Department of Health Education and Behavior, University of Florida, Gainesville, Florida.
Yale School of Medicine, New Haven, Connecticut.
Alcohol Clin Exp Res. 2018 Apr;42(4):803-814. doi: 10.1111/acer.13613. Epub 2018 Mar 12.
Young adult heavy drinking is an important public health concern. Current interventions have efficacy but with only modest effects, and thus, novel interventions are needed. In prior studies, heavy drinkers, including young adults, have demonstrated stronger automatically triggered approach tendencies to alcohol-related stimuli than lighter drinkers. Automatic action tendency retraining has been developed to correct this tendency and consequently reduce alcohol consumption. This study is the first to test multiple iterations of automatic action tendency retraining, followed by laboratory alcohol self-administration.
A total of 72 nontreatment-seeking, heavy drinking young adults ages 21 to 25 were randomized to automatic action tendency retraining or a control condition (i.e., "sham training"). Of these, 69 (54% male) completed 4 iterations of retraining or the control condition over 5 days with an alcohol drinking session on Day 5. Self-administration was conducted according to a human laboratory paradigm designed to model individual differences in impaired control (i.e., difficulty adhering to limits on alcohol consumption).
Automatic action tendency retraining was not associated with greater reduction in alcohol approach tendency or less alcohol self-administration than the control condition. The laboratory paradigm was probably sufficiently sensitive to detect an effect of an experimental manipulation given the range of self-administration behavior observed, both in terms of number of alcoholic and nonalcoholic drinks and measures of drinking topography.
Automatic action tendency retraining was ineffective among heavy drinking young adults without motivation to change their drinking. Details of the retraining procedure may have contributed to the lack of a significant effect. Despite null primary findings, the impaired control laboratory paradigm is a valid laboratory-based measure of young adult alcohol consumption that provides the opportunity to observe drinking topography and self-administration of nonalcoholic beverages (i.e., protective behavioral strategies directly related to alcohol use).
青年期重度饮酒是一个重要的公共卫生关注点。目前的干预措施虽然有效,但效果有限,因此需要新的干预措施。在之前的研究中,重度饮酒者,包括青年期重度饮酒者,对酒精相关刺激表现出比轻度饮酒者更强的自动触发趋近倾向。自动行为倾向矫正已被开发出来以纠正这种倾向,从而减少饮酒量。这项研究首次测试了多次自动行为倾向矫正迭代,然后进行实验室酒精自我给药。
共有 72 名未接受治疗的、重度饮酒的年轻成年人(年龄 21 至 25 岁)被随机分配到自动行为倾向矫正组或对照组(即“假训练”)。其中,69 人(54%为男性)完成了 5 天内 4 次的矫正或对照训练,第 5 天进行了饮酒试验。自我给药是根据一个人类实验室范式进行的,旨在模拟个体在受损控制(即难以遵守饮酒量限制)方面的差异。
与对照组相比,自动行为倾向矫正并没有导致酒精趋近倾向的更大减少或更少的酒精自我给药。鉴于观察到的自我给药行为范围,包括饮酒量和饮酒方式的测量,实验室范式可能足够敏感,能够检测到实验操作的影响。
在没有改变饮酒习惯动机的情况下,自动行为倾向矫正对重度饮酒的年轻人无效。矫正程序的细节可能是导致缺乏显著效果的原因之一。尽管主要发现为阴性,但受损控制实验室范式是一种有效的基于实验室的年轻成年人饮酒测量方法,它提供了观察饮酒方式和非酒精饮料自我给药(即与酒精使用直接相关的保护性行为策略)的机会。