Rebecca J. Houston - US grants

[unreadable] DESCRIPTION (provided by applicant): Alcohol use disorders represent a major societal concern in terms of both physical and psychological well- being. Research to date has demonstrated that many different types of treatments for alcohol use disorders are similarly effective. This suggests that one or more as yet unspecified factors may be serving as underlying mechanisms accounting for the behavioral changes associated with treatment. A growing research literature has suggested that level of impulse control may be an important factor in the development, maintenance, and treatment of addictive disorders. Further, it seems likely that for individuals with an alcohol use disorder, any [unreadable] decision to initiate drinking is indicative of a momentary lapse in impulse control. As a result, the current [unreadable] proposal takes a multi-modal measurement approach to the assessment of impulse control before, during, and after a cognitive behavioral treatment for alcohol dependence. The first specific aim is to investigate whether changes in impulse control during treatment are related to alcohol use during treatment (as compared to pretreatment). The second aim is to investigate whether changes in impulse control during treatment result in changes in post treatment alcohol use (as compared to pretreatment). Participants will be fifty men and women who meet DSM-IV criteria for Alcohol Dependence. A two-group design will be used: a Standard Assessment group, assessed at pretreatment, end of treatment, and at 3- and 6-months post treatment, and a Frequent Assessment group, assessed at the same time points as the Standard group, and at weeks 3, 6, and 9 during treatment. Impulse control will be assessed using self-report, behavioral, and neurophysiological (event-related brain potential) measures taking into account the multi-dimensional nature of the impulsivity construct. It is anticipated that results from this study will better define the role of impulse control as a potential mechanism of behavioral change and inform the development of subsequent avenues of investigation on this mechanism in the treatment of alcohol use disorders. Insight into this and other mechanisms of change during alcohol treatment will provide information to refine existing treatments and to develop new treatment methods. Each year alcohol use disorders are related to serious adverse physical, psychological, interpersonal, and economic effects. In an attempt to gain a better understanding of factors that impact treatment response, the current proposal aims to evaluate the role of impulse control as a mechanism of change in the treatment of alcohol use disorders. [unreadable] [unreadable] [unreadable]

DESCRIPTION (provided by applicant): Alcohol use disorders (AUDs) represent a major societal concern in terms of physical and psychological well-being as well as economic cost. Although recent research efforts have focused on mechanisms that account for the behavioral changes associated with successful treatment approaches for AUDs, future research must focus on novel ways to capitalize on these mechanisms. A growing research literature has indicated that level of impulse control is an important factor in the development, maintenance, and treatment of addictive disorders. Furthermore, our own research suggests that impulse control may serve as an important mechanism of change in the treatment of AUDs, with preliminary findings indicating significant associations between multiple aspects of impulse control and drinking during and after treatment. The next step in this line of research is to experimentally manipulate this potential mediator (i.e., impulse control) in the context of alcoholism treatment. Based on the extant literature, we believe heart rate variability (HRV) biofeedback to be a promising approach for influencing impulse control in the treatment context. A substantial literature exists on the benefits of increased HRV as well as HRV biofeedback in the context of a variety of medical and psychological conditions (e.g., asthma, depression, anxiety). It has also been suggested that HRV may serve as an index of self-regulation. For example, low HRV is typically associated with poor regulatory capacity and has been demonstrated in AUDs and other disorders typically characterized by a lack of impulse control. However, direct links between HRV and measures of impulse control have not been empirically and systematically examined. The present application represents the first step in an innovative line of research designed to focally enhance impulse control via HRV training in the context of treatment for alcohol dependence. The aims of this R03 application are to better delineate the relation between HRV and impulse control in alcohol-dependent men and women and to provide preliminary/feasibility data for a future Stage I investigation of HRV training as an adjunct to alcohol dependence treatment. Participants will be thirty men and women in residential treatment for alcohol dependence. Impulse control will be assessed using self-report and behavioral measures taking into account the multi-dimensional nature of the impulsivity construct. Results from this study will significantly advance our understanding of impulse control and its relation to HRV and will inform the development of subsequent avenues of investigation concerning mechanisms of change in the treatment of AUDs. PUBLIC HEALTH RELEVANCE: Alcohol use disorders are related to serious adverse physical, psychological, interpersonal, and economic effects. In an attempt to gain a better understanding of factors that impact treatment outcome, the current proposal aims to evaluate the relation between heart rate variability (HRV) and impulse control in men and women in treatment for alcoholism and provide feasibilty data for a future study that would incorporate HRV biofeedback as part of alcohol treatment. The overall goal of this line of research is to provide more effective treatment for alcohol dependence.