Comparison of three models of alcohol craving in young adults: a cross‐validation

Abstract

Approach and avoidance inclinations toward alcohol are separable constructs, and their activation may not be invariably reciprocal. Craving can be defined as the relative activation of substance-related response inclinations along these two primary dimensions. There may be a threshold of intensity that separates mild from intense approach inclinations.

Alcohol abuse and ERP components in Go/No-go tasks using alcohol-related stimuli: Impact of alcohol avoidance

“…The Approach and Avoidance of Alcohol Questionnaire (AAAQ, McEvoy et al, 2004) is a 14-item self-report questionnaire developed to assess the compulsive urge to drink alcohol and the avoidance towards alcohol. Participants had to indicate the extent to which they agreed or not with each item on a 9-point Likert scale ranging from "not at all" (0) to "very strongly" (8).…”

Reward Processing in Motivational and Affective Disorders

“…Subsequent studies employed the AAAQ with different populations of drinkers and performed factor analysis on participants' responses. Each of these studies confirmed that approach and avoidance represent distinct underlying factors, although some studies with alcohol dependent patients Schlauch et al, 2013c; but see Klein and Anker, 2013) identified a single underlying factor to approach inclinations rather than the qualitative distinction between mild and strong approach that was reported in the initial study (McEvoy et al, 2004). Many of these studies demonstrated that both approach and avoidance inclinations are independently associated with drinking-related variables.…”

“…According to the ambivalence model of craving (Breiner et al, 1999;McEvoy et al, 2004), the decision to consume alcohol is determined by the balance between motivational inclinations to indulge ("approach") and to abstain ("avoidance"). Approach and avoidance inclinations might arise from the desire for intoxication or the wish to keep a clear head for the next day, respectively.…”

“…Regarding controlled processes, the Approach and Avoidance of Alcohol Questionnaire (AAAQ; McEvoy et al, 2004) was developed to capture the strength of approach and avoidance inclinations for alcohol. The initial factor analysis of nondependent drinkers' responses on the AAAQ yielded three subscales, two representing approach inclinations (inclinedindulgent and obsessed-compelled subscales, corresponding to mild and strong inclinations, respectively), and one representing inclinations to avoid drinking alcohol (the resolved-regulated subscale).…”

“…Many of these studies demonstrated that both approach and avoidance inclinations are independently associated with drinking-related variables. For example, approach and avoidance inclinations account for unique variance in quantity and frequency indices of alcohol consumption in both non-dependent (McEvoy et al, 2004) and alcohol dependent drinkers. Approach and avoidance inclinations also have differential predictive validity in alcohol-dependent patients: following treatment, relapse to drinking is predicted by the strength of approach inclinations, but avoidance inclinations are not predictive (Schlauch et al, 2012;Klein and Anker, 2013; see also Schlauch et al, 2013c).…”