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.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA008972-14
Application #
7179325
Study Section
Health Services Research Review Subcommittee (AA)
Program Officer
Chiapella, Page
Project Start
1992-09-01
Project End
2010-02-28
Budget Start
2007-03-01
Budget End
2008-02-29
Support Year
14
Fiscal Year
2007
Total Cost
$484,292
Indirect Cost
Name
University of Alabama Birmingham
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
063690705
City
Birmingham
State
AL
Country
United States
Zip Code
35294
Schroder, Kerstin E E; Tucker, Jalie A; Simpson, Cathy A (2013) Telephone-based self-change modules help stabilize early natural recovery in problem drinkers. J Stud Alcohol Drugs 74:902-8
Tucker, Jalie A; Roth, David L; Huang, Jin et al. (2012) Effects of interactive voice response self-monitoring on natural resolution of drinking problems: utilization and behavioral economic factors. J Stud Alcohol Drugs 73:686-98
Simpson, Cathy A; Huang, Jin; Roth, David L et al. (2012) Predictors of utilization of an IVR self-monitoring program by problem drinkers with recent natural resolutions. Drug Alcohol Depend 126:111-7
Tucker, Jalie A; Simpson, Cathy A (2011) The recovery spectrum: from self-change to seeking treatment. Alcohol Res Health 33:371-9
Tucker, Jalie A; Roth, David L; Vignolo, Mary J et al. (2009) A behavioral economic reward index predicts drinking resolutions: moderation revisited and compared with other outcomes. J Consult Clin Psychol 77:219-28
Tucker, Jalie A; Reed, Geoffrey M (2008) Evidentiary Pluralism as a Strategy for Research and Evidence-Based Practice in Rehabilitation Psychology. Rehabil Psychol 53:279-293
Tucker, Jalie A; Foushee, H Russell; Black, Bethany C (2008) Behavioral economic analysis of natural resolution of drinking problems using IVR self-monitoring. Exp Clin Psychopharmacol 16:332-40
Tucker, Jalie A; Foushee, H Russell; Black, Bethany C et al. (2007) Agreement between prospective interactive voice response self-monitoring and structured retrospective reports of drinking and contextual variables during natural resolution attempts. J Stud Alcohol Drugs 68:538-42
Tucker, Jalie A; Roth, David L (2006) Extending the evidence hierarchy to enhance evidence-based practice for substance use disorders. Addiction 101:918-32
Tucker, Jalie A; Vuchinich, Rudy E; Black, Bethany C et al. (2006) Significance of a behavioral economic index of reward value in predicting drinking problem resolution. J Consult Clin Psychol 74:317-26

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