Transcranial Direct Current Stimulation for Food Craving in Women Affected by Overweight and Obesity: A Randomized Controlled Trial.

INTRODUCTION: Craving is a multifactorial behavior caused by central circuit imbalance. The proposed treatments involve exercise and reduced food intake. However, the treatments frequently fail. This study aimed to investigate the effect of 10 consecutive sessions of anodal transcranial direct current stimulation over the right dorsolateral prefrontal cortex on food craving and eating consumption of women affected by overweight and obesity. METHODS: A randomized double-blind controlled trial with 50 volunteers was divided into two groups (active-tDCS: n = 25 and sham-tDCS: n = 25). There were a total of 10 consecutive tDCS sessions (2 mA, for 20 min) with an F4 anodal-F3 cathodal montage. We evaluated the effects on eating behavior (food craving, uncontrolled eating, emotional eating, and cognitive restriction), food consumption (calories and macronutrients), and anthropometric and body composition variables (weight, body mass index, waist circumference, and body fat percentage). RESULTS: There were no statistically significant results between groups at the baseline regarding sociodemographic and clinical characteristics. Also, there was no significant interaction between time versus group for any of the variables studied. Treatment with tDCS was well tolerated and there were no serious adverse effects. CONCLUSIONS: In women affected by overweight and obesity with food cravings, 10 sessions of F4 (anodal) and F3 (cathodal) tDCS did not produce changes in eating behavior, food consumption, and anthropometric and body composition.

Validity of the Penn Alcohol Craving Scale (PACS) for the Adolescent Colombian Population.

INTRODUCTION: Addiction behaviors are primary contributors to mental health issues among adolescents, often utilized as coping mechanisms or emotional regulation tools. This study aimed to establish the content validity of the Penn Alcohol Craving Scale (PACS) for Colombian adolescents, recognized for its representation of the cognitive-emotional aspects of craving. METHODOLOGY: This quantitative research focused on instrument validation. Seven subject matter experts evaluated the scale in terms of pertinence, relevance, usefulness, sufficiency, clarity, and appearance. Data analysis was conducted using SPSS version 22, calculating internal consistency and the Content Validity Index. Qualitative feedback from experts was compiled in an Excel matrix, facilitating grammatical and semantic adjustments to the instrument. RESULTS: Cronbach's Alpha values for each item and the scale exceeded 0.8. Content Validity Index scores exceeded 0.7 in four out of five evaluated criteria. These results supported retaining all scale items in the Colombian version. CONCLUSIONS: The content validation process yielded an instrument that satisfied expert opinion regarding conceptual constructs and explanatory power for the Colombian adolescent population.

Is the Caloric Midpoint Associated with Food Cravings and Food Intake in Pregnant Women?

Objective: The field of chrononutrition suggests that mealtime can influence food intake. Previous studies have linked the caloric midpoint - defined as the time at which 50% of the daily energy is consumed - with different aspects of food consumption. However, its relationship with food craving remains unexplored. This cross-sectional study aimed to investigate the association between caloric midpoint, food craving, and food consumption in pregnant women.Methods: The study comprised 233 pregnant women classified as early eaters (caloric midpoint ≤ 1:00pm) and late eaters (caloric midpoint >1:00pm). Food craving were assessed using Food Craving Trait and State Questionnaires. Energy and nutrient intake, as well as mealtimes, were assessed using a 24-h food recall.Results: No association between caloric midpoint and food craving was found. However, late eaters consumed more calories (2039.47 kcal vs 1843.44 kcal; p < 0.001), carbohydrates (255.06 g vs 211.12 g; p = 0.002), total fat (73.1 g vs 64.8 g; p = 0.003), monounsaturated fat (21.33 mg vs 18.59 mg; p = 0.002) and saturated fat (24.37 mg vs 22.21 mh; p = 0.01) and had higher consumption of calories and macronutrients in the first (calories: 275.63 vs 213.41, p = 0.007; carbohydrate: 170.42 vs 142.54, p = 0.01; total fat: 56.49 vs 50.17, p = 0.04) and second (calories: 213.21 vs 151.59, p = 0.04; carbohydrate: 130.44 vs 96.6, p = 0.04; protein: 15.17 vs 13.71, p = 0.03) afternoon snack, dinner (calories: 576.89 vs 412.4, p < 0.001; carbohydrate: 230.76 vs 169.45, p < 0.001; protein: 80.48 vs 68.9, p = 0.02; total fat: 212.77 vs 147.12, p < 0.001) and late-night snack (calories: 135.75 vs 68.3, p = 0.04; total fat: 13.23 vs 22.45, p = 0.04) than early eaters.Conclusion: Pregnant women who concentrate their meals at later times consumed more calories, macro and micronutrients throughout the day and in the night meals when compared to early eaters.

