Department of Family and Community Medicine, College of Medicine, Pennsylvania State University.
Health Promotion Research Center, University of Oklahoma Health Sciences.
J Consult Clin Psychol. 2024 Aug;92(8):493-504. doi: 10.1037/ccp0000914.
Negative affect and affect variability figure prominently in models of addictive behaviors but are not without controversy. Negative affect variability may better capture a mechanism of behavior change in alcohol use disorder (AUD) treatment because it contains information about affect regulation, a common clinical target. The aims of this study are to examine the change in: (a) trajectory of negative affect variability, (b) association of negative affect variability and abstinence, and (c) association of negative affect variability and heavy drinking during AUD treatment.
This article is a secondary analysis of data drawn from a randomized clinical trial. = 181 participants diagnosed with AUD ( = 50.8, = 10.6; 51.4% female) received 12 sessions of Cognitive Behavioral Coping Skills Therapy for AUD. Participants completed one daily diary prompt per day for 84 consecutive days. Each day, participants reported on negative affect and number of alcoholic drinks consumed the previous day. Time-varying effect models examined changes in negative affect variability and its associations with abstinence and heavy drinking.
Negative affect variability decreased throughout treatment. The positive association between negative affect variability and heavy drinking became nonsignificant (decoupled) midway through treatment. The inverse association between negative affect variability and daily abstinence became nonsignificant (decoupled) at approximately day 75 of 84. When mean levels of NA were added as a covariate, the effects were in the same direction but no longer statistically significant.
Reductions in negative affect variability may capture an important change mechanism of behavioral treatments for AUD because it contains information about affect regulation as compared with mean levels of negative affect. Negative affect variability warrants further consideration as a mechanism of behavior change. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
负性情绪和情绪变异性在成瘾行为模型中占有重要地位，但也并非没有争议。负性情绪变异性可能更好地捕捉到酒精使用障碍（AUD）治疗中行为改变的机制，因为它包含了关于情绪调节的信息，而情绪调节是一个常见的临床目标。本研究的目的是检验以下方面的变化：（a）负性情绪变异性的轨迹，（b）负性情绪变异性与戒酒的关系，以及（c）负性情绪变异性与 AUD 治疗期间重度饮酒的关系。
本文是一项来自随机临床试验数据的二次分析。共有 181 名被诊断为 AUD 的参与者（=50.8，=10.6；51.4%为女性）接受了 12 节认知行为应对技能治疗 AUD。参与者每天完成一次每日日记提示，持续 84 天。每一天，参与者报告前一天的负性情绪和饮酒量。时变效应模型检验了负性情绪变异性的变化及其与戒酒和重度饮酒的关系。
负性情绪变异性在整个治疗过程中逐渐降低。负性情绪变异性与重度饮酒之间的正相关在治疗中期变得无统计学意义（脱钩）。负性情绪变异性与每日戒酒之间的负相关在大约第 84 天的第 75 天变得无统计学意义（脱钩）。当平均水平的 NA 被添加为协变量时，效应方向相同，但不再具有统计学意义。
与负性情绪的平均水平相比，负性情绪变异性的降低可能捕捉到 AUD 行为治疗的一个重要变化机制，因为它包含了关于情绪调节的信息。负性情绪变异性值得进一步考虑作为行为改变的机制。
