Recovery & Help-Seeking Processes in Problem Drinkers

恢复

基本信息

批准号：
7853741
负责人：
JALIE A TUCKER
金额：
$ 16.53万
依托单位：
UNIVERSITY OF ALABAMA AT BIRMINGHAM
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-07-20 至 2011-02-28
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7853741
关键词：
Address Alcohol abuse Alcohols Behavior Behavioral Communities Community Services Control Groups Data Drug abuse Economics Equation Event Expenditure Eye Feedback Health Illicit Drugs Individual Intervention Interview Knowledge Lead Life Measures Mediating Mediation Mediator of activation protein Modeling Monitor Nicotine Outcome Participant Pattern Population Process Public Health Randomized Recovery Recruitment Activity Relative (related person)Research Research Support Resolution Resource Allocation Rewards Savings Substance Use Disorder System Testing Time TimeLine Voice Work base brief motivational intervention community based service community setting computerized cost discount discounting drinking economic behavior experience group intervention help-seeking behavior indexing intervention effect motivational enhancement therapy preference problem drinker programs public health priorities response substance abuser theories

项目摘要

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）：此修订后的竞争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的解决工作。该研究以行为经济学为指导，为理解物质使用障碍提供了一个强大的框架，其特点是对短期奖励（即饮酒）的持续偏好，从而导致长期成本，以及延迟的贬值。支持积极功能的替代方案。行为经济学理论和研究支持新的匹配假设，该假设基于对问题饮酒者组织行为的时间间隔的测量。药物滥用者倾向于贬低或“折扣”延迟奖励，但那些在较长“时间范围”内组织行为的人更有可能康复，而延长时间范围可能会增强积极的结果。因此，时间范围变量可能对自然恢复和干预辅助恢复尝试具有调节和中介作用。两种适合在社区环境中使用的干预措施，动机访谈（Ml）和扩展自我监控（SM），似乎可以通过将行为分配从饮酒转向延迟的非饮酒奖励来减少饮酒问题。但它们的应用时间范围不同，这可能与时间范围变量相互作用，使得时间范围较短的饮酒者可能从 Ml 中受益最多，然后是延长的 SM。拟议的研究将使用最近戒烟或正在考虑戒烟的未经治疗的问题饮酒者（N = 330）来评估这些假设。他们将被随机分配到 3 组中的一组 (n = 110) (自然消退对照，仅 M1，或 M1 加 SM 6 个月)，并将随访 2 年。结构方程模型将用于评估调节和中介假设。对这些假设的支持将为基于行为经济变量的匹配提供新的基础，这些变量与 MATCH 项目中研究的变量不同，并将增进对这些已建立但知之甚少的干预措施的作用机制的了解。对这些问题进行调查，着眼于为大多数服务不足的问题饮酒者开发有吸引力的社区服务，解决了公共卫生的优先事项，因为这一人群造成了饮酒问题的大部分危害和成本。拟议的研究适当地模拟了“开放经济”，其中饮酒问题得到发展、维持，并且必须得到解决。