Obsessive Compulsive Drinking Scale Research Articles

Psychological distress, obsessive-compulsive thoughts about drinking, and alcohol consumption in young adult drinkers

ABSTRACT Background Psychological distress is an important predictor of heavy drinking, especially among lower-income drinkers. The mechanisms underlying this effect are not well understood. One possibility is that distressed individuals are more vulnerable to obsessive and compulsive thoughts about drinking. We hypothesized that: 1) distress would predict obsessive and compulsive thoughts about alcohol, which in turn would predict drinking and 2) effects would be particularly pronounced among lower-income drinkers. Methods Young adults (n = 105) were recruited from an urban university and completed the Brief Symptoms Index (BSI), the Obsessive-Compulsive Drinking Scale (OCDS), and a 90-day timeline follow-back (TLFB) drinking interview. Results Consistent with the hypotheses, drinkers with higher distress (BSI) exhibited greater obsessive and compulsive drinking-related thoughts, which in turn predicted drinking over the past 90 days (p < .0001). Path analyses revealed that the BSI had a significant indirect effect on drinking outcomes through increased OCDS. Furthermore, conditional process analyses revealed that effects were particularly pronounced among drinkers with lower household incomes. Conclusions Findings highlight the importance of psychological distress as a predictor of obsessive and compulsive thoughts about alcohol, as well as drinking behavior, and underscore the critical need to address psychological functioning among lower-income drinkers in particular.

The role of the orbitofrontal cortex and the nucleus accumbens for craving in alcohol use disorder

This study aimed to investigate structural and functional alterations of the reward system and the neurobiology of craving in alcohol use disorder (AUD). We hypothesized reduced volume of the nucleus accumbens (NAcc), reduced structural connectivity of the segment of the supero-lateral medial forebrain bundle connecting the orbitofrontal cortex (OFC) with the NAcc (OFC-NAcc), and reduced resting-state OFC-NAcc functional connectivity (FC). Furthermore, we hypothesized that craving is related to an increase of OFC-NAcc FC. Thirty-nine recently abstinent patients with AUD and 18 healthy controls (HC) underwent structural (T1w-MP2RAGE, diffusion-weighted imaging (DWI)) and functional (resting-state fMRI) MRI-scans. Gray matter volume of the NAcc, white matter microstructure (fractional anisotropy (FA)) and macrostructure (tract length) of the OFC-NAcc connection and OFC-NAcc FC were compared between AUD and HC using a mixed model MANCOVA controlling for age and gender. Craving was assessed using the thoughts subscale of the obsessive-compulsive drinking scale (OCDS) scale and was correlated with OFC-NAcc FC. There was a significant main effect of group. Results were driven by a volume reduction of bilateral NAcc, reduced FA in the left hemisphere, and reduced tract length of bilateral OFC-NAcc connections in AUD patients. OFC-NAcc FC did not differ between groups. Craving was associated with increased bilateral OFC-NAcc FC. In conclusion, reduced volume of the NAcc and reduced FA and tract length of the OFC-NAcc network suggest structural alterations of the reward network in AUD. Increased OFC-NAcc FC is associated with craving in AUD, and may contribute to situational alcohol-seeking behavior in AUD.

