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Barrett BW, Meanley S, Brennan-Ing M, Haberlen SA, Ware D, Detels R, Friedman MR, Plankey MW. The Relationship Between Posttraumatic Stress Disorder and Alcohol Misuse and Smoking Among Aging Men Who Have Sex With Men: No Evidence of Exercise or Volunteering Impact. J Aging Health 2023:8982643231215475. [PMID: 37976419 PMCID: PMC11288306 DOI: 10.1177/08982643231215475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVES To determine if the association between posttraumatic stress disorder (PTSD) and substance use (alcohol misuse or smoking tobacco) is mediated/moderated by exercise or volunteering among aging (≥40 years) men who have sex with men (MSM), and if this mediation/moderation differs by HIV serostatus. METHODS Multicenter AIDS Cohort Study data were used. Three datasets with PTSD measured during different time periods (10/1/2017-3/31/2018, 898 men; 4/1/2018-9/30/2018, 890 men; 10/1/2018-3/31/2019, 895 men) were analyzed. Longitudinal mediation analyses estimated the mediation effect of exercise and volunteering on the outcomes. RESULTS Nine percent of MSM had evidence of PTSD. There was no statistically significant mediation effect of exercise or volunteering regardless of substance use outcome. The odds of smoking at a future visit among MSM with PTSD were approximately double those of MSM without PTSD. Results did not differ by HIV serostatus. DISCUSSION There is a particular need for effective smoking cessation interventions for aging MSM with PTSD.
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Affiliation(s)
- Benjamin W. Barrett
- Department of Epidemiology, Bloomberg School of Public
Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Steven Meanley
- Department of Family and Community Health, University of
Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Mark Brennan-Ing
- Brookdale Center for Healthy Aging, Hunter College, The
City University of New York, New York, New York, USA
| | - Sabina A. Haberlen
- Department of Epidemiology, Bloomberg School of Public
Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Deanna Ware
- Department of Medicine, Georgetown University Medical
Center, Washington, District of Columbia, USA
| | - Roger Detels
- Department of Epidemiology, Fielding School of Public
Health, University of California, Los Angeles, Los Angeles, California, USA
| | - M. Reuel Friedman
- Department of Urban-Global Public Health, School of Public
Health, Rutgers University, Newark, New Jersey, USA
| | - Michael W. Plankey
- Department of Medicine, Georgetown University Medical
Center, Washington, District of Columbia, USA
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2
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Piché F, Daneau C, Plourde C, Girard S, Romain AJ. Characteristics and impact of physical activity interventions during substance use disorder treatment excluding tobacco: A systematic review. PLoS One 2023; 18:e0283861. [PMID: 37099488 PMCID: PMC10132651 DOI: 10.1371/journal.pone.0283861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 03/19/2023] [Indexed: 04/27/2023] Open
Abstract
Substance use disorder is a worldwide issue that entails negative health and physical activity is a promising complementary therapy for alleviating the consequences. The objective of this reviews is to characterize physical activity interventions offered in the literature and explore their effects during treatment for people with substance use disorders with excluding studies focusing only on tobacco use. A systematic search of seven databases on articles including a physical activity intervention during a treatment for substance use disorder was done and an examination of the presence of bias was performed. A total of 43 articles including 3135 participants were identified. Most studies were randomized controlled trial (81%), followed by pre-post design (14%) and cohort studies (5%). The most common physical activity intervention identified was of moderate intensity, 3 times per week (≈ 1 hour) for 13 weeks. Cessation/reduction of substance use was the most studied outcome (21 studies, 49%), and 75% showed a decrease in substance use following physical activity intervention. Aerobic capacity was the second most studied effect (14 studies, 33%), with more than 71% of studies showing improvement. Twelve studies (28%) reported a decrease of depressive symptoms. Physical activity interventions in a treatment for substance use disorder seem to be a promising, but more methodologically rigorous scientific studies are needed.
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Affiliation(s)
- Florence Piché
- Department of Human Kinetics, University of Quebec in Trois-Rivières, Trois-Rivières, Québec, Canada
- Faculty of Medicine, University of Montreal, Montreal, Québec, Canada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Québec, Canada
| | - Catherine Daneau
- Department of Human Kinetics, University of Quebec in Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Chantal Plourde
- Department of Psychoeducation, University of Quebec in Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Stéphanie Girard
- Department of Human Kinetics, University of Quebec in Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Ahmed Jérôme Romain
- Faculty of Medicine, University of Montreal, Montreal, Québec, Canada
- Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Québec, Canada
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Köhlerová MZ, Fišerová Z, Páv M. Physical activity habits and their effects on quality of life in patients with addiction: data from the Czech Republic. CURRENT PSYCHOLOGY 2023:1-8. [PMID: 37359646 PMCID: PMC10043521 DOI: 10.1007/s12144-023-04402-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2023] [Indexed: 03/30/2023]
Abstract
Addiction, including substance use disorder (SUD), is a complex condition that can cause serious health problems and negatively affect patient quality of life. Physical activity is known to improve the physical and mental health of patients with SUD. This study aims to determine the relationship between regular physical activity (RPA) and quality of life in SUD patients enrolled in inpatient SUD treatment (n = 159). We divided patients into four groups based on their RPA before and during hospitalization. The SF-36 self-report questionnaire was used to assess quality of life. We found that SUD patients had worse quality of life than a representative sample of the Czech population. Furthermore, we demonstrated that RPA before and during hospitalization and changes during hospitalization affect the perception of quality of life of patients with SUDs. Additionally, physically active patients showed significantly better quality of life than inactive patients. However, patients who initiated RPA during hospitalization reported worse quality of life than those who did not; in addition, this group of patients reported the worst quality of life across the most monitored parameters. We suggest that these patients represent the most vulnerable group. Changes in physical activity habits could be considered an indicator for a more intensive therapeutic focus. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-023-04402-w.
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Affiliation(s)
- Michaela Zahrádka Köhlerová
- Psychiatric Hospital Bohnice, Centre for Psychosomatic Therapy and Rehabilitation, PN Bohnice, Ústavní 91, 181 02 Prague, Czech Republic
- Third Faculty of Medicine, Charles University, Ruská 87, 100 00 Prague 10, Czech Republic
| | - Zdeňka Fišerová
- Department of Addictology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Kateřinská 1660/32, 121 08 Prague 2, Czech Republic
| | - Marek Páv
- Psychiatric Hospital Bohnice, Centre for Psychosomatic Therapy and Rehabilitation, PN Bohnice, Ústavní 91, 181 02 Prague, Czech Republic
- Department of Psychiatry, First Faculty of Medicine, Charles University in Prague, General University Hospital in Prague, Kateřinská 1660/32, 121 08 Prague 2, Czech Republic
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Patterson MS, Spadine MN, Graves Boswell T, Prochnow T, Amo C, Francis AN, Russell AM, Heinrich KM. Exercise in the Treatment of Addiction: A Systematic Literature Review. HEALTH EDUCATION & BEHAVIOR 2022; 49:10901981221090155. [PMID: 35484950 DOI: 10.1177/10901981221090155] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Exercise has been recognized as a promising and emerging treatment for individuals recovering from addiction. The purpose of this article was to systematically review scientific studies using exercise as a means to improve, sustain, or treat addictions, and to provide suggestions for the future use of exercise as a treatment method for addiction. METHODS Using PRISMA guidelines, a database search was conducted for articles that tested the impact of exercise interventions on addiction-related outcomes. To be included, peer-reviewed experimental design studies had to use human subjects to investigate the relationship between exercise and the treatment of or recovery from addiction. Garrard's Matrix Method was used to extract data from reviewed articles (n = 53). RESULTS Nearly three quarters of the studies reviewed documented a significant change in addiction-related outcomes (e.g., more days abstinent, reduced cravings) in response to exercise exposure, particularly while someone was receiving treatment at an in or outpatient clinic. Many studies investigated the effect of acute bouts of exercise on nicotine dependence, and many studies had small sample sizes, leaving room for future research on how exercise might benefit people recovering from substance and process addictions. CONCLUSION Results affirm that exercise can be a helpful aspect of addiction treatment. Future researchers should investigate different exercise settings (e.g., group-based exercise vs individual) and explore exercise maintenance and the long-term outcomes following discharge from treatment facilities.
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5
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Novak JR, Ellis FK. A framework for incorporating physical activity in treatment: Competencies, guidelines, and implications for family therapists. JOURNAL OF MARITAL AND FAMILY THERAPY 2022; 48:523-542. [PMID: 34480488 DOI: 10.1111/jmft.12550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 08/10/2021] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
Physical activity can have a profound impact on the cognitive, emotional, and social aspects of our clients' lives, and can even boost and sustain therapy outcomes. And yet, family therapists may not be trained or educated in the importance of physical activity nor how to assess, educate, and collaborate with health professionals to incorporate physical activity in treatment. As the evidence grows on the connection between physical activity and biopsychosocial functioning and more family therapists enter medical and healthcare settings, a framework for physical activity competencies is needed. As such, the purpose of this conceptual and empirical review paper is to (a) review the important brain-boosting benefits of physical activity for mental, cognitive, and social health, (b) provide a framework for the domains for family therapists for incorporating exercise in assessment and treatment, and finally, (c) outline recommendations for practice, education and supervision, and research for family therapists.
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Affiliation(s)
- Josh R Novak
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
| | - Faith K Ellis
- Department of Human Development and Family Science, Auburn University, Auburn, Alabama, USA
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Alpers SE, Furulund E, Pallesen S, Mamen A, Dyrstad SM, Fadnes LT. The Role of Physical Activity in Opioid Substitution Therapy: A Systematic Review of Interventional and Observational Studies. Subst Abuse 2022; 16:11782218221111840. [PMID: 35845970 PMCID: PMC9280793 DOI: 10.1177/11782218221111840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 06/08/2022] [Indexed: 11/15/2022]
Abstract
Background: Use of physical activity in the treatment and follow-up of people receiving opioid substitution therapy is an understudied area of research. Therefore, the objective of this systematic review was to synthesize the currently available research on the role of physical activity in opioid substitution therapy and proper adaptions for the group. Methods: A systematic search was performed on PsycINFO, EMBASE, MEDLINE, CINAHL, and Web of Science until September 2021 (PROSPERO-reg.no: CRD42020109873). The inclusion criteria were studies involving physical activity interventions for opioid substitution patients. Reference lists of relevant studies were screened to identify additional relevant studies. Data extracted were compiled into tables and descriptively presented. Results: The search yielded 2105 unique records. A total of 10 studies were included, whose methodological quality ranged from satisfactory to very good. Study quality was assessed using a 7-/8-point quality score. The agreement between the reviewers, assessed with Cohen’s kappa, was 0.91. Overall, the results suggest that physical activity increases physical fitness of patients in opioid substitution therapy and decreases substance use. The minority of studies in this field are of high quality with sufficient power. Conclusions: The findings of this systematic review suggest beneficial effects of physical activity on physical fitness, substance use, and mental health for patients in opioid substitution therapy. Although the findings are quite consistent across studies, high-quality studies and sufficiently powered clinical trials are needed to confirm and validate the findings and to conclude on the degree of impact.
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Affiliation(s)
- Silvia Eiken Alpers
- Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Einar Furulund
- Centre for Alcohol and Drug Research, Stavanger University Hospital, Stavanger, Norway
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
- Optentia Research Focus Area, North-West University, Vanderbijlpark, South Africa
| | - Asgeir Mamen
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Sindre M Dyrstad
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of Education and Sport Science, University of Stavanger, Stavanger, Norway
| | - Lars Thore Fadnes
- Bergen Addiction Research, Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
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Marrero-Cristobal G, Gelpi-Dominguez U, Morales-Silva R, Alvarado-Torres J, Perez-Torres J, Perez-Perez Y, Sepulveda-Orengo M. Aerobic exercise as a promising nonpharmacological therapy for the treatment of substance use disorders. J Neurosci Res 2021; 100:1602-1642. [PMID: 34850988 PMCID: PMC9156662 DOI: 10.1002/jnr.24990] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 10/06/2021] [Accepted: 10/14/2021] [Indexed: 12/12/2022]
Abstract
Despite the prevalence and public health impact of substance use disorders (SUDs), effective long-term treatments remain elusive. Aerobic exercise is a promising, nonpharmacological treatment currently under investigation as a strategy for preventing drug relapse. Aerobic exercise could be incorporated into the comprehensive treatment regimens for people with substance abuse disorders. Preclinical studies of SUD with animal models have shown that aerobic exercise diminishes drug-seeking behavior, which leads to relapse, in both male and female rats. Nevertheless, little is known regarding the effects of substance abuse-induced cellular and physiological adaptations believed to be responsible for drug-seeking behavior. Accordingly, the overall goal of this review is to provide a summary and an assessment of findings to date, highlighting evidence of the molecular and neurological effects of exercise on adaptations associated with SUD.
