Clinical and laboratory assessment of the subjective experience of drug craving.
ABSTRACT Measures of subjective drug craving - often defined as the experience of an intense or compelling urge or desire - may be used to predict relapse, evaluate psychological and pharmacological treatments, and test theories of addiction and craving. This review summarizes both direct self-report questionnaires and indirect behavioral, physiological and reaction time measures designed to assess craving for alcohol, amphetamines, cocaine, heroin, marijuana, and tobacco. Multi-item questionnaires have typically been based on one of four underlying conceptualizations of addiction or craving (obsessive-compulsive, approach-avoidance, multi-dimensional, intensity-frequency-duration). Most multi-item self-report questionnaires have high internal consistency, correlate significantly with single-item craving ratings, and demonstrate several aspects of construct validity. Proposed indirect or proxy measures of craving include drug dreams, speed of drug consumption, willingness to work for drug access, selection of monetary rewards over drug access, psychophysiological reactivity, and attentional bias to drug cues. These proxy measures of craving are presumed to obviate self-report biases, to be less subject to conscious self-control, and to reflect craving which the person may not be able to articulate; however, there have been too few demonstrations of their validity and they have too many practical limitations to supplant self-report measures of craving at this time.
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ABSTRACT: The current study was designed to assess the impact of wins and losses in simulated blackjack on craving to gamble and to assess the extent to which this craving was associated with actual wagering in an optional gambling task.Journal of Behavioural Addictions 09/2013; 2(3):133-7.
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ABSTRACT: Drug craving is typically measured through explicit ratings of craving levels. We examined response time to craving ratings as an implicit measure of craving processes in cigarette smokers. Response time and interitem variability were investigated as potential indices of certainty in craving ratings. Cigarette smokers, categorized as tobacco dependent or nondependent, completed multiple cue-reactivity sessions with smoking and neutral cues. After each cue presentation, craving level and response time were assessed. Significant inverted-U relationships emerged between craving level and both response time and interitem variability across conditions, sessions, and groups. Faster response times and less interitem variability emerged after neutral cues relative to smoking cues for nondependent smokers and after smoking cues relative to neutral cues for dependent smokers. Response time provided incremental validity beyond craving level in predicting dependence. Results support use of response time as an implicit measure of craving processes and further distinguish craving experiences between dependent and nondependent smokers.Clinical Psychological Science. 08/2014;
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ABSTRACT: Neuroscience and Neuroeconomics Dovepress submit your manuscript | www.dovepress.com Dovepress 87 R e v i e w open access to scientific and medical research Open Access Full Text Article http://dx.doi.org/10.2147/NAN.S38866 Abstract: Craving is typically thought of as a classically conditioned response characterized by an elevated mesolimbic dopamine response to drug-related stimuli. Although this definition has spurred considerable research, the clinical impact of the research conducted has been less robust. The current review takes a more contemporary approach by conceptualizing craving as the breakdown of executive function and relative strengthening of the limbic system, occurring in the presence of conditioned cues, leading to a maladaptive craving response (ie, an increased likelihood of drug consumption). Working from this framework, the present review focuses on four issues in drug craving research: pivotal findings and limitations of cue-reactivity and neurocognitive tasks; two main processes of craving that include self-control and reward-based explanations; integration of neuroeconomic approaches to craving; and the theoretical implica-tions and future directions of drug craving research.Neuroscience and Neuroeconomics. 10/2014; 2014(3):87-98.