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对成年早期个体的酒精需求和与酒精相关的强化作用进行纵向研究,以预测其重度饮酒和不良饮酒后果。

Longitudinal examination of alcohol demand and alcohol-related reinforcement as predictors of heavy drinking and adverse alcohol consequences in emerging adults.

机构信息

Peter Boris Centre for Addictions Research, St. Joseph's Healthcare Hamilton and McMaster University, Hamilton, Ontario, Canada.

Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.

出版信息

Addiction. 2024 Jun;119(6):1090-1099. doi: 10.1111/add.16443. Epub 2024 Feb 20.

Abstract

BACKGROUND AND AIMS

Behavioral economic theory predicts that high alcohol demand and high proportionate alcohol-related reinforcement are important determinants of risky alcohol use in emerging adults, but the majority of research to date has been cross-sectional in nature. The present study investigated prospective and dynamic relationships between alcohol demand and proportionate alcohol-related reinforcement in relation to heavy drinking days and alcohol problems.

DESIGN

Longitudinal cohort with assessments every 4 months for 20 months.

SETTING

Ontario, Canada.

PARTICIPANTS

Emerging adults reporting regular heavy episodic drinking (n = 636, M = 21.44; 55.8% female).

MEASUREMENTS

Heavy drinking days (HDD; Daily Drinking Questionnaire), alcohol problems (Brief Young Adult Alcohol Consequences Questionnaire), alcohol demand (Alcohol Purchase Task) and proportionate alcohol-related reinforcement (Activity Level Questionnaire).

FINDINGS

Linear mixed effects models revealed that behavioral economic indicators and alcohol-related outcomes significantly decreased over the study, consistent with 'aging out' of risky alcohol use. Random intercept cross-lagged panel models revealed significant between-person relationships, such that higher alcohol demand and alcohol-related reinforcement were positively associated with HDD and alcohol problems (random intercepts = 0.187-0.534, Ps < 0.01). Moreover, alcohol demand indicators (particularly the rate of change in elasticity of the demand curve, as measured by α, and the maximum expenditure, O) and proportionate alcohol-related reinforcement significantly forecasted changes in HDD at all time points (|βs| = 0.063-0.103, Ps < 0.05) in cross-lagged relationships, with bidirectional associations noted for the rate of change in elasticity (βs = -0.085 to -0.104, Ps < 0.01). Proportionate alcohol-related reinforcement also significantly forecasted changes in alcohol problems at all time points (βs = 0.072-0.112, Ps < 0.01).

CONCLUSIONS

Multiple behavioral economic indicators (demand elasticity, maximum expenditure and reinforcement ratio) forecast changes in heavy episodic drinking and alcohol problems over the course of emerging adulthood. These results further implicate alcohol demand and proportionate alcohol-related reinforcement as etiologically and developmentally important mechanisms in alcohol use trajectories.

摘要

背景与目的

行为经济学理论预测,高酒精需求和高比例的酒精相关强化是成年早期个体冒险饮酒的重要决定因素,但迄今为止,大多数研究都是横断面研究。本研究调查了酒精需求与比例酒精相关强化与重度饮酒日和酒精问题之间的前瞻性和动态关系。

设计

纵向队列研究,20 个月内每 4 个月评估一次。

地点

加拿大安大略省。

参与者

报告有规律的重度饮酒的成年早期个体(n=636,M=21.44;55.8%为女性)。

测量

重度饮酒日(HDD;每日饮酒问卷)、酒精问题(青年酒精后果问卷)、酒精需求(酒精购买任务)和比例酒精相关强化(活动水平问卷)。

结果

线性混合效应模型显示,随着危险饮酒行为的“成熟”,行为经济学指标和酒精相关结果在研究过程中显著下降。随机截距交叉滞后面板模型显示了个体间的显著关系,例如较高的酒精需求和酒精相关强化与 HDD 和酒精问题呈正相关(随机截距=0.187-0.534,P<0.01)。此外,酒精需求指标(特别是需求曲线弹性的变化率,由α衡量,以及最大支出,O)和比例酒精相关强化在所有时间点均显著预测了 HDD 的变化(|βs|=0.063-0.103,P<0.05),在交叉滞后关系中,弹性变化率的双向关联显著(βs=-0.085 至-0.104,P<0.01)。比例酒精相关强化也显著预测了所有时间点的酒精问题变化(βs=0.072-0.112,P<0.01)。

结论

多种行为经济学指标(需求弹性、最大支出和强化比)预测了成年早期重度饮酒和酒精问题的变化。这些结果进一步表明,酒精需求和比例酒精相关强化是酒精使用轨迹中具有病因学和发展意义的重要机制。

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