Craving Mediates Stress in Predicting Lapse During Alcohol Dependence Treatment

Background Stress, craving, and depressed mood have all been implicated in alcohol use treatment lapses. Few studies have examined all 3 factors. Progress has been limited because of difficulties with craving assessment. The Alcohol Craving Experience Questionnaire (ACE) is a new measure of alcohol...

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Veröffentlicht in:Alcoholism, clinical and experimental research clinical and experimental research, 2016-05, Vol.40 (5), p.1058-1064
Hauptverfasser: Law, Bonnie, Gullo, Matthew J., Daglish, Mark, Kavanagh, David J., Feeney, Gerald F. X., Young, Ross M., Connor, Jason P.
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container_end_page 1064
container_issue 5
container_start_page 1058
container_title Alcoholism, clinical and experimental research
container_volume 40
creator Law, Bonnie
Gullo, Matthew J.
Daglish, Mark
Kavanagh, David J.
Feeney, Gerald F. X.
Young, Ross M.
Connor, Jason P.
description Background Stress, craving, and depressed mood have all been implicated in alcohol use treatment lapses. Few studies have examined all 3 factors. Progress has been limited because of difficulties with craving assessment. The Alcohol Craving Experience Questionnaire (ACE) is a new measure of alcohol craving. It is both psychometrically sound and conceptually rigorous. This prospective study examines a stress–treatment response model that incorporates mediation by craving and moderation by depressed mood and pharmacotherapy. Methods Five hundred and thirty‐nine consecutively treated alcohol‐dependent patients voluntarily participated in an abstinence‐based 12‐week cognitive‐behavioral therapy (CBT) program at a hospital alcohol and drug outpatient clinic. Measures of stress, craving, depressed mood, and alcohol dependence severity were administered prior to treatment. Treatment lapse and treatment dropout were assessed over the 12‐week program duration. Results Patients reporting greater stress experienced stronger and more frequent cravings. Stronger alcohol craving predicted lapse, after controlling for dependence severity, stress, depression, and pharmacotherapy. Alcohol craving mediated stress to predict lapse. Depressed mood and anticraving medication were not significant moderators. Conclusions Among treatment seeking, alcohol‐dependent patients, craving mediated the relationship between stress and lapse. The effect was not moderated by depressed mood or anticraving medication. Stress, craving and depressed mood are implicated in alcohol‐use treatment lapses. This prospective study examined a stress–treatment response model that incorporated mediation by craving and moderation by depressed mood and pharmacotherapy using the newly developed Alcohol Craving Experience Questionnaire (ACE). In a sample of 539 alcohol‐dependent patients, craving mediated stress to predict lapse. This effect was not moderated by depressed mood or anticraving medication. Treatment focusing on craving reduction could prevent lapse in selected patients.
doi_str_mv 10.1111/acer.13034
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X. ; Young, Ross M. ; Connor, Jason P.</creator><creatorcontrib>Law, Bonnie ; Gullo, Matthew J. ; Daglish, Mark ; Kavanagh, David J. ; Feeney, Gerald F. X. ; Young, Ross M. ; Connor, Jason P.</creatorcontrib><description>Background Stress, craving, and depressed mood have all been implicated in alcohol use treatment lapses. Few studies have examined all 3 factors. Progress has been limited because of difficulties with craving assessment. The Alcohol Craving Experience Questionnaire (ACE) is a new measure of alcohol craving. It is both psychometrically sound and conceptually rigorous. This prospective study examines a stress–treatment response model that incorporates mediation by craving and moderation by depressed mood and pharmacotherapy. Methods Five hundred and thirty‐nine consecutively treated alcohol‐dependent patients voluntarily participated in an abstinence‐based 12‐week cognitive‐behavioral therapy (CBT) program at a hospital alcohol and drug outpatient clinic. Measures of stress, craving, depressed