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The aim of this study was to assess the relationship between feeling of shame related to drinking, rumination about drinking, depression and alcohol craving among psychiatric inpatients with alcohol use disorder (AUD). The clinical sample included 71 inpatients (60 male) average age 49.70 years (SD = 9.78) who were hospitalized for AUD treatment disorder in Psychiatric Hospital Rab. Psychological measures included State Shame Scale, Rumination about Drinking Scale, Beck Depression Inventory and Penn Alcohol Craving Scale. The results show that shame related to drinking is associated with rumination about drinking and depression. Rumination about drinking is associated with depression and alcohol craving, and depression is associated with alcohol craving. Rumination about drinking was also significant predictor of depression and alcohol craving. The results suggest that rumination about drinking is significant for understanding depression and alcohol craving among inpatients with AUD. Since both depression and alcohol craving are significant risk factors for relapse after treatment, these finding also suggest that working through rumination as a part of the treatment could improve AUD treatment outcomes. [ABSTRACT FROM AUTHOR]

Background: Sexual orientation disparities in alcohol use disorder (AUD) are thought to be explained by stigma specific to sexual minorities. Despite the importance of negative affect and craving in addiction, research has yet to test the effects of stigma on affect and alcohol craving among sexual minorities. This laboratory study examined the effects of 3 novel mood inductions (stigma, general unpleasant, and neutral) on affect and alcohol craving among heavy‐drinking sexual minority young adults. We also paired these mood inductions with an established alcohol cue reactivity paradigm to explore the effects of stigma on cue‐elicited craving. Methods: Sexual minority participants (N = 20; 55% female), aged 18 to 27 years (M = 21.80, standard deviation = 2.65), were recruited from the community. Participants completed 3 mood induction and cue reactivity trials counterbalanced over 3 visits on different days: stigma, general unpleasant, and neutral mood inductions. A structured interview assessed criteria for DSM‐5 AUD, and self‐report measures assessed lifetime adverse experiences. Results: Most participants met criteria for past‐year AUD (75%). Exposure to stigma produced more negative affect and greater alcohol craving than the neutral and general unpleasant mood induction conditions. The general unpleasant mood induction did not predict greater alcohol craving than the neutral mood induction. Stigma enhanced alcohol cue reactivity effects, as measured with a single‐item craving measure, compared to the general unpleasant mood condition, and this effect remained significant while controlling for covariates. Conclusions: Findings are the first to demonstrate how stigma uniquely predicts negative affect and alcohol craving among sexual minorities. This study suggests that being exposed to stigma, specifically heterosexism, elicits negative mood and alcohol craving among sexual minority young adults who are heavy drinkers. This study developed a novel laboratory paradigm to investigate the effects of vicarious sexual stigma exposure on negative affect and alcohol craving among heavy drinking sexual minority adults. Participants completed 3 mood induction and cue reactivity trials counterbalanced over 3 visits on different days: stigma, general unpleasant, and neutral mood inductions. The stigma condition induced greater negative affect and alcohol craving than the general unpleasant and neutral conditions. Preliminary evidence also demonstrated that stigma enhanced alcohol cue reactivity effects. [ABSTRACT FROM AUTHOR]

Background: Many studies have indicated that alcohol craving is a core mechanism in the acquisition, maintenance, and precipitation of relapse in alcohol use disorder (AUD). A common treatment approach in AUD is cue exposure therapy (CET). New technologies like virtual reality (VR) have the potential to enhance the effectiveness of CET by creating realistic scenarios in naturalistic environments. In this study, we aimed to determine relevant triggers of alcohol craving in patients with AUD. Methods: We enrolled 75 outpatients diagnosed with AUD according to the DSM-5 criteria Participants completed the Alcohol Use Disorder Identification Test and a self-administered questionnaire to assess alcohol craving. The variables included in the craving questionnaire were as follows: presence of others, situations, time of the day, day of the week, mood, and type of alcoholic beverage. Results: Greater levels of alcohol craving were seen in many situations, including being at a party, in a restaurant, in a bar or pub, and at home. Drinking alone and drinking with two or more friends were equally associated with higher levels of craving. Drinking at night and drinking at weekends also emerged as triggers for alcohol craving. Emotional states like anxiety or tension, sadness, stress, frustration, or irritability were highly associated with urges to drink alcohol. The alcoholic drinks most highly associated with increased levels of craving were beer, wine, and whisky. Gender and age implications were discussed. Conclusion: This study is part of a larger project aiming to develop and validate CET based on VR technology for patients with AUD who are resistant to classical treatment. The identified triggers have been used to develop relevant VR environments for CET, and further research is ongoing to implement our findings. [ABSTRACT FROM AUTHOR]