769 Is Alcohol Craving associated with Insomnia in Patients with Comorbid Insomnia and Alcohol Use Disorder?

Abstract Introduction A preliminary study showed the existence of a relationship between alcohol craving and insomnia symptoms. The current investigation aimed to further assess the relationship between obsessive and compulsive qualities of alcohol craving and insomnia disorder in a larger sample of subjects with Alcohol Use Disorder (AUD) seeking treatment for their drinking. Methods We used baseline cross-sectional data from a clinical trial of treatment-seeking patients with AUD (N=123). We used the following instruments: Insomnia Severity Index (ISI) total score for insomnia; Obsessive Compulsive Drinking Scale (OCDS) scale scores for alcohol craving; Time-Line follow Back interview for computing the number of drinks per drinking day within the past 90 days; Hamilton Anxiety Rating Scale total score for the anxiety symptoms; and Addiction Severity Index for demographic variables. We used bivariate analysis to evaluate whether alcohol craving outcome measures (OCDS subscale scores and total score) were independently associated with the ISI total score. A multivariable model adjusted for sociodemographic and clinical covariates further evaluated this relationship between OCDS and ISI total scores. Results The mean (SD) age was 44.02 (10.37) years with 13.29 (3.10) years of education, 83.74% were males, 41.80% identified themselves as White, 17.21% were married, and 56.09% were employed. In a bivariate analysis, ISI total score was associated with the obsessive subscale (β=0.25, p&amp;lt;0.0001), compulsive drinking subscale (β=0.24, p&amp;lt;0.002), and OCDS total score (β=0.50, p&amp;lt;0.0001). The OCDS total score showed a stronger association with the insomnia symptoms (ISI items 1a-1c) (β=0.99, p&amp;lt;0.0001) than the manifestations of insomnia symptoms (items 2–5; β=0.83, p&amp;lt;0.0001). In the multivariable model adjusted for covariates, the relationship between OCDS and ISI total scores continued to remain significant (β=0.37, R2=0.18, p=0.01). Conclusion This study not only confirmed that alcohol craving was associated with insomnia in a larger sample but also demonstrated that insomnia is linked to both obsessive thoughts about alcohol use and compulsive drinking behavior, especially its obsessive aspect. These findings add to the growing literature on the relationship between a pathologic drive for alcohol use and abnormal wakefulness. Support (if any) The study was supported by VA grant IK2CX000855 (S.C.) and NIH grants R01 AA016553 (K.M.K.).

Progesterone serum levels correlate negatively with craving in female postmenopausal in-patients with alcohol use disorder: A sex- and menopausal status-separated study

ObjectiveAlcohol use disorder (AUD) shows a high prevalence and often takes a severe and chronic course. However, the underlying mechanisms still need to be better understood. There is increasing evidence for a role of sex hormones in AUD and for the importance of sex-separated concepts in addiction research. Nevertheless, only few data give insight into how progesterone is involved in AUD. MethodSerum progesterone levels were measured at baseline (during early abstinence) in 186 in-patients with AUD (19% premenopausal females, 20% postmenopausal females, 61% males) and at median 5 days later. They were compared with those of 233 healthy control subjects (24% premenopausal females, 19% postmenopausal females, 57% males). We quantified craving with the Obsessive Compulsive Drinking Scale (OCDS) and visual analogue scales (VAS). Alcohol-related hospital readmissions within a 24-month period following initial in-patient treatment were recorded. We conducted analyses separately for sex and for menopausal status in female participants. ResultsPostmenopausal females with AUD reported higher craving than premenopausal females. In postmenopausal females, higher baseline progesterone levels correlated with lower OCDS total craving and VAS craving, i.e., lower state craving and lower average, maximum, and less frequent craving during withdrawal. In males with AUD, progesterone levels at baseline tended to be higher than in controls and declined to follow-up. Alcohol-related readmissions were not significantly associated with serum progesterone levels. ConclusionWe provide first evidence that progesterone levels correlate with craving in females with AUD.

The association of plasma acyl ghrelin level with alcohol craving in early abstinent alcohol dependent patients

