Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Addict Biol. 2012 Mar;17(2):441-51. doi: 10.1111/j.1369-1600.2011.00347.x. Epub 2011 Jul 25.
In line with learning theories of drug addiction, drug-related cues may be viewed as important motivators of continued drug use. They may be differentially effective depending on the context and motivational significance. The present study aimed to test the significance of different contexts in modulating alcohol-related cue reactivity. Pictures depicting alcohol intake or its paraphernalia and pictures without any relation to alcohol intake were varied to depict physical and social contexts or different consumptive contexts associated with full/half-full/empty alcohol beverage containers. We obtained ratings of craving, valence and arousal of the cues as well as skin conductance responses (SCRs) and startle reflex modulation measures from 21 abstinent alcohol-dependent patients, recruited from an addiction treatment center, and 21 matched healthy controls. Social scenes and full glasses or bottles were rated as more pleasant and arousing compared with neutral drinking situations and empty glasses or bottles in patients. Furthermore, we found a decreased startle reflex magnitude to social compared with neutral drinking situations, and both higher SCRs and decreased startle reflex magnitude to full compared with empty glasses or bottles in patients versus controls. These results show that both physical and social and consumptive contexts differentially influence cue reactivity in abstinent alcohol-dependent patients with both social and pub-related physical contexts, and the initial consumptive context eliciting the most appetitive and arousing responses. These data have not only important implications for our understanding of the role of learning in drug dependence but also for treatment, which needs to take these factors into account.
根据药物成瘾的学习理论，与药物相关的线索可以被视为持续使用药物的重要动机。它们的效果可能因情境和动机意义的不同而不同。本研究旨在测试不同情境在调节与酒精相关线索反应性方面的重要性。本研究使用了描述酒精摄入或其用具的图片以及与酒精摄入无关的图片，以描绘与酒精摄入有关的不同情境，包括物理情境和社会情境，或与满杯/半满杯/空酒杯相关的不同消费情境。我们从一家戒毒治疗中心招募了 21 名酒精依赖的患者和 21 名匹配的健康对照组，对这些图片进行了渴望、愉悦度和唤醒程度的评分，以及皮肤电导率反应 (SCR) 和惊跳反射调制测量。与中性饮酒情境相比，社会场景和满杯或满瓶被评定为更愉悦和更能唤起人的情绪，而与中性饮酒情境相比，空杯或空瓶被评定为更不愉快和更不能唤起人的情绪。此外，与中性饮酒情境相比，我们发现患者的惊跳反射幅度对社会饮酒情境的反应性降低，而与空杯或空瓶相比，患者的 SCR 更高，惊跳反射幅度降低。这些结果表明，在酒精依赖的患者中，无论是物理的还是社会的，无论是消费的还是非消费的，这些情境都会对线索反应产生不同的影响，而且社会和与酒吧相关的物理情境以及最初的消费情境会引起最有吸引力和最能唤起人的反应。这些数据不仅对我们理解学习在药物依赖中的作用具有重要意义，而且对治疗也具有重要意义，因为治疗需要考虑到这些因素。