Intense craving for eat: standardization of the Food Cravings Questionnaire-State in Mexico.

BACKGROUND: Food craving is an intense-compulsive response to eating highly appetizing foods. The Food Cravings Questionnaire-State (FCQ-S) is the most used instrument for its diagnosis. It is a multidimensional instrument, sensitive and adaptable to contextual and cultural changes. OBJECTIVE: To standardize the FCQ-S in the adult population of Mexico City. METHOD: Non-experimental, cross-sectional, at convenience design, with 1059 adults of both sexes, aged 18-84 years. It is highlighted that 71.9% of the participants were women. RESULTS: A reliability coefficient of 0.95 was obtained, the correlations between the items were from r = 0.598 to r = 0.793. With the exploratory factorial analysis, an MKO of sampling adequacy of 0.943 was obtained, and with the Bartlett sphericity test a p = 0.000. The factors explain 78.61% of the total variation of the data. The RMSEA was 0.068, which indicates an acceptable fit. The CFI was 0.974, considered good, and NNFI was 0.969, good fit. The correlations ranged from p < 0.05 to p < 0.01, showing a connection between the different dimensions. CONCLUSIONS: The FCQ-S is valid and adaptable in the Mexican population.

ANTECEDENTES: El food craving es un deseo intenso y compulsivo de comer alimentos altamente apetecibles. El Food Cravings Questionnaire-State (FCQ-S) es el instrumento más utilizado para su diagnóstico. Es un instrumento multidimensional, sensible y adaptable a cambios contextuales y culturales. OBJETIVO: estandarizar el FCQ-S en población adulta de la Ciudad de México. MÉTODO: Diseño no experimental, transversal y a conveniencia por método de bola de nieve, con 1059 adultos ambos sexos y de 18-84 años. Se destaca que el 71.9% de los participantes fueron mujeres. RESULTADOS: Se obtuvo un coeficiente de fiabilidad de 0.95 y las correlaciones entre los ítems fueron de r = 0.598 a r = 0.793. Con el análisis factorial exploratorio se obtuvo una MKO de adecuación de muestreo de 0.943, y con la prueba de esfericidad de Bartlett una p = 0.000. Los factores explican el 78.61% de la variación total de los datos. La RMSEA fue 0.068, lo cual indica ajuste aceptable. El CFI fue 0.974, considerado bueno, y el NNFI fue 0.969 (buen ajuste). Las correlaciones fueron de p < 0.05 a p < 0.01, lo que muestra una conexión entre las diferentes dimensiones. CONCLUSIONES: El FCQ-S es válido y adaptable en población mexicana.

[Food cravings and aversions in pregnant women in the Buenos Aires Conurban, Argentina]. / Antojos y aversiones alimentarias en gestantes del Conurbano Bonaerense, Argentina.

