Time Horizons and the Behavioral Economics of Recovery from Drinking Problems

饮酒问题恢复的时间范围和行为经济学

• 批准号: 7933528
• 负责人: JALIE A TUCKER
• 金额: $ 57.29万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-15 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7933528
• 关键词: Abstinence; Address; Alcohol abuse; Alcohols; Behavior; Behavior Control; Behavioral; Benchmarking; Clinical; Clinical Treatment; Communities; Dimensions; Economics; Effectiveness; Enrollment; Equilibrium; Evaluation; Expenditure; Foundations; Future; Goals; Heavy Drinking; Individual; Intervention; Knowledge; Measurement; Measures; Mediating; Methods; Outcome; Participant; Pathway interactions; Pattern; Persons; Population; Process; Prospective Studies; Public Health; Questionnaires; Recording of previous events; Recovery; Regulation; Relapse; Relative (related person); Research; Resolution; Rewards; Risk; Sampling; Savings; Services; Severities; Shapes; Time; Time Study; addiction; alcohol related problem; alcohol services; cost; design; discounting; drinking; experience; help-seeking behavior; improved; indexing; interest; outcome forecast; problem drinker; psychologic; public health relevance; research study; restraint; social

DESCRIPTION (provided by applicant): Persons with addictive disorders tend to favor discrete choices involving less valuable, more immediate options (e.g., drinking) over engaging in behavior patterns with delayed positive consequences that are more valuable overall and more conducive to recovery. Behavioral economics provides new concepts and methods to study how the "time horizons" of problem drinkers serve to organize their behavior around present vs. future goals and whether these choice processes serve as a mechanism of change in recovery. This 5-year R01 application will evaluate whether changes in time horizons are temporally related to changes in drinking in community- dwelling problem drinkers who recently stopped excessive drinking on their own (N = 265). Use of a natural recovery sample will maximize variability in dimensions of interest and will address unsettled issues about non- abstinent resolutions, which are more common among natural than treatment-assisted recoveries. Participants will be enrolled soon after resolution onset when initial changes are unstable and relapse risk is high. Drinking problem severity, help-seeking history, and behavioral economic and other measures of time-sensitivity to delayed outcomes will be assessed at baseline, and then time horizon and drinking variables will be assessed prospectively at 3, 6, 9, and 12-months. Three hypotheses will be addressed: (1) Even when drinking heavily, are problem drinkers with greater sensitivity to longer term contingencies more likely to maintain stable resolutions? (2) Do drinkers who maintain stable non-abstinent resolutions organize their behavioral allocation over longer intervals compared to those who remain abstinent or relapse? (3) Do changes in sensitivity to delayed contingencies predict subsequent changes in drinking, including ability to reach and maintain non- abstinent resolutions? The first two hypotheses replicate and extend previous research on stable abstinent and non-abstinent resolutions. The third hypothesis addresses whether changes in time horizons precede changes in drinking and will evaluate the time horizon construct as a potential mechanism of change. The study also will establish how the multiple time sensitivity measures inter-relate and change over time, which will inform method selection in clinical and public health settings. To our knowledge, the study offers the first longitudinal multivariate evaluation of whether changes in time horizons are temporally related to changes in drinking among recently resolved problem drinkers. In addition to elucidating mechanisms of change, the results have potential for increasing the appeal and population impact of services for alcohol problems. PUBLIC HEALTH RELEVANCE: The pathways, processes, and mechanisms of change by which problem drinkers resolve their alcohol-related problems will be investigated prospectively using a large, diverse community sample of problem drinkers who recently stopped excessive drinking on their own. Most problem drinkers do not seek help, many recover on their own, and studying natural recoveries has potential for increasing the appeal, effectiveness, and population impact of services for alcohol-related problems. The proposed research will focus on drinkers' "time horizons," or the extent to which they organize their behavior around present vs. future goals, because successful recoveries likely involve a shift from a shorter to a longer view of the future and organizing behavior accordingly.

描述（由申请人提供）：具有成瘾性疾病的人倾向于赞成离散的选择，涉及涉及价值较低，更直接的选择（例如，饮酒）而不是从事的行为模式，而行为模式延迟了积极的后果，这些后果更有价值，并且更有益于恢复。行为经济学提供了新的概念和方法来研究问题饮酒者的“时间范围”如何组织其行为围绕当前与未来目标，以及这些选择过程是否是恢复恢复的变化机制。该5年R01应用程序将评估时间范围的变化是否与社区住宅问题饮酒者的饮酒变化有关，他们最近停止了自己自行停止过度饮酒（n = 265）。使用自然恢复样本将最大程度地提高感兴趣维度的可变性，并将解决有关非戒烟决议的不安问题，这些问题在自然中比治疗辅助辅助回收率更为普遍。当初始更改不稳定并且复发风险很高时，分辨率发作后不久就会参加参与者。饮酒问题的严重程度，寻求帮助的历史以及对延迟结果的时间敏感性的行为经济和其他措施将在基准时进行评估，然后将在3、6、9和12个月的时间前瞻性评估时间范围和饮酒变量。将解决三个假设：（1）即使大量饮酒，对长期意外情况更敏感的问题饮酒者是否更有可能保持稳定的分辨率？ （2）与那些戒酒或复发的人相比，维持稳定的非卑鄙决议的饮酒者会在较长的时间间隔内组织其行为分配吗？ （3）对延迟意外事件的敏感性的变化是否可以预测随后的饮酒变化，包括能够达到和维持非戒律的分辨率？前两个假设复制并扩展了先前关于稳定避免和非庇护的决议的研究。第三个假设解决了时间范围的变化是否在饮酒的变化之前，并将时间范围构造评估为变化的潜在机制。这项研究还将确定多个时间敏感性如何随着时间的推移衡量相互关系和变化，这将为临床和公共卫生环境中的方法选择提供信息。据我们所知，该研究提供了第一个纵向多元评估，即时间范围的变化是否与最近解决的问题饮酒者之间的饮酒变化有关。除了阐明变化的机制外，结果还具有增加服务对酒精问题的吸引力和人口影响的潜力。公共卫生的相关性：使用大量的，多样化的问题饮酒者样本的饮酒者解决与酒精相关的问题的变化的途径，过程和机制，这些问题将被前瞻性地调查，他们最近停止了自己自行停止过量饮酒。大多数问题饮酒者都不寻求帮助，许多人自己康复，并且研究自然恢复有可能增加服务对酒精相关问题的吸引力，有效性和人口影响。拟议的研究将侧重于饮酒者的“时间范围”，或者他们围绕当前目标而组织其行为的程度，因为成功的恢复可能涉及从较短的变换转变为对未来和相应地组织行为的更长观点。