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Lee IT, Liao PC, Liu TH, Ogai Y, Chang HM, Liu YL, Huang MC. Psychometric evaluation of the Chinese version of alcohol relapse risk scale (C-ARRS) in patients with alcohol use disorder. Alcohol 2024; 120:25-33. [PMID: 38843962 DOI: 10.1016/j.alcohol.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/29/2024] [Accepted: 05/30/2024] [Indexed: 07/02/2024]
Abstract
Alcohol use disorder (AUD) is recognized as a chronic relapsing disorder. Alcohol Relapse Risk Scale (ARRS), a multidimensionally self-rating scale, was developed initially by the Japanese to assess the risk of alcohol reuse. The study aimed to validate the reliability and factor structure of the Chinese version of the ARRS (C-ARRS) for patients with AUD. A total of 218 patients diagnosed with AUD according to DSM-5 were recruited for self-administering C-ARRS. We assessed the internal consistency of C-ARRS using Cronbach's α coefficients and examined the factor structure through confirmatory factor analysis (CFA). Additionally, we investigated the concurrent validity by correlating C-ARRS with the Visual Analog Scale of Alcohol Craving (VAS), Penn Alcohol Craving Score (PACS), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) scores. CFA demonstrated inadequate data fit for the original 32-item C-ARRS, prompting the development of a revised 27-item version consisting of 6 subscales with satisfactory model fit estimates. The 27-item C-ARRS exhibited favorable internal consistency, with Cronbach's α ranging from 0.611 to 0.798, along with adequate factor loadings. The 27-item C-ARRS scores displayed significant correlations with the scores of VAS, PACS, BDI and BAI (p < .001). Our results indicated favorable reliability and factor structure of the 27-item C-ARRS. The significant correlation between the 27-item C-ARRS and clinical measures (such as depression, anxiety, and craving) demonstrates satisfactory concurrent validity. These observations collectively support the feasibility of using 27-item C-ARRS to assess the risk of alcohol relapse in patients with AUD.
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Affiliation(s)
- I-Ting Lee
- Department of Psychiatry, Taipei City Hospital, Songde Branch, Taipei, Taiwan
| | - Po-Chiao Liao
- Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan
| | - Tung-Hsia Liu
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Yasukazu Ogai
- Addictive Substance Project, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan; Faculty of Medicine, Social Psychiatry and Mental Health, University of Tsukuba, Tsukuba, Japan
| | - Hu-Ming Chang
- Department of Psychiatry, Taipei City Hospital, Songde Branch, Taipei, Taiwan
| | - Yu-Li Liu
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan.
| | - Ming-Chyi Huang
- Department of Psychiatry, Taipei City Hospital, Songde Branch, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
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Amano Y, Koizumi K, Takizawa H, Hamaguchi T. Cravings for alcohol in alcohol use disorders are associated with attention deviation to alcohol: An observational study of Japanese in-patients. Medicine (Baltimore) 2023; 102:e33222. [PMID: 36897713 PMCID: PMC9997779 DOI: 10.1097/md.0000000000033222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/16/2023] [Indexed: 03/11/2023] Open
Abstract
Alcohol use disorder (AUD) may be associated with increased attentional bias (AB) toward alcohol-related information. Accordingly, our aim was to explore the relationships between alcohol-related AB, cravings, and risk of relapse among individuals with AUD after treatment. The study group included 24 in-patients with AUD who had completed alcohol withdrawal management. AB was evaluated using an image-based task, with participants asked to select the nonalcoholic image as fast and as accurately as possible and the response time (RT) measured. The intensity of the desire to drink was evaluated using a 100-mm Visual Analog Scale and the risk of relapse using the Alcohol Relapse Risk Scale. Linear regression was used to evaluate the relationship between these variables, with age, gender, duration of hospitalization, and depression score used as covariates. Intensity of cravings was significantly associated with AB RT (R2 =.625) and risk of relapse of drinking behavior (Alcohol Relapse Risk Scale score, R2 =.64). Gender and γ-GTP were significant explanatory variables of identified relationships. The main limitations of our study are a higher proportion of men than women in our study group and the absence of a control group for baseline comparison of AB RTs. This study results suggested that the desire to drink is related to AB among patients with AUD and that the intensity of the desire to drink is related to the risk of a relapse in drinking behavior after AUD treatment.