Background:Craving plays an important role in maintenance of alcohol dependence. Earlier studies have analyzed the role of ghrelin in craving and their results have been heterogenous. Acyl ghrelin is its more active form as it crosses the blood brain barrier. Hence we aimed to examine the relationship between plasma acyl ghrelin and craving in Indian patients having alcohol dependence syndrome.Methods:The present study was a hospital-based prospective study. A total of 60 drug-naive patients of alcohol dependence and 30 healthy controls were included. After taking informed consent fasting blood samples were collected from them on day 1 and tested for plasma acyl ghrelin level. Fasting blood samples were repeated in all cases on day 14. During this time, we also assessed the patients' cravings by obsessive compulsive drinking scale, and alcohol craving questionnaire; and withdrawal by clinical institute withdrawal assessment for alcohol scale. These scales were repeated on day 14. Data analysis was done by SPSS version 25.0.Results:Plasma concentrations of acyl ghrelin increased significantly during early abstinence in patients from day 1 to day 14 (P < 0.0001). Pearson correlation test revealed a trend of positive correlation between plasma concentration of acyl ghrelin on day 14 and severity of craving on day 1.Conclusion:Our results suggest the plasma concentration of acyl ghrelin may be a predictor of severity of alcohol craving during early abstinence. Anti-craving drugs acting on acyl ghrelin level in brain may open an innovative avenue for optimum treatment of alcohol dependence.

Effects of Virtual Reality Therapy on Neuro-Cognitive and Behavioral Skills in Alcohol-Dependent Patients: A Quantitative Electroencephalography Imaging Investigation

An immersive virtual reality based cognitive-behavioral therapy (VR-CBT) has been clinically used to improve the neuro-cognitive and behavioral skills in alcohol-dependent patients with destructive impulse-control disorders, but the therapeutic effects are unknown. The purpose of the investigation was to determine the effectiveness of an impulse-anger management VR-CBT program (IAM-VR-CBTP) on cortical activation, neuro-cognitive and behavioral skills as well as drinking, impulse-anger control, anxiety, and depression. A convenience sample of 11 patients diagnosed with DICD participated and underwent the IAM-VR-CBTP intervention, a 90-minute session, two times/week for 3 weeks. The intervention related physiological and neuro-psychiatric behavioral changes were measured with a quantitative electroencephalogram (QEEG) brain mapping and standardized neurocognitive and behavioral tests including the alcohol dependence scale, the obsessive compulsive drinking scale, the readiness to change questionnaire, the Barratt impulsiveness scale II, the Beck anxiety, the Beck depression inventory II, and the state trait anger expression inventory-2. The non-parametric Wilcoxon statistic was used at P &lt; 0.05. There were no statistically significant differences between the pretest and the posttest scores induced by the IAM-VR-CBTP. QEEG data analyses showed that the post-QEEG maps were characterized by mildly diminished (z -score &lt; – 1.5) relative powers in theta (Fz and Cz), fast alpha (Cz), and slow beta (Cz) bands after the IAM-VR-CBTP intervention. The results suggest that the IAM-VR-CBTP had promising effects on abnormal brain activity underlying compulsive drinking behaviors, motivation to change, and anger experience and unfair treatment by others and provide the first clinical evidence of IAM-VR-CBT on non-invasive neuromodulation and associated neuro-cognitive and behavioral outcomes in alcohol-dependent patients.

Effects of Virtual Reality Therapy on Neuro-Cognitive and Behavioral Skills in Alcohol-Dependent Patients: A Quantitative Electroencephalography Imaging Investigation

An immersive virtual reality based cognitive-behavioral therapy (VR-CBT) has been clinically used to improve the neuro-cognitive and behavioral skills in alcohol-dependent patients with destructive impulse-control disorders, but the therapeutic effects are unknown. The purpose of the investigation was to determine the effectiveness of an impulse-anger management VR-CBT program (IAM-VR-CBTP) on cortical activation, neuro-cognitive and behavioral skills as well as drinking, impulse-anger control, anxiety, and depression. A convenience sample of 11 patients diagnosed with DICD participated and underwent the IAM-VR-CBTP intervention, a 90-minute session, two times/week for 3 weeks. The intervention related physiological and neuro-psychiatric behavioral changes were measured with a quantitative electroencephalogram (QEEG) brain mapping and standardized neurocognitive and behavioral tests including the alcohol dependence scale, the obsessive compulsive drinking scale, the readiness to change questionnaire, the Barratt impulsiveness scale II, the Beck anxiety, the Beck depression inventory II, and the state trait anger expression inventory-2. The non-parametric Wilcoxon statistic was used at P &lt; 0.05. There were no statistically significant differences between the pretest and the posttest scores induced by the IAM-VR-CBTP. QEEG data analyses showed that the post-QEEG maps were characterized by mildly diminished (z -score &lt; – 1.5) relative powers in theta (Fz and Cz), fast alpha (Cz), and slow beta (Cz) bands after the IAM-VR-CBTP intervention. The results suggest that the IAM-VR-CBTP had promising effects on abnormal brain activity underlying compulsive drinking behaviors, motivation to change, and anger experience and unfair treatment by others and provide the first clinical evidence of IAM-VR-CBT on non-invasive neuromodulation and associated neuro-cognitive and behavioral outcomes in alcohol-dependent patients.

