HomeEducationDoctorate (PhD & EngD)For current candidatesPhD infoUpcoming public defencesPhD Defence Erika van Lier | Monitoring alcohol craving in daily life - Theories and methods for intensive longitudinal psyco-physiological studies

PhD Defence Erika van Lier | Monitoring alcohol craving in daily life - Theories and methods for intensive longitudinal psyco-physiological studies

Monitoring alcohol craving in daily life - THEORIES AND METHODS FOR INTENSIVE LONGITUDINAL PSYCHO-PHYSIOLOGICAL STUDIES

The PhD defence of Erika van Lier will take place (partly) online and can be followed by a live stream.
Live stream

In this thesis, the extent was explored to which a solid basis can be provided for a monitoring system based on ambulatory, physiological measurements (e.g. heart rate), intensively self-reported psychological experiences (e.g. negative feelings) and contextual situations (e.g. an upcoming party), to prelude craving and (re)lapse in individuals attempting to recover from alcohol addiction. Since this was one of the first longitudinal repeated measures single case designs for alcohol craving with ecological momentary assessment (EMA) and the use of a wearable device in daily life, multiple preliminary studies were carried out prior to the final monitoring study. These studies addressed the following topics: to review the evidence on contextual and psychological variables predictive of craving moments; the validity of ambulant measures of electrodermal activity and cardio vascular activity of the wearable targeted; the feasibility, usability and burden of participating in a longitudinal EMA study with multiple questionnaires a day and possible stigmatization due to the wearable. The final study in this thesis was a longitudinal Intensive Repeated and Continuous Measures in Naturalistic Settings Case-study design of physiology, craving and lapses. Ten clients with alcohol use disorder were followed for 100 days during outpatient treatment. The association between physiology, craving and lapses was explored, as well as the possibility of improving the understanding between physiology and craving by accounting for contextual and psychological variables.

Key findings are that currently, multiple prerequisites to develop a longitudinal ambulatory monitoring system for craving in daily life are in place. Stress, Negative Affect and Positive Social situations are found evidence based context variable to increase the ecological validity of researching craving with an EMA design. Additionally, the E4 wearable is a valid device to measure heart rate (HR) and mean skin conductance level (SCL) in stress events. The device is not perceived as a burden, was usable and compliance was acceptable. However, alarming a person on physiology as replacement for subjective craving seems not viable as an ecological momentary intervention (EMI), meaning outside the lab, since physiology and craving do not co-occur in high enough frequencies over time in daily life.