Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Drug Alcohol Depend. 2021 Feb 1;219:108473. doi: 10.1016/j.drugalcdep.2020.108473. Epub 2020 Dec 21.
Although craving is a formal DSM-5 criterion and a commonly reported feature of opioid use disorder (OUD), there is no universally accepted assessment of opioid craving for treatment outcome studies or clinical trials. This mixed-methods study characterized dimensions of opioid craving identified in qualitative responses collected via Amazon Mechanical Turk (AMT).
Thirty-nine participants completed an online screener on AMT and met inclusion criteria (e.g., > = 18 years old and past 30-day illicit opioid use). These participants completed a series of closed- and open-ended questions about their opioid use and craving, including several commonly-used craving measures. They also rated their preference for how different questions described craving. Responses to the open-ended question "What do you mean when you say you are craving opioids?" were coded according to dimensions in existing opioid craving assessments and other common themes identified in the data.
Among the 39 participants, 8 different dimensions were identified and coded. Descriptions of craving were most frequently categorized as "Anticipation of Negative Reinforcement" (n = 17/39) and "Interfering Thoughts" (N = 14/39). Individuals with drug use characteristics reflecting greater severity of use were more likely to describe craving as "Interfering Thoughts". Participants may prefer opioid craving questions that included Visual Analog Scale response formats relative to Likert scales.
There is a wide range of dimensions that were used to describe opioid craving and no single unifying dimension was identified. These data suggest opioid craving is a multidimensional construct including dimensions currently not included in common craving assessments.
虽然渴望是 DSM-5 中的正式标准，也是阿片类药物使用障碍（OUD）的常见特征，但目前还没有普遍接受的阿片类药物渴望评估方法，用于治疗结果研究或临床试验。本混合方法研究通过亚马逊土耳其机器人（AMT）收集的定性反应，对阿片类药物渴望的维度进行了特征描述。
39 名参与者在 AMT 上完成了在线筛选，符合纳入标准（例如，年龄大于等于 18 岁且过去 30 天有非法阿片类药物使用史）。这些参与者完成了一系列关于他们阿片类药物使用和渴望的封闭和开放式问题，包括几种常用的渴望测量方法。他们还对不同问题描述渴望的偏好进行了评分。对开放式问题“当你说你渴望阿片类药物时，你是什么意思？”的回答根据现有阿片类药物渴望评估的维度以及数据中确定的其他常见主题进行编码。
在 39 名参与者中，确定并编码了 8 个不同的维度。渴望的描述最常被归类为“期待负强化”（n = 17/39）和“干扰思维”（N = 14/39）。具有反映使用严重程度更高的药物使用特征的个体更有可能将渴望描述为“干扰思维”。与李克特量表相比，参与者可能更喜欢包括视觉模拟量表反应格式的阿片类药物渴望问题。
有广泛的维度用于描述阿片类药物渴望，没有一个单一的统一维度被确定。这些数据表明，阿片类药物渴望是一个多维结构，包括目前未包含在常见渴望评估中的维度。