mood, and alcohol dependence severity were administered prior to treatment. Treatment lapse and treatment dropout were assessed over the 12‐week program duration. Results Patients reporting greater stress experienced stronger and more frequent cravings. Stronger alcohol craving predicted lapse, after controlling for dependence severity, stress, depression, and pharmacotherapy. Alcohol craving mediated stress to predict lapse. Depressed mood and anticraving medication were not significant moderators. Conclusions Among treatment seeking, alcohol‐dependent patients, craving mediated the relationship between stress and lapse. The effect was not moderated by depressed mood or anticraving medication. Stress, craving and depressed mood are implicated in alcohol‐use treatment lapses. This prospective study examined a stress–treatment response model that incorporated mediation by craving and moderation by depressed mood and pharmacotherapy using the newly developed Alcohol Craving Experience Questionnaire (ACE). In a sample of 539 alcohol‐dependent patients, craving mediated stress to predict lapse. This effect was not moderated by depressed mood or anticraving medication. Treatment focusing on craving reduction could prevent lapse in selected patients.</description><identifier>ISSN: 0145-6008</identifier><identifier>EISSN: 1530-0277</identifier><identifier>DOI: 10.1111/acer.13034</identifier><identifier>PMID: 27012658</identifier><identifier>CODEN: ACRSDM</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Alcohol ; Alcohol Dependence ; Alcoholism - complications ; Alcoholism - diagnosis ; Alcoholism - psychology ; Alcoholism - therapy ; Cognitive Therapy ; Craving ; Depression - psychology ; Depression - therapy ; Drug therapy ; Female ; Humans ; Male ; Mood ; Patient Compliance - statistics &amp; numerical data ; Patient Dropouts - statistics &amp; numerical data ; Prospective Studies ; Stress ; Stress, Psychological - complications ; Stress, Psychological - psychology ; Stress, Psychological - therapy ; Treatment ; Young Adult</subject><ispartof>Alcoholism, clinical and experimental research, 2016-05, Vol.40 (5), p.1058-1064</ispartof><rights>Copyright © 2016 by the Research Society on Alcoholism</rights><rights>Copyright © 2016 by the Research Society on Alcoholism.</rights><rights>2016 Research Society on Alcoholism</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3954-4490fad6d4b760013e52177a3a9198499b259b21aa4486bb9c4d0aabbafe6db63</citedby><cites>FETCH-LOGICAL-c3954-4490fad6d4b760013e52177a3a9198499b259b21aa4486bb9c4d0aabbafe6db63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Facer.13034$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Facer.13034$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27012658$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Law, Bonnie</creatorcontrib><creatorcontrib>Gullo, Matthew J.</creatorcontrib><creatorcontrib>Daglish, Mark</creatorcontrib><creatorcontrib>Kavanagh, David J.</creatorcontrib><creatorcontrib>Feeney, Gerald F. X.</creatorcontrib><creatorcontrib>Young, Ross M.</creatorcontrib><creatorcontrib>Connor, Jason P.</creatorcontrib><title>Craving Mediates Stress in Predicting Lapse During Alcohol Dependence Treatment</title><title>Alcoholism, clinical and experimental research</title><addtitle>Alcohol Clin Exp Res</addtitle><description>Background Stress, craving, and depressed mood have all been implicated in alcohol use treatment lapses. Few studies have examined all 3 factors. Progress has been limited because of difficulties with craving assessment. The Alcohol Craving Experience Questionnaire (ACE) is a new measure of alcohol craving. It is both psychometrically sound and conceptually rigorous. This prospective study examines a stress–treatment response model that incorporates mediation by craving and moderation by depressed mood and pharmacotherapy. Methods Five hundred and thirty‐nine consecutively treated alcohol‐dependent patients voluntarily participated in an abstinence‐based 12‐week cognitive‐behavioral therapy (CBT) program at a hospital alcohol and drug outpatient clinic. Measures of stress, craving, depressed mood, and alcohol dependence severity