Reward craving and withdrawal relief craving:: Assessment of different motivational pathways to alcohol intake
Reward craving and withdrawal relief craving:: Assessment of different motivational pathways to alcohol intake
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DOI：
10.1093/alcalc/agg005
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发表时间：
2003-01-01
影响因子：
2.8
通讯作者：
Mann, K
中科院分区：
文献类型：
--
作者：
Heinz, A;Löber, S;Mann, K
目的：对酒精奖励效应的渴望可能由条件酒精样效应引起，而条件代偿反应可能引起戒断缓解渴望。我们测试了这样一个假设：在积极的情绪状态下饮酒与对酒精相关线索的食欲反应有关，并有助于奖励渴望，而条件戒断与在消极情况下饮酒以及对酒精的痛苦、强迫性关注有关。方法：采用强迫饮酒量表对38例解毒酗酒者的渴望因素“控制障碍”、“干扰社会功能”和“痴迷”进行评估。对酒精相关视觉刺激的情感性反应采用情绪调节的眨眼惊吓反射、饮酒情境量表（IDS）的阳性和阴性饮酒情境以及饮酒前戒断样症状（ciwaar）进行测量。结果：在积极的情况下，对酒精相关线索的食欲反应与饮酒呈正相关，并显著地促进了渴望因素对社会和工作功能的“干扰”。酒精摄入前类似戒断症状的严重程度导致了渴望因素“痴迷”；然而，与我们的假设相反，这种条件戒断的测量不仅在消极情况下而且在积极情况下都与饮酒相关。结论：在积极和消极情况下饮酒，对酒精的食欲反应和戒断样症状对渴望因素“痴迷”和“干扰”的贡献不同，支持不同渴望因素具有不同潜在机制的概念。
Aims: Craving for the rewarding effects of alcohol may be evoked by conditioned alcohol-like effects whereas conditioned compensatory responses may induce withdrawal relief craving. We tested the hypothesis that drinking in positive emotional states is associated with appetitive reactions to alcohol-associated cues and contributes to reward craving, while conditioned withdrawal is associated with drinking in negative situations and distressful, obsessive preoccupations with alcohol. Methods: In 38 detoxified alcoholics, the Obsessive Compulsive Drinking Scale was used to assess the craving factors 'impaired control', 'interference with social functioning' and 'obsession'. Affective responses to alcohol-associated visual stimuli were measured with the affect-modulated eyeblink startle reflex, positive and negative drinking situations with the Inventory of Drinking Situations (IDS) and withdrawal-like symptoms preceding alcohol intake with the revised Clinical Institute Assessment for Alcohol Scale (CIWA-Ar). Results: Appetitive reactions to alcohol-associated cues correlated positively with drinking in positive situations and contributed significantly to the craving factor 'interference' with social and work functioning. The severity of withdrawal-like symptoms preceding alcohol intake contributed to the craving factor 'obsession'; however, contrary to our hypothesis, this measure of conditioned withdrawal correlated with drinking not only in negative but also in positive situations. Conclusions: Drinking in positive and negative situations, appetitive reactions to alcohol and withdrawal-like symptoms contributed differentially to the craving factors 'obsession' and 'interference', supporting the notion of different craving factors with separate underlying mechanisms.