Lieu : Centre Broca
Fuschia Serre
Sanpsy
Title
Craving in addiction: etiological, prognostic, physiological, and therapeutic exploration in daily life
Abstract
My research is dedicated to exploring the importance of craving (defined as an intense, persistent and involuntary desire to use) in addiction. This work benefited from the use of the EMA (Ecological Momentary Assessment) method in daily life, which enabled a more ecologically valid view at issues previously explored by retrospective methods, or by experimental studies conducted in the laboratory, in conditions that were often far from those in which the phenomena occur naturally (in real life).
Addiction is defined as a ‘use disorder’, and is characterized by an impaired control over use. Characterizing this dysfunction leads to explore the factors that ‘push’ an individual to use. My PhD thesis contributed to propose a simplified model of addiction in humans: the Cues-Craving-Use model. In this model, craving is proposed as the main cause of use in addiction, and as the main mediator of the influence of the environment on use. This model suggests that craving may be seen as a candidate ‘etiological’ marker of the dysregulation of the control over use.
My first research focus aimed to explore the validity of this model, by testing its external validity, i.e. how this model is applicable to other environments, to other populations or under different conditions. These results support the hypothesis that craving is a central and universal factor in triggering use across addiction types.
Beyond highlighting the predictive value of craving on use in the following hours, my work has also highlighted its prognostic value in the longer term. The results encourage to consider features of craving fluctuations as an individual characteristic, which could provide valuable early predictive information on changes in patient severity and their futures trajectories.
My third research focus is centered on a better characterization of craving at the physiological level and, in a particularly innovative way, through assessment in daily life. The results obtained are very promising in terms of the ability to identify a reliable and robust biomarker of craving. This line of research will also offer a gateway to explore the underlying pathophysiological mechanisms by matching the daily life data with fMRI data in humans and animal models data.
Finally, the willingness to translate this new knowledge into concrete, applicable solutions to help patients in daily life has led, in my fourth research focus, to the development of a smartphone app for treatment, which should contribute to reduce relapse. Importantly, the use of mobile technologies should make treatment more accessible to the large proportion of people with addiction who do not benefit from it. Ongoing and future research should enable to propose breakthrough innovations to this mHealth solution.
Selected publications
Serre, F., C. Gauld, et al. (2024). « Predictors of substance use during treatment for addiction: A network analysis of ecological momentary assessment data » Addiction, DOI: 10.1111/add.16658
Serre, F., S. Moriceau, et al., (2023). « The Craving-Manager smartphone app designed to diagnose substance use/addictive disorders, and manage craving and individual predictors of relapse: a study protocol for a multicenter randomized controlled trial » Front Psychiatry 14: 1143167, DOI: 10.3389/fpsyt.2023.1143167
Serre, F., M. Fatseas, et al. (2018). « Predictors of craving and substance use among patients with alcohol, tobacco, cannabis or opiate addictions: Commonalities and specificities across substances » Addict Behav 83: 123-129, DOI: 10.1016/j.addbeh.2018.01.041
Fatseas, M., F. Serre, Jet al. (2015). « Craving and substance use among patients with alcohol, tobacco, cannabis or heroin addiction: a comparison of substance-specific and person-specific cues » Addiction 110(6): 1035-1042, DOI: 10.1111/add.12882
Serre, F., M. Fatseas, et al. (2012). « Ecological momentary assessment in alcohol, tobacco, cannabis and opiate dependence: A comparison of feasibility and validity » Drug Alcohol Depend 126(1-2): 118-123, DOI: 10.1016/j.drugalcdep.2012.04.025
Jury
- Mr AURIACOMBE, Marc – Professeur – Univ. Bordeaux – Garant
- Mme CHILDRESS, Anna-Rose – Professeure – Univ. Pennsylvania – Rapportrice
- Mme CHALLET-BOUJU, Gaëlle – Ing. de Recherche – Univ. Nantes – Rapportrice
- Mr BENYAMINA, Amine – Professeur – Univ. Paris-Saclay – Rapporteur
- Mme CHANRAUD, Sandra – Ens.- Chercheuse – Univ. Bordeaux – Examinatrice
- Mme ROUX, Perrine – Dir. de recherche – Univ. Aix-Marseille – Examinatrice
- Mr AHMED, Serge – Dir. de recherche – Univ. Bordeaux – Examinateur