were administered prior to treatment. Treatment lapse and treatment dropout were assessed over the 12‐week program duration. Results Patients reporting greater stress experienced stronger and more frequent cravings. Stronger alcohol craving predicted lapse, after controlling for dependence severity, stress, depression, and pharmacotherapy. Alcohol craving mediated stress to predict lapse. Depressed mood and anticraving medication were not significant moderators. Conclusions Among treatment seeking, alcohol‐dependent patients, craving mediated the relationship between stress and lapse. The effect was not moderated by depressed mood or anticraving medication. Stress, craving and depressed mood are implicated in alcohol‐use treatment lapses. This prospective study examined a stress–treatment response model that incorporated mediation by craving and moderation by depressed mood and pharmacotherapy using the newly developed Alcohol Craving Experience Questionnaire (ACE). In a sample of 539 alcohol‐dependent patients, craving mediated stress to predict lapse. This effect was not moderated by depressed mood or anticraving medication. Treatment focusing on craving reduction could prevent lapse in selected patients.</description><subject>Adult</subject><subject>Alcohol</subject><subject>Alcohol Dependence</subject><subject>Alcoholism - complications</subject><subject>Alcoholism - diagnosis</subject><subject>Alcoholism - psychology</subject><subject>Alcoholism - therapy</subject><subject>Cognitive Therapy</subject><subject>Craving</subject><subject>Depression - psychology</subject><subject>Depression - therapy</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Mood</subject><subject>Patient Compliance - statistics &amp; numerical data</subject><subject>Patient Dropouts - statistics &amp; numerical data</subject><subject>Prospective Studies</subject><subject>Stress</subject><subject>Stress, Psychological - complications</subject><subject>Stress, Psychological - psychology</subject><subject>Stress, Psychological - therapy</subject><subject>Treatment</subject><subject>Young Adult</subject><issn>0145-6008</issn><issn>1530-0277</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMlOwzAURS0EgjJs-AAUiQ1CCjzHTpwsq5ZJFIoY1KX1krxCIE2KnTD8PQ4tLFhgybJsn3d0dRnb5XDE3TrGjMwRFyDkCuvxUIAPgVKrrAdchn4EEG-wTWufAUDGUbTONgIFPIjCuMfGA4NvRfXoXVFeYEPWu2sMWesVlXdj3FvWdL8jnFvyhq3pLv0yq5_q0hvSnKqcqoy8e0PYzKhqttnaFEtLO8tziz2cntwPzv3R-Oxi0B_5mUhC6UuZwBTzKJepcgG5oDDgSqHAhCexTJI0CN3miNJFTtMkkzkgpilOKcrTSGyxg4V3burXlmyjZ4XNqCyxorq1mqtYKhnHMTh0_w_6XLemcuk6SiQSgqATHi6ozNTWGprquSlmaD41B93VrLua9XfNDt5bKtt0Rvkv-tOrA_gCeC9K-vxHpfuDk9sfqb-YKWxDH78zaF50pIQK9eT6TEu4g8kQLvVEfAETdJUf</recordid><startdate>201605</startdate><enddate>201605</enddate><creator>Law, Bonnie</creator><creator>Gullo, Matthew J.</creator><creator>Daglish, Mark</creator><creator>Kavanagh, David J.</creator><creator>Feeney, Gerald F. X.</creator><creator>Young, Ross M.</creator><creator>Connor, Jason P.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K7.</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201605</creationdate><title>Craving Mediates Stress in Predicting Lapse During Alcohol Dependence Treatment</title><author>Law, Bonnie ; Gullo, Matthew J. ; Daglish, Mark ; Kavanagh, David J. ; Feeney, Gerald F. X. ; Young, Ross M. ; Connor, Jason P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3954-4490fad6d4b760013e52177a3a9198499b259b21aa4486bb9c4d0aabbafe6db63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Alcohol</topic><topic>Alcohol Dependence</topic><topic>Alcoholism - complications</topic><topic>Alcoholism - diagnosis</topic><topic>Alcoholism - psychology</topic><topic>Alcoholism - therapy</topic><topic>Cognitive Therapy</topic><topic>Craving</topic><topic>Depression - psychology</topic><topic>Depression - therapy</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Mood</topic><topic>Patient Compliance - statistics &amp; numerical data</topic><topic>Patient Dropouts - statistics &amp; numerical data</topic><topic>Prospective Studies</topic><topic>Stress</topic><topic>Stress, Psychological - complications</topic><topic>Stress, Psychological - psychology</topic><topic>Stress, Psychological - therapy</topic><topic>Treatment</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Law, Bonnie</creatorcontrib><creatorcontrib>Gullo, Matthew J.