Salud Mental

Impaired control in heavy drinking and its association with alcohol craving and alcohol use disorder severity

##plugins.themes.bootstrap3.article.main##

Edén Sánchez
Carlos S. Cruz Fuentes
Corina Benjet
María Elena Medina-Mora

Resumen

Introducción. El deterioro del control sobre el consumo del alcohol se ha mencionado con frecuencia en diversas descripciones teóricas relativas al uso nocivo y es un criterio clínico del DSM para el trastorno por uso de alcohol. Las diferencias en la frecuencia con que se admite el deterioro del control se han considerado como un reflejo de la gravedad del problema. Además, se ha postulado que la capacidad de poner un límite al consumo de alcohol puede estar mediada por el deseo de consumirlo (craving).

Objetivo. En este estudio se abordó la relación entre el deterioro del control, el autoreporte del craving y la gravedad de la dependencia del alcohol en un grupo de bebedores fuertes.

Método. Se realizó un análisis de clases latentes usando las dimensiones del deterioro del control (control percibido, control fallido e intento de control) de 208 bebedores fuertes. Para determinar si las clases identificadas podían representar diferentes formas de gravedad del trastorno se contrastó el modelo más adecuado con las puntuaciones de la Escala de Dependencia del Alcohol. Además, se evaluó la relación entre los criterios de deterioro del control (utilizando la Escala de Control Deficiente, ECD) y el craving.

Resultados. Identificamos una solución de tres clases basada en la gravedad del deterioro de control. En esa solución se identificó una relación con el aumento graduado de las puntuaciones de craving y la gravedad de la dependencia entre las clases. Sólo los elementos de la ECD que comprenden el control percibido y parcialmente los relacionados con el control fallido, pero no los que evalúan el intento de control, distinguieron el gradiente entre las clases latentes.

Discusión y conclusión. Este estudio proporciona más apoyo a la propuesta de un continuum unidimensional de gravedad entre los usuarios de alcohol y refuerza la relación teórica entre el fenómeno de deterioro del control y el craving.
Palabras clave:
Alcoholismo, trastornos relacionados con el alcohol, craving, funciones ejecutivas

Referencias

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., Text Revision). Washington, DC: Psychiatric Pub.

Anton, R. F. (2000). Obsessive–compulsive aspects of craving: development of the Obsessive Compulsive Drinking Scale. Addiction, 95(8s2), 211-217. doi: 10.1046/j.1360-0443.95.8s2.9.x

Bucholz, K. K., Heath, A. C., Reich, T., Hesselbrock, V. M., Krarner, J. R., Nurnberger, Jr. J. I., & Schuckit, M. A. (1996). Can We Subtype Alcoholism? A latent class analysis of data from relatives of alcoholics in a multicenter family study of alcoholism. Alcoholism: Clinical and Experimental Research, 20(8), 1462-1471. doi: 10.1111/j.1530-0277.1996.tb01150.x

Caetano, R. (1999). The identification of alcohol dependence criteria in the general population. Addiction, 94(2), 255-267. doi: 10.1046/j.1360-0443.1999.9422559.x

Castaldelli-Maia, J. M., Silveira, C. M., Siu, E. R., Wang, Y., Milhorança, I. A., Alexandrino-Silva, C., … Martins, S. S. (2014). DSM-5 latent classes of alcohol users in a population-based sample: Results from the São Paulo Megacity Mental Health Survey, Brazil. Drug Alcohol Dependence, 136, 92-99. doi: 10.1016/j.drugalcdep.2013.12.012

Chick, J. (1980). Is there a unidimensional alcohol dependence syndrome?. British Journal of Addiction, 75(3), 265-280. doi: 10.1111/j.1360-0443.1980.tb01380.x

Chung, T., & Martin, C. S. (2001) Classification and course of alcohol problems among adolescents in addictions treatment programs. Alcoholism: Clinical and Experimental Research, 25(12), 1734-1742. doi: 10.1111/j.1530-0277.2001.tb02184.x

Cordero, M., Solís, L., Cordero, R., Torruco, M., & Cruz-Fuentes, C. (2009). Factor structure and concurrent validity of the Obsessive-Compulsive Drinking Scale in a group of alcohol-dependent subjects of Mexico City. Alcoholism: Clinical and Experimental Research, 33(7), 1145-1150. doi: 10.1111/j.1530-0277.2009.00937.x

Cuthbert, B. N., & Insel, T. R. (2013) Toward the future of psychiatric diagnosis: the seven pillars of RDoC. BMC Medicine, 11(1), 126. doi: 10.1186/1741-7015-11-126

de Wildt, W. A. Lehert, P., Schippers, G. M., Nakovics, H., Mann, K., & van den Brink, W. (2005). Investigating the structure of craving using structural equation modelling in analysis of the obsessive-compulsive drinking scale: a multinational study. Alcoholism: Clinical & Experimental Research, 29(4), 509-516. doi: 10.1097/01.ALC.0000158844.35608.48

Drobes, D. J., & Thomas, S. E. (1999). Assessing craving for alcohol. Alcohol Research & Health, 23(3), 179-186.

