Addressing the when, what, and why of opioid craving and drug-related valuation.
Addressing the when, what, and why of opioid craving and drug-related valuation.
复制标题
解决阿片类药物渴求的时间、原因和原因以及与药物相关的估值。
DOI：
10.1038/s41386-021-01261-6
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Bergeria,CeciliaL
中科院分区：
文献类型：
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作者：
Strickland,JustinC;Bergeria,CeciliaL
在这一期的《神经精神药理学》中，Biernacki et al [1].描述了他们最近对食物渴望的神经经济学研究的扩展[2]，旨在研究阿片类药物渴望和阿片类药物特定价值之间的关系。接受美沙酮治疗阿片类药物使用障碍的患者完成了一项支付意愿任务，其个性化刺激在药物相关性的主观维度上有所不同，但通常在愿望评级上匹配。对试验出价的预测显示，在参与者经历更大的阿片类药物渴望的瞬间条件下，更多阿片类药物相关物品的估值增加。这项优雅的工作有助于解决阿片类药物渴求的时间，内容和原因，同时为这一系列工作提出重要方向。Biernacki等人[1]在两个时间点收集试验密集的支付意愿数据，旨在改变渴求状态-一个是美沙酮给药后不久，另一个是给药后24小时。分离阿片类药物渴求和评价之间关系的人与人之间的过程。具体而言，分析表明，在人与人之间和人与人之间的水平上都观察到了药物相关性和渴望之间的相互作用，这意味着（a）总体阿片类药物渴望更高的参与者对药物相关性更高的刺激表现出更高的总体评价，（B）在参与者报告阿片类药物渴望高于平时的时刻，药物相关性和评价之间的关联也更积极。在阿片类药物渴望测试时，将其分离出来是与辛普森悖论相关的重要假设，否则可能会限制这些发现在临床环境中的实施和翻译。辛普森悖论是一种常见的生态谬误，其中人口水平的相关性是在一个给定变量的瞬时相关性的相反方向。辛普森悖论的一个简单例子是身体活动和心脏病发作风险之间的关联-运动的人比那些不运动的人更不容易患心脏病发作（人口水平关联），但对于任何给定的人，当他们运动时比不运动时更容易患心脏病发作（瞬时关联）。如果不能区分这两种途径，可能导致干预失败，甚至有害;例如，如果使用运动时显示更大风险的瞬时数据来设计基于人群的预防方法，它将危险地建议减少运动以预防心脏病发作。在本工作中，Biernacki et al [1].有效地表明，
In this issue of Neuropsychopharmacology, Biernacki et al [1]. describe an extension of their recent research on the neuroeconomics of food craving [2] designed to study the relationship between opioid craving and opioid-specific valuation. Patients receiving methadone treatment for opioid use disorder completed a willingness-to-pay task with personalized stimuli varying on a subjective dimension of drug relatedness, but generally matched on ratings of desirability. Prediction of trial bids showed increases in valuation for more opioid-related items under momentary conditions in which a participant experienced greater opioid craving. This elegant work helps to address the when, what, and why of opioid craving while posing important directions for this line of work.Collection of trial intensive willingness-to-pay data at two time points designed to vary in craving state–one shortly following methadone administration and one 24h following dosing—allowed Biernacki et al [1]. to separate the between and withinperson processes underlying the relationship between opioid craving and valuation. Specifically, analyses indicated that interactions between drug relatedness and craving were observed at both between-and within-person levels meaning that (a) participants with greater overall opioid craving showed greater overall valuation for stimuli that were more drug related and (b) in moments when participants reported opioid craving that was greater than usual, the association between drug relatedness and valuation was also more positive. Isolating this when of opioid craving tests important hypotheses related to the Simpson’s paradox that could otherwise limit implementation and translation of these findings to a clinical context. The Simpson’s paradox is a common ecological fallacy in which population-level correlates are in an opposite direction of momentary correlates for a given variable. A simple example of the Simpson’s paradox is present in the association between physical activity and heart attack risk–people who exercise are less likely to have a heart attack than those that do not (a population-level association), but for any given person, having a heart attack is more likely when they are exercising compared to when they are not (a momentary association). Failing to distinguish these two pathways can lead to failed or even harmful interventions; for instance, if the momentary data that show greater risk when exercising were used to design a populationbased prevention method, it would dangerously recommend reducing exercise to prevent heart attacks. In the present work, Biernacki et al [1]. effectively show that not only do people who