Introduction: The aim of the study was to determine the level of craving in alcohol-dependent subjects, as well as the age and gender-related differences in its occurrence. The correlations between the feeling of craving and the variables that affect its occurrence, such as the need for reward, the desire for relief, or obsessive thoughts about drinking and compulsive behaviours were also analysed. Methods: The study was conducted in a group of 220 subjects, including 110 men and 110 women diagnosed with alcohol dependence syndrome (F10.2). The study was carried out in the third week of therapy, with the use of Yale-Brown Obsessive-Compulsive Scale (YBOCS-hd), Penn Alcohol Craving Scale (PACS) and Craving Typology Questionnaire (CTQ). Results: No gender-related differences in the level of experienced craving and coping with it were found. However, numerous age-related differences in the prevalence of craving were observed. Younger subjects, in comparison to older ones, are characterised by more frequent occurrence of this symptom. The intensity and duration of craving sensations are also higher in the younger group. Conclusions: The approach to the problems of the occurrence of and coping with alcohol craving in the course of the therapy should be similar in men and women. However, there should be more focus on the working out of coping strategies, especially in the younger patients, because of the more frequent and intensive craving they experience, which poses a greater risk of relapse and recurrence of the problem.

Introduction: Craving is recognized as a formidable barrier in the management of patients with alcohol dependence. Among pharmacological agents that have been used in experimental studies for reduction in craving, baclofen appears to have a significant advantage over other agents. Methodology: The study is retrospective chart review of patients (n = 113) who have been treated with baclofen for alcohol dependence in a tertiary hospital of North India. Baseline assessments included sociodemography, motivation, quantity-frequency of alcohol use, and other alcohol-related clinical parameters. Weekly assessments, for a period of 4 weeks, were extracted from records which included dose of baclofen, craving intensity, and alcohol consumption. Results: The study sample was predominantly male, mean age of 41.49 (±9.75) years, most having a family history of substance use (70.97%), and many reporting binge use pattern in last year (49.46%). Baseline assessment revealed 48.7% of the sample was in precontemplation phase for alcohol use and 70% reported severe and persistent craving. This persistent craving was reported by only 15% of the sample by the end of 4 weeks treatment with baclofen (20–40 mg/day). Thirty-four percent of patients reported continued problematic use of alcohol by the end of 4 weeks. Conclusion: Our clinical experience suggests that baclofen reduces craving and alcohol consumption including in those with poor motivation. The drug causes few side effects and does not add to the intoxication effect of alcohol. Considering that baclofen is safe in those with liver cirrhosis and reduces withdrawal symptoms due to alcohol, a controlled trial comparing it with standard treatment is required.

Background The present study aimed at finding any relation between alcohol craving and strategies of coping with stress and satisfaction with life in the addicted. Until now, studies have shown that generalized deficits in coping with stress, and the dominance of avoidance strategies, are significantly related to the increase of the risk of addiction and the course of this disease. This relation, which could link strategies of coping with stress and quality of life with experiencing alcohol craving, has only been explained to a small extent. Also, the role of gender in explaining these relations is ambiguous. Participants and procedure The study was conducted in a group of 550 addicted subjects in out-patient or in-patient treatment (396 men and 114 women). In the present study the following instruments were used: the Craving Typology Questionnaire by Marinotti et al., the Yale-Brown Obsessive-Compulsive Drinking Scale by Modell et al., the Mini-Cope by Carver et al., SADD by Reistrick et al., and the Satisfaction with Life Scale by Diener et al. Statistical correlational analysis and structural equations were applied, namely partial least squares path modelling (PLS-PM). Results There are two types of links between craving and strategies of coping with stress among the addicted. The first dominating type is pointing at casual link between ineffective strategies of coping with stress and craving. The other weaker type indicates the diminishing influence of effective strategies of coping with stress on alcohol craving. Life satisfaction lowers alcohol craving. Conclusions Effective strategies of reacting to stress, together with life satisfaction, protect against increase of alcohol craving. Severity of dependence is an important factor which moderates the influence of strategies of coping with stress on alcohol craving.

Introduction: Visfatin is a protein which belongs to the adiponectines, and exhibits insulinomimetic properties. A high concentration of visfatin may be directly related to an ongoing inflammatory process in the body. The aim of this study was to assess changes in the concentration of visfatin in relation to the intensity of alcohol craving and selected clinical characteristics in patients with alcohol dependency. Materials and methods: The thirty-seven males enrolled in the study had been hospitalised due to alcohol dependence in the addiction treatment unit. In the first week and after four weeks of treatment, clotted blood samples were obtained to determine the concentration of visfatin and other biochemical parameters. Next, patients were divided into two groups – group 1 with a decrease and group 2 with an increase in the concentration of visfatin during the four weeks of treatment. The study used a socio-demographic and clinical scale, the Short Alcohol Dependence Data questionnaire (SADD) and an analogue alcohol craving scale. Additionally, the study considered measurements of waist-to-hip circumference ratio (WHR) and biochemical blood parameters. Results: There was a statistically significant difference between group 1 and group 2 in the concentration of visfatin (35.5 ng/ml vs 146 ng/ml) after four weeks of inpatient alcohol dependence treatment. Discussion: Perhaps different pathophysiological processes were taking place (including inflammatory response) in patients with high and low visfatin concentration in the initial stage of the trial. Conclusions: The dynamic of change in the concentration of visfatin during four weeks of abstinence is not associated with a reduction in craving for alcohol at the time and is associated with alcohol drinking and liver functioning.