INTRODUCTION: Pregnant women often experience food aversions and cravings, of which little is known about their characteristics and consequences. The objective was to know the prevalence of food cravings and aversions, the characteristics of the pattern of foods that are craved or avoided, and the reasons behind their presence. METHODS: Observational, descriptive and cross-sectional study. A validated questionnaire was applied to 370 pregnant and postpartum women in public hospitals. Maternal and neonatal variables were measured with descriptive statistics and those associated with the phenomena under study were identified using logistic regression models and cluster analysis using the multivariate technique. RESULTS: A presence of cravings from 71 to 80% and aversions from 55 to 65% was detected. The most craved foods were fruits and sweet foods and the most avoided meats and mate. The maternal characteristics predictive of cravings were: being younger (OR 0.94), vomiting (OR 2.23), and having gained more weight than expected were negatively associated with the presence of cravings (OR 0.44). The variables associated with the aversions were the absence of a history of hypertension (OR 0.13), a history of macrosomia (OR 2.70), nausea (OR 1.86) and complications during pregnancy (OR 2.23). DISCUSSION: This work allowed to characterize food cravings and aversions during pregnancy and to know their high frequency.

Introducción: Las gestantes suelen experimentar aversiones y antojos alimentarios, de los cuales se conocen poco sus características y consecuencias. El objetivo fue conocer la prevalencia de los antojos y aversiones alimentarias, las características del patrón de alimentos que son antojados o evitados y los motivos que subyacen ante su presencia. Métodos: Estudio observacional, descriptivo y transversal. Un cuestionario validado se aplicó a 370 embarazadas y puérperas en hospitales públicos. Las variables maternas y neonatales se midieron con estadísticas descriptivas y se identificaron aquellas asociadas a los fenómenos en estudio empleando modelos de regresión logística y un análisis por clusters utilizando la técnica multivariante. Resultados: Se detectó una presencia de antojos del 71 al 80% y de aversiones del 55 al 65%. Los alimentos más antojados fueron las frutas y los alimentos dulces y los mayormente rechazados las carnes y el mate. Las características maternas predictoras de antojos fueron: tener menor edad (OR 0.94), vómitos (OR 2.23), y el haber ganado más peso de lo esperado se asoció negativamente con la presencia de antojos (OR 0.44). Las variables asociadas a las aversiones fueron la ausencia de antecedentes de hipertensión (OR 0.13), antecedentes de macrosomía (OR 2.70), náuseas (OR 1.86) y complicaciones durante el embarazo (OR 2.23). Discusión: Este trabajó permitió caracterizar los antojos y aversiones alimentarias durante el embarazo y conocer su elevada frecuencia.

A Systematic Review of Eye-Tracking Studies of Gambling-Related Attentional Biases.

Previous research has identified attentional biases towards addiction-related stimuli, including gambling-related stimuli. Eye-tracking is considered the gold standard methodology for measuring attentional biases, yet no review to date has examined its use in measuring gambling-related attentional biases. This systematic review synthesized the literature using eye-tracking to examine attentional biases among people who gamble. We reviewed articles from Web of Science and PubMed that were published from 1990 to 2021. A total of 11 articles were included, with sample sizes ranging from 38 to 173 participants. Of these studies, seven examined attentional biases for gambling-related visual stimuli. These seven studies provided support that gambling can result in the development of an attentional bias for gambling-related stimuli. With respect to correlates of gambling-related attentional biases, there were mixed results. Some studies identified significant positive associations between gambling-related attentional biases and psychosocial variables, such as problem gambling severity, gambling expectancies, gambling cravings, gambling motives, depressive symptom severity, alcohol use severity, daily stress, affective impulsivity, and immersion. Four studies examined attentional biases for responsible gambling messaging and advertisements, finding that both people who do and do not gamble attend less to responsible gambling messaging compared to other types of information such as the betting odds. Research using eye-tracking to examine attentional biases among people who gamble is in its infancy. Yet, the preliminary results support the identification of attentional biases using the gold-standard methodology. Further studies are needed to examine the correlates and potential clinical utility of assessing gambling-related attentional biases using eye-tracking.

Exploring the pathways from the power of food to food cravings in a sample of Brazilian young adults.