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Affiliation(s)
- Yoshifumi Amano
- Department of Rehabilitation, Graduate School of Health Science, Saitama Prefectural University, Koshigaya, Saitama, Japan
| | - Kouhei Koizumi
- Department of Rehabilitation, Graduate School of Health Science, Saitama Prefectural University, Koshigaya, Saitama, Japan
| | - Hirokazu Takizawa
- Department of Rehabilitation, Graduate School of Health Science, Saitama Prefectural University, Koshigaya, Saitama, Japan
| | - Toyohiro Hamaguchi
- Department of Rehabilitation, Graduate School of Health Science, Saitama Prefectural University, Koshigaya, Saitama, Japan
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Kawata T, Sugihara G, Kakibuchi Y, Tomitaka M, Miyajima M, Matsushima E, Takeuchi T, Takahashi H. Attention-deficit hyperactivity symptoms and risk of alcohol use relapse. Neuropsychopharmacol Rep 2023; 43:103-111. [PMID: 36572959 PMCID: PMC10009435 DOI: 10.1002/npr2.12312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/29/2022] [Accepted: 12/09/2022] [Indexed: 12/28/2022] Open
Abstract
AIM Alcohol use disorder (AUD) is frequently accompanied by comorbid attention-deficit hyperactivity disorder (ADHD). Comorbid ADHD has been reported to increase the severity of AUD. We investigated whether ADHD severity also influences AUD relapse risk at baseline and after inpatient treatment. METHODS In this study, 187 AUD patients admitted to Narimasu Kosei Hospital from October 2019 to March 2021 were included in the analysis. According to the Adult ADHD Self-Report Scale (ASRS), participants were divided into two groups: ASRS+ with ADHD characteristics (n = 43) and ASRS- with low/no ADHD characteristics (n = 144). Groups were compared for AUD relapse risk at the start of treatment (baseline) and before hospital discharge using the multidimensional Alcohol Relapse Risk Scale (ARRS). The change in relapse risk during hospitalization was also compared by assessment of the interaction between groups (ASRS+ vs. ASRS-) and time (at discharge vs. baseline). RESULTS The total ARRS score and dimension subscores for stimulus-induced vulnerability and emotionality problems were significantly higher in the ASRS+ group at baseline and before discharge compared to the ASRS- group. There was a significant group × time interaction indicating less improvement of stimulus-induced vulnerability during inpatient treatment among the ASRS+ group compared to the ASRS- group. CONCLUSIONS Our findings suggest that AUD patients with ADHD characteristics have a higher risk of relapse both at baseline and after inpatient treatment. Stimulus-induced vulnerability to relapse is less likely to improve with treatment in patients with ADHD characteristics.
