Norberg Melissa M, Kavanagh David J, Olivier Jake, Lyras Stephanie
Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia.
Institute of Health and Biomedical Innovation, School of Psychology and Counselling, Queensland University of Technology, Kelvin Grove, QLD, Australia.
Addiction. 2016 Nov;111(11):1923-1934. doi: 10.1111/add.13472. Epub 2016 Aug 4.
To estimate the magnitude of cannabis cue-reactivity responses in people who regularly use cannabis.
EMBASE, PUBMED, PsycINFO, PsycEXTRA and Project CORK were searched for within-subject comparison studies published between January 2000 and December 2014. Eligible studies compared regular cannabis users' subjective craving or psychophysiological responding when exposed to cannabis cues to their responses to neutral cues and/or to their responses during a baseline assessment. Eligible studies presented original data and were written in English. Fourteen studies met inclusion criteria, but data were not available for two. The 12 included studies contained 393 participants (12-97 participants per study; mean age range: 16.4-32.6 years). Standardized effects sizes were computed for heart rate, skin conductance, skin temperature, blood pressure, event-related potentials (Pz P300) and self-reported craving (Visual Analogue Scales and Marijuana Craving Questionnaire) and synthesized using a multivariate meta-regression model.
On average, cannabis users experienced moderate cue-reactivity, as determined by comparisons with baseline conditions [d = 0.59, 95% confidence interval (CI) = 0.43, 0.74, P < 0.001] and with neutral cue comparisons (d = 0.47, 95% CI = 0.32, 0.62, P < 0.001). This model, which excluded studies at a greater than low risk of bias and included PzP300 studies as a moderator (due to having larger effect sizes), had a moderately low level of heterogeneity of effect size (I = 45.6%, Q = 56.97, P = 0.003) and showed no evidence of publication bias. Cue-reactivity was most noticeable (large effect size) when assessed by Pz P300 waves (d = 1.71, 95% CI = 0.77, 2.64, P = 0.0003; I = 86%, Q = 36.30, P < 0.001) and least noticeable (trivial effect size) when examining heart rate (d = 0.14, 95% CI = -0.34, 0.62, P = 0.58; I = 80%, Q = 20.0, P < 0.001). These subgroup models demonstrated high heterogeneity of effect size.
Regular cannabis users experience moderate to extremely intense cue-reactivity, such that their attentional biases towards cannabis cues are much stronger than their perceptions of craving for the drug.
评估经常使用大麻者对大麻线索的反应程度。
检索EMBASE、PUBMED、PsycINFO、PsycEXTRA和Project CORK数据库，查找2000年1月至2014年12月期间发表的受试者内比较研究。符合条件的研究比较了经常使用大麻者在接触大麻线索时的主观渴望或心理生理反应，以及他们对中性线索的反应和/或基线评估期间的反应。符合条件的研究提供了原始数据且以英文撰写。14项研究符合纳入标准，但其中2项无法获取数据。纳入的12项研究包含393名参与者（每项研究12 - 97名参与者；平均年龄范围：16.4 - 32.6岁）。计算心率、皮肤电导率、皮肤温度、血压、事件相关电位（Pz P300）和自我报告的渴望（视觉模拟量表和大麻渴望问卷）的标准化效应量，并使用多元元回归模型进行综合分析。
平均而言，与基线条件相比（d = 0.59，95%置信区间（CI）= 0.43，0.74，P < 0.001）以及与中性线索比较时（d = 0.47，95% CI = 0.32，0.62，P < 0.001），大麻使用者表现出中度的线索反应性。该模型排除了偏倚风险大于低风险的研究，并将PzP300研究作为一个调节因素（因其效应量较大），效应量的异质性水平中等偏低（I² = 45.6%，Q = 56.97，P = 0.003），且未显示发表偏倚的证据。当通过Pz P300波评估时，线索反应性最为明显（效应量较大）（d = 1.71，95% CI = 0.77，2.64，P = 0.0003；I² = 86%，Q = 36.30，P < 0.001），而在检查心率时最不明显（效应量微不足道）（d = 0.14，95% CI = -0.34，0.62，P = 0.58；I² = 80%，Q = 20.0，P < 0.001）。这些亚组模型显示出效应量的高度异质性。
经常使用大麻者经历中度至极强的线索反应性，以至于他们对大麻线索的注意力偏差远强于对毒品渴望的感知。
