酒精治疗期间亚临床焦虑和酒精使用变化轨迹：平行过程增长模型。
Trajectories of change in subclinical anxiety and alcohol use during alcohol treatment: A parallel process growth model.
机构信息
Department of Psychology, University of New Mexico, Albuquerque, NM 87131, United States; Center on Alcohol, Substance use, And Addictions, University of New Mexico, Albuquerque, NM 87106, United States.
Department of Psychology, University of New Mexico, Albuquerque, NM 87131, United States.
出版信息
Drug Alcohol Depend. 2023 May 1;246:109838. doi: 10.1016/j.drugalcdep.2023.109838. Epub 2023 Mar 16.
BACKGROUND
Anxiety is implicated in the course and prognosis of alcohol use disorder (AUD); however, it is unclear how current AUD treatments affect the joint trajectories of anxiety and alcohol use. We used data from the Combined Pharmacotherapies and Behavioral Interventions for Alcohol Dependence (COMBINE) study to examine the longitudinal relationship between subclinical anxiety symptoms and alcohol use during and following AUD treatment in adults with AUD and no comorbid anxiety disorders.
METHODS
Univariate and parallel process growth models using five waves of COMBINE study data were analyzed from 865 adults randomized to medication (n = 429) or medication plus psychotherapy (n = 436). Weekly drinking quantity and average weekly anxiety symptoms were measured at baseline, mid-treatment, end-of-treatment, and three follow-up periods.
RESULTS
Significant positive associations of anxiety symptoms and drinking were found at mid-treatment and over time. Temporal associations revealed that higher mid-treatment anxiety predicted decreases in drinking over time. Baseline anxiety and drinking predicted mid-treatment anxiety and drinking. Only baseline anxiety predicted increases in drinking over time. Group differences revealed mid-treatment drinking predicted decreases in anxiety over time in the medication group.
CONCLUSIONS
Findings demonstrate the influence of subclinical anxiety on alcohol use during and up to one year after AUD treatment. Baseline anxiety symptoms may influence drinking behavior over the course of treatment. Findings suggest that greater attention to negative affect in AUD treatment is warranted even for those individuals who do have a comorbid anxiety disorder.
背景
焦虑与酒精使用障碍（AUD）的病程和预后有关；然而，目前尚不清楚 AUD 治疗如何影响焦虑和酒精使用的共同轨迹。我们使用来自酒精依赖联合药物治疗和行为干预（COMBINE）研究的数据，来检查 AUD 治疗期间和之后，无共病焦虑障碍的 AUD 成人中，亚临床焦虑症状与酒精使用之间的纵向关系。
方法
使用来自 COMBINE 研究的五波数据，对 865 名随机分配至药物治疗（n=429）或药物治疗加心理治疗（n=436）的成年人进行了单变量和并行过程增长模型分析。每周饮酒量和平均每周焦虑症状在基线、治疗中期、治疗结束时和三个随访期进行测量。
结果
在治疗中期和随时间推移，焦虑症状和饮酒之间存在显著的正相关关系。时间相关性表明，较高的治疗中期焦虑预测了随时间推移饮酒量的减少。基线焦虑和饮酒量预测了治疗中期的焦虑和饮酒量。仅基线焦虑预测了随时间推移饮酒量的增加。组间差异表明，在药物治疗组中，治疗中期的饮酒量预测了焦虑随时间的下降。
结论
研究结果表明，亚临床焦虑对 AUD 治疗期间和治疗结束后一年的酒精使用有影响。基线焦虑症状可能会影响治疗过程中的饮酒行为。这些发现表明，即使对于那些患有共病焦虑障碍的人，在 AUD 治疗中更关注负性情绪也是有必要的。
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