Is the Construct of Relapse Heuristic, and Does It Advance Alcohol Use Disorder Clinical Practice?
Is the Construct of Relapse Heuristic, and Does It Advance Alcohol Use Disorder Clinical Practice?
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DOI：
10.15288/jsad.2016.77.849
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发表时间：
2016-11-01
影响因子：
3.4
通讯作者：
Wilson, Adam D.
中科院分区：
文献类型：
--
作者：
Maisto, Stephen A.;Witkiewitz, Katie;Wilson, Adam D.
目的：酒精使用障碍（AUD）复发是一个结构，一直是主要的临床和研究兴趣，但一直不一致的定义。本研究的目的是回顾已在临床研究中使用的AUD复发的定义，作为得出其启发性价值的结论的基础。方法：对以下实证研究进行了文献的系统综述：（a）发表在同行评审期刊上，（B）发表于2010年至2015年之间，（c）用英语撰写，（d）提供了研究中使用的酒精复发（或失效）的定义。结果：该综述产生了139项符合纳入标准的研究。这些研究表明，在文献中如何定义和解释复发存在很大的差异，并且几乎没有为所选择的复发定义提供直接的经验或理论依据。此外，AUD复发作为离散状态的概念与饮酒临床过程的经验文献不一致。结论：我们得出结论，目前研究的AUD复发的启发式价值较低。另一种方法将构建嵌入酒精消费临床过程的理论和数据中，并与当前的医疗保健趋势保持一致，似乎有更好的机会改善AUD临床决策和关于AUD的一般知识。
Objective: Alcohol use disorder (AUD) relapse is a construct that has been of major clinical and research interest but has been inconsistently defined. The purpose of this study was to review the definitions of AUD relapse that have been used in clinical research as a basis for drawing conclusions about its heuristic value. Method: A systematic review of the literature was conducted on empirical studies that (a) were published in peer-reviewed journals, (b) were published between 2010 and 2015, (c) were written in English, and (d) provided a definition of alcohol relapse (or lapse) that was used in the study. Results: The review yielded 139 individual studies that met inclusion criteria. The studies showed wide variability in how relapse was defined and interpreted in the literature, and there was little direct empirical or theoretical rationale provided for the definitions of relapse that were chosen. Furthermore, the concept of AUD relapse as a discrete state is not consistent with the empirical literature on the clinical course of alcohol consumption. Conclusions: We conclude that the heuristic value of AUD relapse as currently studied is low. An alternative approach that embeds the construct in theory and data on the clinical course of alcohol consumption and aligns with current trends in healthcare would seem to have d better chance of improving AUD clinical decision-making and knowledge about AUD in general.