Biomedical subjects

Theodora Duka

Publications and source records attributed to Theodora Duka.

At least 19 recordsLinked to original sources

PubMed2006

Drug expectancy is necessary for stimulus control of human attention, instrumental drug-seeking behaviour and subjective pleasure.

BACKGROUND: It has been suggested that drug-paired stimuli (S+) control addictive behaviour by eliciting an explicit mental representation or expectation of drug availability. AIMS: The aim of the present study was to test this hypothesis by determining whether the behavioural control exerted by a tobacco-paired S+ in human smokers would depend upon the S+ eliciting an explicit expectation of tobacco. DESIGN: In each trial, human smokers (n=16) were presented with stimuli for which attention was measured with an eyetracker. Participants then reported their cigarette reward expectancy before performing, or not, an instrumental tobacco-seeking response that was rewarded with cigarette gains if the S+ had been presented or punished with cigarette losses if the S- had been presented. Following training, participants rated the pleasantness of stimuli. RESULTS: The S+ only brought about conditioned behaviour in an aware group (those who expected the cigarette reward outcome when presented with the S+). This aware group allocated attention to the S+, performed the instrumental tobacco-seeking response selectively in the presence of the S+ and rated the S+ as pleasant. No conditioned behaviour was seen in the unaware group (those who did not expect the cigarette reward outcome in the presence of the S+). CONCLUSIONS: Drug-paired stimuli control selective attention, instrumental drug-seeking behaviour and positive emotional state by eliciting an explicit expectation of drug availability.

Adult↗

PubMed2006

Effects of dose and time on the ability of alcohol to prime social drinkers.

Interoceptive drug cues, through associations with the drug's reinforcing properties, may act as conditioned stimuli and elicit conditioned responses. For instance, a dose of alcohol, given to alcohol-experienced people, can lead to an enhancement of alcohol drinking, a phenomenon known as the priming effect. The present study aimed to investigate the alcohol priming effect in non-dependent social drinkers with respect to the dose of alcohol preload and the time of testing after preload. Fifteen social drinkers participated in five daily consecutive sessions. On days 1 and 2 (training sessions), participants consumed a 500 ml beverage of either 0.6 g/kg of alcohol or placebo (50 ml aliquots) presented in 10 colour-coded cups. During days 3, 4 and 5 (testing sessions), a preload of placebo, 0.3 or 0.6 g/kg of alcohol was given (in randomized sequence) in 10 opaque colourless cups. Thirty, 60 and 90 min following the preload, participants responded to an imagery script referring to the drinks sampled at training including a question on the number of aliquots participants would consume from each of the drinks if given the opportunity (hypothetical choice). Participants completed questionnaires evaluating mood and alcohol desires at baseline (before the beverages were given) and after the hypothetical choice. The hypothetical choice showed significant interactions between dose and time: the greatest number of alcohol aliquots were wanted 30 min following the 0.6 g/kg dose of alcohol preload. Ratings from the Desires for Alcohol Questionnaire also showed that alcohol desires peaked 30 min following the 0.6 g/kg of alcohol preload. These data support previous evidence that priming with alcohol can occur and indicate that dose of, and time after preload might affect the strength of, the priming effect for alcohol-related behaviours.

Adult↗

PubMed2006

Contingency knowledge is necessary for learned motivated behaviour in humans: relevance for addictive behaviour.

