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A broad range of evidence indicates that negative affect is a key motivator and a major risk factor in the development and maintenance of dependence. Consequently, modern psychological therapies approaches seek to address this motivational process. Three therapeutic approaches that specifically aim to disrupt the relationship between negative affect and drug choice have been identified: Cognitive Behavioural Therapy (CBT), Mindfulness Based Interventions (MBIs) and Affect Regulation Therapy (ART0. However, the active ingredients of these interventions are poorly understood while at the same time these interventions are costly and often time consuming. Consequently, there is a need for brief, evidence-based interventions which isolates the active ingredient which targets negative mood-induced drug motivation that can easily be delivered in different settings. To this end, this thesis tested a range of ‘therapeutic’ manipulations for their capacity to abolish the effect of laboratory negative affect induction on measures of alcohol motivation. This thesis trialled three potential interventions inspired by CBT, MBIs and ART. A CBT inspired intervention which paired negative affect drinking triggers with adaptive strategies in undergraduate student drinkers showed no evidence of limiting stress-induced alcohol motivation. A brief negative affect focused functional imagery intervention in which participants paired their own personalised negative affect triggers and adaptive strategies did abolish stress-induced alcohol motivation in the laboratory and increased self-efficacy of control over negative affect drinking in hazardous student drinkers online over a 2-week period. To further isolate the active ingredients four experiments tested whether the core component of MBIs, breath counting would abolish negative affect alcohol motivation. In all four experiments, breath counting attenuated negative affect-induced alcohol choice and craving in hazardous community drinkers. However, our last study showed that the effects of breath counting on stress-induced alcohol motivation were not superior to that of a visual distraction task, suggesting that the therapeutic effects of breath counting may stem from cognitive load. These findings provide preliminary evidence for the efficacy of these interventions and would justify future trials to explore their clinical utility in modifying actual drinking or relapse outcomes. The potential of acute interventions to modify drinking in the natural environment is challenged by the broad spectrum of environmental stressors which hazardous drinkers are subjected to. |
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