Craving mediates stress in predicting lapse during alcohol dependence treatment

Law, Bonnie, Gullo, Matthew J., Daglish, Mark, Kavanagh, David J., Feeney, Gerald F. X., Young, Ross M. and Connor, Jason P. (2016) Craving mediates stress in predicting lapse during alcohol dependence treatment. Alcoholism: Clinical and Experimental Research, 40 5: 1058-1064. doi:10.1111/acer.13034

Author Law, Bonnie
Gullo, Matthew J.
Daglish, Mark
Kavanagh, David J.
Feeney, Gerald F. X.
Young, Ross M.
Connor, Jason P.
Title Craving mediates stress in predicting lapse during alcohol dependence treatment
Journal name Alcoholism: Clinical and Experimental Research   Check publisher's open access policy
ISSN 1530-0277
Publication date 2016-05-01
Year available 2016
Sub-type Article (original research)
DOI 10.1111/acer.13034
Open Access Status Not Open Access
Volume 40
Issue 5
Start page 1058
End page 1064
Total pages 7
Place of publication Malden, MA United States
Publisher Wiley-Blackwell Publishing
Language eng
Formatted abstract
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.

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.

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.

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.
Keyword Alcohol dependence
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

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