Investigating the link between serum concentrations of brain-derived neurotrophic factor and behavioral measures in anxious alcohol-dependent individuals.

Brain-derived neurotrophic factor (BDNF) plays a role in different neurophysiological processes, including those involved in alcohol- and anxiety-related behaviors. Preclinical and clinical studies indicate that chronic excessive alcohol use leads to a downregulation of BDNF production in the periphery and in the brain. In addition, a decrease in BDNF concentrations in the blood has been reported to be associated with increased anxiety levels. Non-treatment-seeking alcohol-dependent individuals with high trait anxiety were studied to assess whether serum BDNF concentrations may be linked to self-reported levels of alcohol drinking, anxiety, and other behavioral measures. Participants had a current diagnosis of alcohol dependence, high trait anxiety score, and were not seeking treatment for alcohol dependence or anxiety. A fasting blood sample was collected from each participant and serum BDNF was measured using an enzyme-linked immunosorbent assay (ELISA). Behavioral data were collected on the same day, including measures of alcohol drinking, craving, dependence severity, and anxiety. Bivariate correlations were run between BDNF levels and behavioral measures. Serum BDNF concentrations were negatively correlated with average drinks per drinking days (r=-0.41, p=0.02) and positively correlated with obsessive-compulsive drinking scale (r=0.48, p=0.007) and state-trait anxiety inventory (r=0.52, p=0.003) scores. These findings shed light on the possible role of the BDNF system in the neurobiology of alcohol- and anxiety-related behaviors.

Depressive and Anxiety Symptoms Predict Obsessive and Compulsive Cravings among Depressed Alcoholics.

Alcohol craving is often associated with mood symptoms and predicts alcohol use in individuals with alcohol dependence. However, little is known about the impact of mood symptoms on alcohol craving in comorbid mood disorders and alcohol dependence. This study examines the predictive value of depressive and anxiety symptoms for obsessive and compulsive aspects of alcohol craving in adults with comorbid Major Depressive Disorder (MDD) and Alcohol Dependence. Fifty-five adults (47% female; mean age of 39.35 (SD=8.80)) with DSM-IV diagnoses of comorbid MDD and alcohol dependence were prospectively assessed over a six-month period. They completed the Hamilton Rating Scales for Depression and Anxiety, the Alcohol Timeline Followback, the Obsessive Compulsive Drinking Scale (OCDS), the Alcohol Dependence Scale (ADS), and the Addiction Severity Index (ASI). The linear mixed model analyses for repeated measures was used to test weather depressive and anxiety symptoms predict OCDS subscale scores. Depressive and anxiety symptoms were strongly associated with obsessive and compulsive subscales of the OCDS. Baseline ASI-alcohol scores were associated with both the obsessive and compulsive and with the obsessive subscale scores in the predictive model including depressive symptoms, and that including anxiety symptoms respectively. Results suggest that depressive and anxiety symptoms predict obsessive and compulsive aspects of alcohol craving in adults with comorbid MDD and alcohol dependence. Assessing the severity of depressive and anxiety symptoms and alcohol use in this population may identify those more likely to experience intense alcohol craving states and at increased risk of relapse.

Comparison of Disulfiram and Naltrexone in Cases of Alcohol Dependence Syndrome.

