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）：这项竞争性延续申请对我们过去五年的资助的主要发现进行了跟进，该发现表明，酒精依赖（AD）与高水平同时发生的反社会精神病理学（AP）始终与较高的风险相关。与具有低水平 AP 和同时发生的外化精神病理学的酒精使用障碍 (AUD) 患者相比，抑制性冲动决策、饮酒的危险决定和执行工作记忆能力 (eWMC) 降低（外）。此外，我们的结果表明，减少的 eWMC 在 AD 和高 AP 患者的去抑制、冲动决策中发挥了关键作用，并且通过认知负荷损害 eWMC 显着增加了患有 AD 和高 AP 患者的冲动决策和危险决策，以饮酒至极端水平。 AD和高AP。本申请建议通过系统地研究旨在 (i) 消耗 eWMC（通过 WM -认知负荷），（ii）抵消 WM 负荷消耗（通过注意力转移 - 重新聚焦技术），以及 (iii) 增强 eWMC 的各个方面（通过自适应 eWMC 训练）。虽然不是临床试验，但这项研究为认知干预措施的开发奠定了基础，该干预措施旨在减少高 AP 患者的冲动决策和行为去抑制。第一个具体目标是系统地研究注意力转移 - 重新聚焦技术的效果，以抵消 WM 负荷对 AD 和高 AP 患者的冲动决策和危险饮酒决策的影响，与 AUD 和低 AP 患者相比，并无需任何 EXT 即可进行控制。第二个具体目标是调查适应性 eWMC 培训计划对 1. 冲动决策/危险饮酒决定和饮酒的影响，2. eWMC 测量，3. 与注意力相关的执行功能的其他测量（侧卫/斯特鲁普）和运动抑制，以及 4. 消极和积极的情感/紧迫性对决策的影响。计算模型用于识别与去抑制、冲动决策和 eWMC 相关的关键认知过程，这些过程可能受到认知负荷和两种训练操作的影响。第三个具体目标是调查人格、认知、主观和注意力转移-重新聚焦技术和 eWMC 决策培训有效性的症状水平预测因素。这项研究具有高度的临床相关性和潜在的临床影响。这项研究的结果将对认知干预措施的开发和完善产生直接影响，以改变 AD 和 EXT 患者的冲动、冒险决策（核心脆弱性），并了解可能预测积极影响的因素。这两种干预措施总体上对 AD 和 EXT 患者的冲动性有影响。