Fatseas Melina, Serre Fuschia, Alexandre Jean-Marc, Debrabant Romain, Auriacombe Marc, Swendsen Joel
Université Bordeaux, Bordeaux, France.
Laboratoire de psychiatrie/SANPSY, CNRS USR 3413, Bordeaux, France.
Addiction. 2015 Jun;110(6):1035-42. doi: 10.1111/add.12882. Epub 2015 Apr 21.
It is well established that craving increases following exposure to substance-related 'cues', but the role of life-styles or substance use habits that are unique to each person remains poorly understood. This study examines the association of substance-specific and personal cues with craving and substance use in daily life.
Ecological momentary assessment was used during a 2-week period.
Data were collected in a French out-patient addiction treatment centre.
A total of 132 out-patients beginning treatment for alcohol, tobacco, cannabis or opiate addiction were included.
Using mobile technologies, participants were questioned four times per day relative to craving, substance use and exposure to either substance-specific cues (e.g. seeing a syringe) or personal cues unique to that individual (e.g. seeing the specific person with whom the substance is used).
Craving intensity was associated with the number of concurrently assessed substance-specific cues (t = 4.418, P < 0.001) and person-specific cues (t = 4.006, P < 0.001) when analysed jointly within the same model. However, only person-specific cues were associated with increases in craving over subsequent hours of the day (t = 2.598, P < 0.05). Craving intensity, in turn, predicted increases in later substance use (t = 4.076, P < 0.001). Causal mediation analyses demonstrated that the association of cues with later substance use was mediated by craving intensity (mediated effect = 0.007, 95% confidence interval = 0.004-0.011).
Unique person-specific cues appear to have a robust effect on craving addictive substances, and the duration of this association may persist longer than for more general substance-specific cues. Mobile technologies provide new opportunities for understanding these person-specific risk factors and for providing individually tailored interventions.
众所周知，接触与物质相关的“线索”后，渴求会增加，但对于每个人独特的生活方式或物质使用习惯的作用仍知之甚少。本研究探讨了特定物质线索和个人线索与日常生活中渴求及物质使用之间的关联。
在为期2周的时间内采用生态瞬时评估法。
数据收集于法国一家门诊成瘾治疗中心。
共纳入132名开始接受酒精、烟草、大麻或阿片类成瘾治疗的门诊患者。
利用移动技术，每天对参与者进行4次询问，内容涉及渴求、物质使用以及接触特定物质线索（如看到注射器）或该个体特有的个人线索（如看到与之一起使用该物质的特定人员）。
在同一模型中联合分析时，渴求强度与同时评估的特定物质线索数量（t = 4.418，P < 0.001）和个人线索数量（t = 4.006，P < 0.001）相关。然而，仅个人线索与当天随后数小时内渴求的增加相关（t = 2.598，P < 0.05）。渴求强度进而预测了随后物质使用的增加（t = 4.076，P < 0.001）。因果中介分析表明，线索与随后物质使用之间的关联由渴求强度介导（中介效应 = 0.007，95%置信区间 = 0.004 - 0.011）。
独特的个人线索似乎对成瘾物质的渴求有强烈影响，且这种关联的持续时间可能比更一般的特定物质线索更长。移动技术为理解这些个人特定风险因素及提供个性化干预提供了新机会。
