1
|
Kavaliotis E, Boardman JM, Clark JW, Ogeil RP, Verdejo-García A, Drummond SPA. The relationship between sleep and appetitive conditioning: A systematic review and meta-analysis. Neurosci Biobehav Rev 2023; 144:105001. [PMID: 36529310 DOI: 10.1016/j.neubiorev.2022.105001] [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: 08/23/2022] [Revised: 11/24/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
This systematic review and meta-analysis (PROSPERO registration animal/human studies: CRD42021234793/CRD42021234790) examined the relationship between sleep and appetitive conditioning. Inclusion criteria included: a) appetitive conditioning paradigm; b) measure of conditioning; c) sleep measurement and/or sleep loss; d) human and/etor non-human animal samples; and e) written in English. Searches of seven databases returned 3777 publications. The final sample consisted of 42 studies using primarily animal samples and involving food- and drug-related conditioning tasks. We found sleep loss disrupted appetitive conditioning of food rewards (p < 0.001) but potentiated appetitive conditioning of drug rewards (p < 0.001). Furthermore, sleep loss negatively impacted extinction learning irrespective of the reward type. Post-learning sleep was associated with increases in REM sleep (p = 0.02). Findings suggest sleep loss potentiates the impact of psychoactive substances in a manner likely to produce an increased risk of problematic substance use. In obese/overweight populations, sleep loss may be associated with deficits in the conditioning and extinction of reward-related behaviours. Further research should assess the relationship between sleep and appetitive conditioning in humans.
Collapse
Affiliation(s)
- Eleni Kavaliotis
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria 3800, Australia
| | - Johanna M Boardman
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria 3800, Australia
| | - Jacob W Clark
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria 3800, Australia
| | - Rowan P Ogeil
- Eastern Health Clinical School and Monash Addiction Research Centre, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria 3800, Australia; Turning Point, Eastern Health, Victoria 3121, Australia
| | - Antonio Verdejo-García
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria 3800, Australia
| | - Sean P A Drummond
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria 3800, Australia.
| |
Collapse
|
2
|
Oei A, Chu CM, Li D, Ng N, Yeo C, Ruby K. Relationship between Adverse Childhood Experiences and substance use in youth offenders in Singapore. CHILD ABUSE & NEGLECT 2021; 117:105072. [PMID: 33892413 DOI: 10.1016/j.chiabu.2021.105072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 03/25/2021] [Accepted: 04/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Adverse Childhood Experiences are associated with worse outcomes in delinquency and substance use. OBJECTIVE Current research is overwhelmingly from Western perspectives, leaving a gap in non-Western, low crime-rate jurisdictions. Moreover, there exists a gap in characterizing the effect of ACE frequency on delinquency. We extend existing research by examining relationships between ACE and substance use in youth offenders in Singapore. PARTICIPANTS AND SETTING The study included 790 youth offenders (669 males, Mage = 17.59 years) from a longitudinal study on youth offending. METHODS Multiple regression was performed to examine relationships between self-reported ACEs and substance use. Latent Class Analysis was conducted to identify classes of substance use onset. The relationship between these classes and cumulative ACEs and ACE frequency were then tested using multiple regression. RESULTS Youth offenders who consume alcohol (B = 0.66, p = .002) and illicit drugs (B = 0.38, p = .02) had more cumulative and more frequent ACEs than those who do not. Moreover, we found a positive relationship between ACEs and substance use frequency. Those who started taking substances in childhood had significantly more ACEs and had worse drug dependency problems than those who started later (t = 5.93, p < .0001). Additionally, there was a positive relationship between ACEs and drug use dependency (B = 0.11, p = .03). CONCLUSIONS Our findings highlight the importance of ACEs as risk factors for substance use. This underscores the need for comprehensive screening and treatment of ACEs and substance use in the rehabilitative context.