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Affiliation(s)
| | - Ursula Gelpi-Dominguez
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR, USA
| | - Roberto Morales-Silva
- Department of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, USA
| | - John Alvarado-Torres
- Department of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, USA
| | - Joshua Perez-Torres
- Department of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, USA
| | - Yobet Perez-Perez
- Department of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, USA
| | - Marian Sepulveda-Orengo
- Department of Basic Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, PR, USA
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8
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Barrera ED, Loughlin L, Greenberger S, Ewing S, Ranaldi R, Ranaldi R. Environmental enrichment reduces heroin seeking following incubation of craving in both male and female rats. Drug Alcohol Depend 2021; 226:108852. [PMID: 34225225 PMCID: PMC8355213 DOI: 10.1016/j.drugalcdep.2021.108852] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/24/2021] [Accepted: 05/01/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Contemporary treatments for heroin use disorder demonstrate only limited efficacy when the goals are long term abstinence and prevention of relapse. We have demonstrated that environmental enrichment (EE) reduces cue-induced heroin reinstatement in male rats. The present study is an attempt to extend the "anti-relapse" effects of EE to female rats and to periods where incubation of craving is hypothesized to occur. METHODS This experiment implemented a 3-phase procedure. In Phase 1, male and female rats were trained to self-administer heroin for 15 days. Phase 2 consisted of a 3- or 15-day forced abstinence (FA) period. In Phase 3 half of the rats were placed into EE and the other half in non-EE housing and subsequently tested for responding in extinction (no heroin or cues) for 15 days followed by a cue-induced reinstatement test. RESULTS We found that rats in the 15 days FA condition showed significantly enhanced drug seeking during extinction, irrespective of sex. We also found that EE significantly reduced this effect. During reinstatement, EE significantly reduced drug seeking in male and female rats and in both 3- and 15-day FA groups. CONCLUSIONS EE, with or without prolonged FA, effectively reduced heroin seeking in male and female rats. These findings indicate that EE can reduce drug-seeking in males and females and when putative incubation of craving (i.e., prolonged abstinence period) has occurred and suggest that it may aid in the development of future long-term behavioral treatments for individuals at risk for heroin relapse.
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Affiliation(s)
| | | | | | | | - Robert Ranaldi
- Department of Psychology, Queens College, the City University of New York, Flushing, NY, United States.
| | - Robert Ranaldi
- Department of Psychology, Queens College, the City University of New York, Flushing, NY, United States.
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9
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Unick JL, Dunsiger SI, Leblond T, Hahn K, Thomas JG, Abrantes AM, Stroud LR, Wing RR. Randomized Trial Examining the Effect of a 12-wk Exercise Program on Hedonic Eating. Med Sci Sports Exerc 2021; 53:1638-1647. [PMID: 34261994 PMCID: PMC8283005 DOI: 10.1249/mss.0000000000002619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This efficacy trial tests the hypothesis that exercise training favorably affects hedonic eating (i.e., overeating, stress-induced overeating, disinhibited eating, eating when tempted), in a sample of women who are overweight or obese. METHODS Participants were inactive at baseline, self-identified as "stress eaters," and were randomized to 12 wk of moderate-intensity exercise training (EX; combination of supervised and objectively confirmed unsupervised sessions) or to a no-exercise control condition (CON). EX participants were given an exercise goal of 200 min·wk-1. No dietary instructions or weight control strategies were provided. Assessments occurred at baseline and 12 wk. Overeating episodes, stress-induced overeating, and dietary temptations were measured over 14 d at each assessment using ecological momentary assessment. Disinhibition and dietary restraint were assessed via a questionnaire. RESULTS Forty-nine participants (age, 40.4 ± 10.8 yr; body mass index, 32.4 ± 4.1 kg·m-2) enrolled, and 39 completed this study. Adherence to the exercise intervention was high (99.4% of all prescribed exercise). At week 12, the proportion of eating episodes that were characterized as overeating episodes was lower in EX versus CON (21.98% in EX vs 26.62% in control; P = 0.001). Disinhibition decreased in EX but not in CON (P = 0.02) and was driven by internal factors. There was a trend such that CON was more likely to give into dietary temptations (P = 0.08). Stress-induced overeating was low and did not differ between conditions (P = 0.61). CONCLUSIONS Exercise training reduced the likelihood of overeating and eating in response to internal cues in women who self-identified as stress eaters. This may be one pathway by which exercise affects body weight.
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Affiliation(s)
- Jessica L Unick
- Weight Control and Diabetes Research Center, The Miriam Hospital and Brown Medical School, Providence, RI
| | - Shira I Dunsiger
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
| | - Tiffany Leblond
- Weight Control and Diabetes Research Center, The Miriam Hospital and Brown Medical School, Providence, RI
| | - Korina Hahn
- Weight Control and Diabetes Research Center, The Miriam Hospital and Brown Medical School, Providence, RI
| | - J Graham Thomas
- Weight Control and Diabetes Research Center, The Miriam Hospital and Brown Medical School, Providence, RI
| | - Ana M Abrantes
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital and Brown University, Providence, RI
| | - Laura R Stroud
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
| | - Rena R Wing
- Weight Control and Diabetes Research Center, The Miriam Hospital and Brown Medical School, Providence, RI
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Kumar R, Kumar KJ, Benegal V, Roopesh BN, Ravi GS. Effects of an integrated intervention program for alcoholism (IIPA) on learning, memory and quality of life (QOL) in persons with alcohol dependence at the Centre for Addiction Medicine, Bengaluru, India. JOURNAL OF HEALTH RESEARCH 2021. [DOI: 10.1108/jhr-03-2020-0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PurposeThis study aims to examine the effectiveness of an integrated intervention program for alcoholism (IIPA) for improving verbal encoding and memory, visuospatial construction, visual memory and quality of life (QoL) in persons with alcohol dependence.Design/methodology/approachThe sample comprised treatment-seeking alcohol-dependent persons (n = 50), allotted into two groups: (1) the treatment as usual (TAU) group (n = 25) and (2) the treatment group (n = 25)]. The groups were matched on age (±1 year) and education (±1 year). The TAU group received standard pharmacological treatment, psychotherapeutic sessions on relapse prevention and yoga for 18 days, while the treatment group received IIPA sessions in addition to the usual treatment. Auditory verbal learning test, complex figure test and QoL scale were administered at pre- and post-treatment along with screening measures.FindingsThe two groups were comparable on demographic variables, clinical characteristics and outcome measures at baseline. Pre- to post-treatment changes (gain scores) comparison between the treatment and TAU groups revealed a significant difference in verbal encoding, verbal and visual memory, verbal recognition, visuospatial construction and QoL.Research limitations/implicationsThis study suggests that IIPA is effective for improving learning and memory in both modality (verbal and visual) and QoL in persons with alcoholism. The IIPA may help in better treatment recovery.Practical implicationsThe IIPA may help in treatment for alcoholism and may enhance treatment efficacy.Originality/valueIIPA is effective for improving learning and memory in both modalities and QoL in persons with alcohol dependence. The IIPA may help in better treatment recovery.
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Wang J, Lu C, Zheng L, Zhang J. Peripheral Inflammatory Biomarkers of Methamphetamine Withdrawal Patients Based on the Neuro-Inflammation Hypothesis: The Possible Improvement Effect of Exercise. Front Psychiatry 2021; 12:795073. [PMID: 35002809 PMCID: PMC8733583 DOI: 10.3389/fpsyt.2021.795073] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/06/2021] [Indexed: 12/15/2022] Open
Abstract
Methamphetamine (MA) induced addiction and neuroinflammation has been implicated. Based on the neuroinflammation hypothesis, this study aims to investigate how exercise influences the craving of patients in MA withdrawal, and explore the mechanism of peripheral inflammation. A total of 90 patients in MA withdrawal were recruited. No difference was noted in the number of years of drug use and the frequency of drug use among patients, and the withdrawal time was within 2 months. The subjects were grouped based on the degree of craving induced by the cues: non-craving control group (NCC group), craving control group (CC group), and craving exercise group (CE group). The CE group was subjected to aerobic combined resistance training. Then, the ELISA method was used to detect plasma IL-6, TNF-α, and IL-1β concentrations; Visual Analog Scale (VAS) measurement of cue-induced cravings under Virtual Reality (VR) exposure (VR-VAS) and the Desires for Drug Questionnaire (DDQ) were used to assess cravings. Consequently, plasma IL-6, TNF-α, IL-1β, levels, and the VR-VAS and DDQ scores of MA withdrawal patients were significantly reduced after exercise. This study confirmed that 8 weeks of incremental load aerobic combined with resistance training reduces peripheral inflammation and significantly reduces the level of craving for MA.
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Affiliation(s)
- Jingsong Wang
- Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, Hunan Normal University, Changsha, China
| | - Chunxia Lu
- Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, Hunan Normal University, Changsha, China
| | - Lan Zheng
- Key Laboratory of Physical Fitness and Exercise Rehabilitation of Hunan Province, Hunan Normal University, Changsha, China
| | - Jun Zhang
- Hunan Judicial Police Vocational College, Changsha, China
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12
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Jha D, Singh R. Analysis of associations between emotions and activities of drug users and their addiction recovery tendencies from social media posts using structural equation modeling. BMC Bioinformatics 2020; 21:554. [PMID: 33375934 PMCID: PMC7772931 DOI: 10.1186/s12859-020-03893-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 12/03/2022] Open
Abstract
Background Addiction to drugs and alcohol constitutes one of the significant factors underlying the decline in life expectancy in the US. Several context-specific reasons influence drug use and recovery. In particular emotional distress, physical pain, relationships, and self-development efforts are known to be some of the factors associated with addiction recovery. Unfortunately, many of these factors are not directly observable and quantifying, and assessing their impact can be difficult. Based on social media posts of users engaged in substance use and recovery on the forum Reddit, we employed two psycholinguistic tools, Linguistic Inquiry and Word Count and Empath and activities of substance users on various Reddit sub-forums to analyze behavior underlining addiction recovery and relapse. We then employed a statistical analysis technique called structural equation modeling to assess the effects of these latent factors on recovery and relapse. Results We found that both emotional distress and physical pain significantly influence addiction recovery behavior. Self-development activities and social relationships of the substance users were also found to enable recovery. Furthermore, within the context of self-development activities, those that were related to influencing the mental and physical well-being of substance users were found to be positively associated with addiction recovery. We also determined that lack of social activities and physical exercise can enable a relapse. Moreover, geography, especially life in rural areas, appears to have a greater correlation with addiction relapse. Conclusions The paper describes how observable variables can be extracted from social media and then be used to model important latent constructs that impact addiction recovery and relapse. We also report factors that impact self-induced addiction recovery and relapse. To the best of our knowledge, this paper represents the first use of structural equation modeling of social media data with the goal of analyzing factors influencing addiction recovery.
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Affiliation(s)
- Deeptanshu Jha
- Department of Computer Science, San Francisco State University, 1600 Holloway Ave., San Francisco, CA, 94132, USA
| | - Rahul Singh
- Department of Computer Science, San Francisco State University, 1600 Holloway Ave., San Francisco, CA, 94132, USA.
