Craving Mediates Stress in Predicting Lapse During Alcohol Dependence Treatment

Law, Bonnie; Gullo, Matthew J.; Daglish, Mark; Kavanagh, David J.; Feeney, Gerald F.X.; Young, Ross McD.; Connor, Jason P.

doi:10.1111/acer.13034

Cited by 34 publications

(31 citation statements)

References 51 publications

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“…Similar results have been reported in the alcohol treatment literature (Cooney et al, 1997;Law et al, 2016;Miller et al, 1996). However, the early treatment context is important to consider here.…”

Section: Discussionsupporting

confidence: 85%

Social cognitive predictors of treatment outcome in cannabis dependence

Gullo

Matveeva

Feeney

et al. 2017

Drug and Alcohol Dependence

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Section: Discussionsupporting

confidence: 85%

Social cognitive predictors of treatment outcome in cannabis dependence

Gullo

Matveeva

Feeney

et al. 2017

Drug and Alcohol Dependence

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“…This study replicated previous research finding a positive association between craving and rash impulsiveness among AUD patients 11,65 . Consistent with previous studies, higher craving 15,20,66 and impulsivity 11,34 were independently predictive of poorer treatment outcomes. Craving was found to diminish the unique effect attributed to rash impulsiveness when included within the same model.…”

Section: Discussionsupporting

confidence: 89%

Craving mediates the effect of impulsivity on lapse-risk during alcohol use disorder treatment

Coates

Gullo

Feeney

et al. 2020

Addictive Behaviors

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Background: Rash impulsiveness, the propensity for approach behaviour despite potential negative consequences, is associated with stronger alcohol craving in patients with Alcohol Use Disorder (AUD). This relationship is poorly understood and implications for treatment response unexamined. This study explored the relationship between rash impulsiveness, craving, and treatment response in a sample of AUD outpatients.Design: Longitudinal study conducted over a 12-week intervention period.Setting: University public hospital outpatient alcohol and drug clinic. Participants: Patients attending an abstinence-based Cognitive-Behavioural Therapy program for AUD (N = 304).Procedure: Assessments were completed pre-and-post treatment. Craving and alcohol consumption were assessed at each treatment session.Results: Higher rash impulsiveness predicted more frequent craving over treatment (b = 0.95, 95% CI = 0.40, 1.50). Higher craving was associated with greater lapse-risk (b = 0.04, 95% CI = 0.03, 0.05). The association between craving and lapse-risk increased as treatment progressed (b = 0.01, 95% CI = 0.01, 0.02). Craving positively mediated the relationship between impulsivity and lapse-risk (µ = 0.38, 95% CI = 0.10, 0.70). Conclusions:Craving mediates the effect of impulsivity in the prediction of lapse during abstinence-oriented treatment for AUD. Frequent assessment and management of craving during treatment is recommended to reduce alcohol lapse.

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“…Though this may seem in contrast to previous studies, perhaps it is actually an indication of successful maintenance of sobriety. Craving in response to stress has previously been found to be an important mediator of relapse (Law et al, 2016, Higley et al, 2011). In heavy drinkers who are not dependent, however, craving was not predictive of alcohol use problems (Tartter and Ray, 2012).…”

Section: Discussionmentioning

confidence: 99%

Blunted amygdala functional connectivity during a stress task in alcohol dependent individuals: A pilot study

Wade

Padula²,

Anthenelli

et al. 2017

Neurobiology of Stress

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BackgroundScant research has been conducted on neural mechanisms underlying stress processing in individuals with alcohol dependence (AD). We examined neural substrates of stress in AD individuals compared with controls using an fMRI task previously shown to induce stress, assessing amygdala functional connectivity to medial prefrontal cortex (mPFC).Materials and methodsFor this novel pilot study, 10 abstinent AD individuals and 11 controls completed a modified Trier stress task while undergoing fMRI acquisition. The amygdala was used as a seed region for whole-brain seed-based functional connectivity analysis.ResultsAfter controlling for family-wise error (p = 0.05), there was significantly decreased left and right amygdala connectivity with frontal (specifically mPFC), temporal, parietal, and cerebellar regions. Subjective stress, but not craving, increased from pre-to post-task.ConclusionsThis study demonstrated decreased connectivity between the amygdala and regions important for stress and emotional processing in long-term abstinent individuals with AD. These results suggest aberrant stress processing in individuals with AD even after lengthy periods of abstinence.

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Craving Mediates Stress in Predicting Lapse During Alcohol Dependence Treatment

Abstract: Among treatment seeking, alcohol-dependent patients, craving mediated the relationship between stress and lapse. The effect was not moderated by depressed mood or anticraving medication.

Cited by 34 publications

References 51 publications

Social cognitive predictors of treatment outcome in cannabis dependence

Social cognitive predictors of treatment outcome in cannabis dependence

Craving mediates the effect of impulsivity on lapse-risk during alcohol use disorder treatment

Blunted amygdala functional connectivity during a stress task in alcohol dependent individuals: A pilot study

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