Affect, motivation, temptation, and drinking among alcohol-dependent outpatients trying to maintain abstinence: An Ecological Momentary Assessment study. (1st January 2020)

• Record Type: Journal Article
• Authors: Waters, Andrew J.; Schoenmakers, Tim M.; Snelleman, Michelle; Szeto, Edwin H.; Franken, Ingmar H.A.; Hendriks, Vincent M.; van de Mheen, Dike
• Is Part Of: Drug and alcohol dependence. Volume 206(2020)
• Publication Date: 2020-01-01
• Subjects: Ecological Momentary Assessment -- Alcohol-dependent -- Negative affect -- Craving -- Temptation -- Motivation; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2019.107626
• Languages: English
• ISSNs: 0376-8716

Abstract

Highlights: In alcohol-dependent outpatients, negative affect was associated with temptation. More evidence that negative affect precipitated temptations than vice versa. In lapsers, abstinence motivation was lower during temptation episodes. Abstract: Objectives: Using Ecological Momentary Assessment we aimed to describe the time course of temptation episodes in alcohol-dependent outpatients in a real-life setting. We also examined whether affective and motivational variables were cross-sectionally and prospectively associated with temptation episodes. Additionally, we tested whether outpatients who drank against treatment goals (i.e., "lapsers") differed in craving, affect, and motivation from abstainers. Methods: Participants were 43 alcohol-dependent outpatients (13 female). Using personal digital assistants (PDAs), patients were signaled to complete three random assessments per day for 4 weeks. They were also instructed to complete a temptation assessment whenever they experienced the temptation to drink alcohol. Results: The number of temptation assessments declined over time and did not differ between lapsers and abstainers. Overall, craving was generally higher in lapsers ( n = 14) than abstainers ( n = 27). In lapsers, but not abstainers, abstinence motivation was lower at temptation assessments vs. random assessments. Across all patients, negative affect was prospectively associated with entry of temptation assessments later the same day. There were no significant effects for positive affect. Conclusions: In alcohol-dependent outpatients attempting to remain abstinent, negative affect is cross-sectionally associated with entry of temptation assessments. There is more evidence that negative affect precipitates temptations than vice versa. Professionals should be watchful of outpatients who report generally high levels of craving, and who report more negative affect and lower abstinence motivation, when tempted.