Relapse prevention in alcoholism is recognised as an important component of management. Use of pharmacotherapies to prevent relapse in combination to psychological intervention is emerging. Disulfiram and Naltrexone are two of three FDA approved drugs for pharmacotherapy. The aim of the study is to compare the effectiveness of these two drugs in preventing relapse in alcohol dependence syndrome cases. A prospective crossectional study was conducted to compare disulfiram and naltrexone in alcohol dependent patients in tertiary institution. Cases of alcohol dependence syndrome were diagnosed based on ICD-10 DCR presenting to psychiatry department of Tribhuvan University Teaching Hospital, over the period of 6 months. After detoxification and fulfillment of inclusion criteria, semi structured proforma, Severity of alcohol dependence questionnaire, Stages of change readiness and treatment eagerness scale, Obsessive compulsive drinking scale were applied. Drug allocation was based on simple random method and on subsequent follow ups done at 2nd, 4th, 8th, 12th week semi structured proforma, Obsessive Compulsive Drinking Scale were completed and psychological intervention continued. After data collection, analysis and final results were computed. Both drugs reduced craving and amount of alcohol intake(p less than 0.001). Relapse was more in naltrexone group but was not statistically significant (p>0.05). Side effects were more with disulfiram(p less than 0.001) whereas dropout was more in naltrexone group,(p less than 0.01). Disulfiram and Naltrexone were equally effective in reducing craving, reducing amount of alcohol intake, and preventing relapse in 12 weeks follow up period. Naltrexone was found to be better in tolerability whereas disulfiram was better in terms of dropout from treatment.

Determination of the Relationship Between Craving and 4-repeat Allele of DRD4 Gene Polymorphism in the Early Withdrawal Period of Alcohol Use Disorders.

Alcohol use disorder (AUD) is a disease with chronic relapses. Risk factors of craving, which is thought to be one of the predictors of relapse, have been studied for a long time. The DRD4 gene is located on chromosome 11p and has a 48-base pair variable number of tandem repeat (VNTR) polymorphisms in the 3rd exon. This study aimed to investigate if a relationship existed between craving and DRD4 VNTR polymorphism and to determine the predictors of craving. A total of 125 patients with AUD were included in the study. The sociodemographic data form, the Michigan Alcoholism Screening Test (MAST), the Obsessive Compulsive Drinking Scale (OCDS), and the Penn Alcohol Craving Scale (PACS) were applied to the patients. Polymerase chain reaction (PCR) was used to determine the DRD4 VNTR variant of all participants in the peripheral blood sample. In the 4R/4R homozygous group, it was found that the age at first alcohol use was higher and the scores of the OCDS on the seventh day were lower, but this relationship could not be demonstrated in further statistical analyses. In the stepwise linear regression model, the age at first alcohol use, MAST score, duration of AUD, and delirium tremens history were found to be the predictors of craving. DRD4 VNTR polymorphism does not play a role as a predictor of craving. A decrease in age at first alcohol use, an increase in the MAST score, and the presence of delirium tremens were found to be the predictors of craving among the participants of this study.

Childhood maltreatment, cognitive emotion regulation strategies, and alcohol craving and dependence in alcohol-dependent males: Direct and indirect pathways

ObjectivesChildhood maltreatment (CM) and cognitive emotion regulation strategies (CERSs) may be important in alcohol craving and dependence in alcohol-dependent individuals. The aim of this study was to evaluate direct effects of CM on the subscales of alcohol craving and alcohol dependence and its indirect effects via CERSs in individuals with a diagnosis of alcohol dependence. MethodsIn a cross-sectional design, 329 alcohol-dependent males completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Cognitive Emotion Regulation Questionnaire-Short version (CERQ-Short), the Alcohol Dependence Scale (ADS), the Obsessive Compulsive Drinking Scale (OCDS), and the Beck Depression Inventory-II (BDI-II). ResultsParticipants with alcohol dependence had early age of onset of alcohol use (mean = 20.78 years), relatively long duration of alcohol use (mean = 11.14 years), and low education (mean = 9.55 years). Indirect effects were observed from CM to the subscales of alcohol craving and dependence only through maladaptive CERSs after adjusting for demographic and clinical factors. No direct effect was observed through CM on the subscales of alcohol craving and dependence. ConclusionsAlthough drawing causal conclusions from the current research is impossible, the findings suggest that maladaptive CERSs may be a possible mechanism relating CM to alcohol craving and dependence in treatment-seeking alcohol-dependent individuals, while adaptive CERSs may be less important regarding this relation. However, the findings of the current study need longitudinal research.

