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Acuff SF, Oddo LE, Johansen AN, Strickland JC. Contextual and psychosocial factors influencing drug reward in humans: The importance of non-drug reinforcement. Pharmacol Biochem Behav 2024; 241:173802. [PMID: 38866372 DOI: 10.1016/j.pbb.2024.173802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/29/2024] [Accepted: 06/01/2024] [Indexed: 06/14/2024]
Abstract
The reinforcing efficacy, or behavior-strengthening effect, of a substance is a critical determinant of substance use typically quantified by measuring behavioral allocation to the substance under schedules of reinforcement with escalating response requirements. Although responses on these tasks are often used to indicate stable reinforcing effects or trait-level abuse potential for an individual, task designs often demonstrate within-person variability across varying degrees of a constraint within experimental procedures. As a result, quantifying behavioral allocation is an effective approach for measuring the impact of contextual and psychosocial factors on substance reward. We review studies using laboratory self-administration, behavioral economic purchase tasks, and ambulatory assessments to quantify the impact of various contextual and psychosocial factors on behavioral allocation toward consumption of a substance. We selected these assessment approaches because they cover the translational spectrum from experimental control to ecological relevance, with consistent support across these approaches representing greater confidence in the effect. Conceptually, we organized factors that influence substance value into two broad categories: factors that influence the cost/benefit ratio of the substance (social context, stress and affect, cue exposure), and factors that influence the cost/benefit ratio of an alternative (alternative non-drug reinforcers, alternative drug reinforcers, and opportunity costs). We conclude with an overview of future research directions and considerations for clinical application.
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Affiliation(s)
- Samuel F Acuff
- Recovery Research Institute, Massachusetts General Hospital and Harvard Medical School, 151 Merrimac Street, Boston, MA 02114, USA.
| | - Lauren E Oddo
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, Richmond, VA 23284-2018, USA
| | | | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA
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Davis CN, Gex KS, Squeglia LM, Trull TJ, McCarthy DM, Baker NL, Gray KM, McRae-Clark AL, Tomko RL. Development and Initial Validation of a Momentary Cannabis Craving Scale Within a Homogeneous Sample of U.S. Emerging Adults. Assessment 2024:10731911241237055. [PMID: 38515003 DOI: 10.1177/10731911241237055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Given the popularity and ease of single-item craving assessments, we developed a multi-item measure and compared it to common single-item assessments in an ecological momentary assessment (EMA) context. Two weeks of EMA data were collected from 48 emerging adults (56.25% female, 85.42% White) who frequently used cannabis. Eight craving items were administered, and multilevel factor analyses were used to identify the best fitting model. The resulting scale's factors represented purposefulness/general desire and emotionality/negative affect craving. Convergent validity was examined using measures of craving, cannabis use disorder symptoms, frequency of use, cannabis cue reactivity, cannabis use, negative affect, and impulsivity. The scale factors were associated with cue-reactivity craving, negative affect, impulsivity, and subfactors of existing craving measures. For researchers interested in using a single item to capture craving, one item performed particularly well. However, the new scale may provide a more nuanced assessment of mechanisms underlying craving.
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Affiliation(s)
- Christal N Davis
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
- Medical University of South Carolina, Charleston, USA
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
- University of Pennsylvania, Philadelphia, USA
| | - Kathryn S Gex
- Medical University of South Carolina, Charleston, USA
| | | | | | | | | | - Kevin M Gray
- Medical University of South Carolina, Charleston, USA
| | - Aimee L McRae-Clark
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
- Medical University of South Carolina, Charleston, USA
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Emery NN, Stanton K, Baumgardner S, Simons JS, Douglass MA, Prince MA. Discrete emotions and global affect: Applying empirically driven approaches to experience sampling data to model state and trait affective structure and affect-alcohol use associations in a heavy drinking young-adult sample. Behav Res Ther 2023; 167:104356. [PMID: 37392487 PMCID: PMC10530525 DOI: 10.1016/j.brat.2023.104356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/13/2023] [Accepted: 06/13/2023] [Indexed: 07/03/2023]
Abstract
Affective functioning is central to most contemporary models of alcohol use. However, the affective structure at the within- and between-person levels is rarely investigated nor is the differential predictive value of specific affect dimensions assessed across state and trait formats. We examined a) the structure of state and trait affect using experience sampling methodology (ESM) and b) predictive associations between the empirically derived affect facets and alcohol use. Participants were 92 heavy drinking college students aged 18-25 who completed 8 momentary assessments of their affect and drinking a day for 28-days. We found evidence for a single positive affect factor at both the within- (i.e., state) and between-person (i.e., trait) levels. We found a hierarchical factor structure for negative affect, represented by a general, superordinate dimension as well as facet-level sadness, anxiety, and anger dimensions. Associations between affect and alcohol use differed across trait and state levels and across specific types of negative affect. Lagged state positive affect and sadness as well as trait positive affect and sadness were inversely associated with drinking. Lagged state anxiety and trait general negative affect were positively associated with drinking. Thus, our study demonstrates how associations between drinking and affect can be studied in relation to general (e.g., general negative affect) and more specific aspects of affective experiences (e.g., sadness versus anxiety) concurrently within the same study and across trait and state levels of assessment.
