A critique of contemporary urge and craving research: Methodological, psychometric, and theoretical issues

Stephen T Tiffany
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引用次数: 92

Abstract

Contemporary theories of drug urges assume that these states are central to the maintenance of drug administration in addicts and are responsible for the high rate of relapse frequently encountered when addicts attempt abstinence. Most urge theories share the assumption that urges and cravings are subjective states that are manifest behaviorally as concordant changes in overt behavior (e.g., drug pursuit and consumption), verbal reports of urges, and particular constellations of somatovisceral responses. Urge research has been impeded by inadequate development of questionnaires for assessing verbal report of urges, limitations of laboratory-based urge-induction procedures, selection and interpretation of relevant psychophysiological measures, and reluctance to critically examine the assumption that urges are necessary for drug use. Examples of research from the author's laboratory illustrating how these issues might be addressed are presented. In addition, a recent cognitive model (Tiffany, 1990) is described that assumes that the processes that control drug use in the addict operate independently of those supporting drug urges. This approach, which draws on the strong parallels between various descriptions of automatic and nonautomatic cognitive processing and some key characteristics of drug-use behavior and drug urges, offers a distinct alternative to current models of drug urges.

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当代冲动和渴望研究的批判:方法论、心理测量学和理论问题
当代的药物冲动理论认为,这些状态是瘾君子维持药物管理的核心,也是瘾君子试图戒断时经常遇到的高复发率的原因。大多数冲动理论都有一个共同的假设,即冲动和渴望是一种主观状态,表现为公开行为的一致变化(例如,药物追求和消费),冲动的口头报告,以及身体本能反应的特定组合。冲动研究受到以下因素的阻碍:评估冲动口头报告的问卷编制不充分、基于实验室的冲动诱导程序的局限性、相关心理生理措施的选择和解释,以及不愿严格审查冲动是吸毒所必需的假设。从作者的实验室研究的例子说明如何解决这些问题提出。此外,一个最近的认知模型(Tiffany, 1990)被描述为假设在成瘾者中控制药物使用的过程独立于那些支持药物冲动的过程。这种方法利用了对自动和非自动认知过程的各种描述以及药物使用行为和药物冲动的一些关键特征之间的强烈相似之处,为当前的药物冲动模型提供了一种独特的替代方案。
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