Department of Psychology, Université Catholique de Louvain, Place du Cardinal Mercier 10, B-1348 Louvain-la-Neuve, Belgium.
Alcohol Alcohol. 2010 May-Jun;45(3):241-6. doi: 10.1093/alcalc/agq012. Epub 2010 Mar 5.
The present study examined the effects of protracted alcohol withdrawal on affectivity, craving, selective attention and executive functions (EFs) in alcohol-dependent patients.
Selective attention (The D2 Cancellation Test), flexibility (Trail Making Test), inhibition (Stroop Task), decision making (Iowa Gambling Task), craving (Obsessive-Compulsive Drinking Scale) and state affectivity (Positive and Negative Affectivity Schedule) were assessed in alcohol-dependent patients (DSM-IV, n = 35) matched to non-alcohol-dependent participants (n = 22) at the onset (T1: day 1 or 2) and at the end (T2: days 14-18) of protracted withdrawal during rehab.
Alcohol-dependent patients' abilities to focus their attention on relevant information, to switch from one pattern to another, to inhibit irrelevant information and to make advantageous choices were lower than those of control participants during both times of a withdrawal cure. No effect of time emerged from analyses for selective attention and EF deficits. Conversely, significant differences between T1 and T2 were observed for craving and affect scores indicating a weakening of alcohol craving and negative affect as well as an improvement of positive affect among patients from onset to the end of cure.
Control functions of the Supervisory Attentional System (Norman and Shallice, 1986) were impaired and did not improve during a 3-week withdrawal cure, whereas alcohol craving and negative state affectivity significantly improved in parallel during this period. Implications for understanding the clinical processes of withdrawal are discussed.
本研究旨在探讨慢性酒精戒断对酒精依赖患者的情感、渴求、选择性注意和执行功能（EF）的影响。
在酒精依赖患者（DSM-IV，n=35）和非酒精依赖参与者（n=22）入院接受长期戒断治疗的开始（T1：第 1 或 2 天）和结束（T2：第 14-18 天）时，评估了选择性注意（D2 取消测试）、灵活性（Trail Making 测试）、抑制（Stroop 任务）、决策（爱荷华赌博任务）、渴求（强迫性饮酒量表）和状态情感（正性和负性情感量表）。
在整个戒断治疗期间，酒精依赖患者集中注意力于相关信息、从一种模式切换到另一种模式、抑制无关信息和做出有利选择的能力均低于对照组参与者。选择性注意和 EF 缺陷的分析中没有出现时间效应。相反，在 T1 和 T2 之间观察到渴求和情感评分的显著差异，这表明患者从开始到治疗结束时，对酒精的渴求以及负面情感减弱，而积极情感有所改善。
在 3 周的戒断治疗期间，监督注意系统（Norman 和 Shallice，1986）的控制功能受损且没有改善，而在此期间，酒精渴求和负性状态情感显著改善。这对理解戒断的临床过程具有重要意义。
