The Desire Thinking Questionnaire: development and psychometric properties

Desire thinking is a voluntary cognitive process involving verbal and imaginal elaboration of a desired target. Recent research has highlighted the role of desire thinking in the maintenance of addictive, eating and impulse control disorders. The goal of this research project was to develop the first self-report measure of desire thinking. In Study 1 we constructed the Desire Thinking Questionnaire (DTQ) and conducted a preliminary factor analysis which identified two factors. The first factor concerned the perseveration of verbal thoughts about desire-related content and experience and was named 'Verbal Perseveration'. The second factor concerned the tendency to prefigure images about desire-related content and experience and was named 'Imaginal Prefiguration'. In Study 2 we performed a confirmatory factor analysis which provided support for this two factor solution, with both factors achieving adequate internal consistency. Divergent validity was also established through correlation analyses. In Study 3 the temporal stability of the DTQ was examined and confirmed. Finally, in Study 4, the predictive validity of the DTQ in a sample of alcohol abusers was investigated. The DTQ was shown to possess good psychometric properties, as well as divergent and predictive validity. This self-report measure may aid future research into desire thinking and craving, as well as facilitate assessment and case formulation within the context of addictive, eating and impulse control disorders.     

The A-OCDS predicts both craving and alcohol cue reactivity in adolescent alcoholics

Adolescents with alcohol dependence may experience marked craving and physiologic reactivity in the presence of alcohol cues which could undermine treatment gains. The Adolescent Obsessive Compulsive Drinking Scale (A-OCDS) was developed to help quantify the severity of alcohol craving in adolescents with alcohol use disorders. The A-OCDS is a relatively new instrument, and empirical data are needed to support its value in clinical trials. The present investigation uses data collected as part of a clinical laboratory study examining alcohol craving and cue reactivity in adolescents with and without alcohol dependence. A-OCDS total and subscale scores from adolescent alcoholics (N = 28) were examined regarding their relationship to drinking and several indices of craving and alcohol cue reactivity. In addition, regression analyses were performed to characterize the predictive ability of A-OCDS total scores and drinking indices (drinks per drinking day and percent days abstinent) on two measures of alcohol craving and cue reactivity. Results showed that the A-OCDS total scores, but not drinks per drinking day or percent days abstinent, predicted scores on both indices of craving. The study uses a small but well-defined sample of adolescents with alcohol dependence and supports the construct validity of the A-OCDS and suggests that, as in adults, alcohol craving and drinking behavior are related but separate elements of alcohol dependence. The results are intended to guide future studies in which the A-OCDS may be employed to measure craving and changes in craving over the course of treatment for adolescents with alcohol dependence.     

内隐致敏法对线索诱发酒依赖患者心理渴求的影响

目的：了解线索诱发酒依赖患者心理渴求情况,探讨内隐致敏法对酒依赖患者心理渴求的干预效果。方法：将90名康复期酒依赖患者随机分为观察组（n=45）和对照组（n=45）,采用视觉模拟评分法根据被试者的自我报告初次评价心理渴求程度,采用内隐致敏法对观察组进行干预,每周干预四次,对照组未采用内隐致敏法,其余干预措施与观察组相同。3周后,对照组、观察组观看饮酒相关视频,同时给予酒瓶、酒杯、酒味刺激,线索诱发后1分钟内再次评价心理渴求程度。结果：线索明显诱发酒依赖患者心理渴求（P〈0．01）,内隐致敏法能降低酒依赖患者心理渴求程度（P〈0．01）。结论：康复期酒依赖患者在线索诱发下产生明显的心理渴求;内隐致敏法能降低酒依赖患者心理渴求程度。     

Core Heritable Personality Characteristics and Relapse in Alcoholics

This article represents the proceedings of a symposium at the 2000 ISBRA Meeting in Yokohama, Japan. The chairs were David S. Janowsky and Jan Fawcett. The presentations were (1) The tridimensional personality questionnaire: Predictor of relapse in detoxified alcoholics, by Kurt Meszaros; (2) Novelty seeking predicts clinical trial attrition in alcoholics, by Jan Fawcett; (3) Personality and alcohol/substance use disorder patient relapse and attendance at self-help group meetings, by David S. Janowsky; and (4) A three-pathway psychobiological model for craving for alcohol, by Roel Verheul.     