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13
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Liu F, Cui J, Liu X, Chen KW, Chen X, Li R. The effect of tai chi and Qigong exercise on depression and anxiety of individuals with substance use disorders: a systematic review and meta-analysis. BMC Complement Med Ther 2020; 20:161. [PMID: 32471415 PMCID: PMC7260819 DOI: 10.1186/s12906-020-02967-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 05/19/2020] [Indexed: 12/16/2022] Open
Abstract
Background Previous studies have acknowledged Tai Chi and Qigong exercise could be potential effective treatments for reducing depression and anxiety in both healthy and clinical populations. However, there is a scarcity of systematic reviews summarizing the clinical evidence conducted among individuals with substance use disorders. This study tries to fill up this gap. Methods A systematic search using Medline, EMbase, PsychINFO, Eric, SPORTDiscus, CINAHL, the Cochrane Central Register of Controlled Trials (CENTRAL), the Chinese National Knowledge Infrastructure (CNKI), Wanfang, and the Chinese Scientific Journal (VIP) databases was initiated to identify randomized controlled trials (RCTs) and non-randomized comparison studies (NRS) assessing the effect of Tai Chi and Qigong versus various comparison groups on depression and anxiety related outcomes. Study quality was evaluated using a Checklist to Evaluate a Report of a Nonpharmacological Trial (CLEAR-NPT) designed for nonpharmacological trial. Results One RCT and six NRS with a total of 772 participants were identified. Some of them were meta-analyzed to examine the pooled effects based on different types of intervention and controls. The results of meta-analyses suggested the effect of Tai Chi was comparable to treatment as usual (TAU) on depression (standardized mean difference (SMD) = − 0.17[− 0.52, 0.17]). Qigong exercise appears to result in improvement on anxiety compared to that of medication (SMD = -1.12[− 1.47, − 0.78]), and no treatment control (SMD = -0.52[− 0.77, − 0.27]). Conclusion The findings suggest potentially beneficial effect of Qigong exercise on symptoms of anxiety among individuals with drug abuse. Considering the small number and overall methodological weakness of included studies and lack of RCTs, results should be interpreted with caution and future rigorously designed RCTs are warranted to provide more reliable evidence.
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Affiliation(s)
- Fang Liu
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China
| | - Jiabao Cui
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China
| | - Xuan Liu
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China
| | - Kevin W Chen
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China.,Center for Integrative Medicine, University of Maryland School of Medicine, Baltimore, USA
| | - Xiaorong Chen
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China
| | - Ru Li
- Faculty of Physical Education, Shenzhen University, Shenzhen, 518060, China.
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14
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Giménez-Meseguer J, Tortosa-Martínez J, Cortell-Tormo JM. The Benefits of Physical Exercise on Mental Disorders and Quality of Life in Substance Use Disorders Patients. Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3680. [PMID: 32456164 PMCID: PMC7277811 DOI: 10.3390/ijerph17103680] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 12/16/2022]
Abstract
Physical exercise seems to have a promising effect on numerous variables related to the recovery of drug-dependent patients. However, some contradictions are found in the literature. The aim of this study was to perform a systematic review and meta-analysis in order to identify the effect of physical exercise on mental disorders, quality of life, abstinence, and craving, and make a comparison of the effect of exercise depending on the type of program. A search for articles was conducted using PubMed, Web of Science, and Scopus databases. Studies were selected that measured the acute effects or long-term effect (≥2 weeks) of exercise in patients who met criteria for alcohol use disorders or substance use disorders. A total of 59 studies were included. An effect of exercise on quality of life and mental disorders was identified. Subgroup analysis revealed an effect of exercise on stress (SMD = 1.11 (CI: 0.31, 1.91); z = 2.73; p = 0.006), anxiety (SMD = 0.50 (CI: 0.16, 0.84); z = 2.88; p = 0.004) and depression (SMD = 0.63 (CI: 0.34, 0.92); z = 4.31; p < 0.0001), and an effect of exercise on the eight variables included in the SF36 test. The results also showed a trend towards a positive effect on craving (SMD = 0.89 (CI: −0.05, 1.82); z = 1.85, p = 0.06). Body-mind activities and programs based on improving physical conditions produced similar results in mental disorders and quality of life. Available evidence indicates that physical exercise, both body-mind and physical fitness programs, can be effective in improving mental disorders, craving, and quality of life in drug-dependent patients.
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Affiliation(s)
| | - Juan Tortosa-Martínez
- Faculty of Education, University of Alicante, 03690 San Vicente del Raspeig, Spain; (J.G.-M.); (J.M.C.-T.)
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15
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Gür F, Can Gür G. Is Exercise a Useful Intervention in the Treatment of Alcohol Use Disorder? Systematic Review and Meta-Analysis. Am J Health Promot 2020; 34:520-537. [PMID: 32212949 DOI: 10.1177/0890117120913169] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES This systematic review and meta-analysis examined the effects of exercise on individuals with alcohol use disorders (AUDs) across multiple health outcomes. DATA SOURCES PubMed, Medline, Web of Science, Scopus, Academic Search complete, Sport Discuss, and ERIC databases. STUDY INCLUSION AND EXCLUSION CRITERIA Interventional studies published between 2000 and 2018 focused on evaluating the effectiveness of exercise interventions in adults with AUD. DATA EXTRACTION This protocol was prepared using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols standard and the Meta-Analyses and Systematic Reviews of Observational Studies guidelines. DATA SYNTHESIS Physical activity levels/fitness [VO2 max (Oxygen Uptake) and HRmax (Maximum Heart Rate)], levels of depression, anxiety, self-efficacy, quality of life, and alcohol consumption (number of standard drinks consumed per day and per week). RESULTS The findings indicated that exercise significantly improved physical fitness as assessed by VO2 max (standardized mean difference [SMD]: 0.487, P < .05) and HRmax (SMD: 0.717, P < .05). Similarly, exercise significantly improved mental health as assessed by quality of life (SMD: 0.425, P < .05), but levels of depression, anxiety, self-efficacy, and alcohol consumption did not change significantly. Aerobic exercise alleviated depression and anxiety symptoms more than that of yoga and mixed types. Duration of exercise also had a similar effect on anxiety and depression. CONCLUSIONS Exercise can be an effective and persistent adjunctive treatment for individuals with AUDs.
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Affiliation(s)
- Fatih Gür
- Faculty of Sport Science, University of Pamukkale, Pamukkale, Turkey
| | - Ganime Can Gür
- Faculty of Sport Science, University of Pamukkale, Pamukkale, Turkey
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16
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Clarke PB, Lewis TF, Myers JE, Henson RA, Hill B. Wellness, Emotion Regulation, and Relapse During Substance Use Disorder Treatment. JOURNAL OF COUNSELING AND DEVELOPMENT 2020. [DOI: 10.1002/jcad.12296] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | - Jane E. Myers
- Department of Counseling and Educational Development, University of North Carolina at Greensboro
| | - Robert A. Henson
- Department of Educational Research Methodology, University of North Carolina at Greensboro
| | - Brent Hill
- School of Education, North Dakota State University
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17
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Nixon SJ, Lewis B. Cognitive training as a component of treatment of alcohol use disorder: A review. Neuropsychology 2019; 33:822-841. [PMID: 31448949 DOI: 10.1037/neu0000575] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Cognitive training is an effective means of improving performance in a range of populations. Whether it may serve to facilitate cognitive recovery and longer-term outcomes in persons with alcohol use disorders (AUDs) is unclear. Here, we review historical and current literature and offer perspectives for model development and potential implementation. METHOD We considered a large literature regarding the nature of alcohol-related compromise, early efforts to clarify the nature of recovery and current models and methods underlying cognitive training paradigms. We then constructed a narrative review demonstrating evolving frameworks and empirical data informing the critical review of cognitive training methods as a means of mitigating compromise and facilitating functional outcomes. RESULTS Cognitive improvement with abstinence is generally noted, but training protocols may enhance performance and generalize benefit to untrained, but highly similar, tasks. Transfer of training to dissimilar tasks and functional outcomes is uncommonly reported. It is noteworthy that some work suggests that clinician ratings for participants are improved. Inconsistency in sample characteristics, training protocols, and outcome measures constrain general conclusions while suggesting opportunities for study and development. CONCLUSIONS Cognitive training protocols have shown benefit in a variety of populations but have been examined infrequently in persons with AUDs. This overview indicates significant opportunity for cognitive improvement and recovery and thus a strong potential role for training protocols. However, supportive data are not robustly obtained. We suggest that one step in bridging this gap is the implementation of a conceptual framework incorporating contextual, behavioral, and neurobiological variables. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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18
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Brellenthin AG, Crombie KM, Hillard CJ, Brown RT, Koltyn KF. Psychological and endocannabinoid responses to aerobic exercise in substance use disorder patients. Subst Abus 2019; 42:272-283. [PMID: 31729933 DOI: 10.1080/08897077.2019.1680480] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Exercise has been examined as an adjunctive treatment for substance use disorders (SUDs), yet few exercise interventions have been conducted among patients undergoing intensive outpatient (IOP) treatment, who may be the most vulnerable to relapse and for whom exercise could provide the most benefits. This study examined the effects of aerobic exercise, in addition to IOP treatment, on psychological variables and endocannabinoids in individuals with SUDs. Methods: Twenty-one SUD patients (mean age 35 years) were recruited from local IOPs. Participants were randomized to either treatment-as-usual (TAU, at their outpatient clinic) or TAU plus aerobic exercise training (EX). EX participants engaged in supervised, moderate-intensity exercise for 30 min, 3 times/week for 6 weeks. TAU participants came into the laboratory once per week for assessments and a 30-min quiet rest session. Participants provided blood samples and completed questionnaires evaluating substance use, mood states, depression, anxiety, perceived stress, self-efficacy to abstain from substance use, and craving. Data were analyzed with Mann-Whitney U tests or mixed model ANOVAs to determine group differences in outcomes acutely and over 6 weeks. Results: Over 6 weeks, there were reductions in perceived stress (p < 0.01) and craving (p < 0.05) for both groups. There were no group differences in abstinence rates or changes from baseline in self-efficacy, depression, or anxiety (p > 0.05). Acutely, both exercise and quiet rest sessions led to reductions in craving, tension, depression, anger, confusion, and total mood disturbance (all ps < 0.05). In addition, the EX group experienced acute increases in vigor and circulating concentrations of the endocannabinoid, anandamide (p < 0.01). Conclusions: An adjunctive aerobic exercise program during SUD treatment was associated with similar reductions in perceived stress and drug craving as standard care. Thirty minutes of exercise or quiet rest led to acute improvements in mood, but exercise produced the additional benefit of increases in vigor and circulating anandamide.
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Affiliation(s)
- Angelique G Brellenthin
- Department of Kinesiology, University of Wisconsin, Madison, Wisconsin, USA.,Department of Kinesiology, Iowa State University, Ames, Iowa, USA
| | - Kevin M Crombie
- Department of Kinesiology, University of Wisconsin, Madison, Wisconsin, USA
| | - Cecilia J Hillard
- Department of Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Randall T Brown
- Department of Family Medicine, University of Wisconsin, Madison, Wisconsin, USA
| | - Kelli F Koltyn
- Department of Kinesiology, University of Wisconsin, Madison, Wisconsin, USA
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19
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Abstract
There are vast literatures on the neural effects of alcohol and the neural effects of exercise. Simply put, exercise is associated with brain health, alcohol is not, and the mechanisms by which exercise benefits the brain directly counteract the mechanisms by which alcohol damages it. Although a degree of brain recovery naturally occurs upon cessation of alcohol consumption, effective treatments for alcohol-induced brain damage are badly needed, and exercise is an excellent candidate from a mechanistic standpoint. In this chapter, we cover the small but growing literature on the interactive neural effects of alcohol and exercise, and the capacity of exercise to repair alcohol-induced brain damage. Increasingly, exercise is being used as a component of treatment for alcohol use disorders (AUD), not because it reverses alcohol-induced brain damage, but because it represents a rewarding, alcohol-free activity that could reduce alcohol cravings and improve comorbid conditions such as anxiety and depression. It is important to bear in mind, however, that multiple studies attest to a counterintuitive positive relationship between alcohol intake and exercise. We therefore conclude with cautionary notes regarding the use of exercise to repair the brain after alcohol damage.