Since its discovery, the gut hormone, ghrelin, has been implicated in diverse functional roles in the central nervous system. Central and peripheral interactions between ghrelin and other hormones, including the stress-response hormone cortisol, govern complex behavioral responses to external cues and internal states. By acting at ventral tegmental area dopaminergic projections and other areas involved in reward processing, ghrelin can induce both general and directed motivation for rewards, including craving for alcohol and other alcohol-seeking behaviors. Stress-induced increases in cortisol seem to increase ghrelin in the periphery, suggesting a pathway by which ghrelin influences how stressful life events trigger motivation for rewards. However, in some states, ghrelin may be protective against the anxiogenic effects of stressors. This critical review brings together a dynamic and growing literature, that is, at times inconsistent, on the relationships between ghrelin, central reward-motivation pathways, and central and peripheral stress responses, with a special focus on its emerging role in the context of alcohol use disorder. [ABSTRACT FROM AUTHOR]

Although epidemiological research has shown an increase in drinking following stressors and trauma, limited paradigms have been validated to study the relationship between stress and drinking in the human laboratory. The current study developed a progressive ratio (PR) operant procedure to examine the effects of psychosocial stress on alcohol craving and several alcohol-motivated behaviors in persons with alcohol use disorder. Current heavy, nontreatment-seeking drinkers (N = 30) were media-recruited and completed a comprehensive assessment of recent drinking, mood and health. Participants were admitted to the clinical research unit and underwent 4-day, physician-monitored alcohol abstinence. On days 4 and 5, participants underwent the Trier Social Stress Test or a neutral session in random order followed by the alcohol-motivated response (AMR) procedure in which subjects worked for money or alcohol under a PR operant procedure. Subjects received earned money vouchers or alcohol at the conclusion of the session. The Trier Social Stress Test increased alcohol craving and rate of responding and decreased the number of changeovers between alcohol versus money reinforcers on the PR schedule. There was a positive relationship between alcohol craving and drinks earned during the stress session. This novel paradigm provides an experimental platform to examine motivation to drink without confounding by actual alcohol ingestion during the work session, thereby setting the stage for future studies of alcohol interventions. [ABSTRACT FROM AUTHOR]

Background: Craving and negative affect are distressing and commonly experienced during alcohol use disorder (AUD) treatment. Patients may assume that initiating abstinence will intensify their cravings and negative affect despite limited empirical data to support this assumption. This study extends and replicates, under improved methodological conditions, previous work that found reductions in daily craving associated with initiating abstinence. Methods: Seventy‐eight adults (80.8% male, 57.1% Caucasian) in a clinical trial testing prazosin for AUD provided daily reports of drinking, craving, and negative affect for up to 12 weeks (mean = 64.77 daily reports). Participants were classified into 3 subgroups based on whether and when they initiated 14 days of continuous abstinence, including (i) “abstinence initiators” who quit drinking during treatment (n = 17), (ii) “already abstainers” who were abstinent at the start of treatment (n = 20), and (iii) “continued drinkers” who never initiated abstinence (n = 41). The timing and degree of change in craving and negative affect were compared across these groups using multivariate growth curve modeling. Results: All participant subgroups reported gradual reductions in craving over the course of treatment, with “abstinence initiators” reporting additional sudden reductions in craving upon initiating abstinence from alcohol. “Continued drinkers” reported higher levels of craving than “already abstainers” throughout the full course of treatment. Negative affect followed a different pattern of change, with “abstinence initiators” experiencing gradual reductions in negative affect after initiating abstinence but no changes prior to or immediately upon initiating abstinence, and with “already abstainers” and “continued drinkers” experiencing no changes in negative affect over time. Conclusions: Initiating abstinence is associated with immediate reductions in craving, followed by gradual reductions in both craving and negative affect. Results provide insight into the timing and magnitude of changes in theoretically and clinically important variables and may help patients anticipate when to expect improvement in craving and negative effect. [ABSTRACT FROM AUTHOR]

