Craving mediates stress in predicting lapse during alcohol dependence treatment

Law, Bonnie, Gullo, Matthew J., Daglish, Mark, Kavanagh, David J., Feeney, Gerald F.X., Young, Ross M., & Connor, Jason P. (2016) Craving mediates stress in predicting lapse during alcohol dependence treatment. Alcoholism: Clinical and Experimental Research, 40(5), pp. 1058-1064.

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Stress, craving, and depressed mood have all been implicated in alcohol use treatment lapses. Few studies have examined all 3 factors. Progress has been limited because of difficulties with craving assessment. The Alcohol Craving Experience Questionnaire (ACE) is a new measure of alcohol craving. It is both psychometrically sound and conceptually rigorous. This prospective study examines a stress–treatment response model that incorporates mediation by craving and moderation by depressed mood and pharmacotherapy.


Five hundred and thirty-nine consecutively treated alcohol-dependent patients voluntarily participated in an abstinence-based 12-week cognitive-behavioral therapy (CBT) program at a hospital alcohol and drug outpatient clinic. Measures of stress, craving, depressed mood, and alcohol dependence severity were administered prior to treatment. Treatment lapse and treatment dropout were assessed over the 12-week program duration.


Patients reporting greater stress experienced stronger and more frequent cravings. Stronger alcohol craving predicted lapse, after controlling for dependence severity, stress, depression, and pharmacotherapy. Alcohol craving mediated stress to predict lapse. Depressed mood and anticraving medication were not significant moderators.


Among treatment seeking, alcohol-dependent patients, craving mediated the relationship between stress and lapse. The effect was not moderated by depressed mood or anticraving medication.

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ID Code: 95060
Item Type: Journal Article
Refereed: Yes
Keywords: alcohol dependence, stress, craving, treatment, mood
DOI: 10.1111/acer.13034
ISSN: 1530-0277
Subjects: Australian and New Zealand Standard Research Classification > PSYCHOLOGY AND COGNITIVE SCIENCES (170000) > PSYCHOLOGY (170100) > Health Clinical and Counselling Psychology (170106)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Psychology & Counselling
Copyright Owner: Copyright 2016 by the Research Society on Alcoholism
Deposited On: 26 Apr 2016 02:50
Last Modified: 27 Apr 2016 00:59

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