Emotional Processing as a Change Mechanism in Alcohol Treatment

描述（由申请人提供）：涉及负面影响的情况占所有酒精使用复发的近一半的男性和女性从事酒精治疗。尽管负面影响的关键作用，有（a）没有完善的，实验室测试，有效的治疗，特别是试图减少负面影响的影响，酒精使用复发，（B）很少有研究直接评估是否干预措施，针对负面影响积极影响情绪状态和/或饮酒的结果酒精依赖的男性和女性。在本研究中（根据申请[RFA-AA-07-005]酒精使用障碍治疗中的行为改变机制提交），我们建议检查通过长时间想象暴露减少对饮酒触发情况的负面情绪反应是否会同时减少由这些相同线索产生的酒精渴望。此外，我们将研究是否减少消极的情绪反应和消极的影响引起的酒精渴望与酒精依赖的男性和女性之间的积极治疗结果。在拟议的研究中，酒精依赖的男性和女性将接受6次长时间的想象暴露于负面影响的饮酒情况，同时接受12次标准的酒精依赖治疗（TAU）。长期暴露干预将包括两个实验室会议（治疗前和治疗后），旨在评估线索引起的负面情绪和酒精渴望的变化。此外，该研究还将评估负面影响的减少是否会导致1个月和3个月随访时酒精治疗结果的改善。在许多疾病中，包括物质使用障碍，情绪体验和情绪处理已被确定为治疗变化的共同原则。成功地证明酒精依赖的治疗如何起作用，可以作为最大限度地提高治疗效果的基础，并确保关键特征，如长期的直接情绪体验，推广到临床实践。涉及负面影响的情况占所有参与酒精治疗的男性和女性中酒精使用复发的近一半。成功地证明，减少情绪反应的负面影响饮酒的情况下，在更好的酒精治疗结果可以作为基础，最大限度地提高治疗效果，并确保关键功能，如情绪体验，推广到临床实践。

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.