Dissertations / Theses on the topic 'Alcohol craving'

A growing body of evidence suggests that mindfulness is a useful treatment for reducing alcohol use, yet little is known about the relationship between trait mindfulness and alcohol misuse. Furthermore, the variation in the measurement of mindfulness means that the existing evidence is difficult to interpret and the prevalent use of student samples greatly limits generalisability. It has been proposed that mindfulness may bring more awareness and acceptance to depression symptoms and craving leading to reduced alcohol use. The present study aimed to examine the relationship between the individual facets of mindfulness and alcohol misuse, taking into account the role of depression and craving. A cross-sectional, correlational design was used to explore these relationships in individuals seeking treatment for alcohol misuse. Seventy seven participants completed self-report measures on depression, craving, mindfulness and alcohol misuse. The results showed that depression symptoms were positively associated with alcohol misuse and negatively correlated with mindfulness, thus supporting previous findings. The mindfulness abilities of bringing full awareness to present moment activities and adopting a non-judgemental and a non-reactive attitude were associated with less alcohol misuse. The ability to bring full awareness to present moment activities was also associated with less craving. However, mindfulness did not moderate the association between depression and alcohol misuse, disconfirming the hypothesis. Higher levels of craving were associated with higher levels of alcohol misuse suggesting that craving represents a cognitive marker that precedes alcohol use. The results provide valuable evidence of the association between certain mindfulness facets and alcohol misuse in a sample of individuals with moderate to severe alcohol misuse problems and suggest that these mindfulness abilities may be a useful focus for interventions for both depression and alcohol misuse.

The elaborated intrusion (EI) theory of desire is a cognitive model that describes the processes involved in craving as intrusive thoughts that are elaborated upon leading to dissonance when desires are not met. While the theory is based on a wide body of research, certain theoretical predictions have not been fully examined. Specifically, EI theory argues that mental imagery has a central role in craving, and predicts that attempts to suppress substance-related intrusive thoughts and mental imagery is related to increased craving. Further, EI theory suggests that elaboration of craving imagery is related to attention and working memory processes, however, there are questions about whether differential performance in these domains is related to craving. The current study examined the relationship between attention/working memory performance and alcohol craving in a sample of 119 young adult males. Additionally, metacognition was examined to clarify the phenomenological aspects of craving within EI theory. Attention and working memory performance did not significantly predict intrusive thought and mental imagery elaboration. Individuals with high craving reported significantly higher levels of anxiety, thought suppression, and greater strength and frequency of craving-related mental imagery. They were also more likely to try to control their own thoughts and make negative judgments on their ability to do so. The strength of craving-related intrusive thoughts, not mental imagery, was the most significant predictor of craving. Implications for the understanding of craving and treatment recommendations based on the findings are discussed.

Previous research has shown that alcohol abuse may cause a deficit in frontal lobe functioning, specifically, areas of the frontal lobe that are related to executive function. Additionally, problems with executive function have been related to increased difficulty in managing cravings to addictive substances. The current study explored the relationship between alcohol use and performance on measures of executive functioning in a sample of 121 traditional college students. Students were given 5 measures of executive function designed to explore mental set shifting, updating, inhibition, sustained attention, and planning. These measures were used to examine the relationship between executive function and craving as measured by the Obsessive Compulsive Drinking Scale. Levels of alcohol use were also examined using the Alcohol Use Disorders Identification Test in relation to executive function performance and family history of alcohol abuse.

Understanding the etiological and maintaining processes of problematic drinking continues to be a challenge. There has been a growing amount of research focusing on the decisional processes that act to maintain addictive behaviors. Elucidating this underlying process is key to understanding the range of drinking behavior observed among individuals. Rather than relying on one theory, examining overlap between multiple theories of alcohol use may lead to a better understanding of such a process. Using a construct validation approach, this study utilized motivational (Ambivalence Model of Craving), cognitive (Alcohol Outcome Expectancy Theory), and behavioral theories (Behavioral Economics) of alcohol use to examine the extent to which they tap into a common underlying decisional process of alcohol use behaviors. Two methods were used including establishing motivational profiles using latent profile analysis and an experimental manipulation of situational context to examine the effect of setting on constructs of interest. Results from the two studies provided partial support for the overlap between these theories as it pertains to a common underlying process.

