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将戒酒作为一种选择:运用“复现即选择”框架探索自愿戒酒自我管理行为

Abstinence as Choice: Exploring Voluntary Abstinence from Alcohol Self-Administration Using the Resurgence-as-Choice Framework.

作者信息

Craig Andrew R, Smith Sean W, Nall Rusty W, Sullivan William E, Roane Henry S

机构信息

SUNY Upstate Medical University, 475 Irving Avenue, Suite 300, Syracuse, NY 13202 USA.

Jacksonville State University, Jacksonville, AL USA.

出版信息

Perspect Behav Sci. 2024 May 6;47(2):335-363. doi: 10.1007/s40614-024-00405-5. eCollection 2024 Jun.

Abstract

Resurgence is an increase in the rate of a previously suppressed behavior that occurs when an alternative source of reinforcement is made worse in some way. The Resurgence as Choice model offers a quantitative approach to understanding resurgence that may provide important insights into the variables that affect this form of relapse in the natural environment. Bringing this model to bear on relapse following reinforcement-based interventions for alcohol and other substance use disorders, however, may not be straightforward. Laboratory work on which the Resurgence as Choice model is based has almost exclusively focused on resurgence following extinction of target behavior, but abstinence from alcohol during intervention is often voluntary: Patients may drink alcohol and forfeit therapeutic reinforcers at any time. In this article, we first will review recent data from our group that demonstrate a method for studying resurgence following voluntary abstinence from alcohol seeking in rats. In a previous experiment, we reduced rats' alcohol-maintained lever pressing to low levels without placing it on extinction by arranging nondrug differential reinforcement of other behavior. Further, when we suspended nondrug reinforcement, resurgence of lever pressing occurred. Next, we will explore methods for modeling these outcomes using the Resurgence-as-Choice framework. We conclude that the data under consideration may not be sufficient to discriminate between candidate models of resurgence following voluntary abstinence and point to areas for future empirical and theoretical development. This work may provide a stronger bridge between preclinical and conceptual work on resurgence and clinical treatments for alcohol use disorder.

摘要

复发是指当某种替代强化源在某种程度上变差时,先前被抑制行为的发生率增加。“复发即选择”模型提供了一种定量方法来理解复发,这可能为影响自然环境中这种复发形式的变量提供重要见解。然而,将该模型应用于基于强化的酒精及其他物质使用障碍干预后的复发情况,可能并非易事。“复发即选择”模型所基于的实验室工作几乎完全集中在目标行为消退后的复发,但干预期间戒酒往往是自愿的:患者可能随时饮酒并放弃治疗性强化物。在本文中,我们首先将回顾我们小组最近的数据,这些数据展示了一种在大鼠自愿戒酒寻求后研究复发的方法。在之前的一项实验中,我们通过安排对其他行为的非药物差别强化,将大鼠由酒精维持的杠杆按压行为减少到低水平,但未使其消退。此外,当我们暂停非药物强化时,杠杆按压行为出现了复发。接下来,我们将探索使用“复发即选择”框架对这些结果进行建模的方法。我们得出结论,所考虑的数据可能不足以区分自愿戒酒后复发的候选模型,并指出未来实证和理论发展的方向。这项工作可能为复发的临床前和概念性研究与酒精使用障碍的临床治疗之间提供更有力的桥梁。

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