Personality Traits and Coping Compensate for Disadvantageous Decision-making in Long-term Alcohol Abstinence
Personality Traits and Coping Compensate for Disadvantageous Decision-making in Long-term Alcohol Abstinence
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DOI：
10.1093/alcalc/agr144
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发表时间：
2012-01-01
影响因子：
2.8
通讯作者：
Almos, Peter Z.
中科院分区：
文献类型：
--
作者：
Ando, Balint;Must, Anita;Almos, Peter Z.
目的：高复发率和极难维持戒断是酒精依赖（AD）的核心特征。先前的研究表明，AD患者存在持续的决策（DM）缺陷。我们的目的是揭示特定的人格特征和压力应对机制，假定补偿无效的DM技能。方法：88例未经药物治疗的AD患者入组。智商高于90的人一般认知状态完好。43例患者的平均戒断期为12周，目前正在接受住院治疗（短期戒断组，STA），45例患者戒断至少3年（长期戒断组，LTA）。两组进行了评估，采用综合方法相结合的领域DM，气质和性格的尺寸和压力应对措施。结果：两组在评估DM充分性的赌博任务上均表现为机会水平，无线性改善趋势。LTA组在自我导向和合作性量表上得分显著更高。相反，STA组的伤害回避，情绪导向的应对和感知压力的水平显着较高。结论：我们的研究结果提供了新的证据，持续DM的缺陷，没有学习效果的AD。尽管存在缺陷，酒精依赖患者可以实现LTA。STA患者感受到更高水平的压力，并使用非适应性应对策略。我们认为，LTA患者更适应性的人格特征有助于补偿酒精中毒中的特质样DM缺陷。这些代偿性特征代表了AD预防措施和治疗干预的有希望的新靶点。
Aims: High relapse rate and extreme difficulty to maintain abstinence are core characteristics of alcohol dependence (AD). Previous studies have demonstrated a persistent decision-making (DM) deficit in AD. We aimed to reveal specific personality features and stress-coping mechanisms presumed to compensate for ineffective DM skills. Methods: Eighty-eight unmedicated patients with AD were enrolled. Intact general cognitive status was assured by IQ above 90. Forty-three patients had an average abstinence period of 12 weeks and were currently in an inpatient treatment program (short-term abstinence group, STA) and 45 patients were abstinent for at least 3 years (long-term abstinence group, LTA). The two groups were assessed using an integrative approach combining domains of DM, temperament and character dimensions and stress-coping measures. Results: Both groups performed at chance level with no linear improvement tendency on the gambling task assessing DM adequacy. The LTA group scored significantly higher on scales of self-directedness and cooperativeness. In contrast, levels of harm avoidance, emotion-oriented coping and perceived stress were significantly higher in the STA group. Conclusion: Our findings provide new evidence for a persistent DM deficit with no learning effect in AD. Despite the deficit, alcohol-dependent patients can achieve LTA. STA patients perceive higher levels of stress and use non-adaptive coping strategies. We propose that the more adaptive personality profile of LTA patients contributes to the compensation of the trait-like DM deficit in alcoholism. These compensatory features represent promising new targets for preventive measures and therapeutic interventions in AD.