Understanding changes in alcohol craving and affective symptoms following treatment entry is critical for developing risk profiles for relapse and developing personalized treatment alternatives. Indeed, understanding the trajectory of these constructs may allow greater diagnostic precision with a disorder that is extremely heterogeneous. The aim of this study was to describe the course of alcohol craving and affect (positive and negative) during the first month of recovery from alcohol dependence. We hypothesized that there would be subgroups of patients with high negative affect and high craving that would be associated with subsequent relapse, however, the study design did not prespecify the number of subgroups. The project took advantage of two treatment residential treatment programs where the use of alcohol and benzodiazepines is strictly prohibited during this time and thus reduces any confound from alcohol use during this critical period of recovery. In addition to studying the trajectories of each of these constructs, we sought to validate their importance by examining outcomes during the first 6 months of outpatient therapy. The study was conducted in middle aged and older adults to reduce confounds related to polysubstance dependence and because this cohort is under-represented in prior research.
