Interventions to date have been minimally effective in reducing the rates of women gaining more weight than recommended by the Institute of Medicine in pregnancy. Food cravings are common in pregnancy, but their relationship, if any, with prenatal weight gain has received little attention in the literature. The purpose of this retrospective chart review study was to describe the frequency of cravings, associations between cravings and weight gain, and to determine what factors were predictive of reporting more cravings in pregnancy. A total of 1,259 charts were reviewed of women receiving care in an urban, community health center between 2006 and 2012. Women with healthy, singleton pregnancies were eligible to be included in the study. Of the 812 eligible women, 620 were excluded due to incomplete data. One-third of women in the sample (n = 194) were primiparous women. Their mean BMI was 28.3 (SD = 6.9). Almost 80% identified themselves as being Multi-Racial or African American. Cravings were reported by 75.3% of women in early pregnancy and 81.4% in late pregnancy. No differences in prenatal weight gain were seen between women with and without cravings. BMI, smoking, stress in early pregnancy, and emotional distress were not related to the numbers of cravings reported in pregnancy. The results of multiple regression analyses indicated that two predictors, age and stress in late pregnancy, accounted for 8.7% of the variance in the numbers of cravings reported in pregnancy (R² =.087, R² adjusted = .070, F (2, 108) = 5.14, p = .007). Younger age was associated with reporting a greater number of cravings, β = -.205, t (110) = -2.222, p =.028, as was higher stress in late pregnancy, β = .201, t (110) =2.184, p =.031. The findings of this study suggest that cravings are not related to prenatal weight gain, although the quality of this study was undermined by its small sample size and problems with the way cravings were measured. Developing a valid and reliable measure of cravings would be a fruitful next step.

Research on factors that predict opioid cravings is lacking. Anhedonia may be a predictor of cravings and particularly relevant to cravings when people struggle to regulate emotions but has yet to be examined among justice-involved populations. This study aimed to examine the relationship between anhedonia, opioid cravings, and emotion dysregulation (ED) in this population. Participants completed several measures. The results showed that anhedonia and opioid cravings were significantly related at the bivariate level, but not in moderation models. The DERS-36 total score and ‘DERS Impulse’ subscale had a significant, positive effect on cravings in moderation models. In a higher severity sample of people who used heroin, there was a significant interaction wherein the relationship between anhedonia and cravings was positive at high levels of difficulty controlling behaviors when distressed. These findings indicate the need to understand how anhedonia and ED influence opioid cravings among justice-involved people with severe heroin use.

No description available.

Purpose: Food cravings are common, more prevalent in the obese, and may differ in those who pursue surgical treatment for obesity. Food craving tools are most often validated in non-clinical, non-obese samples. Methods: In this retrospective study, 227 bariatric surgery candidates at a large medical center completed the Food Cravings Questionnaire-Trait (FCQ-T). The aim was to explore the factor structure of the FCQ-T. Results: Principal components analysis with varimax rotation revealed a seven-factor structure that explained 70.89 % of the variance. The seven factors were: (1) preoccupation with food, (2) emotional triggers, (3) environmental cues, (4) loss of control, (5) relief from negative emotions, (6) guilt, and (7) physiological response. The preoccupation with food factor accounted for 49.46 % of the variance in responses. Conclusions: Unlike other populations, food cravings in bariatric surgery candidates appear to be related most to preoccupations with food.