The present study has three main objectives: a) to analyse, for the first time, the factor structure of the Control of Eating Questionnaire (CoEQ) in a Brazilian sample; b) to explore, through in-depth interviews, motivators and consequences of food cravings among participants with high scores on the CoEQ; and c) to analyse whether and how the power of food is related to food cravings. The study involved 335 young adults aged 18-30 years, balanced for sex. The CoEQ and the Power of Food Scale (PFS) were used in an online survey. The CoEQ and PFS were subjected to confirmatory factor analysis. Semi-structured interviews were also conducted with a subsample (n = 20) with high CoEQ scores. The Socratic questioning method was used for the interviews. The interviews were transcribed and analysed according to thematic content analysis. The PFS and the CoEQ showed adequate factor structure with reliable factors. The results of the qualitative analysis showed that both food availability and seeking relief from stressors serve as motives for food cravings. Concern for health and weight gain were cited as consequences of cravings, as was seeking distraction to cope with these cravings. It was found that the PFS aggregate factor was a significant influencing factor for craving control (ß = 0.604; p < 0.001), craving for savoury (ß = 0.382; p < 0.001), craving for sweet (ß = 0.414; p < 0.001) and positive mood (ß = -0.198; p < 0.001). The findings suggest that the relationship between food cravings and the power of food is significant in today's obesogenic environment.

Unravelling the landscape of Cannabis craving pharmacological treatments: a PRISMA-guided review of evidence.

Currently, few treatments are available for craving in general, and none of them have received approval for cannabis craving. The objective of this review is to evaluate existing studies analysing treatments for cannabis craving and explore novel treatment possibilities for these patients. The study followed PRISMA guidelines and conducted an extensive database search. Inclusion criteria included human randomised controlled trials examining drug effects on craving symptoms. Exclusion criteria involved studies unrelated to craving, non-pharmacological treatments, duplicates, and non-English/Spanish/Portuguese articles. Our included 22 studies that investigated a wide range of compounds used for cravings related to other drugs, as well as interventions based on healthcare professionals' empirical knowledge. The current pharmacological treatments largely involve off-label drug use and the utilisation of cannabinoid-based medications, such as combinations of THC and lofexidine, oxytocin, progesterone, and N-acetylcysteine. These emerging treatments show promise and have the potential to revolutionise current clinical practices, but further investigation is needed to establish their efficacy. In this context, it is essential to consider non-pharmacological interventions, such as psychotherapy and behavioural treatments. These approaches play a crucial role in complementing pharmacological interventions and addressing the complex nature of the disorder.

Impulsividade, fissura e comportamentos sexuais de risco em usuários de cocaína / Impulsivity, craving and risky sexual behavior in cocaine users

O estudo teve por objetivo avaliar as possíveis relações entre impulsividade, fissura e comportamentos sexuais de risco entre usuários de cocaína. Trata-se de um estudo transversal, de abordagem quantitativa. A amostra foi composta por 80 indivíduos acolhidos em duas Comunidades Terapêuticas (CTs). Os instrumentos utilizados foram: Informações sociodemográficas, Escala de Impulsividade de Barrat (BIS-11); o Crack Craving Questionnaire - Brief (CCQB) e Questionário sobre uso de substâncias e comportamentos sexuais (SUSBS). Da amostra, todos eram do sexo masculino adultos, com baixas condições socioeconômicas, acolhidos há mais de um mês, usuários crônicos de múltiplas drogas, sendo as mais usadas: o álcool, a maconha, a cocaína e o crack. Os participantes foram classificados como altamente impulsivos (33,3%), com nível grave de fissura (67,9%), perda o controle sobre o uso de substância (70,5%), metade usava drogas para melhorar o desempenho sexual, 45% concordaram que o uso era para favorecer a atividade sexual e 43% consideram o sexo indissociável do uso de substâncias. A fissura (CQB-B) foi associada com a impulsividade, mas não com o tipo de substância usada. Os resultados mostram a importância compreender e avaliar os entrelaces entre impulsividade, fissura e comportamentos sexuais entre usuários de substâncias psicoativas, assim como ir além da investigação desses problemas, com intuito de melhorar as práticas preventivas para os comportamentos sexuais de risco nas CTs