L’objectif principal de nos études a été de caractériser la pharmacocinétique du baclofène chez le patient alcoolo-dépendant et d’étudier la variation du craving en fonction de l'exposition au baclofène pour objectif de comprendre s’il existait des sujets répondeurs et des sujets non répondeurs. Nous nous sommes intéressés à la sécurité d’emploi du baclofène, à l’influence que pourraient avoir les paramètres démographiques et biologiques ainsi que la consommation de tabac concomitante. Nous avons pu mettre en évidence que le baclofène présentait une pharmacocinétique linéaire avec une relation proportionnelle de 30 à 240 mg par jour avec une importante variabilité interindividuelle. Une modélisation pharmacocinétique/pharmacodynamique par approche de population nous a permis de définir la relation entre l’exposition au baclofène et le craving à l’alcool. Nous avons constaté que le baclofène permettait de diminuer le craving à l’alcool pour l’ensemble des patients traités, et nous avons pu élaborer l’hypothèse qu’il existait deux sous-populations de patients différenciés par leur rapidité de réponse. Bien que chez les patients non-répondeurs (répondeurs tardifs) les taux sanguins de créatinine et de phosphatases alcalines étaient significativement plus élevés laissant supposer que les patients sévèrement malades répondaient moins au traitement, le faible nombre de patients (n=50) et l’absence de placebo ne permettent pas de conclure. Des analyses préliminaires des données de craving à l’alcool et de consommation d’alcool suggèrent qu’il existe une relation entre craving et consommation d’alcool. Des analyses complémentaires sont nécessaires pour confirmer ces résultats
The main objective of our studies was to characterize the pharmacokinetics of baclofen in alcohol-dependent patients and to investigate the variation of craving as a function of exposure with a secondary objective which was to explore the possible existence of baclofen responders and non-responders. We investigated baclofen safety, the potential influence of demographic and biological parameters as well as the concomitant use of tobacco. We observed that baclofen showed linear pharmacokinetics with a proportional relationship from 30 to 240 mg per day with a high inter-individual variability. A pharmacokinetic/pharmacodynamic population approach has enabled us to define the relationship between baclofen exposure and alcohol craving. A wide inter-individual variability in response was depicted but could not be explained by any of the covariates studied. We found that baclofen could possibly reduce alcohol craving in all the patients treated, and we drew up the hypothesis of two subpopulations of patients differentiated by their speed of response. Although in non-responders (late responders) blood levels of creatinine and alkaline phosphatase were significantly higher than in responders, suggesting that seriously ill patients could be less responsive to baclofen treatment, the low number of patients (n = 50) and the absence of a placebo group renders this results inconclusive. Preliminary analyzes of alcohol craving and alcohol consumption data suggest that a relationship exists between craving and alcohol consumption. Additional analyzes are needed to confirm these results

Thesis (Ph. D.)--University of Cincinnati, 2005.
Advisor: Kevin Corcoran. Title from electronic thesis title page (viewed May 20, 2008). Keywords: Stroop; Eating Disorders; Alcohol; Alcoholism; Binge Drinking; Mental Workload; Personality; Bulimia Nervosa. Includes abstract. Includes bibliographical references.

Made available in DSpace on 2015-07-22T20:50:06Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-11-24
Introdução: A fração lipídica das membranas celulares consiste de ácidos graxos poliinsaturados (PUFAS) e o uso crônico do álcool altera sua composição, modificando a permeabilidade. Portanto, a administração de PUFAS pode ser um potencial tratamento para evitar a compulsão pelo álcool. Metodologia: Este foi um estudo placebo controlado, duplo-cego, randomizado, onde, "PUFAS”, “Naltrexone”, “Naltrexone + PUFAS" e "Placebo", foram administrados por 90 dias, sendo aplicadas escalas para avaliar o craving pelo álcool (OCDS) e a severidade da dependência do álcool (SADD) no início e 90 dias após a administração das substâncias. Resultados: Após 3 meses de seguimento, houve uma melhora significativa ao longo do tempo em relação aos "dias de ingesta", SADD e OCDS em todos os grupos (p <0,001) dentre os 43 pacientes que completaram o estudo. A comparação entre os grupos quanto aos "dias de ingesta" não demonstrou diferença estatisticamente significante (F = 0,71, p = 0,69). O mesmo efeito foi observado para a compulsão (OCDS) (F = 1,08, p = 0,37) e escala de severidade da dependência (SADD) (F = 0,73, p = 0,53). Conclusões: A administração de n-3 e n-6 PUFAS por 3 meses não diferiu significativamente do placebo na redução da quantidade de ingesta de álcool, ou dos escores de OCDS e SADD em um grupo de pacientes dependentes de álcool. Estudos posteriores com mais participantes, ou com tratamento mais prolongado são necessários para avaliar o possível benefício da administração de ácidos graxos poli-insaturados para pacientes dependentes de álcool, quer como monoterapia ou em combinação com o Naltrexone.
TEDE
BV UNIFESP: Teses e dissertações