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Affiliation(s)
- Noah N Emery
- Department of Psychology, Colorado State University, USA.
| | - Kasey Stanton
- Department of Psychology, University of Wyoming, USA
| | | | | | | | - Mark A Prince
- Department of Psychology, Colorado State University, USA
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Votaw VR, Tuchman FR, Piccirillo ML, Schwebel FJ, Witkiewitz K. Examining Associations Between Negative Affect and Substance Use in Treatment-Seeking Samples: A Review of Studies Using Intensive Longitudinal Methods. CURRENT ADDICTION REPORTS 2022; 9:445-472. [PMID: 37063461 PMCID: PMC10101148 DOI: 10.1007/s40429-022-00441-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 11/27/2022]
Abstract
Purpose of Review Understanding dynamic relationships between negative affect and substance use disorder (SUD) outcomes, including craving, may help inform adaptive and personalized interventions. Recent studies using intensive longitudinal methods were reviewed to examine relationships between negative affect and the outcomes of either craving or substance use during and following SUD treatment. Recent Findings Results on associations between negative affect and craving/substance use were mixed and difficult to synthesize, given methodological differences across studies. The strength and direction of these relationships varied across outcomes, subgroups, contexts, and time course. Summary The current literature is mixed concerning negative affect and craving/substance use associations during and following SUD treatment. Researchers should increasingly recruit diverse individuals, for example, samples of varying racial and ethnic backgrounds and those reporting co-occurring disorders and polysubstance use. Experimental, qualitative, and person-specific methods will improve our understanding of relationships between negative affect and substance-related outcomes during SUD treatment.
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Affiliation(s)
- Victoria R Votaw
- Department of Psychology, University of New Mexico, Albuquerque, NM
- Center on Alcohol, Substance use, And Addictions, University of New Mexico, Albuquerque, NM
| | - Felicia R Tuchman
- Department of Psychology, University of New Mexico, Albuquerque, NM
- Department of Psychology, Northwestern University, Evanston, IL
| | | | - Frank J Schwebel
- Center on Alcohol, Substance use, And Addictions, University of New Mexico, Albuquerque, NM
| | - Katie Witkiewitz
- Department of Psychology, University of New Mexico, Albuquerque, NM
- Center on Alcohol, Substance use, And Addictions, University of New Mexico, Albuquerque, NM
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Meredith LR, Grodin EN, Montoya AK, Miranda R, Squeglia LM, Towns B, Evans C, Ray LA. The effect of neuroimmune modulation on subjective response to alcohol in the natural environment. Alcohol Clin Exp Res 2022; 46:876-890. [PMID: 35362101 PMCID: PMC10460619 DOI: 10.1111/acer.14821] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/28/2022] [Accepted: 03/18/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Despite the promising implications for novel immune therapeutics, few clinical trials have tested these therapies to date. An understanding of how immune pharmacotherapies influence complex alcohol use disorder (AUD) profiles, including subjective response to alcohol, is very limited. Initial findings show that ibudilast, a neuroimmune modulator, reduces rates of heavy drinking and measures of alcohol craving. METHODS This study is a secondary analysis of a 2-week clinical trial of ibudilast that enrolled a nontreatment-seeking sample with AUD. Eligible participants (N = 52) were randomized to receive ibudilast or matched placebo and completed daily diary assessments (DDAs) during the 2-week period. Each morning, participants reported on their mood and craving levels both before and during the previous day's drinking episode, as well as stimulation and sedation levels during the previous day's drinking episode. Multilevel models were used to compare the effects of ibudilast and placebo on subjective alcohol response. Exploratory analyses tested whether ibudilast moderated the relationship between daily stimulation/sedation and alcohol intake and whether withdrawal-related dysphoria moderated ibudilast's effects on subjective response. RESULTS Ibudilast did not significantly alter mean levels of stimulation or sedation (p's > 0.05). It did, however, moderate the effect of daily stimulation on drinking (p = 0.045). Ibudilast attenuated alcohol-induced increases in craving compared with placebo (p = 0.047), but not other subjective response measures. Ibudilast significantly tempered daily alcohol-induced changes in urge to drink and positive mood only among individuals without withdrawal-related dysphoria. CONCLUSIONS Ibudilast's effects on subjective alcohol responses appear to be nuanced and perhaps most salient for individuals drinking for positive reinforcement as distinguished from those who drink to feel normal. Consistent with previous findings, reductions in alcohol craving may represent a primary mechanism of ibudilast's effects on drinking. The ecologically valid nature of DDAs provide a clinically useful window into how individuals experience alcohol's effects while taking ibudilast.
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Affiliation(s)
| | - Erica N. Grodin
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Amanda K. Montoya
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Robert Miranda
- Center for Alcohol and Addiction Studies, Brown University, Providence, RI, USA
- E. P. Bradley Hospital, Riverside, RI, USA
| | - Lindsay M. Squeglia
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Brandon Towns
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Christopher Evans
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Lara A. Ray
- Department of Psychology, University of California, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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