Edwards, G., & Gross, M. M. (1976). Alcohol dependence: provisional description of a clinical syndrome. British Medical Journal, 1(6017), 1058-1061. doi: 10.1136/bmj.1.6017.1058

Foroud, T., Bucholz, K. K., Edenberg, H. J., Goate, A., Neuman, R. J., Porjesz, B., ... Begleiter, H. (1998). Linkage of an alcoholism-related severity phenotype to chromosome 16. Alcoholism: Clinical and Experimental Research, 22(9), 2035-2042. doi: 10.1111/j.1530-0277.1998.tb05913.x

Hasin, D. S., & Beseler, C. L. (2009). Dimensionality of lifetime alcohol abuse, dependence and binge drinking. Drug and Alcohol Dependence, 101(1-2), 53-61. doi: 10.1016/j.drugalcdep.2008.10.025

Hasin, D. S., O’Brien, C. P., Auriacombe, M., Borges, G., Bucholz, K., Budney, A., ... Grant, B. F. (2013). DSM-5 criteria for substance use disorders: Recommendations and rationale. American Journal of Psychiatry, 170(8), 834-851. doi: 10.1176/appi.ajp.2013.12060782

Heather, N., Booth, P., & Luce, A. (1998). Impaired control scale: Cross-validation and relationships with treatment outcome. Addiction, 93(5), 761-771. doi: 10.1046/j.1360-0443.1998.93576112.x

Heather, N., Tebbutt, J. S., Mattick, R. P., & Zamir, R. (1993). Development of a scale for measuring impaired control over alcohol consumption: a preliminary report. Journal of Studies on Alcohol, 54(6), 700-709. doi: 10.15288/jsa.1993.54.700

Insel, T., Cuthbert, B., Garvey, M., Heinssen, R., Pine, D. S., Quinn, K., Sanislow, C., & Wang, P. (2010). Research Domain Criteria (RDoC): toward a new classification framework for research on mental disorders. American Journal of Psychiatry, 167, 748-751. doi: 10.1176/appi.ajp.2010.09091379

Kahler, C. W., Epstein, E. E., & McCrady, B. S. (1995). Loss of control and inability to abstain: The measurement of and the relationship between two constructs in male alcoholics. Addiction, 90(8), 1025-1036. doi: 10.1111/j.1360-0443.1995.tb01055.x

Kavanagh, D. J., Statham, D. J., Feeney, G. F., Young, R. M., May, J., Andrade, J., & Connor, J. P. (2013). Measurement of Alcohol Craving. Addictive Behaviors, 38(2), 1572-1584. doi: 10.1016/j.addbeh.2012.08.004

Kranzler, H. R., Mulgrew, C. L., Modesto-Lowe, V., & Burleson, J. A. (1999). Validity of the Obsessive-Compulsive Drinking Scale (OCDS): Does craving predict drinking behavior? Alcoholism: Clinical and Experimental Research, 23(1), 108-114. doi: 10.1111/j.1530-0277.1999.tb04030.x

Kwako, L. E., Momenan, R., Litten, R. Z., Koob, G. F., & Goldman, D. (2016). Addictions neuroclinical assessment: A neuroscience-based framework for addictive disorders. Biological Psychiatry, 80(3), 179-189. doi: 10.1016/j.biopsych.2015.10.024

Leeman, R. F., Beseler, C. L., Helms, C. M., Patock-Peckham, J. A., Wakeling, V. A., & Kahler, C. W. (2014). A brief, critical review of research on impaired control over alcohol use and suggestions for future studies. Alcoholism: Clinical and Experimental Research, 38(2) 301-308. doi: 10.1111/acer.12269

Litten, R. Z., Ryan, M. L., Falk, D. E., Reilly, M., Fertig, J. B., & Koob, G. F. (2015). Heterogeneity of alcohol use disorder: Understanding mechanisms to advance personalized treatment. Alcoholism: Clinical and Experimental Research, 39(4), 579-584. doi: 10.1111/acer.12669

Marsh, A., & Saunders, B. (2000). Impaired control over drinking: Perceptions of social and treatment drinkers. Addiction Research, 8(3), 243-265. doi: 10.3109/16066350009004424

