酒精依赖中的缓慢联想学习与酒精线索暴露治疗悖论。

Slow associative learning in alcohol dependence and the alcohol cue exposure treatment paradox.

机构信息

Department of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, SO171BJ, UK.

Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, SO17 1BJ, UK.

出版信息

Addiction. 2021 Apr;116(4):759-768. doi: 10.1111/add.15210. Epub 2020 Aug 27.

DOI:10.1111/add.15210

PMID:32725645

Abstract

AIMS

To examine two explanations for the observation that cue-exposure treatment has not been clearly effective in the treatment of alcohol dependence: do alcohol-dependent individuals have either (1) slower extinction and/or (2) greater contextual specificity of extinction than non-dependent individuals?

DESIGN

In two exploratory laboratory experiments we used mixed factorial designs with two-group between-subjects factors and within-subjects factors corresponding to performance in different parts of a computer-based learning task.

SETTING

University of Southampton psychology research laboratories and two addiction treatment services in the city of Southampton, UK.

PARTICIPANTS

Experiment 1: 74 (54 female) undergraduates from the University of Southampton (age mean = 20.4 years). Experiment 2: 102 (40 female) participants from the University of Southampton, the local community, and from two Southampton alcohol treatment services (age mean = 41.3 years).

MEASUREMENTS

The Alcohol Use Disorders Identification Test, a 1-week time-line follow-back alcohol consumption questionnaire, the Barratt Impulsiveness Scale (11th edn), and a computerized learning task. Experiment 2 additionally used the 44-item Big Five Inventory, a drug use history checklist, and the Hospital Anxiety and Depression Scale.

FINDINGS

Experiment 1: light and heavy drinkers did not differ significantly in extinction [extinction block × drinking status interaction, P = 0.761, , 95% confidence interval (CI) = (0,0.028)] or on contextual control of extinction [recovery block × drinking status interaction, P = 0.514, , 95% CI =(0, 0.084)]. Experiment 2: slower extinction in abstinent alcohol-dependent participants compared with light drinkers [extinction block × drinking status interaction, P = 0.023, , 95% CI = 0, 0.069)] but no significant difference on contextual control of extinction [recovery block × drinking status interaction, P = 0.069, , 95% CI = (0, 0.125)].

CONCLUSION

Abstinent alcohol-dependent people may have slower extinction learning for alcohol-related cues than non-dependent light drinkers.

摘要

目的

探讨 cue-exposure 治疗在治疗酒精依赖方面效果不明显的两种解释：酒精依赖个体是否存在（1）消退较慢和/或（2）消退的上下文特异性较大的情况？

设计

在两项探索性实验室实验中，我们使用了混合因子设计，有两个组间因子和一个对应于计算机学习任务不同部分表现的组内因子。

设置

英国南安普顿大学心理学研究实验室和南安普顿市的两个成瘾治疗服务机构。

参与者

实验 1：74 名（54 名女性）来自南安普顿大学的本科生（年龄平均=20.4 岁）。实验 2：102 名（40 名女性）参与者来自南安普顿大学、当地社区和南安普顿的两个酒精治疗服务机构（年龄平均=41.3 岁）。

测量方法

酒精使用障碍识别测试、为期一周的时间线回溯酒精摄入量问卷、巴瑞特冲动量表（第 11 版）和计算机学习任务。实验 2还使用了 44 项大五人格量表、药物使用历史清单和医院焦虑和抑郁量表。

结果

实验 1：轻、重度饮酒者在消退方面没有显著差异[消退块×饮酒状态交互作用，P=0.761，，95%置信区间（CI）为（0，0.028）]或在消退的上下文控制方面没有显著差异[恢复块×饮酒状态交互作用，P=0.514，，95% CI=（0，0.084）]。实验 2：与轻度饮酒者相比，戒酒的酒精依赖者的消退较慢[消退块×饮酒状态交互作用，P=0.023，，95% CI=0，0.069)]，但在消退的上下文控制方面没有显著差异[恢复块×饮酒状态交互作用，P=0.069，，95% CI=（0，0.125）]。