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20
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Bilberg R, Roessler KK, Nielsen AS. Saying yes or no to physical activity - A comparative cohort analysis of patients seeking treatment for Alcohol Use Disorder. Addict Behav Rep 2019; 9:100180. [PMID: 31193872 PMCID: PMC6544560 DOI: 10.1016/j.abrep.2019.100180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/28/2019] [Accepted: 03/29/2019] [Indexed: 11/25/2022] Open
Abstract
Introduction Engaging individuals, suffering from alcohol use disorder (AUD), in a physical activity can be a challenge, and often it is a limitation of the quality of studies on the topic. The aim of the present study is to investigate differences between participants and non-participants in a randomized controlled trial on the effect of physical exercise as add-on to treatment as usual (TAU) to treatment for alcohol use disorder, thereby identifying potential factors that may predict lack of willingness or ability to consider increasing the level of physical activity. Method The Healthy Lifestyle Study was a randomized controlled trial with three arms, of which two included adding physical activities to treatment for AUD as usual. All patients from an outpatient alcohol treatment clinic were invited to participate in the study. 172 accepted participation, and 384 patients either did not show up for information about the study or declined to participate. All patients in the treatment clinic were assessed by means of European Addiction Severity Index (EuropASI). Results The only predictor of participation in the study was the drinking pattern. Patients, who had been drinking every day for the last 6 months were less likely to participate in the study (OR 0.7 CI 0.4–0.9). Neither somatic nor psychiatric health seemed to impact whether or not the patients participated in the study. Conclusion Non-participants did not differ from participants in this study except in their drinking pattern. No psychological or social differences between participants and non-participants Non-participants drink alcohol on a daily base. Non-participants are affected by something else than health and social problems.
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Affiliation(s)
- Randi Bilberg
- Unit for Clinical Alcohol Research, Institute of Clinical Research, Faculty of Health, University of Southern Denmark, Denmark.,Department of Psychiatry, University Function, Region of Southern Denmark, Denmark.,Odense Patient Data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
| | - Kirsten Kaya Roessler
- Department of Psychology, Faculty of Health, University of Southern Denmark, Denmark
| | - Anette Søgaard Nielsen
- Unit for Clinical Alcohol Research, Institute of Clinical Research, Faculty of Health, University of Southern Denmark, Denmark.,Department of Psychiatry, University Function, Region of Southern Denmark, Denmark.,Odense Patient Data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark
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21
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Linke SE, Hovsepians R, Schnebly B, Godfrey K, Noble M, Strong DR, Isgro M, Lindamer LA. The Go-VAR (Veterans Active Recovery): An Adjunctive, Exercise-Based Intervention for Veterans Recovering from Substance Use Disorders. J Psychoactive Drugs 2019; 51:68-77. [PMID: 30653409 DOI: 10.1080/02791072.2018.1560518] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Substance use disorders (SUD) are prevalent among veterans, and the relapse rate is estimated at ≥60% within one year of treatment. Exercise's broad health benefits make it an appealing adjunctive component to interventions preventing relapse among individuals with SUDs. After conducting formative research, we designed and conducted the Go-VAR! (Veterans Active Recovery) pilot study to examine the feasibility and acceptability of a multi-component exercise-based intervention for veterans seeking SUD treatment through the outpatient Alcohol & Drug Treatment Program (ADTP) at the VA San Diego Healthcare System (VASDHS). Participants (N = 15; mean age = 45 [SD = 9.7]; 13% Hispanic, 60% White) from the La Jolla VASDHS outpatient ADTP were enrolled in this 12-week one-arm pilot study. Feasibility and acceptability were established: 70% of participants attended weekly psychoeducation groups, wore their Fitbit Charge HR, increased their weekly physical activity, and used their study-provided YMCA memberships, group exercise training sessions, and Fit4Me personal training program. Lower use of both alcohol and drugs were reported at the end of the study (p < .0001). Significant increases in daily steps as measured by the Fitbit HR and improvements in measures of physical fitness were also achieved (p < .05). Future work should focus on potential integration within the VA system.
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Affiliation(s)
- Sarah E Linke
- a Department of Family Medicine & Public Health , UC San Diego , San Diego , CA , USA.,b Department of Psychology , VA San Diego Healthcare System , San Diego , CA , USA
| | - Rita Hovsepians
- b Department of Psychology , VA San Diego Healthcare System , San Diego , CA , USA
| | - Brittany Schnebly
- c Department of Psychology , San Francisco State University , San Francisco , CA , USA
| | - Kathryn Godfrey
- d Drexel University Center for Weight, Eating and Lifestyle Science (WELL Center) , PA , USA
| | - Madison Noble
- a Department of Family Medicine & Public Health , UC San Diego , San Diego , CA , USA
| | - David R Strong
- a Department of Family Medicine & Public Health , UC San Diego , San Diego , CA , USA.,b Department of Psychology , VA San Diego Healthcare System , San Diego , CA , USA
| | - Melodie Isgro
- b Department of Psychology , VA San Diego Healthcare System , San Diego , CA , USA
| | - Laurie A Lindamer
- b Department of Psychology , VA San Diego Healthcare System , San Diego , CA , USA.,e Department of Psychiatry , UC San Diego , San Diego , CA , USA
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22
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Colledge F, Gerber M, Pühse U, Ludyga S. Anaerobic Exercise Training in the Therapy of Substance Use Disorders: A Systematic Review. Front Psychiatry 2018; 9:644. [PMID: 30564150 PMCID: PMC6288373 DOI: 10.3389/fpsyt.2018.00644] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 11/15/2018] [Indexed: 12/15/2022] Open
Abstract
Background: In the past 3 decades, there has been an increase in the number of studies assessing exercise as a form of treatment for substance use disorders (SUDs). While a variety of substance types and outcomes have been assessed, exercise intensities have never been systematically examined. Consequently, it remains unclear whether particular forms of exercise are better suited to the treatment of these populations. Anaerobic exercise has been shown to have positive effects in populations with psychiatric disorders, but its effectiveness in the treatment of SUDs has to date not been reviewed. Methods: The aim of this systematic review is to identify and evaluate studies which have employed either an acute or chronic anaerobic exercise component as a therapy modality for SUDs. The primary outcomes are abstinence, craving, withdrawal, consumption, quality of life, and the following psychological symptoms and disorders: depression, anxiety, stress, and mood. A secondary objective is to assess whether the type of training described in the study protocol can be reliably categorized as anaerobic training. Results: Twenty-six studies are included in this review. Twelve studies addressed nicotine dependence, one addressed alcohol dependence, and 13 addressed dependence on various illicit drugs. Thirteen studies reported the intensity at which participants actually exercised, but only one employed a test to determine whether training was carried out above the anaerobic threshold (AT). The risk of bias in the included studies was generally high. Results of the studies were mixed, with the most positive effects being found for abstinence in nicotine dependence. Conclusion: The evidence for the effects of anaerobic exercise in SUDs is weak, although a tendency toward positive effects on abstinence in nicotine dependent individuals was observable. The majority of studies do not report data on exercise intensity, making a categorization of anaerobic exercise impossible in all but one case. This means that the effects of this form of exercise cannot be determined, and therefore not evaluated or compared with other forms. In order to improve the quality of evidence for exercise in SUD treatment, clearly defined and objectively assessed evaluations of anaerobic and anaerobic exercise are necessary.
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Affiliation(s)
- Flora Colledge
- Departement für Sport, Bewegung und Gesundheit, Universität Basel, Basel, Switzerland
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23
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Imperio CG, McFalls AJ, Hadad N, Blanco-Berdugo L, Masser DR, Colechio EM, Coffey AA, Bixler GV, Stanford DR, Vrana KE, Grigson PS, Freeman WM. Exposure to environmental enrichment attenuates addiction-like behavior and alters molecular effects of heroin self-administration in rats. Neuropharmacology 2018; 139:26-40. [PMID: 29964093 PMCID: PMC6067959 DOI: 10.1016/j.neuropharm.2018.06.037] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 06/25/2018] [Accepted: 06/27/2018] [Indexed: 01/11/2023]
Abstract
Environmental factors profoundly affect the addictive potential of drugs of abuse and may also modulate the neuro-anatomical/neuro-chemical impacts of uncontrolled drug use and relapse propensity. This study examined the impact of environmental enrichment on heroin self-administration, addiction-related behaviors, and molecular processes proposed to underlie these behaviors. Male Sprague-Dawley rats in standard and enriched housing conditions intravenously self-administered similar amounts of heroin over 14 days. However, environmental enrichment attenuated progressive ratio, extinction, and reinstatement session responding after 14 days of enforced abstinence. Molecular mechanisms, namely DNA methylation and gene expression, are proposed to underlie abstinence-persistent behaviors. A global reduction in methylation is reported to coincide with addiction, but no differences in total genomic methylation or repeat element methylation were observed in CpG or non-CpG (CH) contexts across the mesolimbic circuitry as assessed by multiple methods including whole genome bisulfite sequencing. Immediate early gene expression associated with drug seeking, taking, and abstinence also were examined. EGR1 and EGR2 were suppressed in mesolimbic regions with heroin-taking and environmental enrichment. Site-specific methylation analysis of EGR1 and EGR2 promoter regions using bisulfite amplicon sequencing (BSAS) revealed hypo-methylation in the EGR2 promoter region and EGR1 intragenic CpG sites with heroin-taking and environmental enrichment that was associated with decreased mRNA expression. Taken together, these findings illuminate the impact of drug taking and environment on the epigenome in a locus and gene-specific manner and highlight the need for positive, alternative rewards in the treatment and prevention of drug addiction.
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Affiliation(s)
- Caesar G. Imperio
- Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Ashley J. McFalls
- Department of Pharmacology, Penn State College of Medicine, Hershey, Pennsylvania
| | - Niran Hadad
- Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | | | - Dustin R. Masser
- Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Elizabeth M. Colechio
- Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Alissa A. Coffey
- Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Georgina V. Bixler
- Genome Sciences Facility, Penn State College of Medicine, Hershey, Pennsylvania
| | - David R. Stanford
- Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Kent. E. Vrana
- Department of Pharmacology, Penn State College of Medicine, Hershey, Pennsylvania
| | - Patricia S. Grigson
- Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Willard M. Freeman
- Oklahoma Center for Neuroscience, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- Department of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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24
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Simonton AJ, Young CC, Brown RA. Physical Activity Preferences and Attitudes of Individuals With Substance Use Disorders: A Review of the Literature. Issues Ment Health Nurs 2018; 39:657-666. [PMID: 29505733 DOI: 10.1080/01612840.2018.1429510] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Substance use disorders (SUDs) are prevalent in the United States and costly to society. SUDs contribute significantly to decreased quality of life and overdose deaths. Physical activity (PA) interventions may be one efficacious method to improve recovery and long-term abstinence from substance use; although PA interventions have resulted in positive physical and psychological outcomes, their adherence and attrition rates have been problematic. To address lack of adherence and high attrition rates, it is important to understand the preferences and attitudes for PA among patients in SUD treatment. We, therefore, conducted a literature review to examine preferences and attitudes for PA among adults with SUDs. Five articles met inclusion and exclusion criteria. The findings from this small sample of studies suggest that adults with SUDs are interested in PA. Walking, strength training, and cycling were the activities preferred most frequently. Participants said that they would like to engage in these activities either alone or with small groups and would prefer their exercise options to be located at facilities they already frequented, such as treatment clinics. Nurses are well positioned to assess patient preferences and attitudes and to enhance recovery efforts in this population. Further exploration of this population's unique preferences and attitudes regarding PA may lay the groundwork for efficacious PA interventions with improved adherence and attrition rates, which may lead to improved recovery outcomes.
