Anxiety Disorders Clinical Trial
Official title:
The Measurement of Mood Variability and Sustained Attention in Women With Alcohol Dependence.
The purpose of this study is to measure daily mood changes and to find out whether these
mood changes are related to the ability to maintain attention on a task. Problems with mood
are more common among women however, the association between symptoms of alcohol abuse and
mood syndromes is inconsistent.
First we hypothesize that women with lifetime diagnoses of alcohol abuse will not
demonstrate higher symptoms of anxiety, depression, neuroticism and mood variability than
control groups. Second, that the severity of these symptoms will not correlate with
performance on measures of sustained attention.
Epidemiological and clinical studies show an association between symptoms of anxiety and
depression (mood) and alcohol abuse. However, the association between alcohol abuse and mood
syndromes is inconsistent. One problem is that mood syndromes tend to be poorly defined.
Also, researchers typically have relied on retrospective recall by patients to evaluate mood
symptoms.
Some of this evidence is that:
1. Most mood symptoms improve with withdrawal in inpatient alcoholism programs without
specific treatment of the mood disorder.
2. Family genetic studies have not shown cosegregation.
3. Psychiatric treatment of mood syndromes does not decrease alcohol use.
4. The self-treatment view has not been supported by controlled drinking studies.
To overcome this difficulty, we have recently developed a procedure to measure mood
variability while it is occurring. We ask participants to rate their moods twice a day on a
10 cm straight line anchored by the terms "not at all" and "very much so" (a visual analogue
scale) (VAS). There are 3 separate lines for “anxiety/tension”, “sadness/low mood” and “high
mood”. We then compute a quantitative measure of variability the "mean squared successive
difference statistic" (MSSD). Our earlier work found that this method identified greater
mood variability in individuals with anxiety disorders as compared to individuals without
anxiety disorders.
Our null hypotheses are:
1. That women with lifetime diagnoses of alcohol abuse will not demonstrate higher symptoms
of anxiety, depression, neuroticism and mood variability than control groups and;
1a. That the severity of these symptoms will not correlate with performance on measures of
sustained attention.
The MINI diagnostic interview will be used to derive DSM-IV diagnoses. This is a brief
semi-structured diagnostic interview that we have used previously. We have not used an
extensive interview schedule such as the SCID because we are not recruiting specific
diagnostic groups.
Participants will be asked to complete 4 scales as validators of the diary visual analogue
scales. These are:
1. The Beck Depression Inventory (BDI-II). This is the most widely used self- completed
depression questionnaire. It has 21 items, each has 4 choices.
2. The Spielberger Trait-State Self-Evaluation Questionnaire (STAI-T). This is a 20 item-
questionnaire, with answers on a 4-point scale. It is the most widely used trait
anxiety inventory.
3. The Mood Disorders Questionnaire. This is a recently developed but well researched
questionnaire to measure high mood. Sixteen questions are in a yes/no format.
4. 12 items from the Neuroticism Scale of the Eysenck Personality Inventory as modified by
Kendler. These items are answered yes/no.
Participants will be females, aged 18-50 years with diagnoses of alcohol abuse. Exclusion
criteria will be chronic medical, psychiatric or brain conditions that might affect mood
variability or test performance. Comorbid drug abuse will not be reason for exclusion.
Only females are included in this study because
1. The association between mood symptoms and substance abuse appears to be clearer in
women (In men, other characteristics such as impulsivity and antisocial traits are more
prominent).
2. We already have data on mood variability in predominantly female normal control
subjects from studies in the Department of Psychiatry at Royal University Hospital.
Participants will be tested in their 3rd and 4th weeks of the program, i.e. they will have
been free of alcohol and illicit drug consumption for 3 weeks. Use of other medication will
be noted but will not be an exclusion.
;
Observational Model: Defined Population, Time Perspective: Cross-Sectional
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