Les Pensées Répétitives Négatives (PRN) font référence à des pensées récurrentes, prolongées et relativement incontrôlables au sujet de nos expériences négatives passées, actuelles ou anticipées. Ce processus transdiagnostique serait impliqué dans de nombreux troubles psychologiques, dont les troubles de l’usage de l’alcool (TUA). Cette thèse s’inscrit dans une démarche processuelle afin d’étudier l’impact des PRN sur la consommation d’alcool chez des patients souffrant d’un TUA. La recension systématique des travaux concernant la relation entre PRN et consommation d’alcool a souligné des interrogations concernant l’influence du sexe et de la symptomatologie anxio-dépressive sur ce lien. Afin de répondre à ces questions laissées sans réponses par la littérature, nous avons menées une étude écologique en temps réel via l’utilisation d’une application électronique qui enregistraient les PRN, les émotions et la consommation d’alcool chez des patients souffrant d’un TUA, suivis en ambulatoire. Pour mener à bien cette étude, deux outils transdiagnostiques d’évaluation des PRN ont d’abord été validés. Le Perseverative Thinking Questionnaire a permis l’évaluation transdiagnostique des PRN-traits, soit la tendance habituelle à utiliser des PRN et le Momentary Ruminative Self-Focus Inventory, a permis d’examiner les PRN-états, soient le recours aux PRN au moment de la passation. Les résultats de la thèse démontrent que les PRN expliquent la consommation d’alcool. Ils sont discutés en lien avec la formulation métacognitive triphasique des problèmes d’alcool. L’intérêt de valider la prise en charge transdiagnostique des PRN dans le cadre des TUA est également développée
Repetitive Negative Thinking (RNT) refers to a style of recurring, relatively uncontrollable and prolonged thoughts about one’s current, past or anticipated negative experiences. This transdiagnostic mental process is shared across a wide range of psychological disorders, including alcohol use disorders (AUD). The current thesis examined the link between RNT and alcohol use among patients suffering from an AUD in a processual perspective. The systematic review of the literature on the relationship between RNT and alcohol use highlighted some questions about the impact of sex and anxious or depressed symptoms. To address these unanswered questions, we conducted an ecological study in real time through the use of an electronical application assessing RNT, mood and alcohol consumption among AUD patients. To accomplish this aim, two transdiagnostic scales evaluating RNT were validated. The Perseverative Thinking Questionnaire assessed RNT-traits which is the habitual tendency to have RNT, and the Momentary Ruminative Self-Focus Inventory examined RNT-state which is the use of RNT at the time of the assessment. Results of this thesis demonstrated that the link between RNT and alcohol use was direct. They are discussed according to the triphasic metacognitive formulation of problem drinking. The interest of validating the Rumination-focused Cognitive and Behavioural Therapy for AUD patients is developed.Repetitive Negative Thinking (RNT) refers to a style of recurring, relatively uncontrollable and prolonged thoughts about one’s current, past or anticipated negative experiences. This transdiagnostic mental process is shared across a wide range of psychological disorders, including alcohol use disorders (AUD). The current thesis examined the link between RNT and alcohol use among patients suffering from an AUD in a processual perspective. The systematic review of the literature on the relationship between RNT and alcohol use highlighted some questions about the impact of sex and anxious or depressed symptoms. To address these unanswered questions, we conducted an ecological study in real time through the use of an electronical application assessing RNT, mood and alcohol consumption among AUD patients. To accomplish this aim, two transdiagnostic scales evaluating RNT were validated. The Perseverative Thinking Questionnaire assessed RNT-traits which is the habitual tendency to have RNT, and the Momentary Ruminative Self-Focus Inventory examined RNT-state which is the use of RNT at the time of the assessment. Results of this thesis demonstrated that the link between RNT and alcohol use was direct. They are discussed according to the triphasic metacognitive formulation of problem drinking. The interest of validating the Rumination-focused Cognitive and Behavioural Therapy for AUD patients is developed

The following thesis is comprised of three parts. Part one is the Literature Review. This section reviews relevant papers with the aim of answering the question "can we enhance Cognitive Behavioural Therapy (CBT) for anxiety disorders using medication". The second part is the Empirical Paper. This details a randomised, placebo-controlled study investigating the effects of combining D-cycloserine (DCS) with cue exposure in a population of heavy social drinkers. Outcome measures of subjective craving and attentional bias are examined to assess if DCS can enhance the efficacy of cue exposure therapy in this population. The study presented in the Empirical Paper was conducted jointly with another trainee, Lydia Rodney (D.Clin.Psy, 2010). See Appendix A for further details. Finally, part three is the Critical appraisal, which includes reflections on the study presented in the empirical paper and, more broadly, on the research process in its entirety.