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Affiliation(s)
- Amanda J Simonton
- a School of Nursing , The University of Texas at Austin , Austin , Texas , USA
| | - Cara C Young
- a School of Nursing , The University of Texas at Austin , Austin , Texas , USA
| | - Richard A Brown
- a School of Nursing , The University of Texas at Austin , Austin , Texas , USA
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25
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Georgakouli K, Manthou E, Fatouros IG, Georgoulias P, Deli CK, Koutedakis Y, Theodorakis Y, Jamurtas AZ. Enhanced erythrocyte antioxidant status following an 8-week aerobic exercise training program in heavy drinkers. Alcohol 2018; 69:57-62. [PMID: 29653379 DOI: 10.1016/j.alcohol.2017.11.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2017] [Revised: 11/17/2017] [Accepted: 11/22/2017] [Indexed: 12/16/2022]
Abstract
Alcohol-induced oxidative stress is involved in the development and progression of various pathological conditions and diseases. On the other hand, exercise training has been shown to improve redox status, thus attenuating oxidative stress-associated disease processes. The purpose of the present study was to evaluate the effect of an exercise training program that has been previously reported to decrease alcohol consumption on blood redox status in heavy drinkers. In a non-randomized within-subject design, 11 sedentary, heavily drinking men (age: 30.3 ± 3.5 years; BMI: 28.4 ± 0.86 kg/m2) participated first in a control condition for 4 weeks, and then in an intervention where they completed an 8-week supervised aerobic training program of moderate intensity (50-60% of the heart rate reserve). Blood samples were collected in the control condition (pre-, post-control) as well as before, during (week 4 of the training program), and after intervention (week 8 of the training program). Samples were analyzed for total antioxidant capacity (TAC), thiobarbituric acid reactive substances (TBARS), protein carbonyls (PC), uric acid (UA), bilirubin, reduced glutathione (GSH), and catalase activity. No significant change in indices of redox status in the pre- and post-control was observed. Catalase activity increased (p < 0.05) after 8 weeks of intervention compared to week 4. GSH increased (p < 0.05) after 8 weeks of intervention compared to the control condition and to week 4 of intervention. TAC, UA, bilirubin, TBARS, and PC did not significantly change at any time point. Moreover, concentrations of GSH, TBARS, and catalase activity negatively correlated with alcohol consumption. In conclusion, an 8-week aerobic training program enhanced erythrocyte antioxidant status in heavy drinkers, indicating that aerobic training may attenuate pathological processes caused by alcohol-induced oxidative stress.
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26
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Da Ros Vettoretto P, Hauw N, Noury-Desvaux B. Impact d’un programme APA sur la qualité de vie, l’appétence à l’alcool, les attitudes et les capacités physiques de personnes présentant un trouble de l’usage d’alcool (TUAL). Sci Sports 2018. [DOI: 10.1016/j.scispo.2018.03.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
Accumulating research in rodents and humans indicates that exercise benefits brain function and may prevent or delay onset of neurodegenerative conditions. In particular, exercise modifies the structure and function of the hippocampus, a brain area important for learning and memory. This review addresses the central and peripheral mechanisms underlying the beneficial effects of exercise on the hippocampus. We focus on running-induced changes in adult hippocampal neurogenesis, neural circuitry, neurotrophins, synaptic plasticity, neurotransmitters, and vasculature. The role of peripheral factors in hippocampal plasticity is also highlighted. We discuss recent evidence that systemic factors released from peripheral organs such as muscle (myokines), liver (hepatokines), and adipose tissue (adipokines) during exercise contribute to hippocampal neurotrophin and neurogenesis levels, and memory function. A comprehensive understanding of the body-brain axis is needed to elucidate how exercise improves hippocampal plasticity and cognition.
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Affiliation(s)
- C'iana Cooper
- Neuroplasticity and Behavior Unit, Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Biomedical Research Center, Baltimore, Maryland 21224
| | - Hyo Youl Moon
- Neuroplasticity and Behavior Unit, Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Biomedical Research Center, Baltimore, Maryland 21224
- Institute of Sport Science, Seoul National University, Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Henriette van Praag
- Neuroplasticity and Behavior Unit, Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Biomedical Research Center, Baltimore, Maryland 21224
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Jensen K, Nielsen C, Ekstrøm CT, Roessler KK. Physical exercise in the treatment of alcohol use disorder (AUD) patients affects their drinking habits: A randomized controlled trial. Scand J Public Health 2018; 47:462-468. [PMID: 29480087 DOI: 10.1177/1403494818759842] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
AIM The aim of this study is to compare the effect of exercise training on physical capacity and alcohol consumption in alcohol use disorder (AUD) patients. METHODS One hundred and five AUD patients were randomly assigned to treatment as usual combined with running and brisk walking for 30-45 min twice a week, either in small supervised groups (GR) or individually (IND), or to a control group with no running (C). Assessments were made after 6 and 12 months of training. RESULTS Training volume was estimated as 36 min per training bout at an intensity of 78% of HRmax with no differences between GR and IND ( p>.05). A highly significant reduction in training frequency was seen in both training groups after the first month ( p<.0001). Only IND increased VO2max, by 5.7% ( p<.05), while no differences were seen between GR, IND and C. Alcohol intake decreased from 219 to 41 units per 30 days as the average for the entire sample with no significant difference of drinking outcomes between groups ( p<.0001). CONCLUSIONS We saw an effect on drinking habits after running in both groups. However, no additional effect was seen when compared with the control group. A drop in the training frequency during the intervention might have resulted in an insignificant training stimulus.
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Affiliation(s)
- Kurt Jensen
- 1 Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | - Charlotte Nielsen
- 1 Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | - Claus Thorn Ekstrøm
- 2 Department of Public Health, Section of Biostatistics, University of Copenhagen, Denmark
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Gür F, Can Gür G, Okanlı A. The Effect of the Cognitive-behavioral Model-based Psychoeducation and Exercise Intervention on Quality of Life in Alcohol Use Disorder. Arch Psychiatr Nurs 2017; 31:541-548. [PMID: 29179818 DOI: 10.1016/j.apnu.2017.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 06/12/2017] [Accepted: 07/15/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of the study was to assess the effect of the cognitive behavior model (CBM)-based psychoeducation and exercise intervention on quality of life (QoL) in alcohol use disorder (AUD). DESIGN This study was a non-randomized controlled trial. METHODS CBM-based psychoeducation and exercise intervention was applied to the experimental group four times a week for 6weeks; no intervention was applied to the control group. FINDINGS No difference was seen between the points of pretest QoL of the experimental and control groups (p>0.05). However, according to the posttest, the experimental group's mean score of QoL was higher than the control groups (p<0.05). CONCLUSION It was found that CBM-based psychoeducation and exercise intervention applied to individuals with AUD affected the QoL positively. CLINICAL RELEVANCE CBM-based psychoeducation and exercise intervention can be used by nurses to improve AUD individuals' quality of life.
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Affiliation(s)
- Fatih Gür
- University of Karadeniz Technical, Faculty of Sport Science, Trabzon 61000, Turkey.
| | - Ganime Can Gür
- University of Atatürk, Faculty of Health Science, Department of Psychiatric Nursing, Erzurum 25000, Turkey.
| | - Ayşe Okanlı
- University of Medeniyet, Faculty of Health Science, Department of Psychiatric Nursing, İstanbul 34710, Turkey
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Damian AJ, Mendelson T. Association of Physical Activity with Alcohol Abuse and Dependence in a Nationally-Representative U.S. Sample. Subst Use Misuse 2017; 52:1744-1750. [PMID: 28704120 PMCID: PMC5794006 DOI: 10.1080/10826084.2017.1310245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Alcohol use is a pervasive and costly public health problem in the United States. Relapse rates from alcohol use disorders are high. Although exercise has been proposed as a strategy to prevent relapse, lifestyle modification is the least studied aspect of relapse prevention programs, especially among racial/ethnic minority populations. OBJECTIVE The current study assessed whether being physically active was associated with remission from alcohol abuse or dependence among Black (African American and Afro Caribbean) adults in the U.S. METHOD We utilized data on Black adult participants (n = 4,828) from the nationally representative National Survey of American Life (NSAL) conducted in 2001-2003. Logistic regression models were estimated to assess the odds of being in 12-month remission or currently meeting DSM-IV criteria for alcohol abuse or dependence based on level of physical activity, adjusting for socio-demographic and neighborhood characteristics. RESULTS People who endorsed being physically active had higher odds of being in 12-month remission from alcohol use problems (OR: 1.67, 95% CI: 1.28, 2.17) than people who were physically inactive, adjusting for individual- and neighborhood-level characteristics. People who were physically active did not differ significantly from those who were inactive with respect to odds of currently meeting DSM-IV criteria for alcohol abuse or dependence. Conclusions/Importance: Physical activity was positively associated with being in 12-month remission from alcohol use problems. Longitudinal studies are needed to establish temporal ordering and to explore exercise as a potential relapse prevention strategy for alcohol use problems.
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Affiliation(s)
- April Joy Damian
- a Mental Health, Bloomberg School of Public Health , Johns Hopkins University , North Broadway, Hampton House, Baltimore , Maryland , USA
| | - Tamar Mendelson
- a Mental Health, Bloomberg School of Public Health , Johns Hopkins University , North Broadway, Hampton House, Baltimore , Maryland , USA
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Roessler KK, Bilberg R, Søgaard Nielsen A, Jensen K, Ekstrøm CT, Sari S. Exercise as adjunctive treatment for alcohol use disorder: A randomized controlled trial. PLoS One 2017; 12:e0186076. [PMID: 29049336 PMCID: PMC5648142 DOI: 10.1371/journal.pone.0186076] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 09/05/2017] [Indexed: 12/11/2022] Open
Abstract
Aims To examine whether physical activity as an adjunct to outpatient alcohol treatment has an effect on alcohol consumption following participation in an exercise intervention of six months’ duration, and at 12 months after treatment initiation. Methods The study is a randomized controlled study with three arms: Patients allocated to (A) treatment as usual, (B) treatment as usual and supervised group exercise, (C) treatment as usual and individual physical exercise. The primary outcome measure was excessive drinking six months after treatment start and completion of the intervention. A logistic regression model was used to evaluate the odds of excessive drinking among the three groups, based on intention-to-treat. Changes in level of physical activity in all three groups were tested by using a generalized linear mixed model. A multiple linear model was used to test if there was an association between amount of performed physical activity and alcohol consumption. Results A total of 175 patients (68.6% male) participated. Response rates were 77.7% at six months and 57.1% at 12 months follow-up. OR 0.99 [95% CI: 0.46; 2.14], p = 0.976 for excessive drinking in the group exercise condition, and 1.02 [95% CI: 0.47; 2.18], p = 0.968 in the individual exercise condition, which, when compared to the control group as reference, did not differ statistically significantly. Participants with moderate level physical activity had lower odds for excessive drinking OR = 0.12 [0.05; 0.31], p<0.001 than participants with low level physical activity. Amount of alcohol consumption in the intervention groups decreased by 4% [95% CI: 0.03; 6.8], p = 0.015 for each increased exercising day. Conclusions No direct effect of physical exercise on drinking outcome was found. Moderate level physical activity was protective against excessive drinking following treatment. A dose-response effect of exercise on drinking outcome supports the need for implementing physically active lifestyles for patients in treatment for alcohol use disorder.
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Affiliation(s)
- Kirsten K. Roessler
- Department of Psychology, University of Southern Denmark, Odense M, Denmark
- * E-mail:
| | - Randi Bilberg
- Unit of Clinical Alcohol Research, Clinical Institute, University of Southern Denmark, Odense C, Denmark
| | - Anette Søgaard Nielsen
- Unit of Clinical Alcohol Research, Clinical Institute, University of Southern Denmark, Odense C, Denmark
| | - Kurt Jensen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark
| | - Claus Thorn Ekstrøm
- Department of Biostatistics, University of Copenhagen, Copenhagen K, Denmark
| | - Sengül Sari
- Department of Psychology, University of Southern Denmark, Odense M, Denmark
- Unit of Clinical Alcohol Research, Clinical Institute, University of Southern Denmark, Odense C, Denmark
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More A, Jackson B, Dimmock JA, Thornton AL, Colthart A, Furzer BJ. Exercise in the Treatment of Youth Substance Use Disorders: Review and Recommendations. Front Psychol 2017; 8:1839. [PMID: 29089915 PMCID: PMC5651015 DOI: 10.3389/fpsyg.2017.01839] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 10/03/2017] [Indexed: 01/26/2023] Open
Abstract
Substance use disorders among youth represent a significant public health concern. It is well established that regular exercise provides important physical and mental health benefits; however, evidence for the role of exercise as an adjunct component within substance use disorder treatment is scarce. In this review, we identify factors associated with the development and persistence of substance use disorders among youth, identify current treatment modalities, and present evidence to support the efficacy of incorporating exercise participation during rehabilitation. We also provide a series of recommendations for future research that explores the feasibility and effectiveness of exercise participation as a complement to substance use disorder treatment among youth.
