What does cue-reactivity have to offer clinical research?

This paper examines the application of the cue-reactivity paradigm as a mea ns of studying alcohol dependence in clinical populations. Three main areas of application will be examined: cue-reactivity as a means of understandin g the nature of alcohol dependence; cue-reactivity as a predictor of relaps e; and cue-reactivity as a method of studying treatment effects. The study of cue exposure and cue-reactivity has a long history but it is only relati vely recently that the potential of cue-reactivity as a means of understand ing and treating addictive behaviours has been studied in depth. The princi pal advantage of cue-reactivity over other existing paradigms to study addi ctive behaviour is in having a solid basis in widely studied general theori es of behaviour. Cue-reactivity also provides a means of measuring and unpa cking the concept of craving. Craving has long been believed to represent t he underlying basis for addictive behaviour, and in the majority of researc h studies craving has been conceptualized and measured in relatively simpli stic ways. Craving has generally been viewed as a unitary phenomenon and me asured using self-reported questionnaires. Such approaches have had limited explanatory value, particularly in recent psychopharmacology research. The re is clearly a need to develop new paradigms to study the effects of pharm acological agents aimed at attenuating drinking behaviour. It is in this ar ea that cue-reactivity currently offers the greatest potential. In particul ar, the cue-reactivity paradigm draws an important distinction between cue mediated craving and withdrawal craving. This can be viewed as similar to t he distinction between generalised anxiety and anxiety provoked by phobic s timuli. However, while much is now known about the phenomenon of cue-reacti vity, several aspects require further elucidation and research investment.