Influence of dopamine-related genes on craving, impulsivity, and aggressiveness in Korean males with alcohol use disorder.

Dopamine is a major neuromodulator that is acutely involved in various cognitive processes, reward-motivated behaviors, and impulsivity. Abnormality in dopaminergic neurotransmission is implicated in the pathophysiology of alcohol use disorder (AUD). The present study examined the genetic influence of dopamine system on problematic drinking, impulsivity, and aggressiveness in a Korean male population with AUD. Five single nucleotide polymorphisms (SNPs) (rs4532 in DRD1, rs2283265 in DRD2, rs6280 in DRD3, rs1800497 in ANKK1, and rs4680 in COMT) and a variable number of tandem repeats (VNTRs) in DAT1 in 295 male patients with AUD were genotyped. For AUD-related clinical characteristics, the Alcohol Use Disorders Identification Test and the Obsessive-Compulsive Drinking Scale (OCDS) were used to assess the severity of hazardous drinking and craving symptoms, respectively. Participants also completed the UPPS-P Impulsive Behavior Scale (UPPS-P) and Buss-Perry Aggression Questionnaire (BPAQ). Analyses were performed using R package SNPassoc; statistical significance was set as p < 0.0083 after Bonferroni correction. A significant association was detected between DRD3 SNP rs6280 and OCDS scores. In regard to impulsivity and aggressiveness, rs4532 of DRD1 was significantly associated with UPPS-P score. Also, rs4532 demonstrated a nominally significant association with BPAQ score, although it did not reach statistical significance after correction for multiple comparisons. Results of this study support the idea that genetic variations in the dopamine system may contribute to alcohol cravings and impulsivity in patients with AUD.

DNA-methylation of the dopamin receptor 2 gene is altered during alcohol withdrawal

The dopaminergic neurotransmission is known to be of crucial importance in addictive behavior. Epigenetic regulation like methylation of DNA influences the function of dopaminergic transmission. The present study investigated alterations of DNA methylation in the dopamine D2 receptor (DRD2)-gene in patients suffering from alcohol dependence. The study sample consists of 99 alcohol dependent males admitted for alcohol withdrawal treatment and a control group of 33 healthy participants. Blood samples underwent bisulfite sequencing to determine levels of DNA-methylation of the promoter region of the DRD2 gene. Mixed linear modeling was used to test differences between patients and controls, course of methylation during detoxification. While DRD2-gene methylation did not differ significantly between patients and controls, we found a significant increase of DRD2-gene methylation during alcohol withdrawal/early abstinence. Craving, measured with the Obsessive Compulsive Drinking Scale (OCDS), was significantly associated with DRD2-gene methylation. Furthermore, smoking significantly influenced DRD2-gene methylation in both, patients and controls. As in other types of addictive disorders, DRD2-gene methylation is altered during alcohol withdrawal/early abstinence. The findings regarding an association with alcohol craving and tobacco consumption point towards a crucial role of DRD2-gene methylation in the neurobiology of addictive behavior.

