@article{ref1,
title="A day-by-day prospective analysis of stress, craving and risk of next day alcohol intake during alcohol use disorder treatment",
journal="Drug and alcohol dependence",
year="2019",
author="Wemm, Stephanie E. and Larkin, Chloe and Hermes, Gretchen and Tennen, Howard and Sinha, Rajita",
volume="204",
number="",
pages="e107569-e107569",
abstract="BACKGROUND: Stress has been known to increase craving in individuals with Alcohol Use Disorders (AUD) and predict future alcohol relapse risk, but whether stress on a particular day affects craving on that day to impact prospective alcohol intake in the real world, particularly during early treatment and recovery, has not been studied thus far. <br><br>METHOD: The first study included 85 AUD individuals who reported their daily stress, craving, and alcohol intake in the first two weeks of early treatment. A second validation study included 28 AUD patients monitored daily during eight weeks of outpatient 12-Step based behavioral counseling treatment for AUD. Data were collected from telephone-based daily diaries for 903 days in Study 1 and 1488 in Study 2. Multilevel latent models tested if daily and person-averaged craving mediated the link between stressful events and next day drinking during treatment. <br><br>RESULTS: In both Study 1 and 2, exposure to a stressful event on a particular day predicted increased craving on that day (p's≤.002); and such increases in craving predicted the likelihood of drinking the next day (p's≤.014) and the drinking amount (p's< = 008). Individuals who experienced more stressful events reported higher craving (p's≤.012), and higher cravers reported greater next day drinking (p's<.001). <br><br>CONCLUSIONS: The results across two studies with separate samples are the first to establish that craving directly mediates the association between stress and next day alcohol intake in individuals with AUD. <br><br>FINDINGS suggest a need for novel treatment approaches to address stress-induced craving to improve alcohol use outcomes.<br><br>Copyright © 2019 Elsevier B.V. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0376-8716",
doi="10.1016/j.drugalcdep.2019.107569",
url="http://dx.doi.org/10.1016/j.drugalcdep.2019.107569"
}