Effects of Initiating Abstinence from Alcohol on Daily Craving and Negative Affect: Results from a Pharmacotherapy Clinical Trial.
Effects of Initiating Abstinence from Alcohol on Daily Craving and Negative Affect: Results from a Pharmacotherapy Clinical Trial.
复制标题
DOI：
10.1111/acer.13591
复制
发表时间：
2018-03
期刊：
影响因子：
--
通讯作者：
Simpson TL
中科院分区：
文献类型：
--
作者：
Hallgren KA;Delker BC;Simpson TL
渴望和负面影响是令人痛苦的，通常在酒精使用障碍（AUD）治疗期间经历。患者可能会认为，开始禁欲将加强他们的渴望和负面影响，尽管有限的经验数据支持这一假设。本研究扩展和复制，在改进的方法条件下，以前的工作，发现减少日常渴望与开始禁欲。在一项测试哌唑嗪治疗AUD的临床试验中，78名成人（80.8%男性，57.1%白人）提供了长达12周的饮酒、渴望和负面情绪的每日报告（平均值=64.77每日报告）。根据参与者是否以及何时开始14天的连续戒酒，将其分为3个亚组，包括：（1）在治疗期间戒酒的“戒酒发起者”（n=17），（2）在治疗开始时戒酒的“已经戒酒者”（n=20），以及（3）从未开始戒酒的“持续饮酒者”（n=41）。使用多变量增长曲线模型比较了这些组的渴望和负面影响的变化的时间和程度。所有参与者亚组都报告了在治疗过程中渴望的逐渐减少，其中“戒酒发起者”报告了在开始戒酒后渴望的额外突然减少。在整个治疗过程中，“持续饮酒者”报告的渴望程度高于“已经戒酒者”。消极影响遵循不同的变化模式，“禁欲发起者”经历了逐渐减少的消极影响后，开始禁欲，但没有变化之前或立即开始禁欲，与“已经戒酒者”和“继续饮酒者”经历了没有变化的消极影响随着时间的推移。开始禁欲与立即减少渴望有关，随后是渴望和负面影响的逐渐减少。研究结果提供了对理论和临床重要变量变化的时间和幅度的洞察，并可能帮助患者预测何时期望改善渴望和负面影响。
Craving and negative affect are distressing and commonly experienced during alcohol use disorder (AUD) treatment. Patients may assume that initiating abstinence will intensify their cravings and negative affect despite limited empirical data to support this assumption. The present study extends and replicates, under improved methodological conditions, previous work that found reductions in daily craving associated with initiating abstinence. Seventy-eight adults (80.8% male, 57.1% Caucasian) in a clinical trial testing prazosin for AUD provided daily reports of drinking, craving, and negative affect for up to 12 weeks (mean=64.77 daily reports). Participants were classified into 3 subgroups based on whether and when they initiated 14 days of continuous abstinence, including: (1) ‘abstinence initiators’ who quit drinking during treatment (n=17), (2) ‘already abstainers’ who were abstinent at the start of treatment (n=20), and (3) ‘continued drinkers’ who never initiated abstinence (n=41). The timing and degree of change in craving and negative affect were compared across these groups using multivariate growth curve modeling. All participant subgroups reported gradual reductions in craving over the course of treatment, with ‘abstinence initiators’ reporting additional sudden reductions in craving upon initiating abstinence from alcohol. ‘Continued drinkers’ reported higher levels of craving than ‘already abstainers’ throughout the full course of treatment. Negative affect followed a different pattern of change, with ‘abstinence initiators’ experiencing gradual reductions in negative affect after initiating abstinence but no changes prior to or immediately upon initiating abstinence, and with ‘already abstainers’ and ‘continued drinkers’ experiencing no changes in negative affect over time. Initiating abstinence is associated with immediate reductions in craving, followed by gradual reductions in both craving and negative affect. Results provide insight into the timing and magnitude of changes in theoretically and clinically important variables and may help patients anticipate when to expect improvement in craving and negative effect.
登录
查看更多内容
DOI：
10.1037/adb0000330
发表时间：
2018-03
期刊：
Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors
影响因子：
--
作者：
Epstein EE;McCrady BS;Hallgren KA;Cook S;Jensen NK;Hildebrandt T
通讯作者：
Hildebrandt T
DOI：
10.1111/j.1530-0277.2007.00487.x
发表时间：
2007-10-01
影响因子：
3.2
作者：
Huebner, Robert B.;Tonigan, Jeffery Scott
通讯作者：
Tonigan, Jeffery Scott
DOI：
10.1111/acer.12205
发表时间：
2013-12
期刊：
Alcoholism, clinical and experimental research
影响因子：
--
作者：
Hallgren KA;Witkiewitz K
通讯作者：
Witkiewitz K
影响因子：
3.2
作者：
Fazzino, Tera L.;Harder, Valerie S.;Helzer, John E.
通讯作者：
Helzer, John E.
影响因子：
2.8
作者：
Bottlender, M;Soyka, M
通讯作者：
Soyka, M