Psychometric properties of the Persian versions of the Positive Alcohol Metacognitions Scale (Persian-PAMS) and the Negative Alcohol Metacognitions Scale (Persian-NAMS) in alcohol-dependent individuals

Positive and negative metacognitions regarding alcohol effects are related to drinking problems. This study aimed to validate the Persian versions of the Positive Alcohol Metacognitions Scale (Persian-PAMS) and the Negative Alcohol Metacognitions Scale (Persian-NAMS) and to assess the relations of metacognitions about alcohol use to alcohol craving and dependence in a clinical sample of males with a DSM diagnosis of alcohol dependence. Three hundred treatment-seeking males with alcohol dependence completed the Alcohol Use Disorders Identification Test (AUDIT), the Alcohol Outcome Expectancy Questionnaire (AOEQ), the Obsessive Compulsive Drinking Scale (OCDS), the Depression Anxiety Stress Scales (DASS-21), and the Persian-translated versions of the PAMS and NAMS. The results showed that similar to original versions of the PAMS and NAMS, the Persian version of the scales had a two-factor structure. Test-retest coefficients over a four-week interval and internal consistency showed good reliability for the Persian-PAMS and Persian-NAMS and their subscales. Predictive validity showed that positive metacognitions about alcohol use were associated with alcohol craving and dependence independent of outcome expectancies about alcohol use. The findings suggest that the Persian-PAMS and Persian-NAMS have appropriate psychometric properties in Iranian males with alcohol dependence. Results also highlight that positive metacognitions may be more related to alcohol craving and dependence relative to outcome expectancies about alcohol use.

Alexithymia and Alcohol Dependence: The Roles of Negative Mood and Alcohol Craving

Background: Alexithymia is a personality trait associated with emotion regulation difficulties. Up to 67% of alcohol-dependent patients in treatment have alexithymia. Objectives: The objective of this study was to investigate the direct and indirect effects of alexithymia, negative mood (stress, anxiety, and depression) and alcohol craving on alcohol dependence severity. Methods: Three hundred and fifty-five outpatients (mean age = 38.70, SD = 11.00, 244 males, range 18–71 years) undergoing Cognitive-Behavioral Therapy for alcohol dependence completed the Toronto Alexithymia Scale (TAS-20), Depression Anxiety Stress Scales (DASS-21), Obsessive Compulsive Drinking Scale (OCDS), and Alcohol Use Disorders Identification Test (AUDIT) prior to the first treatment session. Results: Alexithymia had an indirect effect on alcohol dependence severity, via both negative mood and alcohol craving (b = 0.03, seb = 0.008, 95% CI: 0.02–0.05). An indirect effect of negative mood on alcohol dependence via alcohol craving was also observed (b = 0.12, seb = 0.03, 95% CI: 0.07–0.16). Conclusions/importance: Alexithymia worked through negative mood and alcohol craving leading to increased alcohol dependence severity, indicating that craving had an indirect effect on the relationship between alexithymia and alcohol dependence severity. Targeting alcohol craving and negative mood for alcohol-dependent patients with alexithymia seems warranted.

The effect of childhood trauma on the response to group cognitive behavioural therapy for chronic fatigue syndrome

Childhood maltreatment (CM) and cognitive emotion regulation strategies (CERSs) may be important in alcohol craving and dependence in alcohol-dependent individuals. The aim of this study was to evaluate direct effects of CM on the subscales of alcohol craving and alcohol dependence and its indirect effects via CERSs in individuals with a diagnosis of alcohol dependence.In a cross-sectional design, 329 alcohol-dependent males completed the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Cognitive Emotion Regulation Questionnaire-Short version (CERQ-Short), the Alcohol Dependence Scale (ADS), the Obsessive Compulsive Drinking Scale (OCDS), and the Beck Depression Inventory-II (BDI-II).Participants with alcohol dependence had early age of onset of alcohol use (mean = 20.78 years), relatively long duration of alcohol use (mean = 11.14 years), and low education (mean = 9.55 years). Indirect effects were observed from CM to the subscales of alcohol craving and dependence only through maladaptive CERSs after adjusting for demographic and clinical factors. No direct effect was observed through CM on the subscales of alcohol craving and dependence.Although drawing causal conclusions from the current research is impossible, the findings suggest that maladaptive CERSs may be a possible mechanism relating CM to alcohol craving and dependence in treatment-seeking alcohol-dependent individuals, while adaptive CERSs may be less important regarding this relation. However, the findings of the current study need longitudinal research.