Background: A randomized controlled study (RCT) recently showed that short-term heart rate variability (HRV) biofeedback in addition to standard rehabilitation care for alcohol dependence can reduce craving, anxiety and improve cardiovascular autonomic function. In this one-year follow-up study we aimed to explore whether completion of 2-week HRV-Biofeedback training is associated with long-term abstinence. Furthermore, we sought to identify potential predictors of post-treatment abstinence. Methods: We conducted a survey on abstinence in patients with alcohol dependence 1 year after completion of an RCT comparing HRV-biofeedback in addition to inpatient rehabilitation treatment alone (controls). Abstinence rates were compared and analysed for association with demographic data as well as psychometric and autonomic cardiac assessment before and after completion of the biofeedback training using bivariate and multivariate regression analyses. Results: Out of 48 patients who participated in the RCT, 27 patients (9 females, ages 42.9 ± 8.6, mean ± SD) completed our one-year follow-up. When including in the analysis only patients who completed follow-up, the rate of abstinence tended to be higher in patients who underwent HRV-biofeedback 1 year earlier compared to those who received rehabilitative treatment alone (66.7% vs 50%, p = ns). This non-significant trend was also observed in the intention-to-treat analysis where patients who did not participate in the follow-up were assumed to have relapsed (46,7% biofeedback vs. 33.3% controls, p = ns). Neither cardiac autonomic function nor psychometric variables were associated with abstinence 1 year after HRV-biofeedback. Conclusion: Our follow-up study provide a first indication of possible increase in long-term abstinence after HRVbiofeedback for alcohol dependence in addition to rehabilitation. Trial registration: The original randomized controlled trial was registered in the German Clinical Trials Register (DRKS00004618). This one-year follow-up survey has not been registered.

Cette thèse rapporte les résultats de deux études cherchant à approfondir nos connaissances sur l’efficacité et les mécanismes d’action du disulfirame dans le traitement de l’alcoolodépendance. Dans la première étude, en cross-over et randomisée, 33 sujets alcoolodépendants ont reçu des messages avec menace d’effet aversif ou neutres pendant 2 séances d’exposition au stimulus alcool. La condition menace a consisté à annoncer aux patients qu’ils avaient pris du disulfirame et la condition neutre qu’ils avaient pris un placebo. En réalité, tous avaient reçu un placebo. Dans la condition menace comparée à la condition neutre, la tension artérielle diastolique a baissé (p = 0. 04). Les réponses subjectives sont restées inchangées. Des effets bénéfiques alternatifs qui découlent d’autres processus cognitifs sont discutés. La deuxième étude rapporte les résultats préliminaires d’une méta-analyse de l’efficacité du disulfirame dans l’alcoolodépendance. Des 16 études randomisées et contrôlées confondues, notre méta-analyse a montré une efficacité supérieure du disulfirame à la condition contrôle OR=2. 35 (95%CI=1. 48-3. 78). Dans les études en ouvert comparées à celles en aveugle, le disulfirame avait une efficacité supérieure. Nous avons également pu confirmer que le disulfirame est efficace quand son administration est supervisée. En conclusion, nous avons pu montrer que le disulfirame est un traitement efficace si les études sont ouvertes et supervisées. Son mécanisme d’action, étudié en laboratoire, passe par un effet de la menace d’une réaction aversive, effet qui n’a pas semblé mesurable au niveau subjectif, mais qui s’est révélé au niveau neurovégétatif