The study aimed to evaluate the associations between impulsivity, craving, and risky sexual behaviors among cocaine users. This is a cross-sectional study, with a quantitative approach. The sample consisted of 80 individuals hosted in two Therapeutic Communities in the region of Ribeirão Preto, SP. Sociodemographic information, the Barrat Impulsivity Scale (BIS-11); the Crack Craving Questionnaire - Brief (CCQ-B) and, the Substance Use and Sexual Risk Behavior Questionnaire (SUSBS) were used. Of the sample, all were adult males, with low socioeconomic conditions, housed for more than a month, chronic users of multiple drugs, the most used being: alcohol, marijuana, cocaine and crack. Participants were classified as highly impulsive (33.3%), with a severe level of craving (67.9%), loss of control over substance use (70.5%), half used drugs to improve sexual performance, 45% agreed that use was to promote sexual activity and 43% considered sex to be inseparable from substance use. Craving (CCQBB) was associated with impulsivity, but not with the type of substance used. The results show the importance of understanding and evaluating the links between impulsivity, craving and sexual behaviors among users of psychoactive substances, as well as going beyond investigating these problems, with the aim of improving preventive practices for risky sexual behaviors in TCs

Dental treatment before surgery in a patient with cleft lip and palate: case report / Efeito do Cissus quadrangularis na cicatrização de fraturas em animais de laboratório

Introduction: orofacial clefts are common congenital malformations with an important social, psychological, and economic impact. The treatment of this condition may include different surgical procedures that previously require an adequate oral condition. Case report: we report a case of dental treatment before palatoplasty in a male patient of 17 years-old with bilateral cleft lip and palate and lesion in the jugal mucosa. Final considerations: the adequacy of the oral environment is a fundamental step in the treatment of patients with orofacial clefts and aims to restore oral health regardless of the degree of complexity of the dental treatment through the reduction of the pathogenic microbiota, elimination of retentive niches, instructions on diet and adequate oral hygiene and constant patient motivation.

Objetivos: as fissuras orofaciais são malformações congênitas comuns, com importante impacto social, psicológico e econômico. O tratamento dessa condição pode incluir vários procedimentos cirúrgicos que requerem previamente uma adequada condição bucal. Relato de caso: Relatamos o caso de tratamento odontológico prévio a palatoplastia em um paciente do gênero masculino de 17 anos de idade, com fissura transforame incisivo bilateral e lesão em mucosa jugal. Considerações finais: A adequação do meio bucal é uma etapa fundamental no tratamento de pacientes com fissuras orofaciais e visa restabelecer a saúde bucal independente do grau de complexidade do tratamento odontológico por meio da redução da microbiota patogênica, eliminação de nichos retentivos, orientações sobre dieta e higiene bucal adequada e motivação constante do paciente.

The body asks and the mind judges: the episode of food craving, its triggers and nutritional treatment.

Food desires are defined as motivations that drive the search for and consumption of food. However, when domains of intensity and urgency are activated, these desires can become intense (i.e. food craving), being then characterized by episodes or cognitive events loaded with affectivity, in which food is associated with obtaining pleasure or relief, which is the only attentional focus. Specificity and urgency mark the differentiation between food desires and cravings. The process of elaboration with vivid images, the retention in working memory, the emergence of a negative affect state (awareness of the lack), and a committed attentional focus to seek food are characterized as stages of an episode of food craving. Individuals with eating disorders have the lowest levels of food craving when it comes to anorexia nervosa and the subsequent increase to bulimia nervosa and binge eating disorder. Some environmental and cultural triggers and internal factors of cognition and emotions play a crucial role in the emergence of food craving episodes. The external factors include positive/negative events, food environment, advertisements, cultural beliefs about food, specific locations, and food itself. The internal factors comprise dietary restriction, food reward, impulsivity/inflexibility, emotions, thoughts and feelings about food, hunger/satiety/appetite, and anxious/depressive symptoms. Treatment involves the association of flexibility, awareness, and questioning strategies about dietary practices based on three principles: unconditional permission to eat, eating more for physical than emotional reasons, and tuning in with the body's signs of hunger and satiety (intuitive eating).