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Affiliation(s)
- Alissa More
- School of Human Sciences (Exercise & Sport Science), The University of Western Australia, Perth, WA, Australia
| | - Ben Jackson
- School of Human Sciences (Exercise & Sport Science), The University of Western Australia, Perth, WA, Australia
| | - James A Dimmock
- School of Human Sciences (Exercise & Sport Science), The University of Western Australia, Perth, WA, Australia
| | - Ashleigh L Thornton
- School of Human Sciences (Exercise & Sport Science), The University of Western Australia, Perth, WA, Australia
| | - Allan Colthart
- Drug and Alcohol Youth Service, Mental Health Commission and Mission Australia, Perth, WA, Australia
| | - Bonnie J Furzer
- School of Human Sciences (Exercise & Sport Science), The University of Western Australia, Perth, WA, Australia
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Blevins CE, Rapoport MA, Battle CL, Stein MD, Abrantes AM. Changes in Coping, Autonomous Motivation, and Beliefs about Exercise among Women in Early Recovery from Alcohol Participating in a Lifestyle Physical Activity Intervention. Ment Health Phys Act 2017; 13:137-142. [PMID: 29358975 PMCID: PMC5774644 DOI: 10.1016/j.mhpa.2017.09.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Women are particularly likely to drink alcohol for the purpose of coping with or alleviating negative affect. Engaging in physical activity has been posited as a potentially effective alternate coping strategy during early recovery for managing mood and cravings. Utilizing exercise to cope may be associated with more adaptive coping strategies in general. Additionally, an intrinsic (autonomous) motivational style and positive beliefs about exercise are associated with long-term adherence to physical activity. The current study evaluates changes in coping strategies, autonomous motivation, and beliefs about exercise among women engaged in a physical activity intervention during early recovery (N=20; mean age=39.53). General coping strategies, motivational style, and beliefs about exercise were examined before and after engaging in the 12-week intervention which aimed to help women utilize physical activity as a means to cope with negative affect and alcohol craving. We found that, by the end of the intervention, participants significantly increased utilization of adaptive coping strategies such as the use of emotional support from others. Additionally, participants increased autonomous motivation over time. There were no significant changes in beliefs about exercise. Changes in beliefs about benefits of exercise, autonomous motivation, and adaptive coping were related to use of exercise to cope. However, even though these changes were associated with how women in the intervention used exercise, they were not associated with exercising more. Results from this open pilot suggest that women in early recovery from alcohol who increase physical activity - specifically as a means to cope with negative affect and craving - also demonstrate other wider coping strategies, more positive beliefs, and autonomous motivation.
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Affiliation(s)
- Claire E. Blevins
- Butler Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Cynthia L. Battle
- Butler Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
| | - Michael D. Stein
- Butler Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
- Boston University, Boston, MA, USA
| | - Ana M. Abrantes
- Butler Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
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Can Gür G, Okanli A. The Effects of Cognitive-Behavioral Model-Based Intervention on Depression, Anxiety, and Self-Efficacy in Alcohol Use Disorder. Clin Nurs Res 2017; 28:52-78. [DOI: 10.1177/1054773817722688] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Exercise is constantly gaining attention as adjuvant treatment for alcohol use disorder (AUD), supplementing classical pharmacological and psychotherapeutic approaches. The aim of this study was to determine the effects of cognitive-behavioral model-based (CBM-based) intervention on the depression, anxiety, and self-efficacy levels in AUD. This quasi-experimental study was conducted using pre- and posttests and repeated measurements with a control group; it was completed between February 2015 and August 2015 in Turkey. Participants were 41 individuals with AUD, 20 in the experimental group and 21 in the control group. The individuals in the experimental group performed aerobic exercise 3 days a week as well as attended the psychoeducation provided 1 day a week. The difference between mean scores of the individuals in the experimental and control groups taken in posttest and 4-month follow-up test in the Beck Depression Inventory (BDI) as well as the difference between mean posttest scores in the Beck Anxiety Inventory (BAI) and Self-Efficacy Scale (SES) were found to be statistically significant ( p < .05). In the intragroup comparisons, a significant difference was found between the “BDI,” “BAI,” and “SES” measurement times ( p < .05). It was concluded that CBM-based intervention was effective in reducing depression and anxiety, increasing self-efficacy in individuals with AUD. Appropriate nurse-managed CBM-based intervention for individuals with AUD can promote their health.
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Developing a Fitbit-supported lifestyle physical activity intervention for depressed alcohol dependent women. J Subst Abuse Treat 2017; 80:88-97. [PMID: 28755778 DOI: 10.1016/j.jsat.2017.07.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 06/05/2017] [Accepted: 07/07/2017] [Indexed: 11/21/2022]
Abstract
PURPOSE Women in alcohol treatment are more likely to relapse when in unpleasant, negative emotional states. Given the demonstrated benefits of exercise for decreasing depression, negative affect, and urges to drink, helping women engage in a lifestyle physical activity (LPA) intervention in early recovery may provide them a tool they can utilize "in the moment" in order to cope with negative emotional states and alcohol craving when relapse risk is highest. New digital fitness technologies (e.g., Fitbit activity monitor with web and mobile applications) may facilitate increases in physical activity (PA) through goal setting and self-monitoring. METHOD We piloted a 12-week LPA+Fitbit intervention focused on strategically using bouts of PA to cope with affect and alcohol cravings to prevent relapse in 20 depressed women (mean age=39.5years) in alcohol treatment. RESULTS Participants wore their Fitbit on 73% of days during the intervention period. An average of 9174 steps/day were taken on the days the Fitbit was worn. Participants completed 4.7 of the 6 scheduled phone PA counseling sessions (78%). Among women who completed the intervention (n=15), 44% remained abstinent throughout the entire course of treatment. On average, women were abstinent on 95% of days during the 12-week intervention. Participants reported an increase in using PA to cope with either negative affect or urges to drink from baseline to end of treatment (p<0.05). Further, participants reported high satisfaction with the LPA+Fitbit intervention and with the Fitbit tracker. CONCLUSIONS Further research is needed to evaluate the LPA+Fitbit intervention in a more rigorous randomized controlled trial. If the LPA+Fitbit intervention proves to be helpful during early recovery, this simple, low-cost and easily transported intervention can provide a much-needed alternate coping strategy to help reduce relapse risk among women in alcohol treatment.
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36
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Exercise training reduces alcohol consumption but does not affect HPA-axis activity in heavy drinkers. Physiol Behav 2017; 179:276-283. [PMID: 28684134 DOI: 10.1016/j.physbeh.2017.07.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 06/17/2017] [Accepted: 07/03/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND It has been suggested that physical exercise could have potential beneficial effects in substance abusers, which are based on both physiological and psychological theories. Although a few studies have examined the effect of exercise on alcohol intake and fitness in individuals with alcohol use disorders (AUDs), there is a gap in the literature concerning the physiological and biochemical mechanisms that could be affected by physical exercise in this population. PURPOSE The purpose of the present study was to examine physiological and biochemical responses to exercise after an 8-week supervised exercise training (ET) intervention in heavy drinkers. The investigation was mainly focused on the relationship among exercise, opioids, the hypothalamic-pituitary-adrenal axis (HPA) activity and heavy alcohol drinking. METHODS Eleven (Age: 30.3±3.5yrs; Body Mass Index: 28.4±0.86kg/m2) male heavy drinkers volunteered to participated in an 8-week supervised intervention of moderate intensity exercise (50-60% of Heart Rate Reserve). All participants were exhibiting low physical activity and used to drink heavily. Before intervention, the participants were asked to record their daily alcohol intake without changing their physical activity levels for 4weeks (control condition). During the 8-week supervised ET intervention, participants were recording their daily alcohol intake and were motivated to increase gradually the duration and frequency of ET. Blood samples were collected prior to and after 4weeks of the control condition, the day before the beginning of the ET intervention, and at the end of the 4th and 8th week of ET intervention. Blood samples were analyzed for β-E, epinephrine, norepinephrine, adrenocorticotropin, cortisol, gamma-glutamyl transferase (γ-GT), aspartate transaminase and alanine transaminase. Physiological and alcohol-related indices were also examined. RESULTS The 8-week supervised ET intervention resulted in reduced alcohol consumption, reduced γ-GT levels, and fitness improvement in heavy drinker. ET intervention did not significantly change the hormonal responses. CONCLUSION The results indicate that physical exercise could act as a healthy habit that can help individuals with AUDs reduce alcohol intake and improve health status; however, this is not related with changes in hormones associated with the HPA-axis.
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Sari S, Muller AE, Roessler KK. Exercising alcohol patients don't lack motivation but struggle with structures, emotions and social context - a qualitative dropout study. BMC FAMILY PRACTICE 2017; 18:45. [PMID: 28330457 PMCID: PMC5363022 DOI: 10.1186/s12875-017-0606-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 02/28/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Exercise is an important component of a healthy lifestyle, the development of which is a relapse prevention strategy for those with alcohol use disorder. However, it is a challenge to create exercise interventions with a persistent behavioural change. The aim of this qualitative study was to investigate perceived barriers to participation in an exercise intervention among alcohol use disorder patients, who dropped out of the intervention program. Furthermore, this study aims to propose possibilities for a better practice of future intervention studies based on the participants' experiences and suggestions. METHODS Qualitative interviews with 17 patients who dropped out from an exercise intervention in an outpatient treatment centre about their experiences and reasons for dropping out. Social cognitive theory informed the development of the interview guides and systematic text condensation was used for analysis. RESULTS Analysis revealed three central themes: 1) Structural barriers described as the type of exercise and the timing of the intervention, 2) Social barriers described as need for accountability and unsupportive relations, and 3) Emotional barriers described as fear, guilt and shame, and negative affect of the intervention on long term. CONCLUSIONS Future exercise interventions should include socio-psychological support during the first weeks, begin shortly after treatment initiation instead of concurrently, and focus on garnering social support for participants in both the intervention context and among their existing network in order to best reduce barriers to participation. TRIAL REGISTRATION This study was retrospectively registered at Current Controlled Trials ISRCTN74889852 on 11 July 2013.
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Affiliation(s)
- Sengül Sari
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark.,Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ashley Elizabeth Muller
- Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kirsten K Roessler
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark.
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Squires LE, Palfai TP, Allensworth-Davies D, Cheng DM, Bernstein J, Kressin N, Saitz R. Perceived discrimination, racial identity, and health behaviors among black primary-care patients who use drugs. J Ethn Subst Abuse 2017; 17:460-477. [PMID: 28281940 DOI: 10.1080/15332640.2017.1288189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Blacks who use drugs are at heightened risk for health problems. Discrimination experiences may contribute to these risks by influencing health behaviors. This study examined associations between discrimination, racial identity, and health behaviors (alcohol use, cigarette smoking, low physical activity, and unprotected [condomless] sex) in a sample of 203 Black primary-care patients who reported current drug use. Logistic regression analyses did not find direct effects of discrimination or identity on outcomes. Hypothesized moderation of discrimination by racial identity was not observed in expected direction for the outcome of unprotected sex.
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Affiliation(s)
- Leah E Squires
- a George Washington University , Washington , DC.,b Washington DC Veterans Affairs Medical Center , Washington , DC
| | | | | | - Debbie M Cheng
- e Boston University School of Public Health , Boston , Massachusetts
| | - Judith Bernstein
- e Boston University School of Public Health , Boston , Massachusetts
| | | | - Richard Saitz
- e Boston University School of Public Health , Boston , Massachusetts
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Nani S, Matsouka O, Tsitskari E, Avgerinos A. The role of physical activity in life happiness of Greek drug abusers participating in a treatment program. SPORT SCIENCES FOR HEALTH 2017. [DOI: 10.1007/s11332-016-0345-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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40
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Weinstock J, Farney MR, Elrod NM, Henderson CE, Weiss EP. Exercise as an Adjunctive Treatment for Substance Use Disorders: Rationale and Intervention Description. J Subst Abuse Treat 2017; 72:40-47. [PMID: 27666958 PMCID: PMC5289308 DOI: 10.1016/j.jsat.2016.09.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 08/25/2016] [Accepted: 09/04/2016] [Indexed: 11/26/2022]
Abstract
Substance use disorders (SUDs) are maladaptive patterns of substance use that are associated with psychiatric comorbidity, unhealthy lifestyle choices, and high rates of relapse. Exercise is associated with a wide range of acute and long-term benefits for both mental and physical health and is presently being investigated as a promising adjunctive treatment for SUD. Despite positive effects of regular physical activity on treatment outcomes and risk factors for relapse, low adherence and high attrition rates limit the benefits derived from exercise interventions. Lack of motivation is one of many perceived barriers to initiating exercise that contributes to poor adherence to interventions. In the present article, we describe the protocol for a novel, integrated exercise intervention that combines motivational interviewing (MI), a client-centered approach designed to enhance intrinsic motivation and resolve ambivalence toward change, and contingency management (CM), a behavioral treatment that provides monetary incentives for the completion of target behaviors. The protocol seeks to address the challenges surrounding initiation and maintenance of an exercise program at a level consistent with public health guidelines, particularly for sedentary patients. We conclude with considerations for the implementation of the intervention in SUD specific clinics.
