DiGirolamo Gregory J, Smelson David, Guevremont Nathan
Department of Psychology, College of the Holy Cross, 1 College Street, Worcester, MA 01610, USA; Department of Psychiatry, Medical School, University of Massachusetts, 55 Lake Avenue North, Worcester, MA 01605, USA.
Department of Psychiatry, Medical School, University of Massachusetts, 55 Lake Avenue North, Worcester, MA 01605, USA; Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA.
Addict Behav. 2015 Aug;47:86-90. doi: 10.1016/j.addbeh.2015.03.025. Epub 2015 Apr 1.
Cue-induced craving is a clinically important aspect of cocaine addiction influencing ongoing use and sobriety. However, little is known about the relationship between cue-induced craving and cognitive control toward cocaine cues. While studies suggest that cocaine users have an attentional bias toward cocaine cues, the present study extends this research by testing if cocaine use disorder patients (CDPs) can control their eye movements toward cocaine cues and whether their response varied by cue-induced craving intensity.
Thirty CDPs underwent a cue exposure procedure to dichotomize them into high and low craving groups followed by a modified antisaccade task in which subjects were asked to control their eye movements toward either a cocaine or neutral drug cue by looking away from the suddenly presented cue. The relationship between breakdowns in cognitive control (as measured by eye errors) and cue-induced craving (changes in self-reported craving following cocaine cue exposure) was investigated.
CDPs overall made significantly more errors toward cocaine cues compared to neutral cues, with higher cravers making significantly more errors than lower cravers even though they did not differ significantly in addiction severity, impulsivity, anxiety, or depression levels. Cue-induced craving was the only specific and significant predictor of subsequent errors toward cocaine cues.
Cue-induced craving directly and specifically relates to breakdowns of cognitive control toward cocaine cues in CDPs, with higher cravers being more susceptible. Hence, it may be useful identifying high cravers and target treatment toward curbing craving to decrease the likelihood of a subsequent breakdown in control.
线索诱发的渴望是可卡因成瘾的一个临床重要方面，影响着持续使用和戒断情况。然而，关于线索诱发的渴望与对可卡因线索的认知控制之间的关系，人们知之甚少。虽然研究表明可卡因使用者对可卡因线索存在注意偏向，但本研究通过测试可卡因使用障碍患者（CDP）是否能够控制他们对可卡因线索的眼动，以及他们的反应是否因线索诱发的渴望强度而有所不同，扩展了这一研究。
30名CDP接受了线索暴露程序，将他们分为高渴望组和低渴望组，随后进行了一项改良的反扫视任务，在该任务中，要求受试者通过看向远离突然呈现的线索来控制他们对可卡因或中性药物线索的眼动。研究了认知控制障碍（通过眼动错误来衡量）与线索诱发的渴望（可卡因线索暴露后自我报告的渴望变化）之间的关系。
与中性线索相比，CDP总体上对可卡因线索犯的错误明显更多，高渴望者比低渴望者犯的错误明显更多，尽管他们在成瘾严重程度、冲动性、焦虑或抑郁水平上没有显著差异。线索诱发的渴望是随后对可卡因线索犯错误的唯一特定且显著的预测因素。
线索诱发的渴望直接且具体地与CDP对可卡因线索的认知控制障碍相关，高渴望者更容易受到影响。因此，识别高渴望者并针对抑制渴望进行治疗可能有助于降低随后失去控制的可能性。
