持支持积极功能的延迟替代方案的贬值。行为经济理论和研究支持了基于问题饮酒者组织行为的时间间隔的度量的新匹配假设。滥用药物倾向于贬值或“打折”延迟奖励，但是那些在更长的“时间范围”中组织其行为的人更有可能恢复，而延长时间范围可能会增强积极的结果。 因此，时间范围的变量可能会对自然和干预辅助恢复尝试的调节和中介作用。两种适合在社区环境中使用的干预措施，动机访谈（ML）和扩展的自我监控（SM）似乎通过将行为分配转移到饮酒转移到延迟，不喝酒的奖励来减少问题。但是它们在应用的时间范围上有所不同，这可能与时间范围变量相互作用，因此，时间范围较短的饮酒者可能会从ML中受益最大，然后是扩展SM。拟议的研究将使用最近退出或正在考虑退出的未经处理的问题饮酒者（n = 330）评估这些假设。它们将被随机分为3组中的1个（n = 110）（自然分辨率控制，仅ML或ML加SM 6个月），并将遵循2年。结构方程模型将用于评估适度和中介假设。对假设的支持将基于与项目匹配中研究的经济变量不同的行为经济变量产生新的匹配基础，并将促进有关这些已建立但知之甚少的干预措施的行动机制的知识。调查这些问题是为了为服务不足的大多数问题饮酒者开发吸引人的社区服务，以解决公共卫生的重点，因为该人口领域造成了损害和饮酒问题的大部分危害和成本。拟议的研究适当地模拟了一种“开放经济”，其中制定，维持饮酒问题并必须解决。