Modeling Substance Use Relapse Based on Risky Decision Making, Attentional Bias, and Reward Sensitivity: with the Mediating Role of Craving: A Descriptive Study

Relapse of substance use with negative physical and psychosocial consequences has become a public health concern worldwide. The present study aimed to model the relapse of substance use based on risky decision making, attentional bias, and reward sensitivity with the mediating role of craving.

In this descriptive study, the statistical population included all men with substance use disorder (methamphetamine use) who were quitting in 2019 and had referred to addiction treatment camps in Ardabil. A sample of 172 of these individuals was selected by convenience sampling method and answered the questionnaires of relapse prediction, reward sensitivity, short scale craving, balloon analogue risk task (BART), and Dot-Probe test. Data were analyzed using structural equation modeling.

The results showed that the path coefficients of the risky decision making to craving (β=0.21, p=0.002) and relapse (β=0.30, p=0.001), attentional bias to craving (β=0.29, p=0.004), reward sensitivity to craving (β=0.15, p=0.041), and relapse (β=0.21, p=0.006) are significant in the model under review. But the path coefficients of attentional bias to relapse was not significant (β=0.14, p=113). Craving also mediated the relationship between risky decision-making, attentional bias, and reward sensitivity.

According to the results, risky decision making, attentional bias, reward sensitivity, and mediating role of craving can be used to predict the relapse of substance use. Therefore, it is suggested that addiction specialists use the results of the present study in their treatment programs and counseling.