Toward bridging the gap between biological, psychobiological and psychosocial models of alcohol craving

Citation
Pm. Monti et al., Toward bridging the gap between biological, psychobiological and psychosocial models of alcohol craving, ADDICTION, 95(8), 2000, pp. S229-S236
Citations number
36
Categorie Soggetti
Public Health & Health Care Science","Clinical Psycology & Psychiatry
Journal title
ADDICTION
ISSN journal
09652140 → ACNP
Volume
95
Issue
8
Year of publication
2000
Supplement
2
Pages
S229 - S236
Database
ISI
SICI code
0965-2140(200008)95:8<S229:TBTGBB>2.0.ZU;2-9
Abstract
Urge to drink ("craving") has been a central focus of many theories and tre atments, but some researchers question the importance of urges during recov ery. Several studies assessed reactions to the presence of beverage alcohol (cue-reactivity) or to simulated high-risk situations (role plays). Higher urges in response to role plays predicted more drinking during the 6 month s after treatment. However, urges in response to beverage cues were inconsi stently predictive of outcome while measures of awareness or attention to c ues predicted less drinking. Urge to drink might re? ect a conflict between motivation to drink and awareness of danger. Whether urges predict increas ed risk of drinking should be a function of factors that affect motivation to drink, awareness of risk and effectiveness of coping. Cue-reactivity ass essment has recently been used to bridge the gap between psychosocial and b iomedical approaches in several ways: (1) salivation to cues predicts incre ased drinking independent of urge or attention, showing the value of includ ing both physiological and psychosocial measures; (2) naltrexone has been s hown to decrease cue-elicited urge to drink, illustrating the value of this assessment methodology for medications evaluation and (3) pre-pulse inhibi tion of startle response is being used to investigate the role of dopaminer gic pathways in cue-elicited urge. Thus, this laboratory based program of r esearch has the potential to add to knowledge of both biomedical and psycho social mechanisms involved in urge and relapse, leading to greater integrat ion of models.