Collapse
Affiliation(s)
- Adam Oei
- Translational Social Research Division, National Council of Social Service, 170 Ghim Moh Road, Ulu Pandan Community Building, #01-02, 279621, Singapore; Social Service Research Centre, Faculty of Arts and Social Sciences, National University of Singapore, The Shaw Foundation Building, Blk AS7, Level 3, #03-22, 117570, Singapore.
| | - Chi Meng Chu
- Translational Social Research Division, National Council of Social Service, 170 Ghim Moh Road, Ulu Pandan Community Building, #01-02, 279621, Singapore; Policy Research Office, Ministry of Social and Family Development, 512 Thomson Road, MSF Building, #07-00, 298136, Singapore.
| | - Dongdong Li
- Translational Social Research Division, National Council of Social Service, 170 Ghim Moh Road, Ulu Pandan Community Building, #01-02, 279621, Singapore; Social Service Research Centre, Faculty of Arts and Social Sciences, National University of Singapore, The Shaw Foundation Building, Blk AS7, Level 3, #03-22, 117570, Singapore.
| | - Nyx Ng
- Social Service Research Centre, Faculty of Arts and Social Sciences, National University of Singapore, The Shaw Foundation Building, Blk AS7, Level 3, #03-22, 117570, Singapore.
| | - Carl Yeo
- Social Service Research Centre, Faculty of Arts and Social Sciences, National University of Singapore, The Shaw Foundation Building, Blk AS7, Level 3, #03-22, 117570, Singapore.
| | - Kala Ruby
- Probation and Community Rehabilitation Services, Ministry of Social and Family Development, 1 Kay Siang Rd, #01-10, 248922, Singapore.
| |
Collapse
|
3
|
Corbin WR, Hartman JD, Bruening AB, Fromme K. Contextual influences on subjective alcohol response. Exp Clin Psychopharmacol 2021; 29:48-58. [PMID: 32673048 PMCID: PMC8405099 DOI: 10.1037/pha0000415] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Prior research demonstrates contextual influences on drug responses in both animals and humans, although studies in humans typically focus on only one aspect of context (e.g., social) and examine a limited range of subjective experiences. The current study sought to address these limitations by examining the impact of both social and physical context on the full range of subjective alcohol effects. The sample included 448 young adult social drinkers (57% male, 66.5% White) randomly assigned to consume alcohol (target blood alcohol concentration of .08 g%) or placebo in 1 of 4 contexts (solitary lab, group lab, solitary bar, group bar). Results indicated that high arousal positive (HAP) effects of alcohol (e.g., talkative, lively) were stronger in nonbar relative to bar contexts and that low arousal positive (LAP) effects (e.g., relaxed, calm) were only present in the group lab context. There were also main effects of social context such that high arousal effects (both positive and negative) were stronger in group contexts, regardless of beverage condition. These findings highlight the importance of considering context when examining alcohol effects. Studies designed to isolate pharmacological HAP effects may benefit from a nonbar setting, and studies of LAP effects might be most effective in a simulated living room or home environment, although future studies are needed to directly address this possibility. Further, studies with an explicit focus on expectancies or that need strong control for expectancies might benefit from a group context, particularly when studying high arousal effects. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
|
4
|
Lydon-Staley D, Leventhal A, Piper M, Schnoll R, Bassett D. Temporal networks of tobacco withdrawal symptoms during smoking cessation treatment. JOURNAL OF ABNORMAL PSYCHOLOGY 2021; 130:89-101. [PMID: 33252918 PMCID: PMC7818515 DOI: 10.1037/abn0000650] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A recently developed network perspective on tobacco withdrawal posits that withdrawal symptoms causally influence one another across time, rather than simply being indicators of a latent syndrome. Evidence supporting a network perspective would shift the focus of tobacco withdrawal research and intervention toward studying and treating individual withdrawal symptoms and intersymptom associations. Here we construct and examine temporal tobacco withdrawal networks that describe the interplay among withdrawal symptoms across time using experience-sampling data from 1,210 participants (58.35% female, 86.24% White) undergoing smoking cessation treatment. We also construct person-specific withdrawal networks and capture individual differences in the extent to which withdrawal symptom networks promote the spread of symptom activity through the network across time using impulse response analysis. Results indicate substantial moment-to-moment associations among withdrawal symptoms, substantial between-person differences in withdrawal network structure, and reductions in the interplay among withdrawal symptoms during combination smoking cessation treatment. Overall, findings suggest the utility of a network perspective and also highlight challenges associated with the network approach stemming from vast between-person differences in symptom networks. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Collapse
