Craving and relapse measurement in alcoholism

This paper attempts to summarize the measurement of craving with four diffe rent craving instruments and to relate this to definitions and measurement of relapse. The definitions of relapse may vary between studies and researc hers, but are usually well defined. Five commonly used methods to measure r elapse are: (1) quantity/frequency of drinking; (2) cumulative duration of abstinence (CDA); (3) post-withdrawal abstinent period; (4) stable recovery period; (5) the time line follow-back method. The definition of craving is much less clear and is mostly described as an emotional-motivational state or as obsessive-compulsive behaviour. Four self-rating instruments are bri efly discussed and compared: the Obsessive-Compulsive Drinking Scale, OCDS, the Lubeck Craving Scale, LCRR, the Alcohol Craving Questionnaire, ACQ-Now -SF-R, and ordinal scales (e.g. visual analogue, Likert, or verbal descript ive scales). These instruments-measure different aspects or dimensions of c raving over different periods. The different dimensions measured suggest th at there is still a need to conceptualize a standard interpretation of the word craving. There is a need also to measure an emotional-motivational dim ension, a cognitive-behavioural dimension, expectancies, and effects on pos itive and negative reinforcement with different instruments or with one mul tidimensional instrument. It is suggested that different patients are expec ted to have different craving profiles.