Cognitive Regulation of Craving in Alcohol‐Dependent and Social Drinkers

Abstract

Background Helping alcohol dependent individuals to cope with, or regulate, cue-induced craving using cognitive strategies is a therapeutic goal of cognitive behavioral therapy (CBT) for alcohol dependence. An assumption that underlies this approach is that alcohol dependence is associated with deficits in such cognitive regulation abilities. To date, however, the ability to utilize such strategies for regulation of craving has never been tested in a laboratory setting. Methods Here we compared 19 non-treatment-seeking, alcohol dependent drinkers (AD) to 21 social drinkers (SD), using a laboratory task that measured the ability to reduce cue-induced alcohol craving by thinking about long-term negative consequences of drinking, which is a specific cognitive regulation strategy that is taught in CBT. The task also assessed the ability to reduce food craving elicited by high-calorie food cues using a similar strategy. Results The reduction in craving when using this cognitive regulation strategy was approximately double in SD, compared to AD, for both alcohol and food cues. Furthermore, in SD but not AD, the ability to regulate cue-induced alcohol craving was correlated with the ability to regulate food craving. There were no significant correlations found between the ability to regulate cue-induced alcohol craving and a number of self-report measures related to severity of alcohol dependence, baseline craving, impulsivity and general self-regulation ability, for either AD or SD. Conclusions The results suggest that alcohol dependence is associated with deficits in cognitive regulation of cue-induced craving, and that these deficits are not specific to the regulation of alcohol craving, but generalize to the regulation of other appetitive states, such as food craving. Future studies may use similar procedures to address the neural and cognitive processes that underlie such regulation deficits, as well as the effects of treatments such as CBT on these processes.

Feasibility and Acceptability of the ‘HABIT’ Group Programme for Comorbid Bipolar and Alcohol and Substance use Disorders

“…For example, functioning and quality of life in both BD and ASUD can be impaired by residual mood, anxiety and sleep symptoms (Judd et al, 2003;Gerra et al, 2014;Wang et al, 2014). These symptoms can be partially ameliorated by pharmacotherapy, but it is increasingly clear that psychological interventions, especially cognitive, behavioural or self-regulation approaches, may be more efficient (McMurrich et al, 2012;Naqvi et al, 2015;Strickland, Reynolds, & Stoops, 2016). Also, symptoms of BD and ASUD may all be precipitated or maintained by dysfunctional cognitive emotional regulation (CER), particularly a negative ruminative response style (Gruber et al, 2011;Caselli et al, 2013;de Silveira & Kauer-Sant'Anna, 2015;Grierson et al, 2016).…”

Craving mediates the effect of impulsivity on lapse-risk during alcohol use disorder treatment

“…This supports the present findings that craving mediates rash impulsiveness as the final path to lapse. One explanation for this mediational process is that patients high in rash impulsiveness have an impaired cognitive ability to inhibit craving cognitions 67,68 . A cognitive model of desire, Elaborated Intrusion (EI)…”

Baclofen modulates cardiovascular responses to appetitive cues in treatment‐seeking alcohol use disorder individuals

“…As alcohol shares several characteristics that are inherent to water, such as hydrating qualities and visual cues (Reid, Flammino, Starosta, Palamar, & Franck, 2006), this may explain the overall appetitive HF-HRV responses to associated cues linked to alcohol. Future studies implementing cue types that also elicit arousal (e.g., high-calorie food cues; Naqvi et al, 2015) may clarify whether responses are specific to alcohol or general appetitive arousal.…”