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Roessler KK, Bramsen RH, Dervisevic A, Bilberg R. Exercise based interventions for alcohol use disorder: A comment on motivational aspects of participation. Scand J Psychol 2016; 58:23-28. [PMID: 27727463 DOI: 10.1111/sjop.12334] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 08/19/2016] [Indexed: 12/20/2022]
Abstract
Exercise based treatment for alcohol use disorders have shown an impact on mental health (e.g., depression or anxiety), and alcohol outcomes (e.g., craving or abstinence). However, there is a lack of information on the role of motivational aspects of participation in the process of designing exercise interventions for alcohol use disorder. This study aims to examine: (1) whether motivational aspects are taken into account when the type and delivery method of exercise interventions are chosen; (2) whether motivational aspects are taken into account post intervention; and (3) whether there are different traditions regarding payment for participants. A systematic search was conducted to identify eligible studies in order to investigate the impact of motivational aspects including payment for participation. Twelve samples including ten to 620 participants were investigated. Participants were predominantly male and in their 40s, ranging from 20 to 69 years. Aerobic exercise (running, walking, fitness) either in a group or individual condition is the most frequently used exercise form. Two studies included ball games or cycling, while only one study offered the opportunity to choose between a wide range of sports. Motivational aspects are mentioned explicitly in half of the studies, mostly with regard to adherence to participation and social integration as the reason for using a group condition. Achievement is mentioned in two studies but not explicitly with regard to planning the intervention design. Five studies include payment for participation in exercise. Findings of the present study identify that motivational aspects for participation are rarely involved in the planning of an exercise intervention. With regard to the specific psychosocial vulnerability of an alcohol use disorder population, this should be an important aspect of further research studies.
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Affiliation(s)
| | | | | | - Randi Bilberg
- Department of Clinical Research, University of Southern Denmark, Denmark
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Keane CA, Kelly PJ, Magee CA, Callister R, Baker A, Deane FP. Exploration of Sedentary Behavior in Residential Substance Abuse Populations: Results From an Intervention Study. Subst Use Misuse 2016; 51:1363-78. [PMID: 27249172 DOI: 10.3109/10826084.2016.1170144] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There is a growing body of research linking sedentary behavior with increased risk of chronic disease and all-cause mortality. It is increasingly recommended that service providers address the multiple behavioral risk factors associated with these chronic diseases as part of routine substance abuse treatment. OBJECTIVES The study objective was to investigate rates of physical activity and sedentary behavior in a residential substance abuse population. In addition, efficacy of a sedentary behavior intervention, "Sit Switch," was examined for feasibility in this context. METHODS Participants (n = 54) were residents of The Salvation Army Recovery Service Centres located in Canberra and on the Gold Coast, Australia. Actigraph GT3X+ accelerometers were used to measure rates and patterns of sedentariness and physical activity. A nonrandomized controlled study of a single-session group intervention aimed at decreasing prolonged sitting ("Sit Switch") was conducted. Education, motivational-interviewing, and goal setting components underpinned the "Sit Switch" intervention. RESULTS Individuals were highly sedentary, spending 73% of daily activity at sedentary intensity engaged in inadequate levels of moderate physical activity (6.6%/day). The single session educational program did not lead to any significant changes in sedentary behavior. Conclusion/Importance: High levels of sedentariness and low levels of physical activity engagement are evident in residents in substance abuse treatment programs. It is strongly recommended that sedentariness, a modifiable risk behavior with independent consequences for cardiovascular disease and cancer, be addressed within residential programs.
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Affiliation(s)
- Carol A Keane
- a Centre for Health Initiatives , University of Wollongong , Wollongong , Australia.,b School of Psychology , University of Wollongong , Wollongong , Australia
| | - Peter J Kelly
- b School of Psychology , University of Wollongong , Wollongong , Australia
| | - Christopher A Magee
- a Centre for Health Initiatives , University of Wollongong , Wollongong , Australia.,b School of Psychology , University of Wollongong , Wollongong , Australia
| | - Robin Callister
- c Priority Research Centre for Physical Activity and Nutrition , University of Newcastle , Callaghan , Australia
| | - Amanda Baker
- d School of Medicine and Public Health , University of Newcastle , Callaghan , Australia
| | - Frank P Deane
- b School of Psychology , University of Wollongong , Wollongong , Australia
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Unhjem R, Flemmen G, Hoff J, Wang E. Maximal strength training as physical rehabilitation for patients with substance use disorder; a randomized controlled trial. BMC Sports Sci Med Rehabil 2016; 8:7. [PMID: 27042312 PMCID: PMC4818502 DOI: 10.1186/s13102-016-0032-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 02/29/2016] [Indexed: 12/30/2022]
Abstract
Background Patients with substance use disorder (SUD) suffer from multiple health and psychosocial problems. Because poor physical capacities following an inactive lifestyle may indeed contribute to these problems, physical training is often suggested as an attractive supplement to conventional SUD treatment. Strength training is shown to increase muscle strength and effectively improve health and longevity. Therefore we investigated the feasibility and effect of a maximal strength training intervention for SUD patients in clinical treatment. Methods 16 males and 8 females were randomized into a training group (TG) and a control group (CG). The TG performed lower extremities maximal strength training (85-90 % of 1 repetition maximum (1RM)) 3 times a week for 8 weeks, while the CG participated in conventional clinical activities. Results The TG increased hack squat 1RM (88 ± 54 %), plantar flexion 1RM (26 ± 20 %), hack squat rate of force development (82 ± 29 %) and peak force (11 ± 5 %). Additionally, the TG improved neural function, expressed as voluntary V-wave (88 ± 83 %). The CG displayed no change in any physical parameters. The TG also reduced anxiety and insomnia, while the CG reduced anxiety. Conclusion Maximal strength training was feasible for SUD patients in treatment, and improved multiple risk factors for falls, fractures and lifestyle related diseases. As conventional treatment appears to have no effect on muscle strength, systematic strength training should be implemented as part of clinical practice. Trial regestration ClinicalTrials.gov Identifier: NCT02218970 (August 14, 2014).
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Affiliation(s)
- Runar Unhjem
- Department of Circulation and Medical imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Prinsesse Kristinas gt. 3, 7006 Trondheim, Norway
| | - Grete Flemmen
- Department of Circulation and Medical imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Prinsesse Kristinas gt. 3, 7006 Trondheim, Norway ; Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olav University Hospital, Trondheim, Norway
| | - Jan Hoff
- Department of Circulation and Medical imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Prinsesse Kristinas gt. 3, 7006 Trondheim, Norway ; Department of Physical Medicine and Rehabilitation, St. Olav University Hospital, Trondheim, Norway
| | - Eivind Wang
- Department of Circulation and Medical imaging, Faculty of Medicine, the Norwegian University of Science and Technology, Prinsesse Kristinas gt. 3, 7006 Trondheim, Norway ; Division of Psychiatry, Department of Østmarka, St. Olav University Hospital, Trondheim, Norway ; Department of Internal Medicine, University of Utah, Salt Lake City, Utah USA
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Manthou E, Georgakouli K, Fatouros IG, Gianoulakis C, Theodorakis Y, Jamurtas AZ. Role of exercise in the treatment of alcohol use disorders. Biomed Rep 2016; 4:535-545. [PMID: 27123244 PMCID: PMC4840498 DOI: 10.3892/br.2016.626] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 02/09/2016] [Indexed: 12/16/2022] Open
Abstract
Excessive alcohol use can cause harmful effects on the human body, which are associated with serious health problems, and it can also lead to the development of alcohol use disorders (AUDs). There is certain evidence that physical exercise positively affects excessive alcohol use and the associated problems by leading to reduced alcohol intake. A literature search was conducted using the databases PubMed, Medline and Web of Science. The search terms used as keywords were: Addiction, abuse, alcohol use disorders, exercise training, β-endorphin, opioids, brain, ethanol and alcohol. The current study presents the studies that reported on the use of exercise in the treatment of AUDs between 1970 and 2015. The potential psychological and physiological mechanisms that contribute to the action of exercise were also reviewed, highlighting the role of β-endorphin and the hypothalamic-pituitary-adrenal axis in AUDs and the possible association among physical activity, the endogenous opioid system and the desire for alcohol. Only 11 studies were identified that refer to the effect of exercise on alcohol consumption and/or the associated outcomes. Six of those studies concluded that exercise may have a positive impact towards alcohol consumption, abstinence rates or the urge to drink. One of those studies also indicated that a bout of exercise affects the endogenous opioids, which may be associated with the urge to drink. Another 3 studies indicated that responses to acute exercise in individuals with AUDs are different compared to those in healthy ones. Generally, despite limited research data and often contradictory results, there is certain early promising evidence for the role of exercise as an adjunctive tool in the treatment of AUDs. Physiological and biochemical parameters that would confirm that exercise is safe for individuals with AUDs should be examined in future studies.
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Affiliation(s)
- Eirini Manthou
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece; Department of Kinesiology, Institute for Research and Technology Thessaly, 42100 Trikala, Greece
| | - Kalliopi Georgakouli
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece; Department of Kinesiology, Institute for Research and Technology Thessaly, 42100 Trikala, Greece
| | - Ioannis G Fatouros
- Department of Kinesiology, Institute for Research and Technology Thessaly, 42100 Trikala, Greece
| | - Christina Gianoulakis
- McGill University and Douglas Mental Health University Institute, Montreal, Quebec H4H 1R3, Canada
| | - Yannis Theodorakis
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Athanasios Z Jamurtas
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece; Department of Kinesiology, Institute for Research and Technology Thessaly, 42100 Trikala, Greece
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Flemmen G, Wang E. Impaired Aerobic Endurance and Muscular Strength in Substance Use Disorder Patients: Implications for Health and Premature Death. Medicine (Baltimore) 2015; 94:e1914. [PMID: 26554792 PMCID: PMC4915893 DOI: 10.1097/md.0000000000001914] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Although substance use disorder (SUD) patients are documented to have an inactive lifestyle, which is associated with cardiovascular disease, other lifestyle-related diseases and premature death, evidence regarding their aerobic endurance and muscular strength is limited. Therefore, the authors aimed to evaluate directly assessed maximal oxygen consumption, walking efficiency, as well as maximal strength in a group of SUD patients.A total of 44 SUD patients in residential treatment, 31 men (31 ± 8 years) and 13 women (34 ± 10 years), were included and completed the physical testing. The patients were compared with an age- and sex-matched reference group.Male and female SUD patients exhibited a maximal oxygen consumption of 44.6 ± 6.2 and 33.8 ± 6.6 mL· min kg, respectively. This was significantly lower than the reference group, 15% (P = 0.03) for men and 25% (P = 0.001) for women. In addition, the SUD patients had a 13% significantly reduced walking efficiency (P = 0.02), compared with healthy controls. The impairments in aerobic endurance were accompanied by significant reductions in maximal strength of 30% (P = 0.001) and 33% (P = 0.01) for men and women, respectively. In combination, these results imply that SUD patients have impaired endurance and muscular strength compared with what is typically observed in the population, and consequently suffer a higher risk of developing cardiovascular and other lifestyle-related diseases and early death. Effective physical exercise should be advocated as an essential part of the clinical practice of SUD treatment to improve the patient's health and consequently reduce the costs because of the high use of emergency departments, hospital, and medical care.