Purpose: The purpose of this study was to investigate the effect physical activity has on an attempt to quit smoking, and whether this effect varies over time and/or is mediated by other variables. Previous research has demonstrated that cravings to smoke are associated with higher odds of relapse, and that the strength of this effect increases throughout a quit attempt. A bout of physical activity has also been shown to reduce cravings to smoke. We hypothesized that physical activity would have a time-varying effect on smoking mediated by cravings to smoke. Methods: The Wisconsin Smokers Health study was a randomized, placebo-controlled trial of five smoking cessation therapies. Each day, participants measured their steps with a pedometer and used their cell phone to complete Ecological Momentary Assessments of their cravings to smoke. We analyzed data from 7-days prior to a target quit day through 7-days following quit day. Participants were grouped by their daily step count and considered “less active” if they averaged less than 10,000 steps per day. Results: We found evidence among less physically active smokers that 1,000 additional steps per day on the first 1-3 days of a quit period is associated with a lower odds of smoking relapse on those days. This effect remained significant after including covariates in subsequent models, as well as both the effects of cravings and negative affect on smoking. We were also able to replicate the previous finding in this dataset that the effect of cravings to smoke on smoking odds increases during the first week post-quit day as time from quit day increases. Despite our finding that steps per day was associated with lower relapse among inactive smokers, and that inactive smokers had higher cravings and higher relapse rates, our study did not yield evidence for our mediation hypothesis that steps per day would associate with lower cravings to smoke. Conclusion: These findings could be used to tailor smoking cessation interventions to people at high risk of relapse and failure to successfully quit. A bout of 1,000 steps is roughly a 15-minute walk. Encouraging this kind of behavior when cravings are high could lead to successful quitting for less active smokers. Future cessation research with a focus on framing physical exercise as a protective tool against smoking relapse could be valuable for creating more efficient interventions. / Public Health

No description available.

Many dieters and compulsive overeaters report that sugar and chocolate are the most commonly craved foods. Further, many individuals have proclaimed themselves to be "addicted" to sugar or chocolate. It remains unclear, however, what factors lead to report of specific food addictions. A number of researchers have suggested that highly repetitive consumption of sugar and chocolate may result from various physiological processes (e.g., neurochemical imbalances, glucose/insulin malfunctioning). However, there is also considerable evidence that psychosocial factors (i.e., expectancies, classical, and operant conditioning) play the major role in the development and maintenance of excessive sugar,chocolate intake. Empirical studies examining factors that underlie this behavior are almost nonexistent. Therefore, it is useful for researchers to explore perspectives about the causes of addictive or compulsive behavior. This study addressed the question, "Are adverse eating symptoms/outcomes for women who believe they are addicted to sugar or chocolate explained primarily by learning factors or by the key chemical constituents in these foods?" This study involved procedures that influenced subjects' perceptions and expectations about the sugar/chocolate content of a beverage (i.e., real chocolate, sugar versus synthetic substitute [placebo]) in a laboratory taste test situation. In an ABAB experimental design, self-avowed addict and control subjects were tested on four consecutive days receiving two chocolate/sugar (A) and two placebo (B) beverages. Changes in mood and food cravings were measured, as was an index of perceived eating dyscontrol following the consumption of beverages. In addition to establishing a baseline measure each day, subjects' mood and cravings were assessed immediately after consumption of chocolate or placebo as well as 45 minutes later. The responses (mood, food cravings, food intake) that occurred after exposure to drinks containing placebo or sugar/chocolate suggested that subjects do not always respond in the manner they purport to (e.g., increased cravings, mood improvement, subsequent overeating of treats). Other factors such as learning and conditioning may play a key role in accounting for their report of excessive behavior. Specifically, individuals who believe they are addicted to sugar or chocolate evidence similar responses and symptoms irrespective of wether they consumed a placebo versus sugar or chocolate.

No description available.

