Comparative Evaluation of Recent Tests for Assessing Craving in Alcohol Use Disorder
G. M. Festa, G. Martinotti, I. S. Lancia, A. Viggiani, C. BusdraghiIntroduction
The identification and quantification of craving in Alcohol Use Disorder (AUD) are fundamental for both clinical practice and research. The various tools available across countries and in the literature raise issues of selection, reliability and comparability across contexts and populations.
Objectives
This study focused on identifying various assessment tools (inclusion criteria: tests published from 2020 to the present) for evaluating and measuring alcohol craving. The aim was to provide a critical review of these tools, with a focus on their structure and psychometric properties.
Methods
7 tests were identified:
Approach and Avoidance of Alcohol Questionnaire (AAAQ)
Alcohol Craving Experience (ACE)
Alcohol Craving Questionnaire (ACQ)
Alcohol Craving Scale Based on Three Factors (ACS-3F)
Alcohol Craving Typology Questionnaire (A-CTQ)
Adolescent-Obsessive Compulsive Drinking Scale (A-OCDS)
Jellinek Craving Questionnaire (JACQ)
Multidimensional Alcohol Craving Scale (MACS)
The aspects were analyzed: year of publication, structure, content, reliability, standardization sample, and administration method.
Results
All identified tools showed good internal consistency (Cronbach’s α > 0.70).
AAAQ was designed to assess two aspects of alcohol craving: the desire to drink and the inclination to avoid alcohol consumption.
ACE measures sensory and cognitive aspects of craving, such as imagining the taste, smell, or sensations of drinking, as well as intrusive thoughts about alcohol. It identifies three main factors: imagination, intensity, intrusion.
ACS-3F assesses responses to positively reinforcing stimuli, negatively reinforcing stimuli, and loss of control.
A-CTQ is the most recent scale among those reviewed and includes a large normative and clinical standardization sample. It distinguishes accurately between different types of craving (Reward, Relief, Obsessive), with specific therapeutic implications.
A-OCDS is suitable for adolescents and young adults. It assesses the frequency of alcohol-related thoughts, desires, and imagery, difficulties in avoiding alcohol, and tendencies to skip or drink before/during school hours.
JACQ evaluates craving across four dimensions: emotional impulse, physical sensations, temptation to drink, and uncontrolled thoughts. It is structured to assess both current (immediate urge) and past (retrospective urge) craving.
MACS
specifically measures two main dimensions: alcohol desire and behavioral disinhibition. It evaluates craving intensity and presence while considering aspects of alcohol-use planning and anticipation of positive effects or abstinence improvement.
Image 1: Long description.