Les dérèglements émotionnels ont été largement avancés dans le développement et le maintien des conduites addictives. Ces perturbations des processus émotionnels sont associées à l’utilisation privilégiée de stratégies compensatoires mal adaptées qui vont à leur tour entériner les conduites addictives et entraver une consolidation de l’abstinence. Ce travail vise une meilleure compréhension des facteurs de vulnérabilité de la rechute à l’alcool par l’étude de l’évolution des compétences émotionnelles avec l’abstinence à travers trois volets expérimentaux. Pour cela, nous étudierons spécifiquement les mécanismes de régulation émotionnelle considérés comme centraux dans la problématique addictive. Nous utiliserons des outils particuliers pour étudier ces mécanismes que sont des indicateurs physiologiques du système nerveux autonome.Dans un premier volet, nous avons étudié les réponses du système sympathique par la mesure du diamètre pupillaire en réponse à la présentation d’images neutres etémotionnelles (positives et négatives). Nous avons démontré qu’en situation d’induction émotionnelle les patients abstinents à court terme présentent une activation plus forte du système d’alerte sympathique que les abstinents à long terme et les participants contrôles. Le niveau intermédiaire de la réponse pupillaire observé chez les abstinents à long terme suggère une amélioration partielle dans l’activation sympathique à la présentation d’une information émotionnelle (étude 1). La variabilité de la fréquence cardiaque (VFC) est un indicateur du système parasympathique, est reconnue comme marqueur de la régulation émotionnelle. L’étude de la VFC avant pendant et après une situation d’induction émotionnelle a montré une normalisation de la VFC en réponse aux stimuli émotionnels avec une abstinence à long terme. Cependant, les résultats pour les stimuli à valence négative ne sont pas différents entre les groupes abstinents à court et à long terme. Ce pattern de réponse appuie l’hypothèse d’un maintien de vulnérabilité aux émotions négatives en dépit d’une abstinence prolongée. De plus, une corrélation négative a été observée pour les deux groupes de patients entre les scores de craving et une augmentation de la VFC (étude 2). Enfin, dans un dernier volet expérimental, nous avons investigué les compétences et difficultés de régulation émotionnelle par des autoquestionnaires(CERQ et DERS) auprès de patients abstinents de quelques semaines à plusieurs années. Les résultats supportent l’hypothèse d’une limite de récupération capacités après deux ans d’abstinence (étude 3). L’étude de l’étendue des récupérations des compétences émotionnelles est une piste majeure dans la consolidation de l’abstinence. Ces trois études confirment la récupération des compétences émotionnelles avec l’abstinence mais surtout la persistance d’une vulnérabilité dans les processus émotionnels. Le caractère partiel des récupérations de ces mécanismes suppose non seulement le maintien d’une vulnérabilité en dépit d’une abstinence prolongée et met également en évidence la nécessité d’un travail d’accompagnement dans la remédiation de ces compétences à long terme. Un ensemble de perspectives de recherches et d’applications cliniques s’ouvrent au regard de ces résultats, et seront ici discutées
Emotional disorders are recognized as a major factor of development andcontinuity of addictive behavior. These perturbations of the emotional processes areassociated with the preference given to ill-suited compensatory strategies which will inturn perpetuate addictive behaviors and interfere with the consolidation of abstinence.This study aimed to give a better understanding of the vulnerability factors of alcoholrelapse by studying the evolution of emotional competence with abstinence over threeexperimental chapters. For this purpose, we looked more closely at the mechanisms ofemotional regulation, which are considered as crucial in the addiction problem. In orderto study these mechanisms we used specific tools like the physiological cues of theautonomic nervous system.In a first chapter, we studied sympathetic system response by measuringpupillary diameter after exposure to neutral and emotional pictures (positive andnegative). We showed that when exposed to emotional induction, short-term abstinentpatients showed a stronger activation of the sympathetic nervous system than long-termabstinent patients as well as the control group. The intermediary level of pupillaryresponse found among long-term abstinent patients suggests a partial improvement ofsympathetic activation when exposed to emotional information (study 1). Heart RateVariability (HRV) is an indicator of the parasympathetic system and is viewed as amarker of emotional regulation. The study of HRV before, during and after a situation ofemotional induction showed a normalization of HRV in response to emotional stimuliwith long-term abstinence. However, results for stimuli with negative valence are notdifferent between the long-term and short-term abstinence groups. This responsepattern supports the hypothesis that there is still a vulnerability to negative emotionsdespite the prolonged abstinence. Moreover, a negative correlation between cravingscores and increase of HRV has been observed for the two patient groups (study 2).Finally, in a last experimental chapter, emotional competence and emotional regulationdifficulties were assessed by presenting the Difficulties in Emotion Regulation Scale(DERS) and the Cognitive Emotion Regulation Questionnaire (CERQ) to few weeks tofew years abstinent patients. Results support the hypothesis of a recovery shift of twoyears of abstinence for these abilities (study 3).The study of the extent of the recoveries of emotional competence is a major leadfor the consolidation of abstinence. Those three studies confirm the retrieval ofemotional competence with abstinence but they particularly show the persistence of avulnerability in the emotional processes. The fact that there is a recovery shift for thosemechanisms not only involves the continuity of a vulnerability despite a prolongedabstinence, but also underlines the need of a work of support for the remediation ofemotional competence in the long term. These results can lead to several researchprospects and clinical applications that will be discussed here