Relationship between the serotonin transporter polymorphism and obsessive-compulsive alcohol craving in alcohol-dependent adults: a pilot study

A serotonin deficiency state has been implicated in alcohol-dependent individuals' experience of obsessive-compulsive alcohol craving. Because the serotonin transporter (5-HTT) functions to remove serotonin from the synapse, it is thought that increased reuptake (indicated by the number of high-expressing L_A alleles present in the 5-HTT gene-linked polymorphic region [5-HTTLPR] of the SLC6A4 gene) is associated with an increase in obsessive-compulsive alcohol craving. The current pilot investigation sought to explore this hypothesis by examining the extent to which obsessive-compulsive alcohol craving varies by 5-HTTLPR genotype among participants enrolled in an ongoing pharmacogenetics trial. All participants were screened with a semi-structured diagnostic interview, completed self-report measures of alcohol-related behavior, and underwent peripheral venous blood draw for DNA genotyping. Cross-sectional data obtained at baseline from 176 currently drinking alcohol-dependent individuals were analyzed using multiple regression. Preliminary findings suggest that 5-HTTLPR is not predictive of Obsessive Compulsive Drinking Scale total and factor scores. Although the 5-HTTLPR polymorphism was not related to obsessive-compulsive alcohol craving in this pilot study, additional research is needed to clarify the possible role of serotonergic mechanisms in alcohol craving.     

Does the reaction of abstaining smokers to the smell of other people's cigarettes predict relapse?

Aims Recent ex‐smokers report a range of reactions to other people's cigarette smoke. We examined the hypothesis that those who find the smell of smoke pleasant and tempting are more likely to relapse than those who have a neutral or even negative reaction to it. Design A total of 1110 consecutive patients who attended for smoking cessation treatment and achieved at least 1 week of validated abstinence provided weekly ratings of their reactions to other people's cigarette smoke together with routine baseline measures and weekly ratings of withdrawal discomfort [measured on the Mood and Physical Symptom Scale (MPPS)]. Findings Twenty‐three per cent of the sample found the smell of other people's cigarette smoke during their first week of abstinence pleasant, and 54% found it tempting. There was only a modest correlation between the two variables. Finding the smoke pleasant was not related to smoking status in the following week, but finding the smoke tempting predicted relapse. Ratings of temptation were related to the severity of withdrawal discomfort and to dependence. Entering MPPS ratings of urges to smoke in the given week into regression analysis resulted in the general urges to smoke, rather than urges elicited by other people's smoke, becoming a significant predictor of smoking status in the following week. In patients who maintained continuous abstinence throughout 4 weeks of treatment the pleasantness ratings remained stable, while the ratings of temptation steadily decreased. Conclusions In abstaining smokers, the like or dislike of other people's smoke is not related to relapse. The temptation to smoke elicited by other people's smoke is related to outcome, but only as an indicator of a general ‘temptation threshold’. Patients who find other people's smoke tempting can be reassured that this reaction will gradually decrease.     

Transcranial direct current stimulation of the frontal-parietal-temporal area attenuates cue-induced craving for heroin

BackgroundTranscranial direct current stimulation (tDCS) is an effective approach to modulate brain region functions. We assessed if a single tDCS session over the bilateral frontal-parietal-temporal (FPT) areas would reduce cue induced craving in heroin addicts.MethodsTwenty non-treated, long-term heroin-addicted subjects were randomly assigned to receive either real tDCS (1.5 mA, cathodal over bilateral FPT for 20 min) or control tDCS stimulation (turning off the stimulation after 30 s). The participants received heroin cue exposure (containing both injection and inhalation procedures) before and after stimulation and rated their craving after each block of cue presentation.ResultsStimulation of the bilateral FPT with real tDCS for 20 min reduced craving scores significantly (68 ± 8.4 pre-stimulation vs. 43 ± 7.6 post-stimulation, p = 0.003), while the control stimulation group showed no significant changes. No side effects of tDCS were reported.ConclusionsOne session of tDCS over bilateral FPT area significantly reduced subjective craving score induced by heroin cues in heroin addicted subjects.     

Cue-induced craving and physiological reactions in recently and long-abstinent heroin-dependent patients

Objective

To understand the different patterns of cue-induced craving and physiological reactions among recently abstinent and long-abstinent heroin-dependent patients.

Method

26 healthy adult controls (HC), 29 long-abstinent (more than 1 year, LA), and 26 recently abstinent (less than 1 month, RA) heroin-dependent individuals were exposed to heroin-related and neutral video cues, one video per session, on different days in random order. Self-reported heroin craving by a 10-point visual analog scale (VAS), physiological reactions [skin conductance (SC), muscle electromyography (MEG), skin temperature (TEMP)] and cardiovascular arousal [heart rates (HR), systolic blood pressure (HBP) and diastolic blood pressure (LBP)] were assessed at baseline and after exposure.

Results

Both heroin-abstinent groups showed increased heroin craving, SC, MEG, HR, SBP and LBP after exposure to heroin-related video, compared to the control group and compared to exposure to the neutral video. Except the RA group showed more HR changes, changes of heroin craving, SC, MEG, HR, SBP and LBP after exposure to the heroin cue video were not different between the LA and RA groups.

Conclusions

Abstinent heroin-dependent patients had elevated craving and physiological reactions after exposure to videos containing heroin-related cues and the cue induced responses still occurred in long-abstinent patients. This phenomenon should be addressed in treatment and recovery services for heroin dependence.