Cue-induced craving among inhalant users: Development and preliminary validation of a visual cue paradigm

摘要

Highlights ? First study to investigate cue reactivity among a sample of adolescent inhalant users. ? First study to develop a valid inhalant cue picture paradigm for use in the fMRI study. ? Development of paradigm was done in a step-wise, systematic manner comprising of picture selection, time optimisation and validation. ? A 480s inhalant visual cue paradigm was developed, using 20 highest and 20 lowest craving cue- and neutral-pictures respectively. ? This paradigm may contribute to the future psychological and neurobiological research on inhalant cue reactivity. Abstract Introduction Cue-induced craving is known to be associated with a higher risk of relapse, wherein drug-specific cues become conditioned stimuli, eliciting conditioned responses. Cue-reactivity paradigm are important tools to study psychological responses and functional neuroimaging changes. However, till date, there has been no specific study or a validated paradigm for inhalant cue-induced craving research. The study aimed to develop and validate visual cue stimulus for inhalant cue-associated craving. Method The first step ( picture selection ) involved screening and careful selection of 30 cue- and 30 neutral-pictures based on their relevance for naturalistic settings. In the second step ( time optimization ), a random selection of ten cue-pictures each was presented for 4s, 6s, and 8s to seven adolescent male inhalant users, and pre-post craving response was compared using a Visual Analogue Scale(VAS) for each of the picture and time. In the third step ( validation ), craving response for each of 30 cue- and 30 neutral-pictures were analysed among 20 adolescent inhalant users. Results Findings revealed a significant difference in before and after craving response for the cue-pictures, but not neutral-pictures. Using ROC-curve, pictures were arranged in order of craving intensity. Finally, 20 best cue- and 20 neutral-pictures were used for the development of a 480s visual cue paradigm. Conclusion This is the first study to systematically develop an inhalant cue picture paradigm which can be used as a tool to examine cue induced craving in neurobiological studies. Further research, including its further validation in larger study and diverse samples, is required.