Alcohol craving is a central aspect of alcoholism about which various explanatory theories and assessment questionnaires, based on such craving, have been developed. However, there are no instruments for the assessment of craving in line with the integrative hypotheses recently formulated that propose three types of craving: positive reinforcement, negative reinforcement, and loss of control.
The construction and validation of a craving scale based on three factors. We expect to obtain a correlation between each factor and associated variables from prior studies. We also expect significant differences in craving between alcoholic individuals and controls.
The scale was administered to 209 alcohol-dependent subjects and 137 controls.
Alcohol Craving Scale Based on Three Factors (ACS-3F); Sensitivity to Punishment and Sensitivity to Reward Questionnaire, Barratt Impulsiveness Scale, Severity of Alcohol Dependence Scale.
We confirmed the existence of the three factors initially proposed in the structure of the instrument, with high reliability. The relationship between the scale and the measures employed for its validation was confirmed. Adequate capacity of the scale to discriminate between the sample of alcoholics and the controls was observed.
The ACS-3F has adequate psychometric properties and may be useful in future research and in clinical practice.
[Show abstract][Hide abstract] ABSTRACT: This study addresses, from theories of associative learning, the impulsivity and craving in patients with a diagnosis of substance dependence in abstinence, habitual use and relapse. We present a new method for the assessment of desire based on discount curve self description, in which patients describe how they perceive the temporal evolution and intensity of their desire. At the same time, through a brief questionnaire about emotion and desire -developed by the authors-and the Plutchik Impulsivity Scale, we set out to check whether positive or negative emotions increase, decrease, or are uninvolved in changes of desire and impulsivity. Perception of the evolution of desire in patients from the Relapse and Habitual Use groups is similar and presents a hyperbolic curve, but the Relapse group presented greater impulsivity. Moreover, a relationship is found in patients from the Relapse group between the hyperbolic increase of desire, the pleasurable states and impulsivity. The higher scores on impulsivity and the hyperbolic evolution of desire in patients who have recently suffered a relapse indicate the need to consider and specifically address these aspects as relevant to psychotherapy and/or pharmacological therapy.
[Show abstract][Hide abstract] ABSTRACT: En este estudio se aborda desde las teorías del aprendizaje, el rol de la impulsividad y el deseo de consumo en pacientes con diagnóstico de dependencia de sustancias en abstinencia, consumo habitual y recaída. Para ello, se presenta un nuevo método de valoración del deseo basado en las �curvas de descuento�, en el que los pacientes deben describir como perciben la evolución temporal e intensidad de su deseo. Al mismo tiempo, a través de un breve cuestionario sobre emoción y deseo elaborado por los autores y de la Escala de Impulsividad de Plutchik, se pretende comprobar si las emociones positivas o negativas aumentan, disminuyen o no están implicadas en los cambios de deseo e impulsividad. La percepción de la evolución del deseo de los pacientes pertenecientes a los grupos Recaída y Consumo Habitual es similar y presenta una forma hiperbólica, sin embargo, el grupo Recaída presentaba una mayor impulsividad. Además, se halla relación en pacientes de este grupo Recaída entre incremento del deseo de forma hiperbólica, estados placenteros e impulsividad. La mayor puntuación en impulsividad y la evolución hiperbólica del deseo en pacientes que han sufrido recientemente una recaída muestra la necesidad de tener en cuenta y tratar específicamente estos aspectos como relevantes en terapia psicológica y/o farmacológica.
[Show abstract][Hide abstract] ABSTRACT: The present study examined whether craving as measured by the obsessive-compulsive drinking scale (OCDS) predict long-term outcome in alcohol-dependent inpatients.
This was a 24-month prospective, observational study in 198 alcohol-dependent inpatients treated under standardized conditions. The primary outcome criterion was abstinence, defined as no subjective report or objective indication of alcohol consumption since discharge from treatment. The patients self-rated their craving for alcohol at the 6- and 12-month follow-ups by using the German version of the OCDS, which measures obsessive and compulsive aspects of craving. Univariate and logistic regression analyses with covariates were performed.
Of the 104 patients interviewed at the 24-month follow-up, 60% (n = 62) were abstinent. We found significant associations between total OCDS scores at 6 months and outcome at 12 months and between total OCDS scores at 12 months and outcome at 24 months: the higher the OCDS total score at one follow-up evaluation, the less likely patients were to be abstinent at the subsequent one. The same association was found for each of the two OCDS subscales, control and consequences and drinking obsessions.
These results support earlier findings that OCDS scores can predict outcome in alcohol-dependent patients. This information can be used for the timely development of protective resources. Hence, decisions over the use of resources can be made on the basis of objectified parameters to develop a personalized treatment concept. Consequently, economic considerations can induce a reduction of high medical costs.
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