</creatorcontrib><creatorcontrib>Daglish, Mark</creatorcontrib><creatorcontrib>Kavanagh, David J.</creatorcontrib><creatorcontrib>Feeney, Gerald F. X.</creatorcontrib><creatorcontrib>Young, Ross M.</creatorcontrib><creatorcontrib>Connor, Jason P.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Criminal Justice (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Alcoholism, clinical and experimental research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Law, Bonnie</au><au>Gullo, Matthew J.</au><au>Daglish, Mark</au><au>Kavanagh, David J.</au><au>Feeney, Gerald F. X.</au><au>Young, Ross M.</au><au>Connor, Jason P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Craving Mediates Stress in Predicting Lapse During Alcohol Dependence Treatment</atitle><jtitle>Alcoholism, clinical and experimental research</jtitle><addtitle>Alcohol Clin Exp Res</addtitle><date>2016-05</date><risdate>2016</risdate><volume>40</volume><issue>5</issue><spage>1058</spage><epage>1064</epage><pages>1058-1064</pages><issn>0145-6008</issn><eissn>1530-0277</eissn><coden>ACRSDM</coden><abstract>Background Stress, craving, and depressed mood have all been implicated in alcohol use treatment lapses. Few studies have examined all 3 factors. Progress has been limited because of difficulties with craving assessment. The Alcohol Craving Experience Questionnaire (ACE) is a new measure of alcohol craving. It is both psychometrically sound and conceptually rigorous. This prospective study examines a stress–treatment response model that incorporates mediation by craving and moderation by depressed mood and pharmacotherapy. Methods Five hundred and thirty‐nine consecutively treated alcohol‐dependent patients voluntarily participated in an abstinence‐based 12‐week cognitive‐behavioral therapy (CBT) program at a hospital alcohol and drug outpatient clinic. Measures of stress, craving, depressed mood, and alcohol dependence severity were administered prior to treatment. Treatment lapse and treatment dropout were assessed over the 12‐week program duration. Results Patients reporting greater stress experienced stronger and more frequent cravings. Stronger alcohol craving predicted lapse, after controlling for dependence severity, stress, depression, and pharmacotherapy. Alcohol craving mediated stress to predict lapse. Depressed mood and anticraving medication were not significant moderators. Conclusions Among treatment seeking, alcohol‐dependent patients, craving mediated the relationship between stress and lapse. The effect was not moderated by depressed mood or anticraving medication. Stress, craving and depressed mood are implicated in alcohol‐use treatment lapses. This prospective study examined a stress–treatment response model that incorporated mediation by craving and moderation by depressed mood and pharmacotherapy using the newly developed Alcohol Craving Experience Questionnaire (ACE). In a sample of 539 alcohol‐dependent patients, craving mediated stress to predict lapse. This effect was not moderated by depressed mood or anticraving medication. Treatment focusing on craving reduction could prevent lapse in selected patients.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>27012658</pmid><doi>10.1111/acer.13034</doi><tpages>7</tpages></addata></record>
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source MEDLINE; Journals@Ovid Complete; Access via Wiley Online Library
subjects Adult
Alcohol
Alcohol Dependence
Alcoholism - complications
Alcoholism - diagnosis
Alcoholism - psychology
Alcoholism - therapy
Cognitive Therapy
Craving
Depression - psychology
Depression - therapy
Drug therapy
Female
Humans
Male
Mood
Patient Compliance - statistics & numerical data
Patient Dropouts - statistics & numerical data
Prospective Studies
Stress
Stress, Psychological - complications
Stress, Psychological - psychology
Stress, Psychological - therapy
Treatment
Young Adult
title Craving Mediates Stress in Predicting Lapse During Alcohol Dependence Treatment
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