Craving for carbs: food craving and disordered eating in low-carb dieters and its association with intermittent fasting.

Studies point to positive outcomes in a diet with reduction of carbohydrates and that the associated practice of intermittent fasting (IF) might increase weight loss. Although dieting might be related to disordered eating, little evidence is available about the role of restrictive carbohydrates diets on disordered eating. This study aimed to explore if doing low-carb (LC) diets was related to disordered eating and if IF would increase these symptoms. The sample comprised university students (n = 682), with a mean age of 22 years old and average BMI of 23.6 kg/m2 (SD = 4.3). Twenty-seven percent (n = 188) of respondents reported doing LC diet in the last three months. Of those, 31% (n = 58) reported doing LC diet combined with periods of IF. Mean scores were compared using parametric tests, and effects size and correlations between variables were calculated. Dieters showed higher levels of binge eating, food cravings, cognitive restraint, cognitive restraint toward carbohydrates when compared to non-dieters. The association of LC and IF was related to an increase in disordered eating, especially binge eating and food cravings, specifically 'Lack of control', 'Thoughts or preoccupation with food,' and 'Guilt from cravings and/or for giving in to them'. These results provide evidence that restrictive carbohydrate diets and IF may increase cognitive restraint and, consequently, food cravings.Level III: Evidence obtained from cohort or case-control analytic studies.

Macrostomia congênita associada à microtia unilateral: um Relato de Caso / Congenital macrostomia associated with unilateral microtia: a case report

A macrostomia congênita, também denominada fissura facial transversa, horizontal ou lateral, constitui 1,5% de todas as fissuras. A expressão clínica variável envolve desde uma forma discreta até casos graves com malformações desfigurantes. Deformidades da orelha externa podem estar presentes, desde excesso de pele até ausência do pavilhão. A macrostomia congênita deve ser submetida a uma investigação sistemática clínica e de imagem para definir o âmbito das anomalias, uma vez que a doença é rara, complexa e manifesta-se fenotipicamente de maneiras distintas. Este presente artigo relata um caso de macrostomia congênita associada à microtia unilateral.

Congenital macrostomia, also called transverse, horizontal, or lateral facial cleft, constitutes 1.5% of all clefts. The variable clinical expression ranges from mild to severe cases with disfiguring malformations. External ear deformities can be present, from excess skin to the absence of the pinna. Congenital macrostomia must be submitted to a systematic clinical and imaging investigation to define the scope of the anomalies, since the disease is rare, complex and manifests itself phenotypically in different ways. This article reports a case of congenital macrostomia associated with unilateral microtia.

Cannabidiol for the treatment of crack-cocaine craving: an exploratory double-blind study

Objective: To assess the efficacy of cannabidiol (CBD) in the management of crack-cocaine craving and the treatment of frequent withdrawal symptoms. Methods: Thirty-one men with a diagnosis of crack-cocaine dependence were enrolled in a randomized, double-blind, placebo-controlled trial. We applied neuropsychological tests and assessed craving intensity, anxiety and depression symptoms, and substance use patterns at baseline and at the end of the trial. The participants were treated with CBD 300 mg/day or placebo for 10 days. During this period, we used a technique to induce craving and assessed the intensity of symptoms before and after the induction procedure. Results: Craving levels reduced significantly over the 10 days of the trial, although no differences were found between the CBD and placebo groups. Craving induction was successful in both groups, with no significant differences between them. Indicators of anxiety, depression, and sleep alterations before and after treatment also did not differ across groups. Conclusion: Under the conditions of this trial, CBD was unable to interfere with symptoms of crack-cocaine withdrawal. Further studies with larger outpatient samples involving different doses and treatment periods would be desirable and timely to elucidate the potential of CBD to induce reductions in crack-cocaine self-administration.

