Meta-analysis of cue-reactivity in addiction research

Aims. The cue-reactivity procedure exposes addicts to a variety of drug-rel ated stimuli while self-report of craving and physiological responses are m onitored. The present review sought to determine the magnitude and overall pattern of responses typically found in cue-reactivity research and which, if any, learning-based model of cue reactivity is best supported by the fin dings. Design. Meta-analytical techniques were used to select and evaluate results from 41 cue-reactivity studies that compared responses of alcoholic s, cigarette smokers, cocaine addicts or heroin addicts to drug-related ver sus neutral stimuli. Effect sizes were calculated, separately by addict typ e, for self-report of craving and physiological responses (heart rate, swea t gland activity and skin temperature). Findings. Across all addict groups, the effect size for craving was + 0.92. Alcoholics had a significantly sma ller craving effect size (+ 0.53) compared to other addict groups (+1.18 to + 1.29). Relatively smaller effect sizes were found for physiological resp onses. The general profile of effect sizes across all addict groups was inc reased heart rate (+ 0.26) and sweat gland activity (+ 0.40) and decreased skin temperature (- 0.24) when addicts were presented with drug-related sti muli. Conclusions. The cue-reactivity paradigm can produce a stable profile of significant effects and, therefore, has a number of potential applicati ons for investigating addictive phenomena. The implications of these findin gs for conditioning-based models; of cue-reactivity phenomena are discussed .