Affectivity, alexithymia and craving : a systematic review [E-Poster Presentation]

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Submitted on 8 Mar 2021

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Affectivity, alexithymia and craving : a systematic review [E-Poster Presentation]

Laura Cyr, Bernard Laura, Christophe Cutarella, Pedinielli Jean-Louis, Vincent Bréjard

To cite this version:

Laura Cyr, Bernard Laura, Christophe Cutarella, Pedinielli Jean-Louis, Vincent Bréjard. Affectiv- ity, alexithymia and craving : a systematic review [E-Poster Presentation]. European congress of Psychiatry, Apr 2020, Madrid, France. �10.1192/j.eurpsy.2020.5�. �hal-03149170�

Context

Craving is defined as a “strong desire or urge to consume a substance” (APA, 2013). It is a central symptom in substance use disorders. Researches on substance cues reactivity in addiction showed the influence of situational and affective cues-elicited craving (e.g., Preston et al., 2009) and highlighted strong links between negative affects (NA) and craving reactivity (e.g., Cooney et al., 1997). NA and craving are both know to be associated with substance use and to interfere with intervention outcomes. However, it is still not known how these variables relate to each other and if some others affective variables, for instance positive affects (PA) and alexithymia, may play an important role.

AFFECTIVITY, ALEXITHYMIA AND CRAVING IN SUBSTANCE USE DISORDERS : A SYSTEMATIC REVIEW

L. Cyr ^{1 2} , L. Bernard ^{1 2} , C. Cutarella ² , J.-L. Pedinielli ¹ , V. Bréjard ¹

1

Aix-Marseille Université, LPCPP, Aix-en-Provence, France,

2

Clinique Saint-Barnabé, Ramsay Santé group, Marseille, France

Results of the 21 studies selected after the selection process

0 10 20 30 40 50 60 70

NA

(as a state or a trait) (n=13)

PA

(as a state or a trait) (n=3)

NA and PA (interrelated) (n=2)

Alexithymia (n=3) Total of studies according to affective variables,

direct and indirect links

Total of studies Direct link Indirect Link

28th European congress of psychiatry – EPA 2020 (Madrid)

Sources

• APA (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Washington, DC : American Psychiatric Association.

• Cooney, N.L., Litt, M.D, Morse, P.A, Bauer, L.O, & Gaupp L. (1007). Alcohol cue reactivity, negative-mood reactivity, and relapse in treated alcoholic men. Journal of abnormal Psychology, 106, 243–250.

• Preston, K. L., Vahabzadeh, M., Schmittner, J., Lin, J. L., Gorelick, D. A. & Epstein, D. H. (2009). Cocaine craving and use during daily life. Psychopharmacology, 207(2), 291-301. doi:

10.1007/ s00213-009-1655-8

• Thorberg, F.A., Young, R.M., & Sullivan, K.A. (2009). Alexithymia and alcohol use disorders: a critical review. Addictive Behaviors, 34(3), 237-245. doi: 10.1016/j.addbeh.2008.10.016

Objectives

This review aims to synthesize independent and dependent affective variables ( dispositional trait or transient state) with craving and identify gaps in the literature.

Method

Data base used: PsycINFO, PubMed/Medline, Web of Science (+ grey literature).

Research algorithm:

Alexithymia OR emotion regulation OR emotion dysregulation OR negative affect OR positive affect AND craving OR drug craving OR alcohol craving OR urges.

Negative affectivity (trait and state) and craving

• Risk factor : mood/anxiety disorders high associated with craving.

• Causal link (n=7).

• Moderating effect (n=6) of personality variables (self-consciousness, anxiety sensitivity, emotional.

intelligence) which act like protective or risk factors.

Positive affectivity (trait and state) and craving

• Protective or risk factor.

• Mediating effect of PA between personality variables (impulsivity, hedonic capacities) and craving.

• Majority of studies on tobacco (n=3).

Alexithymia (trait) , affectivity and craving

• One study on the link between alexithymia, affectivity and craving.

• Positive correlation between alexithymia and craving (n=3).

• Alexithymia moderated the association between depression on craving in dfferent ways according to gender (protective and risk factor).

Study selection criterions

• Period: 1990 to 2019.

• Type of studies: 12 longitudinal (until 6 months), 9 cross sectional.

• Type of assessments: All quantitative studies included self assessment (with satisfactory validity).

• Size and age of samples: 30 to 362 subjects, 18 to 66 years old.

• Type of substances: Alcohol (n=9), Tobacco (n=9), Opioids (n=5), Cannabis (n=2), Methamphetamine (n=1), Benzodiazepine (n=1).

Conclusions

• This systematic review supports the role of affective individual differences in reactivity to craving among substance dependence.

• Overall, a strong association between affective disturbances (depression, anxiety) and craving was found including mediating or moderating effects of personality and level of positive affectivity despite of little data on negative affectivity like a trait.

• There is a lack of consideration on the thymic-dependent role of alexithymia in craving whereas it’s strong association with depression has been demonstrated for substance use disorders (Thorberg et al., 2009).

• Future researches should included longitudinal design to determine directional pathways from affectivity to craving and clarify

its moderating and/or mediating effects according to substances types.