AIMS: Many forms of human conditioned behaviour depend upon explicit knowledge of the predictive contingency between stimuli, responses and the reinforcer. However, it remains uncertain whether the conditioning of three key behaviours in drug addiction-selective attention, instrumental drug-seeking behaviour and emotional state--are dependent upon contingency knowledge. To test this possibility, we employed an avoidance procedure to generate rapidly these three forms of conditioned behaviour without incurring the methodological problems of drug conditioning. DESIGN: In two experiments, participants (16 students) were trained on a schedule in which one stimulus (S +) predicted the occurrence of a startling noise, which could be cancelled by performing an instrumental avoidance response. MEASUREMENTS: The allocation of attention to the S + and the rate and probability of the avoidance response in the presence of S + were measured. Following training, participants were tested for their knowledge of the stimulus-noise contingencies arranged in the study and rated the emotional qualities of the stimuli. FINDINGS: Both experiments showed that S + gained control of selective attention, instrumental avoidance behaviour and subjective anxiety, but only in participants who reported explicit knowledge of the Pavlovian contingency between the S + and the startling noise. CONCLUSIONS: The implication of the present findings is that the control of selective attention, instrumental drug-seeking behaviour and emotional state by drug-paired stimuli is mediated by cognitive knowledge of the predictive contingency between the stimulus and the drug.

Adult↗

PubMed2005

Human nicotine conditioning requires explicit contingency knowledge: is addictive behaviour cognitively mediated?

RATIONALE: Two seemingly contrary theories describe the learning mechanisms that mediate human addictive behaviour. According to the classical incentive theories of addiction, addictive behaviour is motivated by a Pavlovian conditioned appetitive emotional response elicited by drug-paired stimuli. Expectancy theory, on the other hand, argues that addictive behaviour is mediated by an expectancy of the drug imparted by cognitive knowledge of the Pavlovian (predictive) contingency between stimuli (S+) and the drug and of the instrumental (causal) contingency between instrumental behaviour and the drug. AIMS AND METHOD: The present paper reviewed human-nicotine-conditioning studies to assess the role of appetitive emotional conditioning and explicit contingency knowledge in mediating addictive behaviour. RESULTS: The studies reviewed here provided evidence for both the emotional conditioning and the expectancy accounts. The first source of evidence is that nicotine-paired S+ elicit an appetitive emotional conditioned response (CR), albeit only in participants who expect nicotine. Furthermore, the magnitude of this emotional state is modulated by nicotine deprivation/satiation. However, the causal status of the emotional response in driving other forms of conditioned behaviour remains undemonstrated. The second source of evidence is that other nicotine CRs, including physiological responses, self-administration, attentional bias and subjective craving, are also dependent on participants possessing explicit knowledge of the Pavlovian contingencies arranged in the experiment. In addition, several of the nicotine CRs can be brought about or modified by instructed contingency knowledge, demonstrating the causal status of this knowledge. CONCLUSIONS: Collectively, these data suggest that human nicotine conditioned effects are mediated by an explicit expectancy of the drug coupled with an appetitive emotional response that reflects the positive biological value of the drug. The implication of this conclusion is that treatments designed to modify the expected value of the drug may prove effective.

Animals↗

PubMed2005

Repeated ethanol exposure and withdrawal impairs human fear conditioning and depresses long-term potentiation in rat amygdala and hippocampus.

BACKGROUND: In rats, repeated episodes of alcohol consumption and withdrawal (RWD) impair fear conditioning to discrete cues. METHODS: Fear conditioning was measured in human binge drinkers as the increased startle response in the presence of a CS+ conditioned to aversive white noise. Secondly, the ability of tone CSs, paired with footshock, to induce c-fos expression, a marker of neuronal activity, in limbic structures subserving emotion was studied in rats. Additionally, consequences of RWD on subsequent induction of long term potentiation (LTP) in external capsule/lateral amygdala and Schaffer collateral/hippocampus CA1 pathways were studied in rat brain slices. RESULTS: Fear conditioning was impaired in young human binge drinkers. The ability of fear-conditioned CSs to increase c-fos expression in limbic brain areas was reduced following RWD, as was LTP induction. Rats conditioned prior to RWD, following RWD showed generalization of conditioned fear from the tone CS+ to a neutral control stimulus, and a novel tone. CONCLUSIONS: Binge-like drinking impairs fear conditioning, reduces LTP, and results in inappropriate generalization of learned fear responses. We propose a mechanism whereby RWD-induced synaptic plasticity reduces capacity for future learning, while allowing unconditioned stimuli access to neuronal pathways underlying conditioned fear.

