ReviewCraving's place in addiction theory: Contributions of the major models
Section snippets
Craving as a term
During a meeting in 1954 convened specifically to clarify the use of the term craving, the World Health Organization (WHO Expert Committees on Mental Health and on Alcohol, 1955) concluded that as a technical term in research on alcohol use, the term craving was confusing and inappropriate because of its everyday connotations as an “urgent and overpowering desire”. As a result, two more precise formulations were proposed to replace the term craving: (1) “physical dependence” as a substitute for
Theories of craving
From the earliest theories of motivation to the latest findings from neuroimaging, the notion of craving has evolved to reflect multidimensional aspects including classical conditioning, cognitive science, neuroanatomy/neurotransmitter systems and psychology. It is generally accepted to be context dependent and modulated by individual differences. We present here the basic premises of the principal theories of craving: four conditioning-based models, four cognitive models, seven
Summary and conclusions
The foundation of cue–reactivity research began with classical conditioning explanations of craving as a biological drive provoked by withdrawal symptoms or cues. Specific clinical or theoretical goals inspired by these models led investigators to an expanded understanding of craving with a focus on cognitive components. Tiffany's idea of craving as being effortful, requiring cognitive resources and arising when confronted with an obstacle, explained the ambivalence that so many patients face
Acknowledgements
This research was supported in part by grants from the Department of Clinical Research and Development, Assistance Publique-Hôpitaux de Paris (CIRC 05131) and from the Institut de Recherches Scientifiques sur les Boissons (IREB-Institute of Scientific Research on Drinks).
In addition, this paper is based on research for a doctoral dissertation with alcohol-dependent patients that focuses on the relationship of a threat to alcohol craving using a cue exposure paradigm in a French hospital. We
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