Craving and the body: Sensations of cue-elicited craving in binge drinking university students

Theoretical models of addiction identify craving as a key symptom, but its investigation has been mostly confined to its neurocognitive, psychological and behavioral facets, leaving its other dimensions unexplored. Beyond these approaches, craving could also have a strong bodily component. We explored the bodily sensations of craving in a subclinical population of excessive drinkers.

Observational study. Following a multimodal craving induction, participants reported the bodily manifestations of their current craving state through a body mapping procedure.

Laboratory study at UCLouvain, Louvain-la-Neuve, Belgium.

Ninety-one (53 females) young adults (mean age = 20.35, standard deviation = 2.13) with a heavy episodic pattern of alcohol consumption (binge drinkers, BD).

We assessed four dimensions of bodily craving: the type of sensations felt (i.e. taxonomy, assessed by asking participants to name the bodily sensations associated with craving), where in the body they were felt (i.e. localization, assessed by asking participants to indicate in which area of the body these sensations manifested), how intense they were (i.e. intensity, assessed by asking participants to rate through crosses the strength of these sensations) and their overall agreeability [i.e. pleasantness, assessed by instructing participants to rate through numbers how (un)pleasant these sensations were].

BD reported bodily sensations of craving most often and with the highest intensity in the mouth (84.62% of participants reported sensations in this body part, mean intensity = 0.51 on a scale from 0 to 1), shoulders/thorax (51.65% of participants, mean intensity = 0.23) and hands (53.85% of participants, mean intensity = 0.21). These sensations principally manifested as salivation (45.45%), palpitations (56.25%) and tremors (38.00%), respectively. Pleasantness ratings ranged from unpleasant (e.g. for perspiration in the shoulders and thorax) to pleasant (e.g. for ease in the abdomen).

Among binge drinkers, craving does not appear to be exclusively a psychological phenomenon but also encompasses various and strong bodily sensations. Bodily craving for alcohol encompasses both positive sensations resembling those felt when experiencing pleasurable acute alcohol effects (e.g. relaxation/ease in upper parts of the body) but also negative ones close to those reported in alcohol withdrawal (e.g. tremors, perspiration).