OBJECTIVE To better understand the timing and unique contribution of four potential mechanisms of behavior change (MOBC) during alcohol use disorder (AUD) treatment (negative affect, positive affect, alcohol craving, and adaptive alcohol coping), we used a time-varying effect modeling analytic approach to examine the change trajectories of alcohol abstinence, heavy drinking, the hypothesized MOBCs, and the time-varying associations between the MOBCs and alcohol outcomes. METHOD Participants (N = 181; Mage = 50.8 years, SD = 10.6; 51% women; 93.5% Caucasian) were enrolled in a 12-week randomized clinical trial of cognitive behavioral outpatient treatment program for AUD. For 84 consecutive days, participants provided self-reports of positive and negative affect, craving, alcohol use, and adaptive alcohol coping strategies employed. RESULTS Throughout the 84-day treatment window, higher daily average craving levels were associated with both decreased likelihood of alcohol abstinence and increased odds of heavy drinking, whereas higher adaptive alcohol coping was associated with increased odds of abstinence and decreased odds of heavy drinking. Higher negative affect was associated with decreased odds of abstinence in the first 10 days of treatment and increased odds of heavy drinking before Day 4 or Day 5. Higher positive affect was associated with decreased odds of heavy drinking during the first 4 or 5 days. CONCLUSIONS The differential time-varying associations between negative affect, positive affect, alcohol craving, adaptive alcohol coping, and alcohol use provide insights into how and when each of the MOBCs is active during AUD treatment. These findings can help optimize the efficacy of future AUD treatments. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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负面影响饮酒者酒精治疗期间行为变化的机制：使用连续 84 天生态瞬时评估的时变效应模型分析。

目的 为了更好地了解酒精使用障碍 (AUD) 治疗期间行为改变 (MOBC) 的四种潜在机制（消极情感、积极情感、酒精渴望和适应性酒精应对）的时机和独特贡献，我们使用了时变效应建模分析方法来检查戒酒、大量饮酒、假设的 MOBC 的变化轨迹以及 MOBC 和酒精结果之间随时间变化的关联。方法 参与者（N = 181；Mage = 50.8 岁，SD = 10.6；51% 女性；93.5% 白种人）参加了一项为期 12 周的 AUD 认知行为门诊治疗计划随机临床试验。参与者连续 84 天提供了关于积极和消极情绪、渴望、饮酒以及所采用的适应性酒精应对策略的自我报告。结果在整个 84 天的治疗窗口中，较高的每日平均渴望水平与戒酒可能性降低和大量饮酒几率增加相关，而较高的适应性酒精应对与戒酒几率增加和大量饮酒几率降低相关。较高的负面情绪与治疗前 10 天戒酒的几率降低相关，并且在第 4 天或第 5 天之前酗酒的几率增加。较高的正面情绪与治疗前 4 或 5 天期间酗酒的几率降低相关。结论 负面情绪、正面情绪、酒精渴望、适应性酒精应对和饮酒之间随时间变化的差异关联提供了关于每个 MOBC 在 AUD 治疗期间如何以及何时活跃的见解。这些发现有助于优化未来 AUD 治疗的疗效。（PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。