Aim. The conducted studies were aimed at making a Polish adaptation of the Penn Alcohol Craving Scale (PACS) by B. Flannery and co-workers. The Scale is a self-assessment method, it comprises 5 statements, and is designed to assess alcohol craving experienced by a patient in a week prior to the examination. Methods. 550 patients with diagnosed alcohol dependence syndrome were examined, and the final analysis included results of 510 persons. The examined group consisted of 396 men and 114 women. The study was made in the 3rd week of their alcohol treatment. There were used: the PENN Craving Scale, the Alcohol Dependence Development Scale (SRUA) (the part in which craving is dealt with), a clinical interview with specially prepared questions about alcohol craving experienced last month and last week, and the Yale-Brown Obsessive Compulsive Intense Drinking Scale. Results. The Polish version of the Penn Scale is characterised by very good psychometric properties - it is a reliable and valid tool. The exploratory and confirmatory factor analyses have proved the existence of one factor. The internal consistency, assessed on the basis of Cronbach's alpha, equalled 0.89. The method displays statistically significant (majority p < 0.0010) relationships with levels of craving experienced last year, last month, and last week before the examination, and also with total score on the Yale-Brown Scale. Conclusions. The effects of the conducted adaptation works on the Penn Scale speak for recommending the method for scientific research and use in therapeutic practice. [ABSTRACT FROM AUTHOR]

Background: Substance use is known to be episodic, dynamic, complex, and highly influenced by the environment, therefore a situational and momentary focus to alcohol craving research is appropriate. Current advances in mobile and wearable technology provide novel opportunities for craving research. However, the lack of consensus within craving theory impedes the identification and prioritization of parameters to be monitored. The aim of this study is to critically review current craving models in order to determine viable theoretical frameworks of alcohol craving and its essential parameters. Methods: Eighteen models of craving were reviewed by applying a literature search with a five-step strategy that accounted for the momentary nature of craving and included a snowballing search and a key term extraction algorithm. Based on this review, multiple decision criteria were defined upon which to evaluate the models. Results: Six models for alcohol craving were supported by sufficient empirical research to be eligible. The inferences drawn on these six models resulted in three decision criteria: the model should (1) incorporate negative affect as a predictor of relapse; (2) explain that dependent drinkers have a higher attentional bias towards alcohol cues than nondependent drinkers; (3) incorporate increased risk of relapse with heightened stress levels. Conclusions: The affective processing model of negative reinforcement, the cognitive processing model, the incentive sensitization theory of addiction and the theory of neural opponent motivation are classified as viable theoretical frameworks, resulting in negative affect and stress as relevant parameters to include in real-time craving monitoring research. [ABSTRACT FROM AUTHOR]

Ghrelin, which is mainly released from the stomach, is the most important orexigenic regulator of food intake, inducing appetite, enhancing adiposity and releasing growth hormone. Besides the hypothalamus, ghrelin receptors (GHS-R1A) are also expressed in the mesolimbic dopaminergic system, which increases the possibility that ghrelin plays an important role in reward regulation for substance use disorders such as alcohol addiction, especially through activating the cholinergic-dopaminergic reward link. In this review we focus on the impact of ghrelin on the development and maintenance of alcohol addiction/dependence, alcohol consumption, alcohol craving and alcohol withdrawal, attempting to integrate preclinical and clinical studies concerning the intriguing relationship between appetite regulation, reward and alcohol addiction. Integrating the existing preclinical and clinical data on ghrelin antagonism, specifically at the GHS-R1A receptor in mesolimbic dopaminergic pathways, may reveal a new and innovative target for the treatment of alcohol dependence in the future. [ABSTRACT FROM AUTHOR]

For a long time researchers have been interested in alcohol cravings, which may be defined as a strong desire or sense of compulsion to take the substance. The need for further research and reflection on the issue has at the same time been emphasised in the literature. The article presents various terms and models of alcohol craving. The paper describes the most important categories of craving model highlighted by Skinner and Aubin (2010), namely models arising from the theory of conditioning, and cognitive, psychobiological and motivational models. The advantages and limitations of the described models are pointed out. The paper also describes the most important tools for measuring alcohol craving and their psychometric properties. The need to develop research tools based on empirically verified theory of craving is highlighted. The article also contains reflections on directions for further research on craving.

Corticotropin releasing factor ( CRF) is a neuropeptide that plays a key role in behavioral and physiological responses to stress. A large body of animal literature implicates CRF acting at type 1 CRF receptors ( CRFR1) in consumption by alcohol-dependent subjects, stress-induced reinstatement of alcohol seeking, and possibly binge alcohol consumption. These studies have encouraged recent pilot studies of CRFR1 antagonists in humans with alcohol use disorder ( AUD). It was a great disappointment to many in the field that these studies failed to show an effect of these compounds on stress-induced alcohol craving. Here, we examine these studies to explore potential limitations and discuss preclinical and human literature to ask whether CRFR1 is still a valid drug target to pursue for the treatment of AUD. [ABSTRACT FROM AUTHOR]