Adult↗

PubMed2005

Binge drinking, cognitive performance and mood in a population of young social drinkers.

BACKGROUND: Binge drinking may lead to brain damage and have implications for the development of alcohol dependence. The aims of the present study were to determine individual characteristics as well as to compare mood states and cognitive function between binge and nonbinge drinkers and thus further validate the new tool used to identify these populations among social drinkers. METHODS: The lowest and the highest 33.3% from a database of 245 social drinkers' binge scores derived from the Alcohol Use Questionnaire (AUQ) were used as cutoff points to identify nonbinge drinkers and binge drinkers in a further population of 100 young healthy volunteers. Personality characteristics, expectations of the effects of alcohol and current mood were evaluated. Cognitive performance was tested with a Matching to Sample Visual Search task (MTS) and a Spatial Working Memory task (SWM) both from the CANTAB battery, and a Vigilance task from the Gordon Diagnostic System. RESULTS: The binge drinkers had less positive mood than the nonbinge drinkers. In the MTS choice time on an 8-pattern condition and movement time on an 8- and 4-pattern condition was found to be faster in the binge drinkers compared to nonbinge drinkers. A gender by binge drinking interaction in the SWM and the Gordon Diagnostic System task revealed that female binge drinkers were worse on both these tasks than the female nonbinge drinkers. CONCLUSIONS: These results confirm previous findings in binge drinkers and suggest that in a nondependent alcohol-drinking group, differences can be seen in mood and cognitive performance between those that binge drink and those that do not.

Adolescent↗

PubMed2005

Alcohol withdrawal and conditioning.

This review contains the proceedings from a symposium held at the RSA conference in 2003 on "Alcohol Withdrawal and Conditioning." The presentations covered a range of interactions between conditioning and alcohol withdrawal, in both animal behavior and the clinic. Dr. D.N. Stephens first described his studies exploring the consequences of alcohol dependence and repeated experience of withdrawal on the conditioning process. His data suggested that repeated withdrawal from moderate alcohol intake impairs amygdala-dependent mechanisms for learning about aversive events. Dr. H. Becker then detailed studies examining the consequences of repeated ethanol withdrawal experience on subsequent ethanol drinking behavior in mice, and conditions in which motivational properties of odor cues that are associated with different phases of ethanol withdrawal influence such relapse behavior. The data suggested that cues associated with acute withdrawal or "recovery" from withdrawal may serve as modulating factors in influencing subsequent ethanol drinking behavior, and that the timing of the cues determines their consequences. Dr. F. Weiss described recent findings from animal models of relapse that suggested the efficacy of alcohol-associated contextual stimuli in eliciting alcohol-seeking behavior resembles the endurance of conditioned cue reactivity and cue-induced cocaine craving in humans. The interactive effects of stress and ethanol-related environmental stimuli were found to be dependent on concurrent activation of endogenous opioid and corticotropin-releasing factor systems. Conditioning factors (i.e., exposure to drug-associated stimuli) and stress could therefore interact to augment vulnerability to relapse. Dr. C. Drummond then addressed the clinical aspects of conditioning during alcohol withdrawal and described studies showing exposure of alcoholics to alcohol-related cues elicited greater subjective and physiological responses than exposure to neutral cues. The former responsivity showed a relationship with a measure of motivation to drink alcohol. Finally, Dr. C. Cunningham provided a summary of the concepts involved in the presentations and discussed the conditioning processes that affect behavior during and after alcohol withdrawal.

Alcohol Drinking↗

PubMed2005

Gender differences in response to lorazepam in a human drug discrimination study.

