Abstract
According to the ambivalence model of craving, alcohol craving involves the dynamic interplay of separate approach and avoidance inclinations. Cue-elicited increases in approach inclinations are posited to be more likely to result in alcohol consumption and risky drinking behaviors only if unimpeded by restraint inclinations. Current study aims were (1) to test if changes in the net balance between approach and avoidance inclinations following alcohol cue exposure differentiate between low and high risk drinkers, and (2) if this balance is associated with alcohol consumption on a subsequent taste test. In two experiments (N = 60; N = 79), low and high risk social drinkers were exposed to alcohol cues, and pre- and post- approach and avoidance inclinations measured. An ad libitum alcohol consumption paradigm and a non-alcohol exposure condition were also included in Study 2. Cue-elicited craving was characterized by a predominant approach inclination only in the high risk drinkers. Conversely, approach inclinations were adaptively balanced by equally strong avoidance inclinations when cue-elicited craving was induced in low risk drinkers. For these low risk drinkers with the balanced craving profile, neither approach or avoidance inclinations predicted subsequent alcohol consumption levels during the taste test. Conversely, for high risk drinkers, where the approach inclination predominated, each inclination synergistically predicted subsequent drinking levels during the taste test. In conclusion, results support the importance of assessing both approach and avoidance inclinations, and their relative balance following alcohol cue exposure. Specifically, this more comprehensive assessment reveals changes in craving profiles that are not apparent from examining changes in approach inclinations alone, and it is this shift in the net balance that distinguishes high from low risk drinkers.
Highlights
Alcohol craving is recognized as a diagnostic feature in substance use disorders, (DSM-5; American Psychiatric Association, 2013) and is associated with a wide range of treatment outcomes, such as engagement (Schlauch et al, 2012), relapse (Miller et al, 1996; Law et al, 2016) and drinking behavior (Klein et al, 2007; Klein and Anker, 2013; Schlauch et al, 2015b; Approach and Avoidance of AlcoholMcHugh et al, 2016)
The ambivalence model of craving (Breiner et al, 1999), posits that craving involves the dynamic interplay of separate approach and avoidance inclinations
Predominant avoidance or ambivalent craving profiles are more likely to result in restraint, whereas predominant approach is more likely to result in alcohol consumption and potentially risky drinking if unimpeded by restraint
Summary
Alcohol craving is recognized as a diagnostic feature in substance use disorders, (DSM-5; American Psychiatric Association, 2013) and is associated with a wide range of treatment outcomes, such as engagement (Schlauch et al, 2012), relapse (Miller et al, 1996; Law et al, 2016) and drinking behavior (Klein et al, 2007; Klein and Anker, 2013; Schlauch et al, 2015b; Approach and Avoidance of AlcoholMcHugh et al, 2016). Different craving profiles might be observed when individuals are exposed to alcohol cues, because one or both inclinations may change following cue exposure, but those changes may result in a shift in the relative strength of approach versus avoidance over time. After cue-elicited changes in craving, the strength of an approach inclination outweighs the strength of an avoidance inclination, the risk of unrestrained and potentially harmful drinking episodes increases. The aim of the present studies was to examine if cueelicited changes in approach and avoidance inclinations result in different craving profiles for low and high risk drinkers, and subsequent drinking behavior in a lab-based alcohol taste test
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