title: Changes on the Modulation of the Startle Reflex in Alcohol-Dependent Patients after 12 Weeks of a Cognitive-Behavioral Intervention.
abstract: OBJECTIVE
  Little is known about changes in the modulation of the startle reflex when patients go through an alcohol-dependence treatment in an outpatient facility. In the current study, the affective modulation of the cue-related startle reflex has been used to evaluate changes in the emotional processing of alcohol-related stimuli that occurred after a standard cognitive-behavioral intervention, and to assess the outcome of this intervention. We hypothesized a 'normalization' of the startle inhibition for the alcohol-related cues during the period of treatment. We also assumed that higher startle inhibition at baseline elicited by alcohol cues would predict the relapse on alcohol consumption during treatment.
  
  
  METHODS
  A total of 98 alcohol-dependent subjects were included who fulfilled DSM-IV criteria for alcohol dependence. A control group of 72 subjects was selected to match demographic characteristics.
  
  
  METHODS
  All patients received a standard cognitive-behavioral therapy once a week throughout the study period.
  
  
  RESULTS
  Results show that the startle response differed significantly after 12 weeks of treatment for alcohol-related, neutral and aversive stimuli between alcohol-dependent patients and controls. Low startle responses at baseline to alcohol cues predicted relapse.
  
  
  CONCLUSIONS
  These results may indicate that the startle reflex is referred to enduring and permanent processes of cue reactivity, and that the emotional processing of alcohol-associated cues assessed with the affect-modulated startle reflex is less altered by interventions attempting to influence explicit cognitions. Furthermore, lower values of the baseline startle reflex elicited by alcohol-associated stimuli were associated with higher probability of relapse on alcohol use.
authors.affiliation: Department of Psychiatry, School of Medicine, Complutense University of Madrid, Madrid, Spain.
authors.forename: Rosa
authors.initials: R
authors.lastname: Jurado-Barba
authors.forename: Gabriel
authors.initials: G
authors.lastname: Rubio Valladolid
authors.forename: Isabel
authors.initials: I
authors.lastname: Martínez-Gras
authors.forename: María José
authors.initials: MJ
authors.lastname: Alvarez-Alonso
authors.forename: Guillermo
authors.initials: G
authors.lastname: Ponce Alfaro
authors.forename: Alberto
authors.initials: A
authors.lastname: Fernández
authors.forename: Stephan
authors.initials: S
authors.lastname: Moratti
authors.forename: Andreas
authors.initials: A
authors.lastname: Heinz
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Jimenez-Arriero
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000503:physiopathology / Q000628:therapy*; D016022:Case-Control Studies; D015928:Cognitive Behavioral Therapy; D003463:Cues; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests; D013216:Reflex, Startle; D011795:Surveys and Questionnaires; D016896:Treatment Outcome