碩士
國立成功大學
行為醫學研究所
93
Objective: This study was designed to examine the relationship between the ALDH genotype and alcohol outcome expectancies, craving, and the amount of alcohol consumed among alcoholics. 　　Method: All alcoholic participants were divided into two groups by their ALDH2 genotype, and we examined if there are differences in their alcohol outcome expectancies, craving or amount of alcohol consumed which were assessed by the Alcohol Expectancies Scale (AES), Alcohol craving scale and Form 90, respectively. 　　Results: The ALDH2*1/*2 group had lower negative alcohol expectancies. In social/interpersonal, emotional, physical and cognitive aspects, they expected less negative impacts than did the ALDH2*1/*1 group. Even more surprisingly, the ALDH2*1/*2 group had higher positive expectancies and they expected higher effects in sexual enhancement, physical and social pleasure, relaxation, and tension reduction. Interestingly, the two groups did not differ in alcohol craving or in amount of alcohol consumed. 　　Conclusion: Although the ALDH2*2 allele is a protective factor against being alcoholic in normal subjects, due in part to the elevated blood level of acetaldehyde and its accompanying physiological discomfort after drinking, once people become alcoholics, they will have the ability to tolerate or inhibit the adverse effects of elevated acetaldehyde, or can even experience a euphoric feeling after an accumulation of acetaldehyde. A future study to make a correlation between the blood levels of acetaldehyde and the physiological response and perception of alcoholics is needed. The differential response to acetaldehyde between alcoholics and non-dependent people with the ALDH2*1/*2 or ALDH2*2/*2 genotype also have to be addressed.

Varenicline is used to treat tobacco dependence. While varenicline decreases craving during a quit attempt, no studies have investigated its effect on cue-induced craving. Varenicline has also been shown to decrease alcohol consumption in animal and humans. This double-blind, randomized, placebo-controlled trial investigated the effect of varenicline on tobacco and alcohol cue-induced craving and alcohol consumption in dependent smokers/light drinkers. Tobacco and alcohol craving were assessed at baseline and after 2-weeks of drug administration using the QSU and ACQ. Significant decreases in cigarette and alcohol craving were observed between the pre- and post-drug session in the varenicline group on QSU Factor 1(87.5811.66 vs.70.5820.79, p=0.008) and ACQ Total (3.371.16 vs. 2.661.15, p=0.004) scores. This effect remained significant after correction for craving during neutral cues in the alcohol but not tobacco condition. No significant decreases in alcohol consumption were seen. These results suggest varenicline decreases overall craving, but not cue-induced craving specifically.

No
We previously reported that music-assisted systematic desensitization can counter-condition substance-related cues and reduce the implicated craving responses, as well as improve cognitive and psychopathological components of substance addiction. This follow-up study investigated the therapeutic contribution of listening to recorded New Age relaxing music in counterconditioning external substance-conditioned cues, as well as in the amelioration of everyday life craving reactivity, craving beliefs and depression. Twenty-one substance addicted individuals participated in a three-week randomized controlled trial consisting of two therapeutic sessions per week. Participants were randomly assigned to one of the two study groups, systematic desensitization combined with listening to New Age relaxing music recorded in individual MP3 devices, and systematic desensitization without music. Measurements of craving in response to external substance-conditioned cues, craving beliefs, everyday craving reactivity and depression took place at baseline, post-treatment and one month after the end of treatment. No significant group differences in the outcome measures were observed between both arms of the study but within group and time results suggest that listening to New Age relaxing music significantly enhances systematic desensitization and accounts for significant reductions of craving responses to external substance-conditioned cues and of craving beliefs associated with compulsive behaviour in the music group. Our study provides the first evidence on the potential therapeutic contribution of music to cue counterconditioning in substance addiction treatment. Further investigation on the capacity of music to increase the effectiveness of systematic desensitization seems warranted.

