[Attention and craving. Advances in its conceptualization and its implications for relapse prevention]

Irresistible compulsion to use, or craving, is one of the key symptoms of substance dependence syndrome, and of major relevance with regard to relapse in the abuse of alcohol or other drugs. In the present paper, the relationship between attention, attentional processes and the craving phenomenon is reviewed. The paper also explores the different elements of attention, and particularly the relevance of selective attention in craving and the initial stages of relapse. Those psychological strategies that have emerged as effective in the management of craving for substances are also reviewed, with particular emphasis on the cognitive-behavioral model of relapse and on relapse-prevention therapy. Finally, we discuss the characteristics of so-called attentional therapy, based on mindfulness, and its potential effectiveness in the management of addictive disorders in general and of craving in particular.