Affect, motivation, temptation, and drinking among alcohol-dependent outpatients trying to maintain abstinence: An Ecological Momentary Assessment study

A.J. Waters*, T.M. Schoenmakers, M. Snelleman, E. Szeto, I.H.A. Franken, V.M. Hendriks, H. van de Mheen

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

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.
Original languageEnglish
Article number107626
Number of pages7
JournalDrug and Alcohol Dependence
Volume206
Early online date2020
DOIs
Publication statusPublished - 2020

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Keywords

  • ASSESSMENT EMA
  • ATTENTIONAL BIAS
  • Alcohol-dependent
  • Craving
  • DISORDERS
  • Ecological Momentary Assessment
  • HEROIN
  • Motivation
  • Negative affect
  • RELAPSE
  • TENDENCIES
  • TIME
  • TOBACCO
  • Temptation
  • URGES
  • VALIDATION

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