Association of opioid receptor gene polymorphisms with drinking severity and impulsivity related to alcohol use disorder in a Korean population.

AimsRecent evidence suggests that the opioid system is implicated in the pathophysiology of alcohol use disorder (AUD). We aimed to examine the genetic influence of opioid receptors on susceptibility to AUD and its clinical and psychological characteristics including harmful drinking behavior and various aspects of impulsivity in AUD patients.MethodsThree μ‐opioid receptor gene (OPRM1) variants and two κ‐opioid receptor gene (OPRK1) variants were examined in 314 male patients with AUD and 324 male controls. We applied the Alcohol Use Disorders Identification Test (AUDIT), Obsessive Compulsive Drinking Scale (OCDS), and Alcohol Dependence Scale. AUD patients also completed the stop‐signal task, delay discounting task, balloon analogue risk task, and the Barratt Impulsiveness Scale version 11 (BIS‐11).ResultsNo significant differences in genotype distributions or haplotype frequencies were found between AUD patients and controls. However, OPRK1 SNP rs6473797 was significantly related to the severity of alcohol‐related symptoms as measured by AUDIT and OCDS and a haplotype containing rs6473797 was also related to OCDS scores in AUD patients. For other psychological traits, OPRM1 SNP rs495491 was significantly associated with scores on the motor subfactor of the BIS‐11.ConclusionGenetic variations in opioid receptors may contribute to symptom severity and impulsivity in AUD patients.

Acute alcohol effects on impulsive choice in adolescents.

Neurodevelopmental and alcohol-induced changes in decision-making have been proposed to critically influence impulsive behaviour in adolescents. This study tested the influence of acute alcohol administration on impulsive choice in adolescents. Fifty-four males aged 18-19 years were tested in a single-blind placebo-controlled cross-over design. During alcohol administration (infusion resulting in an arterial blood alcohol concentration of 80 mg%) and placebo condition (saline infusion), participants performed a task battery providing estimates of delay discounting, probability discounting for gains, for losses and loss aversion, and also rated subjectively experienced alcohol effects. Additionally, baseline alcohol consumption (Alcohol Use Disorders Identification Test, blood phosphatidylethanol levels), motives (Drinking Motive Questionnaire, Alcohol Expectancy Questionnaire and Obsessive Compulsive Drinking Scale), family history and self-report measures of impulsivity (Barratt Impulsiveness Scale, Substance Use Risk Profile Scale) were provided. No overall effects of treatment on choice behaviour were found. However, individual differences were observed. In the alcohol condition, more impulsive choice tendencies for delay discounting were associated with higher subjectively experienced alcohol effects. Further, higher risk aversion for probabilistic gains and higher loss aversion during alcohol condition were related to higher levels of real-life alcohol consumption and a family history of alcohol problems, respectively. Finally, the time to make a decision was substantially shortened for choices involving negative prospects. Contrary to common beliefs, acute alcohol intoxication did not generally incite impulsive decision-making. It rather appears that alcohol-induced behavioural changes in adolescents vary considerably depending on prior experiences and subjective effects of alcohol.

A multi-dimensional evaluation of craving and impulsivity among people admitted for alcohol-related problems in emergency department

Craving and impulsivity are key psychological dimensions involved in the development and maintenance of severe alcohol-use disorders. This study proposes an integrative evaluation of craving (Visual Analogue Scale, VAS and Obsessive Compulsive Drinking Scale, OCDS) and impulsivity (UPPS Scale and Barratt Impulsiveness Scale) among patients admitted in emergency department for alcohol misuse. Ninety-eight patients were included. Regression analyses showed that the scores obtained at the compulsive subscale of the OCDS, at the VAS and at the Urgency subscale of impulsivity constitute the main predictors of the severity of alcohol-use disorders (indexed by the AUDIT). These results suggest that specific sub-dimensions of craving and impulsivity may play a critical and joint role in the maintenance of excessive alcohol consumption.