Emotional Processing as a Change Mechanism in Alcohol Treatment

描述(由申请人提供)：在接受酒精治疗的男性和女性中，涉及负面影响的情况占所有酒精复发的近一半。尽管负面情绪发挥着关键作用，但(A)没有成熟的、经过经验检验的有效治疗方法专门试图减少负面情绪对酗酒复发的影响，(B)很少有研究直接评估针对负面情绪的干预措施是否对酒精依赖男性和女性的情绪状态和/或饮酒结果产生积极影响。在本研究中(应申请[RFA-AA-07-005]酒精使用障碍治疗的行为改变机制)，我们建议研究通过长时间的想象暴露，减少对饮酒触发情况的负面情绪反应，是否会伴随着由同样的线索产生的酒精渴望的减少。此外，我们将研究在酒精依赖的男性和女性中，负面情绪反应和负面情绪引发的酒精渴望的减少是否与积极的治疗结果相关。在这项拟议的研究中，酒精依赖者的男性和女性将接受六个疗程的想象，长期暴露在负面影响的饮酒情景中，同时接受标准的12个疗程的照常治疗(TAU)。长期暴露干预将包括两个实验室会议(治疗前和治疗后)，旨在评估线索引发的负面情绪和酒精渴望的变化。此外，这项研究将在1个月和3个月的随访中评估负面影响的减少是否会导致酒精治疗结果的改善。在包括物质使用障碍在内的许多障碍中，情绪体验和情绪处理已被确定为治疗变化的共同原则。成功地展示了酒精依赖的治疗如何发挥作用，作为最大限度地发挥治疗效果的基础，并确保将关键特征，如长时间直接感受情绪，推广到临床实践中。在接受酒精治疗的男性和女性中，涉及负面影响的情况占所有酒精复发的近一半。成功地证明，将情绪反应性降低到负面影响饮酒情况会导致更好的酒精治疗结果，这可以作为最大化治疗效果的基础，并确保将情绪体验等关键特征推广到临床实践中。

DESCRIPTION (provided by applicant): Situations involving negative affect account for nearly half of all relapses to alcohol use among men and women engaged in alcohol treatment. Despite the key role of negative affect, there are (a) no well-developed, empirically-tested, efficacious treatments that specifically attempt to reduce the impact of negative affect on relapse to alcohol use, and (b) few studies that have directly assessed whether interventions that target negative affect positively impact emotional states and/or drinking outcomes among alcohol dependent men and women. In the present study (submitted in response to the Request for Application [RFA-AA-07-005] Mechanisms of Behavior Change in the Treatment of Alcohol Use Disorders ), we propose to examine whether a reduction of negative emotional responses to drinking trigger situations, via prolonged imaginal exposure, will produce a concomitant reduction in alcohol craving produced by those same cues. Further, we will examine whether a reduction in negative emotional responses and negative affect-elicited alcohol craving is associated with positive treatment outcomes among alcohol dependent men and women. In the proposed study, alcohol dependent men and women will receive six sessions of prolonged imaginal exposure to negative affect drinking situations delivered concurrent with a standard 12-session Treatment as Usual (TAU) for alcohol dependence. The prolonged exposure intervention will incorporate two laboratory sessions (pre-and post-treatment) intended to assess change in cue-elicited negative emotions and alcohol craving. In addition, the study will assess if reductions in negative affect lead to improved alcohol treatment outcomes at 1 and 3-month follow up. Across many disorders, including substance use disorders, emotional experiencing and emotional processing have been identified as a common principle of therapeutic change. Success in demonstrating how treatments for alcohol dependence work can serve as a basis for maximizing treatment effects and ensure that critical features, such as prolonged direct experiencing of emotions, are generalized to clinical practice. Situations involving negative affect account for nearly half of all relapses to alcohol use among men and women engaged in alcohol treatment. Success in demonstrating that a reduction in emotional reactivity to negative affect drinking situations results in better alcohol treatment outcomes can serve as a basis for maximizing treatment effects and ensure that critical features, such as emotional experiencing, are generalized to clinical practice.