Gender differences in the discriminative stimulus properties of drugs of abuse have sometimes been reported, although we have previously found no differences in subjective or discriminative responses in human subjects acquiring an alcohol discrimination. The aim of the present work was to determine if there were gender differences in the effects of lorazepam, a benzodiazepine-receptor agonist which substituted for the alcohol stimulus in trained social drinkers. Volunteers who had already acquired an alcohol (0.2g/kg) placebo discrimination were administered (double-blind) either placebo (nine females, nine males) or lorazepam 2mg (six females, six males). They then sampled a series of five drinks and rated each one for likeness to the training stimulus (the generalization response). In addition they completed rating scales for subjective effects and the Digit Symbol Substitution Test (DSST). Lorazepam substituted for the alcohol stimulus equally in both sexes and increased associated scores for lightheadedness. Females however, showed a much greater DSST performance impairment following lorazepam, compared with males. This effect was independent of body weight differences and sedation. These results are discussed in the light of current knowledge of gender differences in response to drugs of abuse and suggest that the stimulus and cognitive effects of benzodiazepine-receptor agonists are modulated by different brain mechanisms.

Adolescent↗

PubMed2004

Explicit knowledge of stimulus-outcome contingencies and stimulus control of selective attention and instrumental action in human smoking behaviour.

RATIONALE: External stimuli (S+) that reliably signal that addictive drugs are available command the focus of selective attention and control instrumental action that procures the drug. According to incentive salience theory, as the contingency between the S+ and the drug is learned the magnitude of attentional orienting towards the S+ increases. By contrast, alternative theories propose that processing of the S+ becomes more efficient with training such that the measured attentional orienting response elicited by the S+ decreases. OBJECTIVES: The aim of the present study was to prompt half of participants to acquire explicit knowledge of the stimulus-reinforcer contingencies arranged in training, to examine the impact of this manipulation on the magnitude of attentional orienting towards the S+. METHODS: Smokers (n=32) completed an instrumental discrimination training procedure in which a set of stimuli were established as differential predictors that an instrumental response would yield tobacco-smoke reinforcement. During training, attention for the stimuli and performance of the instrumental tobacco-seeking response were measured in parallel. One group (n=16) was prompted to develop explicit knowledge of the discriminative contingencies in training whereas another group (n=16) underwent discrimination training without prompting. RESULTS: The prompted group reported accurate knowledge of the contingencies and showed no attentional orienting response towards the S+. By contrast, the unprompted group reported inaccurate knowledge of the contingencies and showed an attentional orienting response towards the S+. The S+ appeared to control the instrumental tobacco-seeking response in both groups equally. CONCLUSIONS: The results suggest that attention for drug paired S+ is associated with the process of learning about the relationship between those cues and the drug.

Attention↗

PubMed2004

The priming effect of alcohol pre-load on attentional bias to alcohol-related stimuli.

BACKGROUND: Previous research has shown attentional bias toward alcohol-related stimuli in non-dependent social drinkers. The aim of this study was to investigate whether attentional bias towards alcohol-related stimuli would increase after priming with either one of two doses of alcohol (0.3 or 0.6 g/kg) or placebo. METHODS: Questionnaires were used to measure alcohol use, mood states, craving for alcohol and alcohol outcome expectancies. Attentional bias was assessed using a dot-probe detection task and a modified Stroop task. RESULTS: Mood ratings showed dose dependent increases in positive mood after the alcohol pre-load. In the dot-probe task, all subjects showed an attentional bias towards the alcohol-related stimuli over neutral stationery-related items, although the attentional bias was significantly positive only at the low alcohol dose. In addition, a negative correlation was found between the attentional bias under the high alcohol dose and the alcohol use questionnaire score. In the Stroop task, a dose related effect of alcohol was found, with subjects making more errors for alcohol-related words under the high alcohol dose. CONCLUSIONS: These data support ideas derived from the incentive learning theories of drug addiction. Furthermore, these data suggest that history of alcohol exposure may influence the priming effects of an alcohol pre-load on attentional bias.

Adolescent↗

PubMed2004

Cue reactivity in smokers: the effects of perceived cigarette availability and gender.