Rationale: Clinical trials and human laboratory studies have established that varenicline can reduce rates of alcohol use among heavy drinkers. Less is known about the mechanisms by which varenicline has this effect on drinking behavior. Reactivity to alcohol cues is often cited as the primary cause of relapse among those being treated for alcohol use disorder, and several front-line treatments for alcohol use disorder work, at least in part, by minimizing cue-induced alcohol craving. Objective: The current double-blind, placebo-controlled human laboratory study tested the effects of varenicline on alcohol cue reactivity in a group of heavy-drinking adult smokers and nonsmokers. Methods: As part of a larger series of sequential human laboratory experiments testing the effects of varenicline on drinking outcomes, participants were assigned (between-participant) to receive either active varenicline (2 mg/day) or placebo. Following a titration period, participants ( n = 77) attended a laboratory session during which they were exposed to alcohol and neutral cues using a standard cue reactivity paradigm. Results: Alcohol cue exposure increased craving for alcohol in both medication groups. However, participants receiving varenicline showed a smaller increase in alcohol craving compared to participants receiving placebo. The medication effect did not differ between smokers and nonsmokers. Among smokers, alcohol cue exposure also increased tobacco craving. Varenicline did not attenuate this effect. Conclusions: Results support the use of varenicline for reducing alcohol use in heavy drinkers and identify a potential mechanism by which varenicline reduces drinking. Varenicline continues to show promise as a pharmacological treatment for alcohol use disorder. [ABSTRACT FROM AUTHOR]

Introduction: Craving is a clinically important feature of alcohol use disorders (AUD), representing a diagnostic criterion as well as a target for treatment. The Desire for Alcohol Questionnaire (DAQ) is a widely used scale to measure craving. The aim of the current study was to evaluate the psychometric properties of a Swedish version of the Shortened-DAQ.Method: The English DAQ was translated into Swedish and back translated to English. Individuals with a diagnosis of AUD (n=118) participated in a laboratory experiment comprising presentation of alcohol and non-alcohol cues, as well as consumption of an alcoholic drink, with the aim of exploring changes in the craving responses following pharmacological treatment for AUD. Subjective craving across the experimental conditions was recorded using Shortened-DAQ and a Visual Analogue Scale (VAS). The psychometric analysis of the Shortened-DAQ investigated some important aspects of reliability, validity and the factor solution using principal components analysis.Results: Cronbach's alphas were above 0.8 across all sessions, the test-retest correlations were statistically significant. In the alcohol cue session the Shortened-DAQ total score was significantly greater compared to the non-alcohol cue session, and correlated significantly with the VAS craving item across all sessions. The principal component analysis resulted in two significant factors comprised of (1) Alcohol desire and reinforcement and (2) Ability to control drinking. No difference in psychometric properties between treatment and placebo groups were found.Conclusion: In future clinical studies on alcohol craving responses in Swedish patients with AUD, we suggest the use of the Swedish Shortened-DAQ, due to its comparably swift administration and overall acceptable psychometric properties. [ABSTRACT FROM AUTHOR]

Background Elevated depression and stress have been linked to greater levels of alcohol problems among young adults even after taking into account drinking level. This study attempts to elucidate variables that might mediate the relation between symptoms of depression and stress and alcohol problems, including alcohol demand, future time orientation, and craving. Methods Participants were 393 undergraduates (60.8% female, 78.9% White/Caucasian) who reported at least 2 binge-drinking episodes (4/5+ drinks for women/men, respectively) in the previous month. Participants completed self-report measures of stress and depression, alcohol demand, future time orientation, craving, and alcohol problems. Results In separate mediation models that accounted for gender, race, and weekly alcohol consumption, future orientation and craving significantly mediated the relation between depressive symptoms and alcohol problems. Alcohol demand, future orientation, and craving significantly mediated the relation between stress symptoms and alcohol problems. Conclusions Heavy-drinking young adults who experience stress or depression are likely to experience alcohol problems, and this is due in part to elevations in craving and alcohol demand, and less sensitivity to future outcomes. Interventions targeting alcohol misuse in young adults with elevated levels of depression and stress should attempt to increase future orientation and decrease craving and alcohol reward value. [ABSTRACT FROM AUTHOR]

