Jurado-Barba Rosa, Rubio Valladolid Gabriel, Martínez-Gras Isabel, Alvarez-Alonso María José, Ponce Alfaro Guillermo, Fernández Alberto, Moratti Stephan, Heinz Andreas, Jimenez-Arriero Miguel Ángel
Department of Psychiatry, School of Medicine, Complutense University of Madrid, Madrid, Spain.
Eur Addict Res. 2015;21(4):195-203. doi: 10.1159/000371723. Epub 2015 Apr 21.
Little is known about changes in the modulation of the startle reflex when patients go through an alcohol-dependence treatment in an outpatient facility. In the current study, the affective modulation of the cue-related startle reflex has been used to evaluate changes in the emotional processing of alcohol-related stimuli that occurred after a standard cognitive-behavioral intervention, and to assess the outcome of this intervention. We hypothesized a 'normalization' of the startle inhibition for the alcohol-related cues during the period of treatment. We also assumed that higher startle inhibition at baseline elicited by alcohol cues would predict the relapse on alcohol consumption during treatment.
A total of 98 alcohol-dependent subjects were included who fulfilled DSM-IV criteria for alcohol dependence. A control group of 72 subjects was selected to match demographic characteristics.
All patients received a standard cognitive-behavioral therapy once a week throughout the study period.
Results show that the startle response differed significantly after 12 weeks of treatment for alcohol-related, neutral and aversive stimuli between alcohol-dependent patients and controls. Low startle responses at baseline to alcohol cues predicted relapse.
These results may indicate that the startle reflex is referred to enduring and permanent processes of cue reactivity, and that the emotional processing of alcohol-associated cues assessed with the affect-modulated startle reflex is less altered by interventions attempting to influence explicit cognitions. Furthermore, lower values of the baseline startle reflex elicited by alcohol-associated stimuli were associated with higher probability of relapse on alcohol use.
对于门诊接受酒精依赖治疗的患者，惊吓反射调制的变化了解甚少。在本研究中，线索相关惊吓反射的情感调制已被用于评估标准认知行为干预后酒精相关刺激的情绪加工变化，并评估该干预的效果。我们假设在治疗期间，与酒精相关线索的惊吓抑制会“正常化”。我们还假设，酒精线索在基线时引起的较高惊吓抑制可预测治疗期间酒精消费的复发情况。
共纳入98名符合DSM-IV酒精依赖标准的酒精依赖受试者。选取72名受试者作为对照组，使其在人口统计学特征上相匹配。
在整个研究期间，所有患者每周接受一次标准认知行为疗法。
结果显示，酒精依赖患者和对照组在接受治疗12周后，对于酒精相关、中性和厌恶刺激的惊吓反应存在显著差异。基线时对酒精线索的低惊吓反应可预测复发。
这些结果可能表明，惊吓反射涉及线索反应性的持久和永久过程，并且通过情感调制惊吓反射评估的酒精相关线索的情绪加工，受试图影响显性认知的干预影响较小。此外，酒精相关刺激引起的基线惊吓反射值较低与酒精使用复发的较高可能性相关。