We examined the effects of perceived cigarette availability and gender on smoking cue reactivity. Smokers were exposed to smoking cues (smoking paraphernalia) and control cues whilst their subjective and physiological responses were measured. Perceived cigarette availability was manipulated on a between-subjects basis before cue exposure. Relative to control cues, smoking cues evoked increases in the level of skin conductance in all participants. Cigarette craving was also increased in the presence of smoking cues, but only in female participants. Perceived cigarette availability had no effect on these responses. Participants also showed salivary reactivity to smoking cues, with males showing a decrease in salivation, and females showing an increase, but only when cigarettes were perceived as unavailable. These results suggest that perceived cigarette availability may not influence craving and skin conductance reactivity to smoking cues in minimally dependent smokers who are not nicotine deprived. In addition, the present data suggest that there are important gender differences in craving reactivity to smoking cues.

Adult↗

PubMed2004

Consequences of multiple withdrawals from alcohol.

This article represents the proceedings of a symposium at the 2003 annual meeting of the Research Society on Alcoholism in Fort Lauderdale, FL, organized by Theodora Duka and chaired by Dai Stephens. The purpose of the symposium was to examine the effects of multiple experiences of withdrawal from alcohol in animals made dependent on alcohol and in humans who are alcohol dependent. Parallels were drawn to the effects of repeated short-lived high-content alcohol exposures in animals and in humans who are social drinkers but indulge in binge drinking. The presentations were (1) Multiple detoxifications and risk of relapse in abstinent alcoholics, by John Gentry and Robert Malcolm; (2) Emotional and cognitive impairments after long-term use of alcohol: relationship to multiple detoxifications and binge drinking, by Theodora Duka; (3) The effect of repeated withdrawal from ethanol on conditioning to appetitive stimuli, by Tamzin Ripley, Gilyanna Borlikova, and Dai Stephens; (4) Alcohol withdrawal kindling: electrographic measures in a murine model of behavioral seizure sensitization, by Lynn Veatch and Howard Becker; and (5) Binge drinking induced changes in CNS, by Fulton Crews.

Alcoholism↗

PubMed2003

Discriminative stimuli that control instrumental tobacco-seeking by human smokers also command selective attention.

RATIONALE: Incentive salience theory states that acquired bias in selective attention for stimuli associated with tobacco-smoke reinforcement controls the selective performance of tobacco-seeking and tobacco-taking behaviour. OBJECTIVES: To support this theory, we assessed whether a stimulus that had acquired control of a tobacco-seeking response in a discrimination procedure would command the focus of visual attention in a subsequent test phase. METHODS: Smokers received discrimination training in which an instrumental key-press response was followed by tobacco-smoke reinforcement when one visual discriminative stimulus (S+) was present, but not when another stimulus (S-) was present. The skin conductance response to the S+ and S- assessed whether Pavlovian conditioning to the S+ had taken place. In a subsequent test phase, the S+ and S- were presented in the dot-probe task and the allocation of the focus of visual attention to these stimuli was measured. RESULTS: Participants learned to perform the instrumental tobacco-seeking response selectively in the presence of the S+ relative to the S-, and showed a greater skin conductance response to the S+ than the S-. In the subsequent test phase, participants allocated the focus of visual attention to the S+ in preference to the S-. Correlation analysis revealed that the visual attentional bias for the S+ was positively associated with the number of times the S+ had been paired with tobacco-smoke in training, the skin conductance response to the S+ and with subjective craving to smoke. Furthermore, increased exposure to tobacco-smoke in the natural environment was associated with reduced discrimination learning. CONCLUSIONS: These data demonstrate that discriminative stimuli that signal that tobacco-smoke reinforcement is available acquire the capacity to command selective attentional and elicit instrumental tobacco-seeking behaviour.

Adult↗

PubMed2003

Lorazepam substitutes for the alcohol stimulus in social drinkers.