Affiliation(s)
- D.M. Lydon-Staley
- Annenberg School for Communication, University of Pennsylvania
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania
- Leonard Davis Institute of Health Economics, University of Pennsylvania
| | - A.M. Leventhal
- Department of Preventive Medicine, Institute for Addiction Science, University of Southern California Keck School of Medicine
- Department of Psychology, University of Southern California
| | - M.E. Piper
- Department of Medicine, University of Wisconsin Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health
| | - R.A. Schnoll
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
- Abramson Cancer Center, University of Pennsylvania
| | - D.S. Bassett
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
- Department of Electrical & Systems Engineering, School of Engineering and Applied Science, University of Pennsylvania
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania
- Department of Physics & Astronomy, College of Arts and Sciences, University of Pennsylvania
- The Santa Fe Institute
| |
Collapse
|
5
|
Otto MW, Zvolensky MJ, Rosenfield D, Hoyt DL, Witkiewitz K, McKee SA, Bickel WK, Smits JAJ. A randomized controlled trial protocol for engaging distress tolerance and working memory to aid smoking cessation in low socioeconomic status (SES) adults. Health Psychol 2020; 39:815-825. [PMID: 32833483 PMCID: PMC8489738 DOI: 10.1037/hea0000858] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Low income and low educational attainment are among the strongest predictors of both smoking prevalence and lapse (i.e., return) to smoking after cessation attempts. Treatment refinement is limited by inadequate knowledge of the specific lapse- or relapse-relevant vulnerabilities characteristic of populations that should be the target of treatment. In the context of a randomized clinical trial design, we describe an experimental medicine approach for evaluating the role of 2 specific lapse-relevant targets relative to the higher stress characteristic of low-socioeconomic contexts: low distress tolerance and low working memory capacity. Furthermore, we use an innovative approach for understanding risk of smoking lapse in smokers undergoing a quit attempt to examine candidate mechanistic targets assessed not only during nicotine use, but also during the conditions smokers will face upon a cessation attempt-during stressful nicotine-deprivation windows. This study is designed to show the incremental value of assessments during deprivation windows, in part because of the way in which specific vulnerabilities are modified by, and interact with, the heightened stress and withdrawal symptoms inherent to nicotine-deprivation states. Specifically, the study is designed to evaluate whether a novel mindfulness intervention (mindfulness combined with interoceptive exposure) can improve upon existing mindfulness interventions and extend therapeutic gains to the modification of mechanistic targets assessed in high-stress or negative affectivity contexts. The overall goal is to validate mechanistic targets and associated interventions for the purpose of expanding treatment options for at-risk smokers. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
- Michael W. Otto
- Department of Psychological and Brain Sciences, Boston University
| | | | | | - Danielle L. Hoyt
- Department of Psychological and Brain Sciences, Boston University
| | | | - Sherry A. McKee
- Department of Psychiatry, Yale School of Medicine, New Haven, CT 06519
| | - Warren K. Bickel
- Addiction Recovery Research Center, Fralin Biomedical Research Institute
| | | |
Collapse
|
6
|
Saedy M, Rezaei Ardani A, Kooshki S, Firouzabadi MJ, Emamipour S, Darabi Mahboub L, Mojahedi M. Effectiveness of Acceptance–Commitment Therapy on Craving Beliefs in Patients on Methadone Maintenance Therapy: A Pilot Study. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2018. [DOI: 10.1007/s10942-018-0287-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
7
|
|
8
|
