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使用复发的近一半。尽管消极影响起着关键作用，但(a)没有完善的、经过经验检验的、有效的治疗方法专门试图减少消极影响对酒精使用复发的影响，(b)很少有研究直接评估针对消极影响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），我们建议通过长时间的想象暴露来检查对饮酒触发情境的负面情绪反应的减少是否会同时减少由这些线索产生的酒精渴望。此外，我们将研究在酒精依赖的男性和女性中，消极情绪反应和消极情感引发的酒精渴望的减少是否与积极的治疗结果相关。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环境中，同时进行标准的12次酒精依赖治疗（TAU）。延长暴露干预将包括两个实验阶段（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，该研究将在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疾病中，情绪体验和情绪处理已被确定为治疗改变的共同原则。成功地证明酒精依赖治疗是如何起作用的，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，如长期直接体验情绪，推广到临床实践。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使用复发的近一半。成功地证明对负面影响饮酒情况的情绪反应的减少会导致更好的酒精治疗结果，可以作为最大限度地提高治疗效果的基础，并确保将关键特征（如情绪体验）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.