Rationale: Cigarette cravings are one of the most important clinical phenomena in tobacco addiction. A wide range of studies and research designs may help to increase understanding of the relationship between physical activity (PA) and cigarette cravings. Aims: (i) To investigate the acute effects of walking and isometric exercise on cigarette cravings, withdrawal, and attentional bias among temporarily abstaining smokers. (ii) To quantify the effects of short bouts of PA on cigarette cravings among temporarily abstaining smokers. (iii) To examine who most benefits from PA, whether changes in affect mediate these effects, and whether a specific attribute of PA is associated with cravings. (iv) To investigate whether any association between habitual PA and cravings in smokers could be found. Methods: A randomised controlled crossover trial with three arms addressed aim (i). A systematic review of literature and individual participant data meta-analysis using hierarchical modelling addressed aims (ii) and (iii). Aim (iv) was achieved by using linear regression modelling of cross-sectional data from a smoking cessation study. Results: No difference in cravings, withdrawal, and attentional bias between walking and isometric exercise versus control was found. Bouts of PA decreased cigarette cravings by approximately 30%. Moderate intensity PA provided increased benefit when compared with light intensity, whereas vigorous intensity did not confer additional benefits compared with moderate intensity PA. Also bouts of medium (10 minutes) and longer duration (≥15minutes) appeared to be more effective than short duration (≤ 5 min). No moderators and mediators of this association were identified. Habitual moderate intensity PA was the strongest predictor of cigarette cravings in smokers, MPSS was an additional predictor and alcohol consumption moderated the effects of habitual PA on cravings. Conclusion: Moderate intensity PA could be recommended to smokers to help decrease cigarette cravings.