Ekhtiari H, Rezapour T, Aupperle RL, Paulus MP. Neuroscience-informed psychoeducation for addiction medicine: A neurocognitive perspective. PROGRESS IN BRAIN RESEARCH 2017; 235:239-264. [PMID: 29054291 PMCID: PMC5771228 DOI: 10.1016/bs.pbr.2017.08.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Psychoeducation (PE) is defined as an intervention with systematic, structured, and didactic knowledge transfer for an illness and its treatment, integrating emotional and motivational aspects to enable patients to cope with the illness and to improve its treatment adherence and efficacy. PE is considered an important component of treatment in both medical and psychiatric disorders, especially for mental health disorders associated with lack of insight, such as alcohol and substance use disorders (ASUDs). New advancements in neuroscience have shed light on how various aspects of ASUDs may relate to neural processes. However, the actual impact of neuroscience in the real-life clinical practice of addiction medicine is minimal. In this chapter, we provide a perspective on how PE in addiction medicine can be informed by neuroscience in two dimensions: content (knowledge we transfer in PE) and structure (methods we use to deliver PE). The content of conventional PE targets knowledge about etiology of illness, treatment process, adverse effects of prescribed medications, coping strategies, family education, and life skill training. Adding neuroscience evidence to the content of PE could be helpful in communicating not only the impact of drug use but also the beneficial impact of various treatments (i.e., on brain function), thus enhancing motivation for compliance and further destigmatizing their symptoms. PE can also be optimized in its "structure" by implicitly and explicitly engaging different neurocognitive processes, including salience/attention, memory, and self-awareness. There are many interactions between these two dimensions, structure and content, in the delivery of neuroscience-informed psychoeducation (NIPE). We explore these interactions in the development of a cartoon-based NIPE to promote brain recovery during addiction treatment as a part of the brain awareness for addiction recovery initiative.
Collapse
Affiliation(s)
- Hamed Ekhtiari
- Laureate Institute for Brain Research, Tulsa, OK, United States; Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran.
| | - Tara Rezapour
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran; Translational Neuroscience Program, Institute for Cognitive Science Studies, Tehran, Iran
| | - Robin L Aupperle
- Laureate Institute for Brain Research, Tulsa, OK, United States; School of Community Medicine, University of Tulsa, Tulsa, OK, United States
| | - Martin P Paulus
- Laureate Institute for Brain Research, Tulsa, OK, United States
| |
Collapse
|
9
|
Lydon-Staley DM, Cleveland HH, Huhn AS, Cleveland MJ, Harris J, Stankoski D, Deneke E, Meyer RE, Bunce SC. Daily sleep quality affects drug craving, partially through indirect associations with positive affect, in patients in treatment for nonmedical use of prescription drugs. Addict Behav 2017; 65:275-282. [PMID: 27544697 DOI: 10.1016/j.addbeh.2016.08.026] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 07/28/2016] [Accepted: 08/13/2016] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Sleep disturbance has been identified as a risk factor for relapse in addiction to a range of substances. The relationship between sleep quality and treatment outcome has received relatively little attention in research on nonmedical use of prescription drugs (NMUPD). This study examined the within-person association between sleep quality and craving in medically detoxified patients in residence for the treatment of NMUPD. METHOD Participants (n=68) provided daily reports of their sleep quality, negative affect (NA), positive affect (PA), and craving for an average of 9.36 (SD=2.99) days. Within-person associations of sleep quality and craving were examined using multilevel modeling. Within-person mediation analyses were used to evaluate the mediating roles of NA and PA in the relationship between sleep quality and craving. RESULTS Greater cravings were observed on days of lower than usual sleep quality (γ10=-0.10, p=0.003). Thirty-one percent of the overall association between sleep quality and craving was explained by PA, such that poorer sleep quality was associated with lower PA and, in turn, lower PA was associated with greater craving. No evidence emerged for an indirect association between sleep quality and craving through NA. CONCLUSIONS Daily fluctuations in sleep quality were associated with fluctuations in craving, an association partially explained by the association between sleep quality and daily PA. These data encourage further research on the relationship between sleep, affect, and craving in NMUPD patients, as well as in patients with other substance use disorders.