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Affiliation(s)
- Takahiro Kawata
- Liaison Psychiatry and Psycho-Oncology Unit, Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Narimasu Kosei Hospital, Tokyo, Japan
| | - Genichi Sugihara
- Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | | | - Midori Tomitaka
- Narimasu Kosei Hospital, Tokyo, Japan.,Jiyu Clinic, Tokyo, Japan
| | - Miho Miyajima
- Liaison Psychiatry and Psycho-Oncology Unit, Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Eisuke Matsushima
- Liaison Psychiatry and Psycho-Oncology Unit, Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Takeuchi
- Liaison Psychiatry and Psycho-Oncology Unit, Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hidehiko Takahashi
- Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Center for Brain Integration Research, Tokyo Medical and Dental University, Tokyo, Japan
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Sasaki J, Matsubara T, Chen C, Fujii Y, Fujita Y, Nakamuta M, Nitta K, Egashira K, Hashimoto T, Nakagawa S. Prefrontal activity during the emotional go/no-go task and computational markers of risk-based decision-making predict future relapse in alcohol use disorder. Front Psychiatry 2022; 13:1048152. [PMID: 36683993 PMCID: PMC9845941 DOI: 10.3389/fpsyt.2022.1048152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/28/2022] [Indexed: 01/05/2023] Open
Abstract
AIM To longitudinally examine if the results of cognitive tasks or brain function during emotional or cognitive tasks can predict relapse in alcohol use disorder. METHODS We selected 41 patients with alcohol use disorder during hospitalization. Functional near-infrared spectroscopy (fNIRS) measured the relative change in oxygenated hemoglobin in the frontotemporal areas during an emotional go/no-go task and verbal fluency task (VFT). They performed the N-back and risk-based decision-making tasks for determining working memory or risk-based decision-making. The presence of relapse 6 months following discharge was the primary outcome. RESULTS Twenty-four patients (21 men, three women) remained abstinent, whereas 17 (14 men, three women) relapsed. Compared with the abstinent group, those with relapse displayed significantly decreased activation in the right frontotemporal region during the emotional go/no-go task, significantly shorter reaction time to non-emotional stimuli, and greater risk preference in the risk-based decision-making task. In the abstinent group, we observed a negative correlation between oxygenated hemoglobin and the craving scale. A logistic regression analysis demonstrated that the risk of relapse increased with smaller oxygenated hemoglobin in the right frontotemporal region (odds ratio = 0.161, p = 0.013) and with greater gambling thoughts (odds ratio = 7.04, p = 0.033). CONCLUSION Decreased activation in the right frontotemporal region in response to an emotional stimulus and risk preference could predict relapse in alcohol use disorder.
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Affiliation(s)
- Jun Sasaki
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan.,Koryo Hospital, Ube, Japan
| | - Toshio Matsubara
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Chong Chen
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Yuko Fujii
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | | | | | | | | | | | - Shin Nakagawa
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
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J JM, Kunjumon NC, Ruben JP, Devarbhavi H. Stressful life events, social support, and risk for relapse in relapsed harmful alcohol users in South India: a comparative study between psychiatry and gastroenterology patients. J Addict Dis 2020; 39:125-132. [PMID: 33064059 DOI: 10.1080/10550887.2020.1828536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Previous studies have identified risk factors for relapse in patients with alcohol use disorders in deaddiction or community settings. There are limited studies comparing the stressful life events, social support, and risk of relapse in relapsed harmful alcohol users between psychiatry and gastroenterology departments.Objective: To compare the stressful life events, social support, and risk of relapse in relapsed harmful alcohol users between psychiatry and gastroenterology departments.Methods: Comparative, cross-sectional study design was used in males with harmful alcohol use as defined by AUDIT and with at least one relapse. Presumptive Stressful Life Events Scale, Multidimensional Perceived Social Support Scale, and Alcohol Relapse Risk Scale were used.Results: Severity of alcohol harmful use was significantly higher in psychiatry patients than gastroenterology. Increased number of gastroenterology patients reported "change in their sleeping habits" as an important factor for relapse than psychiatry, which was not significant. Only stimulus-induced vulnerability was significantly increased in psychiatry patients compared to gastroenterology. Social support significantly correlated with the alcohol relapse risk scores in the psychiatry group, while in the gastroenterology, the severity of alcohol harmful use scores significantly correlated with total alcohol relapse risk scores.Conclusions: The individual stressors and the risk for relapse were different between the two groups. There was no difference in social support between the two groups. These findings can have implications for using these factors in relapse prevention strategies by focusing on the factors specifically found in each group. However, these findings have to be studied in a larger community sample.
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Affiliation(s)
- Jobi Mol J
- Department of Psychiatry Nursing, St. Johns College of Nursing, Bengaluru, India
| | | | | | - Harshad Devarbhavi
- Department of Gastroenterology, St. John's Medical College, Bengaluru, India
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