Development and Initial Validation of a Measure of Drinking Urges in Abstinent Alcoholics

TLDR

Drinking urges are common among alcoholics, yet prospective studies show inconsistent links to relapse, and existing measures rely on single‑item ratings with questionable reliability. The study aimed to develop a comprehensive questionnaire to better evaluate alcohol craving hypotheses. The 49‑item instrument assessed desire, expected positive effects, withdrawal relief, negative affect relief, and intention to drink. Factor analyses of 351 abstinent alcoholics revealed a single‑factor structure, leading to an 8‑item Alcohol Urge Questionnaire that is internally consistent, reliable, and valid, and AUQ scores correlated strongly with dependence severity and cognitive preoccupation, and decreased with longer abstinence, suggesting utility in treatment research and laboratory studies.

Abstract

Although drinking urges and cravings are commonly reported by alcoholics, prospective studies have found inconsistent associations between such urges and drinking relapses. Previous studies have measured drinking urges by use of single‐item ratings of alcohol craving or other measures of unknown reliability and validity. To permit improved evaluation of hypotheses regarding alcohol craving, a 49‐item questionnaire that reflects several urge‐related domains was developed and pretested. Items assessed subjects'desire for a drink, expectations of positive effects following drinking, relief of withdrawal and negative affect following drinking, and intention to drink. Exploratory and confirmatory factor analyses of the responses of 351 abstinent, treatment‐seeking alcoholics indicated that alcohol urges are best described by a single factor. Based on these analyses, an internally consistent, reliable, and psychometrically valid 8‐item scale, the Alcohol Urge Questionnaire (AUQ), was developed. Data indicated that AUQ scores were strongly related to alcohol dependence severity and to cognitive preoccupation with alcohol, and that they declined with prolonged abstinence. The AUQ may be useful in alcoholism treatment research and in laboratory studies of reactivity to alcohol or other manipulations.