RATIONALE: The alcohol discriminative stimulus has been extensively studied in animals and demonstrated to be pharmacologically complex. In contrast, however, the alcohol stimulus has been less frequently studied in humans. OBJECTIVES: The aim of the experiments reported here was to characterise pharmacologically an alcohol discriminative stimulus in social drinkers. METHODS: Volunteers were first trained to discriminate a dose of 0.2 g/kg alcohol from placebo, using an established method. We then investigated the generalisation response and subjective effects following a range of doses of the gamma-amino-butyric acid (GABA)(A) benzodiazepine-receptor agonist lorazepam (0, 0.5, 1 and 2 mg, PO). RESULTS: Low doses of lorazepam (0.5 and 1 mg) did not cross-generalise with the alcohol stimulus and produced only minimal subjective effects. However, a dose of 2 mg lorazepam substituted (60.8%) for the stimulus ( P<0.02) and increased subjective ratings of "lightheaded" ( P<0.05). CONCLUSIONS: These results are consistent with the pre-clinical literature and indicate the cross-species generality of the GABA(A) component of the alcohol discriminative stimulus.

Adolescent↗

PubMed2003

Impairment in cognitive functions after multiple detoxifications in alcoholic inpatients.

BACKGROUND: Repeated experience of withdrawal from alcohol results in a kindling-like process leading to increased likelihood and severity of convulsions during detoxification. The aim of this study was to determine whether repeated withdrawals affect cognitive function. METHODS: We investigated alcoholic patients undergoing detoxification in an inpatient setting, using tasks sensitive to dysfunction of prefrontal areas. The tasks applied were two maze tasks from the Wechsler Intelligence Scale for Children, the color Stroop task, and the vigilance task for adults and the delay task from the Gordon Diagnostic System. Forty-two abstinent alcoholic patients who were no longer receiving pharmacotherapy for detoxification participated. RESULTS: Compared to a group of forty-three social drinkers matched for age, sex, and verbal IQ, the alcoholic patients took more time to complete maze 1 and made more errors in both mazes. Alcoholics made more commission errors and gave fewer correct answers in the vigilance task. No differences were found in the color Stroop task between alcoholic patients and social drinkers. Patients with 2 or more detoxifications were more impaired in the maze 1, in the vigilance task and in the delay task than patients with a single, or no previous detoxification. When patients were reclassified on the basis of the total number of attempts at withdrawing from alcohol (including the medically supervised) only the deficit in the vigilance task was associated with the number of withdrawal attempts. The effects of medically supervised detoxifications on maze 1 and vigilance task were confounded with other factors related to the history of alcoholism, alcohol use, age of starting heavy drinking and years of problem drinking. CONCLUSIONS: Repeated experience of withdrawal from alcohol is thus associated with impaired cognitive function although it appears that for some of these effects, other factors associated with the history of alcoholism might also be involved.

Adult↗

PubMed2003

Effects of alcohol and lorazepam during extinction of alcohol self-administration in rats.

Systemic injections of alcohol have previously been reported to 'prime' or to reinstate self-administration of alcohol in rats, and it has been suggested that the priming effects of drugs are related to their stimulus properties. We tested this hypothesis by investigating the effects of lorazepam, which cross-generalizes with alcohol in animal drug-discrimination studies, in rats trained to self-administer 7% alcohol in an operant paradigm. Once animals were trained, extinction tests were carried out twice weekly, before which rats were injected with either vehicle, alcohol (0.063-0.5 g/kg, i.p.) or lorazepam (0.03-0.25 mg/kg, i.p.). Alcohol did not increase responding for alcohol during extinction. Doses of 0.25 and 0.5 g/kg reduced alcohol-appropriate lever pressing (p < 0.05 versus 0 g/kg), with the largest dose also suppressing general activity (p < 0.02 versus 0 g/kg). Lorazepam also reduced alcohol-appropriate responding, in a behaviourally specific manner; doses of 0.03 mg/kg and above decreased lever pressing (p < 0.05 versus 0 mg/kg), whereas general activity was depressed at 0.06 mg/kg and larger doses (p < 0.05 versus 0 mg/kg). Although lorazepam mimicked the effect of alcohol at doses predicted to do so on the basis of their relative potency in drug discrimination studies, neither alcohol nor lorazepam primed rats to respond for alcohol. By contrast, the pattern of results suggested that, in this model, they 'satiated' or substituted for alcohol, resulting in a reduced motivation to respond.

