Context and Craving Among Individuals With Alcohol Use Disorder Attempting to Moderate Their Drinking
Context and Craving Among Individuals With Alcohol Use Disorder Attempting to Moderate Their Drinking
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DOI：
10.1037/pha0000349
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发表时间：
2020-12-01
影响因子：
2.3
通讯作者：
Morgenstern, Jon
中科院分区：
文献类型：
--
作者：
Kuerbis, Alexis N.;Shao, Sijing;Morgenstern, Jon
许多患有酒精使用障碍（AUD）的人更喜欢适度的目标，因为他们不认为他们的饮酒会造成足够严重的后果，值得戒酒。鉴于试图节制饮酒的人将继续将自己置于饮酒的环境中，了解不同的外部酒精暗示如何引发渴望对于对AUD患者实施最佳治疗非常重要。本研究使用来自AUD阶梯式护理简短干预的随机对照试验的数据，探讨了试图使用生态瞬时评估（EMA）调节饮酒的个体的饮酒环境与渴望之间的关系。在基线时，参与者被要求前瞻性地识别特别可能引起强烈渴望和大量饮酒的饮酒环境，称为高度重视的饮酒环境（HVC）。在EMA期间，参与者被要求每天三次（上午，下午，晚上）报告他们的非相互排斥的背景和他们的渴望程度。使用多层次模型，所有的饮酒环境都被测试为在84天的研究中渴望的并发预测因素。接下来，AUD严重性被测试为HVC对渴望的调节剂。结果表明，在HVC中对应于更多的任何渴望和渴望强度的报告，超过了其他几个背景因素的影响（例如，负面影响和已经喝酒）。AUD严重性显著缓和HVC对任何渴望的影响，使得更大的AUD严重性增强HVC已经很高的任何渴望的几率。与AUD的个人治疗的影响进行了讨论。
Many individuals with alcohol use disorder (AUD) prefer a goal of moderation, because they do not see their drinking as causing severe enough consequences to merit abstinence. Given that individuals attempting to moderate will continue to put themselves in contexts where drinking occurs, understanding how distinct external alcohol cues prompt craving is important for implementing the optimal treatments for individuals with AUD. Using data from a randomized controlled trial of stepped care brief interventions for AUD, this study explored the relationship between drinking contexts and craving in individuals attempting to moderate their drinking using ecological momentary assessment (EMA). At baseline, participants were asked to prospectively identify drinking contexts that were particularly likely to elicit intense craving and heavy drinking, called highly valued drinking contexts (HVCs). During EMA, participants were asked to report three times a day (morning, afternoon, evening) on their non-mutually exclusive contexts and their level of craving. Using multilevel modeling, all drinking contexts were tested as concurrent predictors of craving across the 84 days of the study. Next, AUD severity was tested as a moderator of HVC on craving. Results demonstrated that being in an HVC corresponded to greater reports of any craving and intensity of craving, over and above the influences of several other contextual factors (e.g., negative affect and already drinking). AUD severity significantly moderated HVC's impact on any craving, such that greater AUD severity potentiated HVC's already high odds of any craving. Implications for treatments for individuals with AUD are discussed.