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Cue-elicited heart rate variability and attentional bias predict alcohol relapse following treatment

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Abstract

Rationale

Identification of malleable neurocognitive predictors of relapse among alcohol-dependent individuals is important for the optimization of health care delivery and clinical services.

Objectives

Given that alcohol cue-reactivity can predict relapse, we evaluated cue-elicited high-frequency heart rate variability (HFHRV) and alcohol attentional bias (AB) as potential relapse risk indices.

Method

Alcohol-dependent patients in long-term residential treatment who had participated in mindfulness-oriented therapy or an addiction support group completed a spatial cueing task as a measure of alcohol AB and an affect-modulated alcohol cue-reactivity protocol while HFHRV was assessed.

Results

Post-treatment HFHRV cue-reactivity and alcohol AB significantly predicted the occurrence and timing of relapse by 6-month follow-up, independent of treatment condition and after controlling for alcohol dependence severity. Alcohol-dependent patients who relapsed exhibited a significantly greater HFHRV reactivity to stress-primed alcohol cues than patients who did not relapse.

Conclusions

Cue-elicited HFHRV and alcohol AB can presage relapse and may therefore hold promise as prognostic indicators in clinical settings.

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Notes

  1. Although the design of the study makes it impossible to totally separate the effects of alcohol AB and HFHRV stress cue-reactivity, we additionally tested the effects of HFHRV responses to stress alone (prior to presentation of the alcohol cues). In a multiple logistic regression model with pre-treatment AUDIT scores, treatment group condition (MORE vs. ASG), post-treatment alcohol AB, and post-treatment HFHRV stress cue-reactivity, alcohol AB did not significantly predict the odds of relapse over the 6-month follow-up. HFHRV reactivity to stress cues was a marginally significant predictor of relapse, OR = 0.90 (95% CI = .81, 1.00), p = 0.06.

  2. Again, in order to test the effects of HFHRV responses to stress alone (prior to presentation of the alcohol cues), we conducted an additional Cox proportional hazards model with treatment condition, pre-treatment AUDIT scores, post-treatment alcohol AB, and post-treatment HFHRV stress cue-reactivity did not significantly predict the occurrence and timing of relapse, χ 2 = 9.01, df = 4, p = 0.06. While the other variables in the model did not significantly predict the rate and timing of relapse, HFHRV reactivity to stress cues was a significant predictor, OR = 0.91 (95% CI = 0.83, 0.99), p = 0.04.

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Acknowledgments

The first author (E.L.G.) was supported in developing this manuscript by Grant Number R03DA032517-01 from the National Institute of Drug Abuse, Grant Number T32AT003378 from the National Center for Complementary and Alternative Medicine, a Francisco J. Varela Research Grant from the Mind and Life Institute, and a grant from the Florida State University Council on Research and Creativity.

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Authors and Affiliations

  1. College of Social Work, Trinity Institute for the Addictions, Florida State University, University Center, Building C, Tallahassee, FL, 32306-2570, USA

    Eric L. Garland

  2. Erasmus University Rotterdam, 3000 DR, Rotterdam, The Netherlands

    Ingmar H. A. Franken

  3. University of North Carolina, Chapel Hill, NC, 27599-3550, USA

    Matthew O. Howard

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  1. Eric L. Garland
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  2. Ingmar H. A. Franken
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  3. Matthew O. Howard
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Correspondence to Eric L. Garland.

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Garland, E.L., Franken, I.H.A. & Howard, M.O. Cue-elicited heart rate variability and attentional bias predict alcohol relapse following treatment. Psychopharmacology 222, 17–26 (2012). https://doi.org/10.1007/s00213-011-2618-4

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  • DOI: https://doi.org/10.1007/s00213-011-2618-4

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