Les Pensées Répétitives Négatives (PRN) font référence à des pensées récurrentes, prolongées et relativement incontrôlables au sujet de nos expériences négatives passées, actuelles ou anticipées. Ce processus transdiagnostique serait impliqué dans de nombreux troubles psychologiques, dont les troubles de l’usage de l’alcool (TUA). Cette thèse s’inscrit dans une démarche processuelle afin d’étudier l’impact des PRN sur la consommation d’alcool chez des patients souffrant d’un TUA. La recension systématique des travaux concernant la relation entre PRN et consommation d’alcool a souligné des interrogations concernant l’influence du sexe et de la symptomatologie anxio-dépressive sur ce lien. Afin de répondre à ces questions laissées sans réponses par la littérature, nous avons menées une étude écologique en temps réel via l’utilisation d’une application électronique qui enregistraient les PRN, les émotions et la consommation d’alcool chez des patients souffrant d’un TUA, suivis en ambulatoire. Pour mener à bien cette étude, deux outils transdiagnostiques d’évaluation des PRN ont d’abord été validés. Le Perseverative Thinking Questionnaire a permis l’évaluation transdiagnostique des PRN-traits, soit la tendance habituelle à utiliser des PRN et le Momentary Ruminative Self-Focus Inventory, a permis d’examiner les PRN-états, soient le recours aux PRN au moment de la passation. Les résultats de la thèse démontrent que les PRN expliquent la consommation d’alcool. Ils sont discutés en lien avec la formulation métacognitive triphasique des problèmes d’alcool. L’intérêt de valider la prise en charge transdiagnostique des PRN dans le cadre des TUA est également développée
Repetitive Negative Thinking (RNT) refers to a style of recurring, relatively uncontrollable and prolonged thoughts about one’s current, past or anticipated negative experiences. This transdiagnostic mental process is shared across a wide range of psychological disorders, including alcohol use disorders (AUD). The current thesis examined the link between RNT and alcohol use among patients suffering from an AUD in a processual perspective. The systematic review of the literature on the relationship between RNT and alcohol use highlighted some questions about the impact of sex and anxious or depressed symptoms. To address these unanswered questions, we conducted an ecological study in real time through the use of an electronical application assessing RNT, mood and alcohol consumption among AUD patients. To accomplish this aim, two transdiagnostic scales evaluating RNT were validated. The Perseverative Thinking Questionnaire assessed RNT-traits which is the habitual tendency to have RNT, and the Momentary Ruminative Self-Focus Inventory examined RNT-state which is the use of RNT at the time of the assessment. Results of this thesis demonstrated that the link between RNT and alcohol use was direct. They are discussed according to the triphasic metacognitive formulation of problem drinking. The interest of validating the Rumination-focused Cognitive and Behavioural Therapy for AUD patients is developed.Repetitive Negative Thinking (RNT) refers to a style of recurring, relatively uncontrollable and prolonged thoughts about one’s current, past or anticipated negative experiences. This transdiagnostic mental process is shared across a wide range of psychological disorders, including alcohol use disorders (AUD). The current thesis examined the link between RNT and alcohol use among patients suffering from an AUD in a processual perspective. The systematic review of the literature on the relationship between RNT and alcohol use highlighted some questions about the impact of sex and anxious or depressed symptoms. To address these unanswered questions, we conducted an ecological study in real time through the use of an electronical application assessing RNT, mood and alcohol consumption among AUD patients. To accomplish this aim, two transdiagnostic scales evaluating RNT were validated. The Perseverative Thinking Questionnaire assessed RNT-traits which is the habitual tendency to have RNT, and the Momentary Ruminative Self-Focus Inventory examined RNT-state which is the use of RNT at the time of the assessment. Results of this thesis demonstrated that the link between RNT and alcohol use was direct. They are discussed according to the triphasic metacognitive formulation of problem drinking. The interest of validating the Rumination-focused Cognitive and Behavioural Therapy for AUD patients is developed

Stress and limbic iritability in depression and alcohol dependency Denisa Jasová Abstract Depressive disorders and alcohol dependency recently present epidemiologically most significant psychiatric disorders. According to current research both diseases are multifactorial, mainly represented by genetic and environmental conditions. Several recent research studies are mainly focused on social factors related to stress and traumatic events such as neglect, deprivation, verbal, emotional, physical and sexual abuse, bullying and others. Important feature of these pathological conditions present disbalance between excitatory and inhibitory systems. In this context in affective disorders as well as in alcohol dependency these inhibitory deficits are represented by increased sensitivity and excitability of the limbic system called limbic irritability. Several studies suggested that these pathological changes may be described using the kindling model that potentially may explain limbic changes similar to temporal lobe epilepsy which may produce affective, cognitive and psychosensory symptoms but without typical changes that occur in neurologically diagnosed epilepsy. Following these findings significant correlations between depression and limbic irritability and between limbic irritability and alcohol craving have...

