Alcohol Consumption, Craving, and Craving Control Efforts Assessed Daily in the Context of Readiness to Change Among Individuals with Alcohol Dependence and PTSD
Alcohol Consumption, Craving, and Craving Control Efforts Assessed Daily in the Context of Readiness to Change Among Individuals with Alcohol Dependence and PTSD
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DOI：
10.1016/j.jsat.2015.09.005
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发表时间：
2016-02-01
影响因子：
3.9
通讯作者：
Simpson, Tracy L.
中科院分区：
文献类型：
--
作者：
Browne, Kendall C.;Wray, Tyler B.;Simpson, Tracy L.
研究已经证明了酒精渴望和酒精使用之间的正相关关系，并已确定渴望是酒精使用障碍(AUD)的一个核心组成部分。尽管有潜在的临床意义，但很少有研究检查患有AUD和常见精神共病的人的渴望和酒精使用之间的关系，或者探索渴望-酒精使用关系的可能调节因素。目前的研究使用日常监测数据来：1)重复先前的发现，在患有AUD和共生的创伤后应激障碍(PTSD)的人中，渴望和饮酒之间存在正相关关系；2)通过检查最初的改变动机对渴望-使用关系的影响，以及渴望、控制渴望的努力和饮酒之间的日内联系，扩展了这些发现。参与者是84名酒精依赖和创伤后应激障碍患者，他们参加了一项干预研究。使用治疗前基线每日数据的综合估计方程显示了对渴望、渴望控制和改变饮酒动机的显著主效应。日常渴求与饮酒呈正相关。更大的改变动机和渴望控制(即努力抵抗渴望，避免与渴望有关的想法和感觉)与饮酒负相关。基线改变动机和日常渴望之间存在显着的交互作用，这表明对于那些基线改变动机较低的人来说，渴望和饮酒之间的关联显着更强。研究还发现，渴望控制和日常渴望之间存在显著的相互作用，这表明如果参与者报告的渴望控制水平较低，那么当他们经历高水平的渴望时，他们更有可能饮酒。研究结果支持了这样的观点，即预防或改善渴望的努力对寻求减少或戒酒的AUD和PTSD患者的治疗成功至关重要。由爱思唯尔公司出版。
Research has demonstrated the positive association between alcohol craving and alcohol use and has identified craving as a central component of alcohol use disorders (AUD). Despite potential clinical implications, few studies have examined the relationship between craving and alcohol use in individuals with AUD and common psychiatric comorbidities or explored possible moderators of the craving-alcohol use relationship. The current study used daily monitoring data to: 1) replicate previous findings detecting a positive relationship between craving and alcohol use in individuals with AUD and co-occurring posttraumatic stress disorder (PTSD) and 2) extend these findings by examining the influence of initial change motivation on the craving-use relationship and within-day associations among craving, efforts to control craving, and alcohol consumption. Participants were 84 individuals with alcohol dependence and PTSD enrolled in an intervention study. Generalized estimating equations using pre-treatment baseline daily data revealed significant main effects for craving, craving control, and motivation to change alcohol use. Daily craving was positively related to alcohol use. Greater change motivation and craving control (i.e., efforts to resist craving, avoidance of thoughts and feelings related to craving) were negatively related to alcohol use. A significant interaction was detected between baseline change motivation and daily craving indicating that the association between craving and alcohol use was significantly stronger for those with low baseline change motivation. A significant interaction was also detected between craving control and daily craving, suggesting that participants were more likely to consume alcohol when experiencing high levels of craving if they reported low levels of craving control. Findings bolster the idea that efforts to prevent or ameliorate craving are critical to treatment success for individuals with AUD and PTSD who are seeking to reduce or quit drinking. Published by Elsevier Inc.