Within- and between-person effects of naltrexone on the subjective response to alcohol and craving: A daily diary investigation.
Within- and between-person effects of naltrexone on the subjective response to alcohol and craving: A daily diary investigation.
复制标题
DOI：
10.1111/acer.14780
复制
发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
O'Malley, Stephanie S.
中科院分区：
文献类型：
--
作者：
Waddell, Jack T.;Corbin, William R.;MacKinnon, David P.;Leeman, Robert F.;DeMartini, Kelly S.;Fucito, Lisa M.;Kranzler, Henry R.;O'Malley, Stephanie S.
纳曲酮是年轻人酗酒的有效治疗方法，实验室研究表明纳曲酮可以抑制对酒精和渴望的主观反应。然而，很少有研究测试纳曲酮在自然饮酒环境中对年轻人主观反应和渴望的动态、个人影响。利用一项随机、安慰剂对照的年轻人纳曲酮疗效研究的每日日记数据，我们检查了治疗条件（即纳曲酮与安慰剂）和药物剂量（每日、靶向、每日+靶向）对饮酒日对酒精和渴望的主观反应的人间影响。多层次中介模型预测主观反应和渴望从治疗条件（人与人之间）和药物剂量（人体内），考虑饮酒水平。所有的影响都在人体内和人之间进行了分解。在人与人之间，纳曲酮直接钝化强烈的主观效应（即“受损”、“醉酒”），并通过减少饮酒间接钝化主观效应。纳曲酮与渴望无关。经α校正后，人间效应不显著，但其效应量（bs= 0.14 - 0.17）超过了最小效应量。在个人层面，服用2粒（vs. 1粒）药片与重度饮酒有关，服用1粒（vs. 0粒）药片与轻度饮酒有关，轻度饮酒与较低的主观反应和渴望有关。治疗条件并没有缓和剂量对结果的人内效应。研究结果表明，纳曲酮的直接人际效应在强烈的主观反应中最大，减弱了“喝醉”和“受损”的感觉。未来的研究使用瞬间（而不是每天）评估可以证实和扩展这些发现。
Naltrexone is an effective treatment for heavy drinking among young adults, and laboratory-based studies have shown that naltrexone dampens the subjective response to alcohol and craving. However, few studies have tested naltrexone’s dynamic, within-person effects on subjective response and craving among young adults in natural drinking environments. Using daily diary data from a randomized, placebo-controlled study of naltrexone efficacy in young adults, we examined the between-person effects of treatment condition (i.e., naltrexone vs. placebo) and medication dosage (daily, targeted, daily+targeted) on the subjective response to alcohol and craving on drinking days. Multilevel mediation models predicted subjective response and craving from treatment condition (between-person) and medication dosage (within-person), accounting for drinking levels. All effects were disaggregated within- and between-person. At the between-person level, naltrexone directly blunted intense subjective effects (i.e., “impaired”, “drunk”), and indirectly blunted subjective effects through reduced drinking. Naltrexone was not associated with craving. Between-person effects were not significant after alpha correction, but their effect sizes (bs=.14-.17) exceeded the smallest effect size of interest. At the within-person level, taking 2 (vs. 1) pills was associated with heavier drinking, and taking 1 (vs. 0) pills was associated with lighter drinking, and lighter drinking was associated with a lower subjective response and craving. Treatment condition did not moderate the within-person effects of dosing on outcomes. The findings suggest that the direct between-person effect of naltrexone was largest on intense subjective responses, blunting feeling “drunk” and “impaired”. Future research using momentary (rather than daily) assessments could confirm and extend these findings.
登录
查看更多内容
DOI：
10.1080/10705519909540118
发表时间：
1999-01-01
影响因子：
6
作者：
Hu, Li-tze;Bentler, Peter M.
通讯作者：
Bentler, Peter M.
DOI：
10.1037/adb0000738
发表时间：
2021-09
期刊：
Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors
影响因子：
--
作者：
Fairlie AM;Graupensperger S;Duckworth JC;Patrick ME;Lee CM
通讯作者：
Lee CM
有针对性的纳曲酮用于饮酒者。
影响因子：
2.9
作者：
Kranzler HR;Tennen H;Armeli S;Chan G;Covault J;Arias A;Oncken C
通讯作者：
Oncken C
DOI：
10.3200/jach.58.1.26-32
发表时间：
2009-07
期刊：
Journal of American college health : J of ACH
影响因子：
--
作者：
Epler AJ;Sher KJ;Loomis TB;O'Malley SS
通讯作者：
O'Malley SS
影响因子：
3.4
作者：
Anton, RF;Drobes, DJ;Moak, D
通讯作者：
Moak, D