title: A daily process examination of the bidirectional relationship between craving and alcohol consumption as measured via interactive voice response.
abstract: BACKGROUND
  Craving is a central component to alcohol use disorders, although there are contradictory findings in the literature regarding the importance of craving in alcohol use. The study goal was to examine the bidirectional relationship between craving and alcohol consumption in heavy drinkers.
  
  
  METHODS
  Participants received brief alcohol interventions from their primary care physicians and then were asked to make daily reports of craving and alcohol consumption to an interactive voice response (IVR) telephone system for 180 days. The study sample included 246 participants (166 men) with mean age of 46. Ninety-seven percent were Caucasian and 66% met criteria for alcohol dependence. Analysis used generalized estimating equations (GEE) to evaluate whether craving intensity predicted next day alcohol consumption and whether alcohol consumption predicted next day craving intensity. Significant interactions with gender led to stratified analyses.
  
  
  RESULTS
  GEE analyses revealed a significant bidirectional relationship between craving and drinking, where craving intensity predicted next day total drinks consumed (p = 0.001), and total drinks predicted next day craving intensity (p = 0.02). Exploratory analysis found that gender significantly moderated the craving-drinking relationship (p = 0.002) with men increasing next day alcohol use more (b = 0.19) than women (b = 0.08).
  
  
  CONCLUSIONS
  Findings suggest a bidirectional relationship between craving and drinking may contribute to the development or maintenance of heavy drinking, particularly for men. Based on our findings, we recommend that during brief interventions, physicians address both drinking and craving and provide advice for coping with craving.
authors.affiliation: Department of Psychology, University of Vermont, Burlington, Vermont; Department of Psychiatry, University of Vermont, Burlington, Vermont.
authors.forename: Tera L
authors.initials: TL
authors.lastname: Fazzino
authors.forename: Valerie S
authors.initials: VS
authors.lastname: Harder
authors.forename: Gail L
authors.initials: GL
authors.lastname: Rose
authors.forename: John E
authors.initials: JE
authors.lastname: Helzer
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000523:psychology*; D000437:Alcoholism / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012737:Sex Factors; D013375:Substance Withdrawal Syndrome / Q000523:psychology*; D013689:Telephone
keywords: Alcohol; Craving; Gender; Interactive Voice Response
references.citation: Am J Psychiatry. 1995 Mar;152(3):332-40
references.pmid: 7864257
references.citation: Br J Addict. 1989 Jul;84(7):801-14
references.pmid: 2758153
references.citation: J Stud Alcohol. 1994 Jul;55(4):487-94
references.pmid: 7934057
references.citation: Alcohol Clin Exp Res. 1999 Aug;23(8):1289-95
references.pmid: 10470970
references.citation: Psychol Addict Behav. 2007 Sep;21(3):277-86
references.pmid: 17874878
references.citation: J Consult Clin Psychol. 1994 Aug;62(4):809-17
references.pmid: 7962885
references.citation: Psychol Rev. 1990 Apr;97(2):147-68
references.pmid: 2186423
references.citation: Br J Clin Psychol. 2009 Sep;48(Pt 3):241-54
references.pmid: 19364447
references.citation: Addict Behav. 2005 Jul;30(6):1209-24
references.pmid: 15925129
references.citation: Br J Addict. 1990 Jun;85(6):725-43
references.pmid: 2198966
references.citation: Addiction. 2000 Aug;95 Suppl 2:S247-55
references.pmid: 11002919
references.citation: Psychopharmacology (Berl). 1976 Oct 20;50(1):35-9
references.pmid: 827760
references.citation: Addiction. 2008 Jun;103(6):953-9
references.pmid: 18482418
references.citation: QJM. 1997 Apr;90(4):253-61
references.pmid: 9307759
references.citation: Addiction. 2000 Jun;95(6):889-900
references.pmid: 10946438
references.citation: Am J Addict. 2006 May-Jun;15(3):242-5
references.pmid: 16923671
references.citation: Biometrics. 2001 Mar;57(1):120-5
references.pmid: 11252586
references.citation: J Addict Dis. 2007;26(1):79-84
references.pmid: 17439871
references.citation: Neurosci Biobehav Rev. 2010 Mar;34(4):606-23
references.pmid: 19961872
references.citation: Psychiatr Danub. 2008 Dec;20(4):500-7
references.pmid: 19011591
references.citation: Am J Addict. 2010 Sep-Oct;19(5):450-7
references.pmid: 20716308
references.citation: J Consult Clin Psychol. 1993 Dec;61(6):1011-9
references.pmid: 7906700
references.citation: Am J Addict. 2005 May-Jun;14(3):248-55
references.pmid: 16019975
references.citation: Alcohol Res Health. 1999;23(3):215-24
references.pmid: 10890817
references.citation: J Stud Alcohol. 2003 Jan;64(1):120-6
references.pmid: 12608492
references.citation: Alcohol Alcohol. 2004 Jul-Aug;39(4):357-61
references.pmid: 15208171
references.citation: Addict Behav. 2007 Dec;32(12):2811-8
references.pmid: 17524566
references.citation: J Consult Clin Psychol. 1994 Jun;62(3):620-6
references.pmid: 8063989
references.citation: J Stud Alcohol. 1990 May;51(3):263-70
references.pmid: 2342366
references.citation: Psychiatr Serv. 1997 Aug;48(8):1048-57
references.pmid: 9255838
references.citation: J Stud Alcohol. 1995 Jul;56(4):375-82
references.pmid: 7674671
references.citation: Br J Clin Psychol. 2006 Nov;45(Pt 4):515-29
references.pmid: 17076961
references.citation: Drug Alcohol Depend. 2009 Aug 1;103(3):131-6
references.pmid: 19443131
references.citation: J Stud Alcohol. 2006 Sep;67(5):770-7
references.pmid: 16847547
references.citation: Alcohol Alcohol. 2003 Jan-Feb;38(1):35-9
references.pmid: 12554605
references.citation: Q J Stud Alcohol. 1974 Mar;35(1):108-30
references.pmid: 4827273
references.citation: Am J Psychiatry. 1948 Nov;105(5):329-38
references.pmid: 18890902
references.citation: Behav Pharmacol. 1998 Nov;9(7):631-42
references.pmid: 9862088
references.citation: J Subst Abuse Treat. 2006 Jun;30(4):349-53
references.pmid: 16716850
references.citation: Drug Alcohol Depend. 2011 Jun 1;115(3):205-12
references.pmid: 21146940
references.citation: J Nerv Ment Dis. 2004 Jul;192(7):494-502
references.pmid: 15232320
references.citation: J Stud Alcohol Drugs. 2008 Mar;69(2):251-8
references.pmid: 18299766
references.citation: J Abnorm Psychol. 1997 May;106(2):243-50
references.pmid: 9131844