Citation

McEvoy PM, Stritzke WG, French DJ, Lang AR, Ketterman R. Addiction 2004; 99(4): 482-497.

Affiliation

University of Western Australia, Australia. werner@psy.uwa.edu.au

Copyright

(Copyright © 2004, John Wiley and Sons)

DOI

10.1111/j.1360-0443.2004.00714.x

PMID

15049748

Abstract

AIMS: The aim of study 1 was to develop a three-factor Approach and Avoidance of Alcohol Questionnaire (AAAQ), designed to assess mild and intense inclinations to drink, as well as inclinations to avoid drinking. The aims of study 2 were to cross-validate the AAAQ with an independent sample and to test the goodness-of-fit of three models of craving for alcohol: (a) the traditional unidimensional model; (b) a two-dimensional, approach-avoidance ambivalence model; and (c) an expanded two-dimensional neuroanatomical model that retains avoidance, while positing a threshold that partitions approach into two distinct levels and relates all three factors involved in craving to brain pathways associated with inhibitory processes, reward and obsessive-compulsive behaviour, respectively. DESIGN, SETTING AND PARTICIPANTS: The survey was administered to 589 Australian university students (69% women) in study 1 and to 523 American university students (64% women) in study 2. MEASUREMENTS: Inclinations to drink and to not drink (AAAQ), drinking behaviour (quantity and frequency), drinking problems (Young Adult Alcohol Problems Screening Test; YAAPST) and readiness for change (Stages of Change Readiness and Treatment Eagerness Scale; SOCRATES). FINDINGS: The expanded two-dimensional neuroanatomical model provided the best fit to the data. The AAAQ explained a substantial proportion of the variance in drinking frequency (41-53%), drinking quantity (49-60%) and drinking problems (43%). AAAQ profiles differed as a function of drinking-related risk, and the three AAAQ scales differentially predicted readiness for change. CONCLUSIONS: Approach and avoidance inclinations toward alcohol are separable constructs, and their activation may not be invariably reciprocal. Craving can be defined as the relative activation of substance-related response inclinations along these two primary dimensions. There may be a threshold of intensity that separates mild from intense approach inclinations.

Language: en