Reward and relief dimensions of temptation to drink: construct validity and role in predicting differential benefit from acamprosate and naltrexone - PubMed (original) (raw)

Randomized Controlled Trial

. 2017 Nov;22(6):1528-1539.

doi: 10.1111/adb.12427. Epub 2016 Aug 2.

Affiliations

Randomized Controlled Trial

Reward and relief dimensions of temptation to drink: construct validity and role in predicting differential benefit from acamprosate and naltrexone

Corey R Roos et al. Addict Biol. 2017 Nov.

Abstract

Researchers have sought to distinguish between individuals whose alcohol use disorder (AUD) is maintained by drinking to relieve negative affect ('relief drinkers') and those whose AUD is maintained by the rewarding effects of alcohol ('reward drinkers'). As an opioid receptor antagonist, naltrexone may be particularly effective for reward drinkers. Acamprosate, which has been shown to down-regulate the glutamatergic system, may be particularly effective for relief drinkers. This study sought to replicate and extend prior work (PREDICT study; Glöckner-Rist et al. ) by examining dimensions of reward and relief temptation to drink and subtypes of individuals with distinct patterns of reward/relief temptation. We utilized data from two randomized clinical trials for AUD (Project MATCH, n = 1726 and COMBINE study, n = 1383). We also tested whether classes of reward/relief temptation would predict differential response to naltrexone and acamprosate in COMBINE. Results replicated prior work by identifying reward and relief temptation factors, which had excellent reliability and construct validity. Using factor mixture modeling, we identified five distinct classes of reward/relief temptation that replicated across studies. In COMBINE, we found a significant class-by-acamprosate interaction effect. Among those most likely classified in the high relief/moderate reward temptation class, individuals had better drinking outcomes if assigned to acamprosate versus placebo. We did not find a significant class-by-naltrexone interaction effect. Our study questions the orthogonal classification of drinkers into only two types (reward or relief drinkers) and adds to the body of research on moderators of acamprosate, which may inform clinical decision making in the treatment of AUD.

Keywords: Acamprosate; alcohol use disorder; naltrexone; temptation.

© 2016 Society for the Study of Addiction.

PubMed Disclaimer

Figures

Figure 1

Figure 1

Standardized factor loadings for confirmatory factor analysis models of AASE temptation items. AASE = Alcohol Abstinence Self-Efficacy Scale. Arrows on far left of figure represent the residual errors. Unbolded parameters are for the COMBINE study sample. Bolded parameters are for MATCH study sample.

Figure 2

Figure 2

Interaction of acamprosate and latent class in predicting drinking outcomes. * = mean difference is significant at p < .05. Error bars are 95% confidence intervals.

Similar articles

Cited by

References

    1. Adams ZW, Schacht JP, Randall P, Anton RF. The Reasons for Heavy Drinking Questionnaire: Factor structure and validity in alcohol dependent adults involved in clinical trials. J Stud Alcohol Drugs. 2016;77:354–361. - PMC - PubMed
    1. Addolorato G, Abenavoli L, Leggio L, Gasbarrini G. How many cravings? Pharmacological aspects of craving treatment in alcohol addiction: a review. Neuropsychobiology. 2005;51:59–66. - PubMed
    1. Aiken LS, West SG. Multiple regression: Testing and interpreting interactions. Thousand Oaks: Sage; 1991.
    1. Annis H, Davis CS, Graham JM, Ontario . Inventory of drinking situations (IDS): User’s guide. Addiction Research Foundation; 1987.
    1. Anton RF, O’Malley SS, Ciraulo DA, Cisler RA, Couper D, Donovan DM, … Longabaugh R. Combined pharmacotherapies and behavioral interventions for alcohol dependence: the COMBINE study: a randomized controlled trial. JAMA. 2006;295:2003–2017. - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources