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METHODOLOGICAL APPROACHES TO CRAVING RESEARCH
Abstract
The nature of drug craving and its role in the addictive process is a contentious issue in the addiction sciences. There are numerous disputes regarding the definition, assessment, manipulation and interpretation of craving, and progress toward resolving the enigmas of craving confronts numerous conceptual and methodological challenges. Greater attention to certain fundamental principles of measurement and manipulation should generate immediate and substantial improvements in efforts to understand and control alcohol craving. This paper provides suggestions for enhancing the measurement of self reported alcohol craving and improving the manipulation of alcohol craving under controlled laboratory conditions. With regard to measurement, single-item scales commonly employed in craving research tend to be handicapped by limited reliability and validity. Multi-item craving scales are more likely to provide the accuracy required to accurately discriminate between different levels of craving across individuals or across different settings. Conceptual and practical considerations for the selection of multi-item craving instruments are discussed. With regard to the manipulation of alcohol craving in the laboratory, recent meta-analyses suggest that alcohol craving effects in such research may be relatively weaker than craving effects found in similar research with other addicts. Therefore, laboratory-based investigations into the nature of alcohol craving should utilize procedures and assessments that are particularly sensitive to the detection of alcohol craving. This paper offers methodological recommendations for enhancing the magnitude of alcohol craving effects generated in laboratory research.
Introduction
Craving is one of the most pressing and contentious issues confronting the science of addictive disorders. The addiction literature is replete with disputes about how craving should be defined, measured, manipulated and interpreted. During the past 10 years, several national and international meetings have attempted to come to grips with the mysteries of craving (e.g. Altman et al., 1996; Pickens & Johanson, 1992; UNDCP & WHO, 1992). These meetings generally produce recommendations about the future course of craving research that might be paraphrased in the following way:
Although we do not know what craving is and we can establish no consensus about the best way to measure it or manipulate it, we certainly believe that more research should be conducted on this possibly, but not necessarily, important construct.
The collective message of these craving meetings is...