Association between alcohol and crack: Prevalence, effects, associated factors and experiences of combined use.

OBJECTIVE: To estimate the prevalence and factors associated with the effect of alcohol on crack cocaine use and to analyze experiences related to combined use. Materials and methods: sequential mixed methods (qualitative and quantitative) research, carried out between August 2014 and August 2015 with people who use crack. In the quantitative approach, a cross-sectional study was conducted with 1,062 participants. Factors associated with "alcohol use with the effect of increasing the effect of crack/crack craving" were estimated by multiple regression. In the qualitative approach, 39 interviews were conducted using Bardin's content analysis technique. RESULTS: 871 (82.0%) participants reported consuming alcohol, among them, 668 (76.7%) used alcohol combined with crack: 219 (32.8%) reported feeling an effect of reduction in paranoia and/or crack craving and 384 (57.5%) reported feeling an increase in the effect of crack and in the craving to consume the drug. This relationship was also observed in the narratives of the people who use crack, with the possibility of a cyclic effect of consumption of the two substances. Those who related alcohol use to the effect of increasing crack craving (384) were more likely to use alcohol before crack (OR: 1.81; 95%CI: 1.13-2.89); to consume more than 20 stones daily (OR: 1.48; 95%CI: 1.01-2.16); to remain in abstinence from crack for less than one month (OR: 3.20; 95%CI: 1.91-5.35); to use dependence treatment services (OR: 1.85; 95%CI: 1.26-2.71); and to commit physical violence (OR:1.67; 95%CI:1.08-2.56). CONCLUSION: The findings of this study indicate that the modulation of the effect of alcohol use on crack cocaine depends on the moment when the drugs are consumed, and the use of alcohol before crack consumption is associated with characteristics that suggest a greater vulnerability to patterns of harmful crack use. Even though combined use is referred to as a way of reducing the negative effects of crack, the damage of this association may be greater than its possible benefits.

Cognitive restraint directed at carbohydrates in individuals on low-carb diet with binge eating: the role of guilt about food cravings.

OBJECTIVE: To evaluate whether the carbohydrate-restricted diet leads to higher levels of food cravings in individuals with binge eating. METHODS: A total of 146 individuals with binge eating participated in the Low-Carb Diet Group (n=48) and Control Group (n=98). The Binge Eating Scale, Hay's questionnaire, Food Cravings Questionnaire - Trait and State, Cognitive restraint subscale and its adapted version for the cognitive restraint toward carbohydrates, were used as measures. Parametric tests were used for comparison between groups (Student's t test), and Pearson's correlation test to verify correlations between variables of interest. RESULTS: No differences were found between groups with and without diet concerning the level of binge eating or food craving total score. The differences found were the higher levels of cognitive restraint (p=0.01), cognitive restraint for carbohydrates (p=0.01) and subscales of 'guilt about food craving' (p=0.04) in the Low-Carb Diet Group. CONCLUSION: Individuals with binge eating and a history of low-carb diet have greater cognitive restraint toward carbohydrates and association with altered eating attitudes (guilt about food craving).

A pilot randomized controlled trial of dialectical behavior therapy (DBT) for reducing craving and achieving cessation in patients with marijuana use disorder: feasibility, acceptability, and appropriateness.

