Measurement of alcohol craving

Abstract

Despite considerable research activity and application in treatment, the construct of craving remains poorly understood. We propose that cravings and urges are cognitive-emotional events in time, characterised by frequency, duration, intensity and salience. Commonly used measures of alcohol craving are reviewed, and their strengths and weaknesses identified. Most measures confound craving with behaviours, or with separable cognitive phenomena such as expectancies, intentions, or perceived behavioural control. These confounds have limited our advances in understanding the determinants and consequences of craving. Based on the criteria applied in this review, among the better performing multi-item measures are the Penn Alcohol Craving Scale and Obsessive subscale of the Obsessive-Compulsive Drinking Scale. Optimal assessment strategies are likely to involve daily assessments of peak intensity of cravings, desires or urges and of the frequency and duration of craving episodes. Of particular interest are measures of intensity at times when individuals are at risk of drinking or of other functional impacts from craving.

The Craving Experience Questionnaire: a brief, theory-based measure of consummatory desire and craving

“…Together, the CEQ-S and CEQ-F measure the core desire components of frequency, intensity and the salience or dismissability of related intrusive thoughts, as identified in the recent review by Kavanagh et al [13]. They also track a key cognitive feature of craving-desire-related imagery-the theoretical and empirical importance of which is demonstrated in other work [5,27], and by the close association of the Imagery subscale and QSU Desire to Smoke.…”

“…The CEQ-S represents a distinct departure from most previous measures, which ask people to make average ratings of intensity over long or undefined time periods [13]. Instead, it focuses on the current experience or on a highly salient episode in the recent past, e.g.…”

“…Kavanagh, Statham, Feeney et al [13] reviewed existing measures of alcohol craving, demonstrating that many can be confounded with correlated but separate phenomena (drinking behaviour, intentions to drink, outcome Craving Experience Questionnaire 4 expectancies about perceived benefits or consequences of drinking, and perceptions of behavioural control or self-efficacy). Similar issues apply to craving measures in other domains: for instance, the Questionnaire on Smoking Urges (QSU) [14] and state version of the Food Craving Questionnaire (FCQ-S) [15] include items on expectancy and intention (QSU) or control (FCQ-S).…”

Validación de tres instrumentos de evaluación del craving al alcohol en una muestra española: PACS, OCDS-5 y ACQ-SF-R.

“…Por su mayor aplicabilidad en el contexto clínico habitual, adquieren especial interés aquellos instrumentos breves que requieren apenas unos minutos para su administración y corrección. Entre éstos destaca la Penn Alcohol Craving Scale (PACS; Flannery, Volpicelli y Pettinati, 1999), uno de los cuestionarios breves que mejor reflejan la naturaleza cognitivoemocional del craving (Kavanagh et al, 2013 Likert, que recoge aspectos relacionados con la frecuencia, intensidad y duración de los pensamientos asociados a las bebidas alcohólicas, la capacidad del sujeto para resistir la tentación de beber y, finalmente, la intensidad del deseo de beber durante la semana anterior a la administración de la escala. Al igual que en la OCDS y OCDS-5, el tiempo de referencia de la PACS se circunscribió a la semana previa a la administración del cuestionario.…”

Exploration des mécanismes potentiels sous-jacents aux troubles liés à l’utilisation d’une substance chez les personnes atteintes d’un trouble de la personnalité

“…D'autre part, le craving joue un rôle clé dans la dépendance aux substances psychotropes (Leggio, 2009) et fait maintenant partie des critères diagnostiques du TLUS dans le DSM-5 (APA, 2013). Le craving, un terme emprunté à l'anglais qui fait référence au désir impérieux ou à la compulsion de consommer chez certains toxicomanes (Kavanagh et al, 2013), est associé à des taux de rechute plus élevés, même en cas d'abstinence prolongée (Paliwal, Hyman et Sinha, 2008) ; cela explique que ce symptôme soit devenu une cible importante dans la mise au point de traitements pharmacologiques ou thérapeutiques en toxicomanie (voir l'article de Morrissette et al du présent numéro sur le craving et ses différents aspects). Un nombre important de corrélats neurobiologiques, psychologiques et environnementaux, notamment relativement à la désinhibition comportementale et la dysrégulation des affects, ont été établis et permettent maintenant de mieux comprendre ce symptôme (Abrams, 2000).…”