Background Stress and anxiety are widely considered to be causally related to alcohol craving and consumption, as well as development and maintenance of alcohol use disorder ( AUD). However, numerous preclinical and human studies examining effects of stress or anxiety on alcohol use and alcohol-related problems have been equivocal. This study examined relationships between scores on self-report anxiety, anxiety sensitivity, and stress measures and frequency and intensity of recent drinking, alcohol craving during early withdrawal, as well as laboratory measures of alcohol craving and stress reactivity among heavy drinkers with AUD. Methods Media-recruited, heavy drinkers with AUD ( N = 87) were assessed for recent alcohol consumption. Anxiety and stress levels were characterized using paper-and-pencil measures, including the Beck Anxiety Inventory ( BAI), the Anxiety Sensitivity Index-3 ( ASI-3), and the Perceived Stress Scale ( PSS). Eligible subjects ( N = 30) underwent alcohol abstinence on the Clinical Research Unit; twice daily measures of alcohol craving were collected. On day 4, subjects participated in the Trier Social Stress Test; measures of cortisol and alcohol craving were collected. Results In multivariate analyses, higher BAI scores were associated with lower drinking frequency and reduced drinks/drinking day; in contrast, higher ASI-3 scores were associated with higher drinking frequency. BAI anxiety symptom and ASI-3 scores also were positively related to Alcohol Use Disorders Identification Test total scores and AUD symptom and problem subscale measures. Higher BAI and ASI-3 scores but not PSS scores were related to greater self-reported alcohol craving during early alcohol abstinence. Finally, BAI scores were positively related to laboratory stress-induced cortisol and alcohol craving. In contrast, the PSS showed no relationship with most measures of alcohol craving or stress reactivity. Conclusions Overall, clinically oriented measures of anxiety compared with perceived stress were more strongly associated with a variety of alcohol-related measures in current heavy drinkers with AUD. [ABSTRACT FROM AUTHOR]

Background: Increasing evidence supports a role for appetite-regulating pathways like ghrelin, insulin, and leptin in alcoholism. We previously reported that intravenous (i.v.) exogenous ghrelin increases alcohol craving. We also reported i.v. ghrelin reduces endogenous serum leptin, whose levels, in turn, negatively correlated with alcohol craving. Exogenous ghrelin administration decreases insulin secretion both in vitro and in vivo experiments. This study tested the hypothesis that i.v. ghrelin may also decrease endogenous serum insulin levels in alcoholic individuals. Additionally, we explored possible correlations between serum insulin and alcohol craving, since a correlation between insulin and alcohol craving was previously reported. Methods: This was a double-blind, placebo-controlled human laboratory study (n = 43). Non-treatment-seeking, alcoholdependent, heavy drinkers were randomized to receive i.v. ghrelin or placebo, followed by an alcohol cue-reactivity procedure. Results: There was a main effect for i.v. ghrelin, compared to placebo in reducing serum insulin (P < .05). There was also a time effect (P < .001) but not ghrelin x time interaction (P > .05). We did not find a correlation between the reduction of serum insulin and alcohol craving (P > .05). The change in serum insulin was consistent with a parallel reduction in serum connectivepeptide in the ghrelin group compared with placebo, although this difference did not reach statistical significance (P = .076). No similar effects were found for other glucose-regulating hormones analyzed i.e. glucagon, glucagon-like peptide-1, and gastric inhibitory peptide (Ps > .05). Conclusions: These findings indicate i.v. ghrelin administration has an effect on reducing serum insulin in alcohol-dependent individuals; however, the reduction of insulin did not correlate with changes in alcohol cue-elicited craving. We speculate that, unlike for leptin, the interactions between ghrelin and insulin relationship are limited at the peripheral level. However, mechanistic studies are needed to investigate this hypothesis. [ABSTRACT FROM AUTHOR]

Background Quantifying craving longitudinally during the course of withdrawal, early abstinence, and relapse is essential for optimal management of alcohol use disorder ( AUD). In an effort to identify biological correlates of craving, we used proton magnetic resonance spectroscopy (1H- MRS) to investigate the correlation between craving and glutamate levels in the left dorsolateral prefrontal cortex ( LDLPFC) of patients with AUD. Methods Participants underwent 1H- MRS of the LDLPFC with 2-dimensional J-resolved (2 DJ) averaged PRESS. MRS data were processed with LCModel and cerebrospinal fluid ( CSF)-corrected to generate metabolite concentrations. The Penn Alcohol Craving Scale ( PACS) and the 30-day time line follow-back ( TLFB 30) were used to quantify craving for alcohol and drinking patterns, respectively. Results There was a statistically significant positive correlation between CSF-corrected glutamate ([Glu]) levels and PACS scores ( n = 14; p = 0.005). When PACS scores were dichotomized (< or ≥median = 16), [Glu] levels were significantly higher in the high- versus low-craving group ( p = 0.007). In addition, there was a significant negative correlation between CSF-corrected N-acetyl aspartic acid ([ NAA]) levels and mean number of drinks per drinking day in the past month ( n = 13; TLFB 30; p = 0.012). When mean TLFB 30 was dichotomized (< or ≥median = 7.86), [ NAA] levels were significantly lower in subjects that consumed more alcoholic beverages. There was no significant correlation between [Glu] and [ NAA] levels with other measures of drinking behavior and or depression symptom severity. Conclusions While limited by small sample size, these data suggest that glutamate levels in LDLPFC are associated with alcohol craving intensity in patients with AUD. Further study with larger sample size is needed to replicate this finding and evaluate the merits of glutamate spectroscopy as a biological correlate of alcohol craving intensity and a guide to treatment interventions. [ABSTRACT FROM AUTHOR]

