Craving and relapse measurement in alcoholism

Area of Science:

• Psychiatry
• Clinical Psychology
• Behavioral Science

Background:

• Relapse definitions in addiction studies are generally well-defined.
• Craving definitions are less clear, often described as emotional-motivational states or obsessive-compulsive behaviors.

Purpose of the Study:

• To summarize the measurement of craving using four different instruments.
• To relate craving measurement to the definitions and measurement of relapse.
• To identify needs in conceptualizing and measuring craving.

Main Methods:

• Comparison of four self-rating craving instruments: Obsessive-Compulsive Drinking Scale (OCDS), Lübeck Craving Scale (LCRR), Alcohol Craving Questionnaire (ACQ-Now-SF-R), and ordinal scales.
• Review of five common relapse measurement methods: quantity/frequency of drinking, cumulative duration of abstinence (CDA), post-withdrawal abstinent period, stable recovery period, and time line follow-back.

Main Results:

• The discussed instruments measure different aspects of craving over varying periods.
• Existing instruments suggest a need for a standardized interpretation of 'craving'.
• Different patients may exhibit distinct craving profiles.

Conclusions:

• There is a need to conceptualize a standard interpretation of craving.
• Future measurement should address emotional-motivational and cognitive-behavioral dimensions, expectancies, and reinforcement effects.
• A multidimensional instrument may be beneficial for comprehensive craving assessment.