Craving & EtOH Intake in Alcoholics: a Test of 2 Models

描述(由申请者提供)：渴望可以说是成瘾研究中最有争议的概念。一方面是酗酒者的证明，他们的欲望主导了他们的思想，削弱了他们保持清醒的决心。另一方面，研究发现，渴望既不是解释饮酒的必要条件，也不是解释饮酒的充分理由。1996年，NIAAA召集了成瘾专家，以确定为什么渴望不是饮酒的可靠预测因素。该小组发现的知识基础中的空白之一是，人类对渴望还没有充分的概念化和研究。缺乏这样的研究是一个重要的问题，因为它阻碍了对酒精消费渴望的性质、过程、行为后遗症和调节功能的理解。我研究的长期目标是更好地了解渴望现象及其与饮酒和复发的关系。本应用的目的是检验两个影响渴望的模型，即渴望和药物使用的认知加工模型，以及冲动和药物动机的两个影响模型，这两个模型对渴望和饮酒之间的联系产生了不同的预测。这项拟议研究的中心假设是，渴望可能预测饮酒的情况只有通过理论驱动的研究和使用范式才能得到阐明，这些范式可以操纵已知的饮酒因素，并同时衡量渴望和饮酒行为。建议进行三项研究，通过使用对传统线索反应性方法-线索可获得性范式的创新修改来调查已知的导致酗酒者饮酒的因素。研究一将考察酒精激发和酒精可获得性对不寻求治疗的酗酒者的渴望、情感、酒精寻求和饮酒行为的影响。研究2将考察消极情绪诱导和酒精供应对不寻求治疗的酗酒者的渴求、情感、饮酒和饮酒行为的影响。研究3将复制和补充研究2的发现，提供一项关于饮酒行为的有效性的测试，该测试通过线索可获得性范式衡量，与通过验证的味觉评级任务评估的类似措施相同。参与这些实验室酒精管理研究对随后的临时饮酒的影响将作为次要目标进行衡量。这项拟议的研究具有创新性，因为它使用了一种范式，可以灵活地操纵已知的影响饮酒和饮酒行为的因素，同时测量渴望和情感，并测试两种渴望模型。我们期待这项研究将提供重要的新信息，关于适度渴望的因素，以及在感兴趣的酗酒者群体中渴望和饮酒之间的联系。这项研究的主要影响将是解决关于人类渴求概念化的知识基础中的一个空白，这反过来将推动该领域的发展，并为患者护理提供信息。

DESCRIPTION (provided by applicant): Craving is arguably the most contentious construct in addiction research. On the one hand are the testimonials of alcoholics that cravings dominate their thoughts and weaken their resolve to stay sober. On the other hand, research finds that craving is neither necessary nor sufficient to explain drinking. In 1996, the NIAAA brought together addiction experts to determine why craving is not a reliable predictor of drinking. One of the gaps in the knowledge base identified by this group was that craving has not been adequately conceptualized and studied in humans. Lack of such research is an important problem because it impedes the understanding of the nature, course, behavioral sequelae, and regulatory function of craving on alcohol consumption. The long-term goal of my research is to better understand the phenomenon of craving and its relation to drinking and relapse. The objective of this application is to examine 2 influential models of craving, the Cognitive Processing Model of Craving and Drug Use, and the Two-Affect Model of Urges and Drug Motivation, which yield different predictions regarding the association between craving and drinking. The central hypothesis of the proposed research is that the circumstances under which craving is likely to predict drinking will only be elucidated through theory-driven research and the use of paradigms that can manipulate factors known to elicit drinking, and simultaneously measure craving and drinking behavior. Three studies are proposed to investigate factors known to elicit drinking in alcoholics by using an innovative modification of conventional cue-reactivity methodology-the cue-availability paradigm. Study I will examine the effects of alcohol priming and alcohol availability on craving, affect, alcohol seeking, and drinking behavior in non treatment-seeking alcoholics. Study 2 will examine the effects of negative mood induction and alcohol availability on craving, affect, alcohol seeking, and drinking behavior in non treatment-seeking alcoholics. Study 3 will replicate and add to the findings from Study 2 by providing a test of convergent validity on drinking behaviors measured by the cue-availability paradigm to similar measures assessed by a validated taste-rating task. The effects of participating in these laboratory alcohol administration studies on subsequent ad libitum drinking will be measured as a secondary aim. The proposed research is innovative because it uses a paradigm that has the flexibility to manipulate factors known to affect alcohol seeking and drinking behaviors, simultaneously measures craving and affect, and tests two models of craving. We expect that this research will provide important new information regarding factors that moderate craving, and the association between craving and drinking in the population of interest-alcoholics. The major impact of this research will be to address a gap in the knowledge base regarding the conceptualization of craving in humans, which in turn will advance the field and inform patient care.