Introduction: Interoceptive awareness (IA) is defined as an ability to accurately perceive interoceptive processes, which comprise receiving, processing, and integrating body-relevant signals together with external stimuli. Interoceptive processes affect the motivated approach or avoidance behavior toward stimuli. Alcohol and other substances have effects on the autonomic system that result in altered interoceptive processes. Individuals who have disturbed IA may be at a higher risk of addiction because they are not able to utilize sufficiently body-relevant signals to guide their decision-making. The hypothesis that IA in alcohol-addicted patients would be affected and that the disturbed IA would be associated with alcohol craving was tested in this study. Methods: The study was conducted with 55 patients diagnosed with alcohol addiction according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria and who had been sober for at least two weeks and 52 non-addicted healthy controls. IA measurements were performed using the heartbeat perception performance method, which determines participants' awareness of their own heartbeat by comparing the number of subjectively perceived heartbeats with an objective heart rate measure recorded with ECG during four separate intervals. In addition, the Alcohol Use Disorders Identification Test (AUDIT), Penn Alcohol Craving Scale (PACS), and Obsessive Compulsive Drinking Scale (OCDS) were performed on the alcohol-addicted patient group. Results: IA scores were significantly lower in the alcohol-addicted patients than the control subjects. IA scores of alcohol-addicted patients were negatively correlated with the levels of alcohol craving sensations according to the PACS results. Conclusion: Our results corroborate the suggestion that IA in alcohol-addicted patients would be affected and that poor IA would be associated with alcohol craving and could be a maintaining factor for drinking behavior. [ABSTRACT FROM AUTHOR]

Background The aim of the research work was to present the process of adapting the Polish version of the YBOCS-hd by Modell and colleagues ( Alcohol Clin Exp Res 1992;16:266) to Polish conditions and to characterize the psychometric validation of the measure (e.g., validity, internal structure, and reliability). The scale is a self-assessment method consisting of 10 statements designed for measuring the severity of obsessive and compulsive craving-related thoughts and behaviors in alcohol-dependent or alcohol-abusing patients. Methods The study was carried out in a group of 550 patients diagnosed with alcohol dependence syndrome, 510 of whom (396 males and 114 females) were included in the final analysis. The patients were interviewed during the third week of therapy by the Polish version of the Yale-Brown Compulsive Scale Modified to Reflect Obsessions and Compulsions Related to Heavy Drinking ( YBOCS-hd- PL), the Penn Alcohol Craving Scale ( PACS), Short Alcohol Dependence Data Questionnaire ( SADD), and the 'compulsive' subscale of SCL-90. Results The YBOCS-hd- PL is characterized by good psychometric properties. Factor analysis identified 2 factors corresponding to the structure of the original version. Its internal consistency, assessed on the basis of Cronbach's alpha, is satisfactory: 0.84 for YBOCS-hd- PL (overall), 0.75 for factor 1 (obsessive thoughts), and 0.79 for factor 2 (compulsive behaviors). The discriminant power of the questions ranged from 0.46 to 0.68 ( p < 0.001). For the adapted YBOCS-hd- PL, significant correlations were found between its scores and the PACS and the 'compulsive' subscale of the SCL-90 scale. The obtained results indicate the Polish version of the YBOCS-hd ( YBOCS-hd- PL) proved to be a reliable and valid instrument. Conclusions In view of its very good psychometric properties, the Polish version of the YBOCS-hd can be recommended as an instrument for assessment of alcohol craving and its obsessive and compulsive aspects in individuals with alcohol use disorders. [ABSTRACT FROM AUTHOR]

Background: Addiction is associated with dorso-lateral prefrontal cortex (DLPFC) dysfunction and altered brain-oscillations. High frequency repetitive transcranial magnetic stimulation (HFrTMS) over DLPFC reportedly reduces drug craving. Its effects on neuropsychological, behavioural and neurophysiological are unclear.Methods: We assessed psychological, behavioural and neurophysiological effects of 4 sessions of 10-min adjunctive HFrTMS over the left DLPFC during two weeks during a residential programme for alcohol detoxification. Participants were randomized to active HFrTMS (10 Hz, 100% motor threshold) or sham. Immediately before the first and after the last session, 32-channels EEG was recorded and alcohol craving Visual Analogue Scale, Symptom Check List-90-R, Numeric Stroop task and Go/No-go task administered. Tests were repeated at 1-month follow-up.Results: 17 subjects (mean age 44.7 years, 4 F) were assessed. Active rTMS subjects performed better at Stroop test at end of treatment (p=0.036) and follow up (p=0.004) and at Go-NoGo at end of treatment (p=0.05) and follow up (p=0.015). Depressive symptoms decreased at end of active treatment (p=0.036). Active-TMS showed an overall decrease of fast EEG frequencies after treatment compared to sham (p=0.026). No significant modifications over time or group emerged for craving and number of drinks at follow up.Conclusion: 4 HFrTMS sessions over two weeks on the left DLPFC can improve inhibitory control task and selective attention and reduce depressive symptoms. An overall reduction of faster EEG frequencies was observed. Nonetheless, this schedule is ineffective in reducing craving and alcohol intake. [ABSTRACT FROM AUTHOR]