Marsh, A., Smith, L., Saunders, B., & Piek, J. (2002). The Impaired Control Scale: confirmation of factor structure and psychometric properties for social drinkers and drinkers in alcohol treatment. Addiction, 97(10), 1339-1346. doi: 10.1046/j.1360-0443.2002.00190.x

Modell, J. G., Glaser, F. B., Cyr, L., & Mountz, J. M. (1992) Obsessive and compulsive characteristics of craving for alcohol in alcohol abuse and dependence. Alcoholism: Clinical and Experimental Research, 16(2), 272‐274. doi: 10.1111/j.1530-0277.1992.tb01375.x

Modell, J. G., Glaser, F. B., Mountz, J. M., Schmaltz, S., & Cyr, L. (1992). Obsessive and compulsive characteristics of alcohol abuse and dependence: quantification by a newly developed questionnaire. Alcoholism: Clinical and Experimental Research, 16(2), 266-271. doi: 10.1111/j.1530-0277.1992.tb01374.x

Modell, J. G., Mountz, J. M., Glaser, F. B., & Lee, J. Y. (1993). Effect of haloperidol on measures of craving and impaired control in alcoholic* subjects. Alcoholism: Clinical and Experimental Research, 17(2), 234-240. doi: 10.1111/j.1530-0277.1993.tb00755.x

Muthén, B. (2006). Should substance use disorders be considered as categorical or dimensional? Addiction, 101(Suppl. 1), 6-16. doi: 10.1111/j.1360-0443.2006.01583.x

Nylund, K. L., Asparouhov, T., & Muthén, B. O. (2007) Deciding on the number of classes in latent class analysis and growth mixture modeling: A Monte Carlo Simulation Study. Structural Equation Modeling: A Multidisciplinary Journal, 14(4), 535-569. doi: 10.1080/10705510701575396

Ray, L. A., Bujarski, S., & Roche, D. J. (2016). Subjective response to alcohol as a research domain criterion. Alcoholism: Clinical and Experimental Research, 40(1), 6-17. doi: 10.1111/acer.12927

Saha, T. D., Chou, S. P., & Grant, B. F. (2006). Toward an alcohol use disorder continuum using item response theory: results from the National Epidemiologic Survey on Alcohol and Related Conditions. Psychological Medicine, 36(7), 931-941. doi: 10.1017/S003329170600746X

Sánchez, E., & Cruz-Fuentes, C. (2016). Cognitive Control and Negative and Positive Valence Systems in the Development of an NIMH RDoC-Based Model for Alcohol Use Disorder. Alcoholism: Clinical and Experimental Research, 40(1), 214-215. doi: 10.1111/acer.12920

Sayette, M. A. (2016). The role of craving in substance use disorders: theoretical and methodological issues. Annual Review of Clinical Psychology, 12, 407-433. doi: 10.1146/annurev-clinpsy-021815-093351

Skinner, H. A., & Allen, B. A. (1982). Alcohol dependence syndrome: Measurement and validation. Journal of Abnormal Psychology, 91(3), 199-209. doi: 10.1037/0021-843X.91.3.199

Skinner, H. A., & Horn, J. L. (1984). Alcohol Dependence Scale: Users Guide. Toronto, Canada: Addiction Research Foundation.

Solís R, L., Cordero O, M., Cordero O, R., & Martínez, M. (2007). Caracterización del nivel de dependencia al alcohol entre habitantes de la Ciudad de México. Salud Mental, 30(6), 62-68.

Vermunt, J. K., & Magidson, J. (2002). Latent class cluster analysis. In: Hagenaars, J. A., & McCutcheon, A. L. (Eds.). Applied Latent Class Analysis, pp. 89-106. Cambridge: Cambridge University Press.

Vermunt, J. K., & Magidson, J. (2005). Structural equation models: Mixture models. In: Everitt, B., & Howell, D. (Eds.). Encyclopedia of Statistics in Behavioral Science, 1922-1927. Chichester, UK: Wiley.

Wardell, J. D., Le Foll, B., & Hendershot, C. S. (2018). Preliminary evaluation of a human laboratory model of impaired control over alcohol using intravenous alcohol self-administration. Journal of Psychopharmacology, 32(1), 105-115. doi: 10.1177/0269881117723000

Wardell, J. D., Ramchandani, V. A., & Hendershot, C. S. (2015). A multilevel structural equation model of within- and between-person associations among subjective responses to alcohol, craving, and laboratory alcohol self-administration. Journal of Abnormal Psychology, 124(4), 1050-1063. doi: 10.1037/abn0000121