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酒精激发试验反应可预测未来酒精使用障碍症状:一项为期6年的前瞻性研究。

Alcohol challenge responses predict future alcohol use disorder symptoms: a 6-year prospective study.

作者信息

King Andrea C, McNamara Patrick J, Hasin Deborah S, Cao Dingcai

机构信息

Department of Psychiatry and Behavioral Neuroscience (ACK, PJM), University of Chicago, Chicago Illinois.

Department of Psychiatry and Behavioral Neuroscience (ACK, PJM), University of Chicago, Chicago Illinois.

出版信息

Biol Psychiatry. 2014 May 15;75(10):798-806. doi: 10.1016/j.biopsych.2013.08.001. Epub 2013 Oct 2.

Abstract

BACKGROUND

Propensity for alcohol misuse may be linked to an individuals' response to alcohol. This study examined the role of alcohol response phenotypes to future drinking problems.

METHODS

One hundred four young heavy social drinkers participated in a within-subject, double-blind, placebo-controlled laboratory alcohol challenge study with 6-year follow-up. Participants were examined for subjective responses before and after receiving an intoxicating dose of alcohol (.8 g/kg) or a placebo beverage, given in random order. Follow-up was conducted in 5 waves over 6 years after the sessions to assess drinking behaviors and alcohol use disorder (AUD) symptoms. Retention was high with 98% (509 of 520) of possible follow-ups completed.

RESULTS

Greater sensitivity to alcohol, in terms of stimulation and rewarding effects (like, want more) and lower sensitivity to alcohol sedation predicted greater number of AUD symptoms through 6 years of follow-up. Cluster analyses revealed that for half the sample, increasing levels of stimulation and liking were predictors of more AUD symptoms with the other half divided between those showing like and want more and want more alone as significant predictors.

CONCLUSIONS

The findings extend previous findings and offer new empirical insights into the propensity for excessive drinking and alcohol problems. Heightened alcohol stimulation and reward sensitivity robustly predicted more alcohol use disorder symptoms over time associated with greater binge-drinking frequency. These drinking problems were maintained and progressed as these participants were entering their third decade of life, a developmental interval when continued alcohol misuse becomes more deviant.

摘要

背景

酒精滥用倾向可能与个体对酒精的反应有关。本研究探讨了酒精反应表型对未来饮酒问题的作用。

方法

104名年轻的重度社交饮酒者参与了一项为期6年随访的受试者内双盲安慰剂对照实验室酒精激发研究。参与者在随机接受致醉剂量的酒精(0.8克/千克)或安慰剂饮料前后接受主观反应检查。在实验结束后的6年里分5波进行随访,以评估饮酒行为和酒精使用障碍(AUD)症状。随访完成率很高,完成了可能随访的98%(520次中的509次)。

结果

在刺激和奖赏效应(喜欢、想要更多)方面对酒精更敏感,以及对酒精镇静作用更不敏感,预测在6年随访期间会出现更多的酒精使用障碍症状。聚类分析显示,对于一半的样本,刺激和喜欢程度的增加是更多酒精使用障碍症状的预测因素,另一半则分为显示喜欢和想要更多以及仅想要更多作为显著预测因素的两组。

结论

这些发现扩展了先前的研究结果,并为过度饮酒倾向和酒精问题提供了新的实证见解。随着时间的推移,酒精刺激和奖赏敏感性增强有力地预测了更多与更高频率暴饮相关的酒精使用障碍症状。随着这些参与者进入第三个十年,即持续酒精滥用变得更加偏离常态的发育阶段,这些饮酒问题持续存在并发展。

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