Cue-Induced Cigarette Craving and Mixed Emotions: A Role for Positive Affect in the Craving Process.

Cue-induced cigarette craving and mixed emotions: A role for positive affect in the craving process.

Filed under: Addiction Rehab

Addict Behav. 2012 Dec 16; 38(4): 1881-1889
Veilleux JC, Conrad M, Kassel JD

Craving is an important component of nicotine addiction, and extant research has demonstrated a clear link between cue-induced craving and negative affect, with mixed results in the positive affect domain. The current study was designed to test the idea that cue-reactive craving might be associated with a mixed emotional process, or the simultaneous experience of positive and negative affect. Participants were 86 non-deprived regular smokers and tobacco chippers who provided simultaneous ratings of positive and negative affect during cue exposure to pleasant, unpleasant, neutral and cigarette cues. Results indicated that self-reported craving was elevated in response to cigarette cues compared to other valenced cue types and craving was higher to pleasant cues than either neutral or unpleasant cues. Mixed emotional responses were higher to cigarette cues than other cue types. In addition, mixed emotional responses to cigarette cues predicted craving even after controlling for smoker type, difficulties regulating negative emotion, baseline craving level and mixed emotional responses to neutral cues. As the first study to investigate mixed emotions and cigarette craving, our results highlight the importance of examining the relationship between cue-reactive craving and emotional response using models of emotion that allow for measurement of nuanced emotional experience. In addition, our findings suggest that positive affect processes may indeed play a role in craving among non-deprived smokers.
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Asian Federation of Early Career Psychiatrists: Building bridges and expanding horizons.

Filed under: Addiction Rehab

Asian J Psychiatr. 2013 Feb; 6(1): 93-4
Sinha SK, Bezborodovs N, Krupchanka D, Paravaya O, Bendix M, Smirnova D

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Web-based treatment program using intensive therapeutic contact for patients with eating disorders: before-after study.

Filed under: Addiction Rehab

J Med Internet Res. 2013; 15(2): e12
Ter Huurne ED, Postel MG, de Haan HA, Drossaert CH, Dejong CA

Although eating disorders are common in the Netherlands, only a few patients are treated by mental health care professionals. To reach and treat more patients with eating disorders, Tactus Addiction Treatment developed a web-based treatment program with asynchronous and intensive personalized communication between the patient and the therapist.This pilot study evaluated the web-based treatment program using intensive therapeutic contact in a population of 165 patients with an eating disorder.In a pre-post design with 6-week and 6-month follow-ups, eating disorder psychopathology, body dissatisfaction, Body Mass Index, physical and mental health, and quality of life were measured. The participant’s satisfaction with the web-based treatment program was also studied. Attrition data were collected, and participants were classified as noncompleters if they did not complete all 10 assignments of the web-based treatment program. Differences in baseline characteristics between completers and noncompleters were studied, as well as reasons for noncompletion. Furthermore, differences in treatment effectiveness, treatment adherence, and baseline characteristics between participants of the three major eating disorder diagnostic groups EDNOS (n=115), BN purging (n=24), and BN nonpurging (n=24) were measured.Of the 165 participants who started the web-based treatment program, 89 participants (54%) completed all of the program assignments (completers) and 76 participants (46%) ended the program prematurely (noncompleters). Severe body dissatisfaction and physical and mental health problems seemed to have a negative impact on the completion of the web-based treatment program. Among the participants who completed the treatment program, significant improvements were found in eating disorder psychopathology (F=54.6, df = 68, P<.001, d=1.14). Body dissatisfaction, quality of life, and physical and mental health also significantly improved, and almost all of these positive effects were sustained up to 6 months after the participants had completed the web-based treatment program. Body Mass Index improved only within the group of participants suffering from obesity. The improvement in eating disorder psychopathology occurred in all three eating disorder diagnostic groups, and the percentage of completers did not differ significantly between these groups. Participants' satisfaction with the treatment program, as well as with their therapist, was high, and participants indicated that they would recommend the program to other patients with eating disorders.The results of this study suggest that the web-based treatment program has the potential to improve eating disorder psychopathology in patients with different types of eating disorders. HubMed – addiction


The appropriate use of opiates in chronic pain.

Filed under: Addiction Rehab

J Clin Psychiatry. 2012 Aug; 73(8): e26
Parker AJ

Chronic pain is a common but undertreated health problem in the United States. Opioids are effective for moderate-to-severe chronic pain, but these drugs must be used with care due to the risks for overdose and addiction. When initiating opioid treatment, physicians should perform a complete patient history, physical exam, and other appropriate testing and also assess the patient’s risk for substance misuse, abuse, or addiction. Patients should be monitored regularly for both improvement of function and for aberrant drug behaviors. With proper monitoring and risk management, patients with chronic pain can be treated effectively and safely with opioids.
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