Indiana University-Purdue University Indianapolis (IUPUI)
Prior research indicated a high prevalence of problematic drinking among college students, suggesting a need for more effective screening approaches and treatments. The tendency to act rashly in face of strong emotions (e.g. positive and negative urgency), alcohol cravings, and cue reactivity all have been associated with problematic alcohol use. However, no studies have examined the interactive effects of alcohol cravings, urgency, and cue reactivity. I hypothesized that alcohol cravings will be associated with greater problematic drinking among individuals with higher levels of (1) urgency, (2) cue reactivity, and (3) cue reactivity and urgency. Data were collected from a sample (final n = 240) of college students through a survey, which consisted of measures of urgency, problematic drinking, and alcohol cravings. On the survey, participants were also exposed to alcohol and non-alcohol pictures, after which they assessed their level of cue reactivity. Results were examined using multiple regression and simple slope analyses. Results provided partial support for our hypotheses. Alcohol cravings were associated with greater problematic drinking at lower levels of negative urgency (b = 7.36, p< 0.001). Furthermore, alcohol cravings were most strongly associated with problematic drinking at high levels of cue reactivity and low levels of negative urgency (b = 8.69, p<0.001), and at low levels of cue reactivity and high levels of positive urgency (b = 6.56, p<0.001). These findings emphasize the importance of considering urgency and cue reactivity in understanding how alcohol cravings create risk for problematic drinking.

Indiana University-Purdue University Indianapolis (IUPUI)
In order to elucidate the role of classical conditioning in food and alcohol co-consumption, the present study examined: (1) the effects of alcohol odor cues on alcohol and food cravings and attentional bias (bias in selective attention toward either food or alcohol pictures relative to neutral pictures); and (2) the role of alcohol odor cue elicited cravings and attentional biases on subsequent consumption. Participants (n = 77; mean age = 30.84, SD = 9.46; 51.9% female, 83.1% Caucasian) first completed the lab portion of the study. In this portion, they were exposed to alcohol and neutral odorants, after which their food and alcohol cravings and attentional bias were assessed. Participants then received an online survey the next day, on which they reported their level of food and alcohol consumption following the lab portion of the study. Using repeated measures analysis of covariance, alcohol odor cues were differentially effective in increasing food and alcohol attentional bias and cravings (Fs= 0.06 to 2.72, ps= 0.03 to 0.81). Using logistic and multiple regressions, alcohol odor cue elicited alcohol attentional bias, food attentional bias, and food cravings were associated with later alcohol consumption, but not with later food consumption or concurrent consumption (βs = -0.28 to 0.48, ps = 0.02 to 0.99; Exp(B)s = 0.95 to 1.83, ps = 0.33 to 0.91). Overall, alcohol odor cues can become conditioned stimuli that elicit conditioned food-related and alcohol-related responses, both of which persist long enough to motivate later alcohol consumption; however, these conditioned responses might not persist long enough to motivate later food or concurrent consumption. These findings serve as a first step in clarifying the role of classical conditioning in concurrent consumption. In particular, they suggest that additional empirical investigations are needed to: (1) clarify the classical conditioning mechanisms underlying concurrent consumption; and (2) examine whether interventions targeting classical conditioning mechanisms are effective for reducing alcohol use.

This diploma thesis explores the phenomenon of formation and development of alcohol dependence. In the first series focuses on the historical description, which demonstrates considerable anchored in the life of our ancestors already. It also defines the concept of addiction, its causes and consequences, whether psychological, medical or social. Its objective is to describe the possibilities of social work in this phenomenon. defines therefore primarily targets and understanding of social work and consequently specifics of client alcoholism. An important element is the role of the social worker in the client's motivation to change, which uses Nešpor's model of spontaneous changes in motivation. Then, on the basis of available social services selects several most suitable, which can help to improve the client's situation. Has an essential role in this issue also primary prevention, ie it discusses the methodology, target groups, focusing on adolescents and the focus is on the firm role of the family. Finally contains some official documents on primary prevention, which are discussed current issues of primary prevention practice and subsequent survey, mapping aspect of social workers on the incidence risk of alcohol dependence among adolescents attending social facilities.