Convergence between the Penn Alcohol Craving Scale and diagnostic interview for the assessment of alcohol craving

Abstract

Introduction The Penn Alcohol Craving Scale (PACS) is one of the most widely used instruments to measure craving for alcohol. Recent research has suggested that scores on the PACS can be used as a “stand in” for the diagnostic criterion of alcohol craving with a proposed cutoff of >20 on the PACS indicating a “positive” alcohol craving symptom. The present study examined the convergence between the PACS and face-to-face diagnostic interview for the assessment of alcohol craving. Method A sample of non-treatment seeking heavy drinkers (N = 338) enrolled in experimental studies of AUD completed the PACS as well as a face-to-face diagnostic interview for AUD, which included the craving item from the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA). Results Using the PACS cut-off score of >20, 12.9% (N = 43) of the sample met criteria for alcohol craving compared to 21% (N = 74) of the sample meeting criteria based on the diagnostic interview. Using the PACS cutoff of >20, sensitivity (i.e., true positive rate) was 41% and specificity (i.e., true negative rate) was 95%. Exploratory analyses suggested that a cut-off score of ≥15 achieved the optimal balance of sensitivity (67%) and specificity (81%) in our sample. Conclusions Advancing the assessment of alcohol craving and the conversion from DSM-IV to DSM-5 diagnostic criteria represents an important research direction. The present study recommends that a PACS score cut off of ≥15 should be used as an indicator of clinically significant alcohol craving in community samples of non-treatment seekers.

Effect of Transcutaneous Auricular Vagus Nerve Stimulation on Protracted Alcohol Withdrawal Symptoms in Male Alcohol-Dependent Patients

“…Negative affective states, such as anxiety and depression, and decline in the cognitive function associated with alcohol withdrawal represent the cause of excessive alcohol consumption and may explain a relapse into alcoholism (32). The PACS, one of the most widely used tools to measure the craving for alcohol, has demonstrated reliability and validity in numerous studies (33,34). The SAS and SDS are widely used as screening tools, covering affective, psychological, and somatic symptoms associated with anxiety and depression, respectively (21,35).…”

Developing digital interventions for a post‐Covid world: A smartphone‐based approach‐avoidance training to reduce alcohol craving

“…The Penn Alcohol Craving Scale is a five‐item measure to assess intensity, duration, and frequency of craving for alcohol. High PACS scores can indicate a risk for relapse (Flannery, Volpicelli & Pettinati, 1999; Schneekloth, Biernacka, Hall‐Flavin et al ., 2012), with a cut‐off score of >20 showing a 95% sensitivity in identifying alcohol use disorder, with a cut‐off score as low as >15 having optimal sensitivity and specificity in identifying alcohol use disorder when compared to a diagnostic interview (Hartwell, Bujarski, Green & Ray, 2019).…”

Psychometric properties and longitudinal measurement invariance of the drug craving scale: Modification of the Polish version of the Penn Alcohol Craving Scale (PACS)

“…The PACS is one of the most common instruments for assessing the intensity of tonic alcohol craving [ 9 , 17 , 32 , 33 ]. Research studies that have employed the PACS indicate that this instrument demonstrates a high prognostic utility for a risk of relapse and this exceeds the effect achieved with the application of other instruments [ 5 , 34 ].…”