Collapse
Affiliation(s)
- David M Lydon-Staley
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States.
| | - H Harrington Cleveland
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
| | - Andrew S Huhn
- Department of Psychiatry, The Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Michael J Cleveland
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, United States
| | - Jonathan Harris
- Department of Psychiatry, The Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Dean Stankoski
- Department of Psychiatry, The Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Erin Deneke
- Caron Treatment Centers, Wernersville, PA, United States
| | - Roger E Meyer
- Department of Psychiatry, The Pennsylvania State University College of Medicine, Hershey, PA, United States
| | - Scott C Bunce
- Department of Psychiatry, The Pennsylvania State University College of Medicine, Hershey, PA, United States
| |
Collapse
|
10
|
McCarthy DE, Bold KW, Minami H, Yeh VM. A randomized clinical trial of a tailored behavioral smoking cessation preparation program. Behav Res Ther 2016; 78:19-29. [PMID: 26827293 PMCID: PMC4790439 DOI: 10.1016/j.brat.2015.11.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 11/24/2015] [Accepted: 11/30/2015] [Indexed: 11/28/2022]
Abstract
Despite considerable progress in reducing cigarette smoking prevalence and enhancing smoking cessation treatments, most smokers who attempt to quit relapse. The current randomized clinical trial evaluated the efficacy of an adjunctive behavioral smoking cessation treatment based on learning theory. Adult daily smokers were randomly assigned to standard treatment (N = 47) with nicotine patch and individual counseling or to standard treatment plus a "practice quitting" program involving seven sessions of escalating prescribed abstinence periods (N = 46) prior to a target stop smoking date. Practice quitting was designed to extinguish smoking in response to withdrawal symptoms. Retention in treatment was excellent and the treatment manipulation increased the interval between cigarettes across practice quitting sessions on average by 400%. The primary endpoint, seven-day point-prevalence abstinence four weeks post-quit, was not significantly affected by practice quitting (31.9% in the standard treatment condition, 37.0% in the practice quitting condition). Practice quitting increased latency to a first lapse among those who quit smoking for at least one day and prevented progression from a first lapse to relapse (smoking daily for a week) relative to standard treatment, however. Practice quitting is a promising adjunctive treatment in need of refinement to enhance adherence and efficacy.
Collapse
Affiliation(s)
- Danielle E McCarthy
- Rutgers, The State University of New Jersey Department of Psychology, Institute for Health, Health Care Policy and Aging Research, 112 Paterson St., New Brunswick, NJ 08901, USA.
| | - Krysten W Bold
- Rutgers, The State University of New Jersey Department of Psychology, Institute for Health, Health Care Policy and Aging Research, 112 Paterson St., New Brunswick, NJ 08901, USA.
| | - Haruka Minami
- Rutgers, The State University of New Jersey Department of Psychology, Institute for Health, Health Care Policy and Aging Research, 112 Paterson St., New Brunswick, NJ 08901, USA.
| | - Vivian M Yeh
- Rutgers, The State University of New Jersey Department of Psychology, Institute for Health, Health Care Policy and Aging Research, 112 Paterson St., New Brunswick, NJ 08901, USA.