Animals↗

PubMed2002

Acute alcohol effects on cognitive function in social drinkers: their relationship to drinking habits.

RATIONALE: Several studies suggest that cognitive deficits seen in late stages of alcoholism are related to executive function. However, little is known about the acute effects of alcohol on cognitive executive functions. AIMS: The present investigation examined the acute effects of a moderate alcohol dose on tests of planning and spatial working memory as well as on tests of spatial and pattern recognition. The relationship between the acute alcohol effects on performance in these tasks and extreme drinking patterns were also studied. METHODS: Alcohol (0.8 g/kg) or placebo was administered to 95 social drinkers. In the planning task, alcohol decreased the number of solutions with the minimum moves. Alcohol also decreased the thinking time before initiating a response, while it increased the subsequent thinking time in the same task. Under alcohol, participants recognised fewer items in the spatial recognition task; however no effect of alcohol was found in a spatial working memory task and in a pattern recognition task. Among the participants with moderate to heavy use of alcohol, those who were 'bingers' performed worse in the spatial working memory and in the pattern recognition task than 'non-bingers'; no interaction between treatment and drinking pattern was found. CONCLUSION: These data suggest that alcohol given acutely impairs executive-type cognitive functions and that binge drinking may be associated with impaired cognitive function in a working memory and a pattern recognition task.

Adolescent↗

PubMed2002

Kindling of withdrawal: a study of craving and anxiety after multiple detoxifications in alcoholic inpatients.

BACKGROUND: The increased severity of withdrawal during successive detoxifications from alcohol is well documented for seizures, but the importance of the number of withdrawal events for other withdrawal symptoms such as anxiety and for alcohol craving is not known. Studies in animals are consistent with increases in reinforcing properties of alcohol with a greater number of withdrawal experiences. Thus, we predicted that patients who had undergone multiple detoxifications would show greater desire for alcohol and might experience more anxiety compared with patients with fewer detoxifications or compared with social drinkers. METHODS: Forty-two alcoholic inpatients were divided on the basis of medically supervised detoxifications into HI-med (more than two previous detoxifications, n = 6) and LO-med (two or fewer previous detoxifications, n = 36) and compared with a group of social drinkers matched for age, sex, and verbal IQ (n = 43). An additional analysis was performed by dividing the participants into HI-total (n = 22) and LO-total (n = 20) previous detoxification groups (three or more and less than three previous detoxifications, respectively) by using all previous detoxifications, which included unsupervised attempts. Anxiety was measured by Spielberger's State-Trait Anxiety Inventory; mood was evaluated by using the Profile of Mood States; craving was evaluated with a short version of the Desire for Alcohol Questionnaire; and an emotional Stroop test was used that employed positive, negative, and alcohol-related words. RESULTS: When the analysis was based on the medically supervised detoxifications only, alcoholic participants (HI- and LO-med) had higher ratings in trait anxiety and in feelings of anger, anxiety, depression, and confusion, but also friendliness; had higher craving ratings; and made more errors in the alcohol Stroop compared with social drinkers. In addition, the number of errors in the emotional Stroop for negative words was higher in the group with the higher number of detoxifications. When we analyzed the total number of detoxifications, this effect for the emotional Stroop errors was no longer seen. Instead, ratings of anger in the Profile of Mood States were greater in the HI-total compared with the LO-total detoxification group. These effects remained when the correlates alcohol consumption and degree of dependency were introduced as covariates, which showed that the effects found are probably attributable to the number of withdrawals. CONCLUSIONS: These data suggest that for inpatients with short history of alcoholism, the consequences of multiple withdrawals may not relate to anxiety or craving.

Adult↗