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Affiliation(s)
- Grete Flemmen
- From the Department of Circulation and Medical Imaging, Faculty of Medicine, the Norwegian University of Science and Technology (GF, EW); and Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olav's University Hospital, Trondheim, Norway (GF); Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA (EW)
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Mikkelsen MR, Hendriksen C, Schiødt FV, Rydahl-Hansen S. Coping and rehabilitation in alcoholic liver disease patients after hepatic encephalopathy - in interaction with professionals and relatives. J Clin Nurs 2015; 24:3627-37. [DOI: 10.1111/jocn.13006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2015] [Indexed: 01/20/2023]
Affiliation(s)
| | - Carsten Hendriksen
- Department of Integrated Health Care; Bispebjerg Hospital; Copenhagen NV Denmark
- Department of Public Health Science; University of Copenhagen; Copenhagen NV Denmark
| | | | - Susan Rydahl-Hansen
- Research Unit of Clinical Nursing; Bispebjerg Hospital; Copenhagen NV Denmark
- Department of Nursing Science; University of Aarhus; Aarhus Denmark
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Watson JM, Fairhurst C, Li J, Tober G, Crosby H, Lloyd C, Godfrey C, Mdege ND, Dale V, Toner P, Parrott S, Raistrick D. ADAPTA: A pilot randomised controlled trial of an alcohol-focused intervention versus a healthy living intervention for problem drinkers identified in a general hospital setting. Drug Alcohol Depend 2015; 154. [PMID: 26194955 PMCID: PMC4545229 DOI: 10.1016/j.drugalcdep.2015.06.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
AIM To examine the relative feasibility, acceptability, applicability, effectiveness and explore cost-effectiveness of a healthy living focused intervention (HL) compared to an alcohol-focused intervention (AF) for problem drinkers identified in hospital. METHODS A pragmatic, randomised, controlled, open pilot trial. Feasibility and acceptability were measured by recruitment, attrition, follow-up rates and number of treatment sessions attended. Effectiveness was measured using the Alcohol Use Disorders Identification Test score at six months. Additional economic and secondary outcome measures were collected. RESULTS Eighty-six participants were randomised and 72% (n=62) were retained in full participation. Forty-one participants attended at least one treatment session (48%). A greater proportion in the HL group attended all four treatment sessions (33% vs 19%). Follow-up rates were 29% at six months and 22% at twelve months. There was no evidence of a difference in AUDIT score between treatment groups at six months. Mean cost of health care and social services, policing and the criminal justice system use decreased while EQ-5D scores indicated minor improvement in both arms. However, this pilot trial was not powered to detect differences in either measure between groups. CONCLUSIONS While no treatment effect was observed, this study demonstrated a potential to engage patients drinking at harmful or dependent levels in a healthy living intervention. However, recruitment proved challenging and follow-up rates were poor. Better ways need to be found to help these patients recognise the harms associated with their drinking and overcome the evident barriers to their engagement with specialist treatment.
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Affiliation(s)
- Judith M. Watson
- University of York, Department of Health Sciences, Heslington, York YO10 5DD, United Kingdom
| | - Caroline Fairhurst
- University of York, Department of Health Sciences, Heslington, York YO10 5DD, United Kingdom.
| | - Jinshuo Li
- University of York, Department of Health Sciences, Heslington, York YO10 5DD, United Kingdom.
| | - Gillian Tober
- Leeds Addiction Unit, 19 Springfield Mount, Leeds LS2 9NG, United Kingdom.
| | - Helen Crosby
- Leeds Addiction Unit, 19 Springfield Mount, Leeds LS2 9NG, United Kingdom.
| | - Charlie Lloyd
- University of York, Department of Health Sciences, Heslington, York YO10 5DD, United Kingdom.
| | - Christine Godfrey
- University of York, Department of Health Sciences, Heslington, York YO10 5DD, United Kingdom.
| | - Noreen D. Mdege
- University of York, Department of Health Sciences, Heslington, York YO10 5DD, United Kingdom
| | - Veronica Dale
- University of York, Department of Health Sciences, Heslington, York YO10 5DD, United Kingdom.
| | - Paul Toner
- University of York, Department of Health Sciences, Heslington, York YO10 5DD, United Kingdom.
| | - Steve Parrott
- University of York, Department of Health Sciences, Heslington, York YO10 5DD, United Kingdom.
| | - Duncan Raistrick
- Leeds Addiction Unit, 19 Springfield Mount, Leeds LS2 9NG, United Kingdom.
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Linke SE, Noble M, Hurst S, Strong DR, Redwine L, Norman SB, Lindamer LA. An Exercise-Based Program for Veterans with Substance Use Disorders: Formative Research. J Psychoactive Drugs 2015; 47:248-57. [DOI: 10.1080/02791072.2015.1047915] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Rawson RA, Chudzynski J, Gonzales R, Mooney L, Dickerson D, Ang A, Dolezal B, Cooper CB. The Impact of Exercise On Depression and Anxiety Symptoms Among Abstinent Methamphetamine-Dependent Individuals in A Residential Treatment Setting. J Subst Abuse Treat 2015; 57:36-40. [PMID: 25934458 DOI: 10.1016/j.jsat.2015.04.007] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 04/08/2015] [Accepted: 04/12/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND This paper reports data from a study designed to determine the impact of an 8-week exercise program on depression and anxiety symptoms among newly abstinent methamphetamine (MA)-dependent individuals in residential treatment. METHODS One hundred thirty-five MA-dependent individuals, newly enrolled in residential treatment, were randomly assigned to receive either a 3-times-per-week, 60-minute structured exercise program for 8 weeks (24 sessions) or an equivalent number of health education sessions. Using mixed-modeling repeated-measures regression, we examined changes in weekly total depression and anxiety scores as measured by the Beck Depression Inventory and Beck Anxiety Inventory over the 8-week study period. RESULTS Mean age of participants was 31.7 (SD = 6.9); 70.4% were male and 48% Latino. Analyses indicate a significant effect of exercise on reducing depression (β = -0.63, P = 0.001) and anxiety (β = -0.95, P=0.001) symptoms (total scores) over the 8-week period compared to a health education control group. A significant dose interaction effect between session attendance and exercise was found as well on reducing depression (β = -0.61, P < 0.001) and anxiety symptoms (β = -0.22, P=0.009) over time compared to the control group. CONCLUSIONS Results support the role of a structured exercise program as an effective intervention for improving symptoms of depression and anxiety associated with MA abstinence.
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Affiliation(s)
- Richard A Rawson
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
| | - Joy Chudzynski
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Rachel Gonzales
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Larissa Mooney
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Daniel Dickerson
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Alfonso Ang
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Brett Dolezal
- Exercise Physiology Research Laboratory, Division of Pulmonary Medicine, David Geffen School of Medicine, 10833 Le Conte 37-131 CHS, University of California, Los Angeles, CA, USA
| | - Christopher B Cooper
- Exercise Physiology Research Laboratory, Division of Pulmonary Medicine, David Geffen School of Medicine, 10833 Le Conte 37-131 CHS, University of California, Los Angeles, CA, USA
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50
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Alonso-Alonso M, Woods SC, Pelchat M, Grigson PS, Stice E, Farooqi S, Khoo CS, Mattes RD, Beauchamp GK. Food reward system: current perspectives and future research needs. Nutr Rev 2015; 73:296-307. [PMID: 26011903 PMCID: PMC4477694 DOI: 10.1093/nutrit/nuv002] [Citation(s) in RCA: 135] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This article reviews current research and cross-disciplinary perspectives on the neuroscience of food reward in animals and humans, examines the scientific hypothesis of food addiction, discusses methodological and terminology challenges, and identifies knowledge gaps and future research needs. Topics addressed herein include the role of reward and hedonic aspects in the regulation of food intake, neuroanatomy and neurobiology of the reward system in animals and humans, responsivity of the brain reward system to palatable foods and drugs, translation of craving versus addiction, and cognitive control of food reward. The content is based on a workshop held in 2013 by the North American Branch of the International Life Sciences Institute.
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Affiliation(s)
- Miguel Alonso-Alonso
- M. Alonso-Alonso is with the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. S.C. Woods is with the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA. M. Pelchat and G.K. Beauchamp are with the Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA. P.S. Grigson is with the Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA. E. Stice is with the Department of Psychology, University of Texas at Austin, Austin, Texas, USA. S. Farooqi is with the Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. C.S. Khoo is with the North American Branch of the International Life Sciences Institute, Washington, DC, USA. R.D. Mattes is with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA.
| | - Stephen C Woods
- M. Alonso-Alonso is with the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. S.C. Woods is with the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA. M. Pelchat and G.K. Beauchamp are with the Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA. P.S. Grigson is with the Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA. E. Stice is with the Department of Psychology, University of Texas at Austin, Austin, Texas, USA. S. Farooqi is with the Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. C.S. Khoo is with the North American Branch of the International Life Sciences Institute, Washington, DC, USA. R.D. Mattes is with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Marcia Pelchat
- M. Alonso-Alonso is with the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. S.C. Woods is with the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA. M. Pelchat and G.K. Beauchamp are with the Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA. P.S. Grigson is with the Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA. E. Stice is with the Department of Psychology, University of Texas at Austin, Austin, Texas, USA. S. Farooqi is with the Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. C.S. Khoo is with the North American Branch of the International Life Sciences Institute, Washington, DC, USA. R.D. Mattes is with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Patricia Sue Grigson
- M. Alonso-Alonso is with the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. S.C. Woods is with the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA. M. Pelchat and G.K. Beauchamp are with the Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA. P.S. Grigson is with the Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA. E. Stice is with the Department of Psychology, University of Texas at Austin, Austin, Texas, USA. S. Farooqi is with the Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. C.S. Khoo is with the North American Branch of the International Life Sciences Institute, Washington, DC, USA. R.D. Mattes is with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Eric Stice
- M. Alonso-Alonso is with the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. S.C. Woods is with the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA. M. Pelchat and G.K. Beauchamp are with the Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA. P.S. Grigson is with the Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA. E. Stice is with the Department of Psychology, University of Texas at Austin, Austin, Texas, USA. S. Farooqi is with the Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. C.S. Khoo is with the North American Branch of the International Life Sciences Institute, Washington, DC, USA. R.D. Mattes is with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Sadaf Farooqi
- M. Alonso-Alonso is with the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. S.C. Woods is with the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA. M. Pelchat and G.K. Beauchamp are with the Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA. P.S. Grigson is with the Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA. E. Stice is with the Department of Psychology, University of Texas at Austin, Austin, Texas, USA. S. Farooqi is with the Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. C.S. Khoo is with the North American Branch of the International Life Sciences Institute, Washington, DC, USA. R.D. Mattes is with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Chor San Khoo
- M. Alonso-Alonso is with the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. S.C. Woods is with the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA. M. Pelchat and G.K. Beauchamp are with the Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA. P.S. Grigson is with the Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA. E. Stice is with the Department of Psychology, University of Texas at Austin, Austin, Texas, USA. S. Farooqi is with the Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. C.S. Khoo is with the North American Branch of the International Life Sciences Institute, Washington, DC, USA. R.D. Mattes is with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Richard D Mattes
- M. Alonso-Alonso is with the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. S.C. Woods is with the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA. M. Pelchat and G.K. Beauchamp are with the Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA. P.S. Grigson is with the Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA. E. Stice is with the Department of Psychology, University of Texas at Austin, Austin, Texas, USA. S. Farooqi is with the Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. C.S. Khoo is with the North American Branch of the International Life Sciences Institute, Washington, DC, USA. R.D. Mattes is with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
| | - Gary K Beauchamp
- M. Alonso-Alonso is with the Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. S.C. Woods is with the Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, Ohio, USA. M. Pelchat and G.K. Beauchamp are with the Monell Chemical Senses Center, Philadelphia, Pennsylvania, USA. P.S. Grigson is with the Department of Neural and Behavioral Sciences, Penn State College of Medicine, Hershey, Pennsylvania, USA. E. Stice is with the Department of Psychology, University of Texas at Austin, Austin, Texas, USA. S. Farooqi is with the Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom. C.S. Khoo is with the North American Branch of the International Life Sciences Institute, Washington, DC, USA. R.D. Mattes is with the Department of Nutrition Science, Purdue University, West Lafayette, Indiana, USA
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