BACKGROUND The present study aimed at finding any relation between alcohol craving and strategies of coping with stress and satisfaction with life in the addicted. Until now, studies have shown that generalized deficits in coping with stress, and the dominance of avoidance strategies, are significantly related to the increase of the risk of addiction and the course of this disease. This relation, which could link strategies of coping with stress and quality of life with experiencing alcohol craving, has only been explained to a small extent. Also, the role of gender in explaining these relations is ambiguous. PARTICIPANTS AND PROCEDURE The study was conducted in a group of 550 addicted subjects in out-patient or in-patient treatment (396 men and 114 women). In the present study the following instruments were used: the Craving Typology Questionnaire by Marinotti et al., the Yale-Brown Obsessive-Compulsive Drinking Scale by Modell et al., the Mini-Cope by Carver et al., SADD by Reistrick et al., and the Satisfaction with Life Scale by Diener et al. Statistical correlational analysis and structural equations were applied, namely partial least squares path modelling (PLS-PM). RESULTS There are two types of links between craving and strategies of coping with stress among the addicted. The first dominating type is pointing at casual link between ineffective strategies of coping with stress and craving. The other weaker type indicates the diminishing influence of effective strategies of coping with stress on alcohol craving. Life satisfaction lowers alcohol craving. CONCLUSIONS Effective strategies of reacting to stress, together with life satisfaction, protect against increase of alcohol craving. Severity of dependence is an important factor which moderates the influence of strategies of coping with stress on alcohol craving. [ABSTRACT FROM AUTHOR]

Introduction: Craving is recognized as a formidable barrier in the management of patients with alcohol dependence. Among pharmacological agents that have been used in experimental studies for reduction in craving, baclofen appears to have a significant advantage over other agents. Methodology: The study is retrospective chart review of patients (n = 113) who have been treated with baclofen for alcohol dependence in a tertiary hospital of North India. Baseline assessments included sociodemography, motivation, quantity-frequency of alcohol use, and other alcohol-related clinical parameters. Weekly assessments, for a period of 4 weeks, were extracted from records which included dose of baclofen, craving intensity, and alcohol consumption. Results: The study sample was predominantly male, mean age of 41.49 (±9.75) years, most having a family history of substance use (70.97%), and many reporting binge use pattern in last year (49.46%). Baseline assessment revealed 48.7% of the sample was in precontemplation phase for alcohol use and 70% reported severe and persistent craving. This persistent craving was reported by only 15% of the sample by the end of 4 weeks treatment with baclofen (20-40 mg/day). Thirty-four percent of patients reported continued problematic use of alcohol by the end of 4 weeks. Conclusion: Our clinical experience suggests that baclofen reduces craving and alcohol consumption including in those with poor motivation. The drug causes few side effects and does not add to the intoxication effect of alcohol. Considering that baclofen is safe in those with liver cirrhosis and reduces withdrawal symptoms due to alcohol, a controlled trial comparing it with standard treatment is required.Mots-clés:patients with alcohol dependence. Among pharmacological agents that have been used in experimental studies for reduction in craving, baclofen appears to have a significant advantage over other agents. Methodology: The study is retrospective chart review of patients (n = 113) who have been treated with baclofen for alcohol dependence in a tertiary hospital of North India. Baseline assessments included sociodemography, motivation, quantity-frequency of alcohol use, and other alcohol-related clinical parameters. Weekly assessments, for a period of 4 weeks, were extracted from records which included dose of baclofen, craving intensity, and alcohol consumption. Results: The study sample was predominantly male, mean age of 41.49 (±9.75) years, most having a family history of substance use (70.97%), and many reporting binge use pattern in last year (49.46%). Baseline assessment revealed 48.7% of the sample was in precontemplation phase for alcohol use and 70% reported severe and persistent craving. This persistent craving was reported by only 15% of the sample by the end of 4 weeks treatment with baclofen (20-40 mg/day). Thirty-four percent of patients reported continued problematic use of alcohol by the end of 4 weeks. Conclusion: Our clinical experience suggests that baclofen reduces craving and alcohol consumption including in those with poor motivation. The drug causes few side effects and does not add to the intoxication effect of alcohol. Considering that baclofen is safe in those with liver cirrhosis and reduces withdrawal symptoms due to alcohol, a controlled trial comparing it with standard treatment is required. [ABSTRACT FROM AUTHOR]