Behavioral Disinhibition in Early-onset Alcoholism

早发性酒精中毒的行为去抑制

基本信息

批准号：
9107759
负责人：
PETER R FINN
金额：
$ 46.78万
依托单位：
TRUSTEES OF INDIANA UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2002
资助国家：
美国
起止时间：
2002-05-01 至 2019-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9107759
关键词：
Affect Alcohol consumption Alcohol dependence Antisocial Personality Disorder Attention Attention deficit hyperactivity disorder Avoidance Learning Behavioral Behavioral inhibition Clinical Clinical Trials Cognitive Computer Simulation Conduct Disorder Decision Making Development Dimensions Disinhibition Effectiveness Failure Foundations Frustration Funding Health Heavy Drinking Impulsivity Informal Social Control Intervention Learning Link Measures Mediating Methods Modeling Motor Personality Play Process Psychopathology Research Rewards Role Self-control as a personality trait Severities Short-Term Memory Signal Transduction Symptoms Techniques Training Training Programs alcohol use disorder anti social clinically relevant cognitive development cognitive load cognitive process design discounting drinking early onset early-onset alcoholism executive function high risk drinking indexing negative affect response therapy design therapy development trait

项目摘要

DESCRIPTION (provided by applicant): This competing continuation application follows-up on the major findings from our last five years of funding that showed that alcohol dependence (AD) with high levels of co-occurring antisocial psychopathology (AP) was consistently associated with higher levels of disinhibited impulsive decision making, risky decisions to drink, and reduced executive working memory capacity (eWMC) compared with those with alcohol use disorders (AUDs) with low levels of AP and co-occurring externalizing psychopathology (EXT). Furthermore, our results showed that reduced eWMC played a key role in the disinhibited, impulsive decision making in those with AD and high AP, and compromising eWMC via a cognitive load significantly increased impulsive decision making and risky decisions to drink to extreme levels in those with AD and high AP. This application proposes to further investigate the role / mechanisms of eWMC in impulsive decision-making in AD with high AP by systematically studying the effects (on impulsive decision making and risky drinking decisions) of manipulations designed (i) to deplete eWMC (via WM - cognitive load), (ii) offset the effects of WM load depletion (via an attentional shifting - refocus technique), and (iii) augment aspects of eWMC (via adaptive eWMC training). Although not a clinical trial, this study lays the foundation for the development of cognitive interventions designed to reduce impulsive decision making and behavioral disinhibition in AD with high AP. The first specific aim is to systematically study the effect of an attentional shifting - refocusing technique to offset the impact of a WM load on impulsive decision making and risky drinking decision making in those with AD and high AP compared with those with AUDs and low AP, and controls without any EXT. The second specific aim is to investigate the effects of an adaptive eWMC training program on 1. impulsive decision making/risky drinking decisions and alcohol consumption, 2. measures of eWMC, 3.other measures of executive function associated with attention (flanker/stroop) and motor inhibition, and 4. the effects of negative and positive affect/urgency on decision making. Computational models are used to identify key cognitive processes associated with disinhibited, impulsive decision making and eWMC that may be affected by cognitive load and the two training manipulations. The third specific aim is to investigate the personality, cognitive, subjective, and symptom-level predictors of the effectiveness of the attentional shifting - refocusing technique and eWMC training on decision making. This study has high clinical relevance and potential for clinical impact. The results of the study will have direct implications for the development and refinement of cognitive interventions to modify impulsive, risky decision making (a core vulnerability) in those with AD and EXT in general, and for understanding the factors that may predict the positive impact of these two interventions on impulsivity in those with AD and EXT in general.

描述（由申请人提供）：这种竞争性延续申请遵循我们过去五年的资金的主要发现，这些发现表明，与同时存在的反社会心理病理学（AP）相关的酒精依赖（AD）始终与较高的抑制性抑制性决策，较低的决策，与降低的级别的驾驶员（EW-EAP）相比，与较高的脉冲决策相关（EWMC）与较高的脉冲决策相关（EWMC）同时出现的外部化精神病理学（EXT）。此外，我们的结果表明，减少的EWMC在具有AD和高AP的人中的冲动，冲动性决策中起着关键作用，并且通过认知负荷损害了EWMC，从而显着增加了冲动决策，并在AD和AP高度高的人群中降低了危险的决策，以饮酒至极端水平。该申请建议通过系统地研究（对耗尽EWMC（通过WM -认知负载）耗尽设计的操纵（i），通过系统地研究（对脉冲决策和风险的饮酒决策），进一步研究EWMC在AD中的脉冲决策中的作用 /机制。 WM负载耗竭（通过注意力转移 - 重新聚焦技术）和（iii）EWMC的增强方面（通过自适应EWMC培训）。尽管不是临床试验，但这项研究奠定了旨在减少高度AD中脉冲决策和行为抑制的认知干预措施的基础。第一个具体目的是系统地研究注意力转移的效果 - 重新聚焦技术以抵消WM负载对脉冲决策做出的影响，而与AP和低AP的人相比，对AD和AP高的人的危险饮酒决策，以及没有任何EXT的对照。第二个具体目的是调查自适应EWMC培训计划对1的影响。冲动决策/风险的饮酒决策和饮酒，2。衡量EWMC的措施，3。执行功能的措施与注意力（Fallanker/Stroop）和运动抑制相关的措施，以及4。负面影响和积极影响对决策的影响。计算模型用于识别可能受认知负荷和两个训练操作影响的抑制，冲动决策和EWMC相关的关键认知过程。第三个具体目的是调查个性，认知，主观和症状级别的预测注意力转移的有效性 - 重新集中技术和EWMC对决策的培训。这项研究具有很高的临床相关性和潜在的临床影响。该研究的结果将直接影响认知干预措施的发展和完善，以修改AD和EXT的冲动性，风险的决策（核心脆弱性），并了解可能预测这两种干预措施对AD和EXT和EXT的冲动性的积极影响的因素。