| |
Collapse
|
11
|
Otto MW, Hearon BA, McHugh RK, Calkins AW, Pratt E, Murray HW, Safren SA, Pollack MH. A randomized, controlled trial of the efficacy of an interoceptive exposure-based CBT for treatment-refractory outpatients with opioid dependence. J Psychoactive Drugs 2015; 46:402-11. [PMID: 25364993 DOI: 10.1080/02791072.2014.960110] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Many patients diagnosed with opioid dependence do not adequately respond to pharmacologic, psychosocial, or combination treatment, highlighting the importance of novel treatment strategies for this population. The current study examined the efficacy of a novel behavioral treatment focusing on internal cues for drug use (Cognitive Behavioral Therapy for Interoceptive Cues; CBT-IC) relative to an active comparison condition, Individual Drug Counseling (IDC), when added to methadone maintenance treatment (MMT) among those who had not responded to MMT. Participants (N=78) were randomly assigned to receive 15 sessions of CBT-IC or IDC as an adjunct to ongoing MMT and counseling. Oral toxicology screens were the primary outcome. Results indicated no treatment differences between CBT-IC and IDC and a small, significant reduction of self-reported drug use, but no change on toxicology screens. Tests of potential moderators, including sex, anxiety sensitivity, and coping motives for drug use, did not yield significant interactions. Among opioid-dependent outpatients who have not responded to MMT and counseling, the addition of IDC or CBT-IC did not result in additive outcome benefits. These results highlight the need for more potent treatment strategies for opioid dependence, particularly among those who do not fully respond to frontline treatment.
Collapse
Affiliation(s)
- Michael W Otto
- a Professor of Psychology, Boston University , Boston , MA
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Moshier SJ, Ewen M, Otto MW. Impulsivity as a moderator of the intention-behavior relationship for illicit drug use in patients undergoing treatment. Addict Behav 2013; 38:1651-5. [PMID: 23254213 PMCID: PMC3558639 DOI: 10.1016/j.addbeh.2012.09.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Revised: 07/26/2012] [Accepted: 09/06/2012] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Evident across clinical practice and clinical trials is a divergence between stated intentions and subsequent drug-related behaviors in substance abuse treatment settings. Impulsivity, itself related to drug abuse, may be one variable which may moderate the degree of disconnect in the intention-behavior relationship. The present study examines the relationship between self-stated desire to quit, impulsivity, and drug use in a group of outpatients receiving methadone maintenance treatment. In particular, we examined the direct and moderating influence of different facets of impulsivity (urgency, lack of premeditation, sensation seeking, and lack of perseverance) on drug use in the context of a stated desire to abstain from drugs. METHOD 84 opioid-dependent individuals undergoing counseling and methadone maintenance treatment completed a battery of self-report questionnaires including measures of impulsivity (UPPS Impulsivity Scale), stated desire to quit, and past 30-day drug use. We hypothesized that two facets of impulsivity, urgency and (lack of) premeditation, would moderate the relationship between desire to quit and past 30-day drug use, such that the relationship between intention and behavior would be weaker in those with high levels of these facets of impulsivity. RESULTS Consistent with the disconnect between intentions and drug-use behaviors typical of treatment settings, desire to quit was not directly associated with self-reported past month drug use. However, in separate regression analyses, 2 facets of impulsivity, premeditation and sensation seeking, moderated the relationship between desire to quit and past month use. Whereas there was not a significant relationship between desire to quit and drug use in individuals high in sensation-seeking or lack of premeditation, the relationship between intention and drug use behaviors was preserved in those low in these facets of impulsivity. CONCLUSION These findings indicate that the relationship between desire to quit and self-reported past-month drug use is weak for those high in sensation seeking or low in premeditation. These results are discussed in the context of current interventions for substance dependence.
Collapse
|
13
|
Abstract
Cognitive behavioral therapy (CBT) for substance use disorders has shown efficacy as a monotherapy and as part of combination treatment strategies. This article provides a review of the evidence supporting the use of CBT, clinical elements of its application, novel treatment strategies for improving treatment response, and dissemination efforts. Although CBT for substance abuse is characterized by heterogeneous treatment elements such as operant learning strategies, cognitive and motivational elements, and skills-building interventions, across protocols several core elements emerge that focus on overcoming the powerfully reinforcing effects of psychoactive substances. These elements, and support for their efficacy, are discussed.
Collapse
Affiliation(s)
- R Kathryn McHugh
- Department of Psychology, Boston University, 648 Beacon Street, 6th Floor, Boston, MA 02215, USA.
| | | | | |
Collapse
|