OBJECTIVE: To conduct a pilot RCT investigating the feasibility, acceptability, and preliminary efficacy of dialectical behavioral therapy (DBT) for marijuana cessation and craving reduction. METHODS: Sixty-one patients with marijuana use disorder diagnoses were randomly assigned to a DBT group or a control group (psycho-education). Patients completed measures at pre-intervention, post-intervention, and at two-month follow-up. The Marijuana Craving Questionnaire (MCQ) and marijuana urine test kits were used to assess craving and abstinence respectively. RESULTS: The feasibility of DBT was significantly higher than control group feasibility. In the DBT 29/30 participants completed all sessions (96% retention) and 24/31 control group participants completed all sessions (77% retention) (χ2 = 4.95, p = 0.02). Moreover, 29/30 (96%) participants in the DBT group completed the two-month follow-up and 20/31 (64.5%) control group members completed the two-month follow-up (χ2 = 9.97, p = 0.002). The results showed that patients in the DBT group had significantly higher intervention acceptability rates (16.57 vs. 9.6) than those in the control group. This pattern was repeated for appropriateness rates (p < 0.05). The overall results for craving showed that there was no significant difference between the groups (F = 3.52, p > 0.05), although DBT showed a significant reduction in the "emotionality" subscale compared to the control group (F = 19.94, p < 0.05). To analyze cessation rates, DBT was compared to the control group at the posttest (46% vs. 16%) and follow-up (40% vs. 9.5%) and the results confirmed higher effectiveness in the DBT group for cessation (p < 0.05). Furthermore, among those who had lapsed, participants in the DBT group had fewer consumption days than those in the control group (p < 0.05). CONCLUSIONS: DBT showed feasibility, acceptability, and promising efficacy in terms of the marijuana cessation rate. CLINICAL TRIAL REGISTRATION: Thailand Registry of Clinical Trials, TCTR20200319007.

Interoception and alcohol addiction: Vagotomy induces long-lasting suppression of relapse-type behavior.

Drug addictions are chronic mental disorders characterized by compulsive drug seeking and drug use, despite their negative consequences. It is a priority to find therapeutic alternatives to prevent relapse, as there are still no treatments that can ensure abstinence. One of the neural systems implicated in the appearance of the states of discomfort that motivate relapse is the interoceptive system, which oversees our internal body states. However, less attention has been given to the peripheral components of the interoceptive system and their role in addictions. Within these pathways, the vagus nerve represents one of the main visceral afferents of the interoceptive system. We hypothesized that the interruption of visceral afferent pathways would decrease the motivational effects of the drug, thereby either decreasing or preventing drug cravings. To test this idea, we used rats of a high-alcohol-drinking line and measured the effect that vagus nerve resection had on the relapse-like alcohol drinking, expressed as the alcohol deprivation effect, a phenomenon that has been linked to addiction-related events such as alcohol cravings. We found that even though vagotomy completely eliminates the effect of alcohol deprivation, it has no impact on water consumption or animal weight. These results give us valuable information about the relationship between the autonomic nervous system and alcohol use disorders and allow us to propose new clinical research that might have translational options.

Cannabidiol for the treatment of crack-cocaine craving: an exploratory double-blind study.

OBJECTIVE: To assess the efficacy of cannabidiol (CBD) in the management of crack-cocaine craving and the treatment of frequent withdrawal symptoms. METHODS: Thirty-one men with a diagnosis of crack-cocaine dependence were enrolled in a randomized, double-blind, placebo-controlled trial. We applied neuropsychological tests and assessed craving intensity, anxiety and depression symptoms, and substance use patterns at baseline and at the end of the trial. The participants were treated with CBD 300 mg/day or placebo for 10 days. During this period, we used a technique to induce craving and assessed the intensity of symptoms before and after the induction procedure. RESULTS: Craving levels reduced significantly over the 10 days of the trial, although no differences were found between the CBD and placebo groups. Craving induction was successful in both groups, with no significant differences between them. Indicators of anxiety, depression, and sleep alterations before and after treatment also did not differ across groups. CONCLUSION: Under the conditions of this trial, CBD was unable to interfere with symptoms of crack-cocaine withdrawal. Further studies with larger outpatient samples involving different doses and treatment periods would be desirable and timely to elucidate the potential of CBD to induce reductions in crack-cocaine self-administration.