Submitted by Maicon Juliano Schmidt (maicons) on 2015-07-14T13:42:06Z No. of bitstreams: 1 Iracil Rosinda Pires Soares.pdf: 5974329 bytes, checksum: ac4333b5efc51234ae48c04c15c79d7d (MD5) / Made available in DSpace on 2015-07-14T13:42:06Z (GMT). No. of bitstreams: 1 Iracil Rosinda Pires Soares.pdf: 5974329 bytes, checksum: ac4333b5efc51234ae48c04c15c79d7d (MD5) Previous issue date: 2014-01-31 / Nenhuma / A dependência de substâncias é um dos problemas mais graves e complexos de saúde pública, reconhecida mundialmente. A necessidade de desenvolvimento de tratamento é fundamental e deve levar em conta diferenças entre os sexos no que diz respeito à depressão e à ansiedade, à motivação para a mudança do comportamento problema e à fissura (craving) pelo crack. Para tal, conhecer as características e especificidades do dependente químico é essencial para o desenvolvimento de medidas efetivas de prevenção e intervenção. Esta dissertação de mestrado está organizada em dois artigos empíricos. O primeiro artigo apresenta os resultados do perfil sociodemográfico de homens e mulheres dependentes de crack internados para desintoxicação nos sistemas de saúde público e privado. Participaram 159 adultos (80 homens e 79 mulheres), com idades entre 18 e 60 anos, com média de 30,7 anos (DP=8,54). Dos participantes, 99 (62,3%) estavam internados em duas instituições públicas, e 60 (37,7%) em uma instituição privada, localizadas em Porto Alegre, RS, Brasil. A média de idade para a primeira situação de consumo de crack foi de 24 anos (DP=8,6). Os instrumentos utilizados foram uma entrevista sociodemográfica e padrão de consumo de substâncias psicoativas e o Mini International Neuropsychiatric Interview (M.I.N.I. Plus). Os resultados identificaram vulnerabilidades em ambos os sexos e em ambas as instituições, no presente estudo, nas seguintes variáveis: escolaridade, renda familiar, doenças diagnosticadas, uso de drogas lícitas e/ou ilícitas na família, motivos do consumo de crack, frequência do consumo de pedras de crack no início do uso e antes da internação, recursos para obtenção do crack, locais de tratamento, processo penal e ato infracional. Os dados indicam a importância de conhecer o perfil do dependente de crack, delineamento este que pode contribuir para o planejamento de programas preventivos em relação ao uso e abuso de substâncias psicoativas. O segundo artigo empírico teve como objetivo verificar os sintomas de ansiedade e depressão, avaliar a fissura pelo crack e identificar a motivação para mudança do comportamento, caracterizando as diferenças entre adultos do sexo feminino e masculino dependentes de crack internados para desintoxicação em instituições públicas e privadas. Os instrumentos utilizados foram o Inventário de Ansiedade de Beck (BAI), Inventário de Depressão de Beck (BDI-II), Cocaine Craving Questionnaire-Brief (CCQ-B) para o Crack, Escala URICA (University of Rhode Island Change Assessment) e Régua de Prontidão para Mudança. De acordo com os resultados, a amostra (N=159) apresentou sintomas de ansiedade moderada; sintomas de depressão mínima; fissura pelo crack moderada; encontrava-se no estágio de pré-contemplação e manutenção em relação à motivação para mudança do comportamento aditivo, no entanto, quando investigado o escore de prontidão para mudança, a amostra apresentou-se desmotivada em relação à mudança do comportamento, ao passo que, na Régua de Prontidão para a mudança mostrou vontade de mudar e confiança para alcançar a mudança. Observou-se uma frequência maior de casos graves de ansiedade no sistema público e maior frequência de mulheres com ansiedade grave no sistema público. Verificou-se que os principais preditores de prontidão para mudança (URICA) foram: em relação ao sexo, feminino; ao local de internação, instituição privada; e que não tenham vivenciado perdas significativas no decorrer da vida. Esses achados sugerem que o sexo tem relevante papel na dependência química, visto que apresentaram diferenças estatisticamente significativas no que se refere à ansiedade e à motivação para mudança do comportamento. Estes resultados confirmam a necessidade de mais pesquisas envolvendo as questões investigativas entre homens e mulheres na dependência de crack e outras substâncias psicoativas. / Substance dependence is recognized as one of the most serious and complex public health problems worldwide. The need to develop treatment is essential and must take into account the differences between sexes when concerning depression and anxiety, motivation to change problem behavior and craving for crack. To this end, it is essential to identify the characteristics and specificities of the chemically dependent in order to develop effective prevention and intervention measures. This dissertation is organized in two empirical articles. The first article presents the results of the demographic profile of men and women addicted to crack hospitalized for detoxification in public and private health systems. Participated 159 adults (80 men and 79 women), aged between 18 and 60 years, mean age of 30.7 years (SD=8.54). Of the participants, 99 (62.3%) were hospitalized in two public institutions, and 60 (37.7%) in a private institution located in Porto Alegre, RS, Brazil. The average age for the first situation of crack consumption was 24 years (SD=8.6). The instruments used were a sociodemographic interview and pattern of psychoactive substance use and the Mini International Neuropsychiatric Interview (M.I.N.I. Plus). The results identified, in the present study, vulnerabilities in both sexes and at both institutions in the following variables: education, family income, diagnosed diseases, use of licit and/or illicit drugs in the family, reasons for crack consumption, frequency of consumption of crack rocks at the beginning of use and before hospitalization, resources for obtaining crack, treatment settings (rehabilitation centers, inpatient settings), criminal prosecution and offense. The data indicate the importance of knowing the profile of the crack dependent for this can contribute to the planning of preventive programs regarding the use and abuse of psychoactive substances. The second empirical article aimed to verify the anxiety and depression symptoms, assess the craving for crack and identify the motivation for behavior change, characterizing the differences between male and female crack dependent adults admitted for detoxification in public and private institutions. The instruments used were the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), Cocaine Craving Questionnaire-Brief (CCQ-B) for Crack, Scale URICA (University of Rhode Island Change Assessment) and The Readiness-to-Change ruler. According to the results, the sample (N=159) presented moderate symptoms of anxiety; minimal symptoms of depression; moderate craving for crack; it was found on the stage of contemplation and action regarding the motivation to change the addictive behavior, however, when the score of readiness to change was inquired, the sample was unmotivated 18 regarding behavior change, whereas The Readiness-to-Change ruler showed willingness to change and confidence to achieve change. We observed a higher frequency of severe cases of anxiety in the public system and increased frequency of women with severe anxiety in the public system. It was verified that the main predictors of readiness to change (RTC) were in relation to sex, female; the place of addmition, private institution; and who have not experienced significant losses throughout life. These findings suggest that sex plays an important role in chemical dependency, since they showed statistically significant differences with respect to anxiety and motivation to change behavior. These results confirm the need for more research involving investigative issues between male and female in crack dependence and other psychoactive substances.