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Disentangling between- and within-person alcohol and expectancy effects on acute alcohol craving

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Abstract

Objective

Alcohol craving is a predictor of continued drinking and a diagnostic criterion for alcohol use disorder. Rewarding subjective effects potentiate craving, but it remains unclear if relations are expectancy-driven vs. alcohol-induced. In addition, it remains unclear if relations operate solely at the person level, or if there is also within-person dynamic change.

Methods

Participants (N = 448) come from a placebo-controlled alcohol administration study. Participants in the alcohol condition reported subjective effects and alcohol craving on ascending (BAC = .068), peak (BAC = .079), and descending (BAC = .066) BAC limbs. Participants in the placebo condition were yoked to alcohol condition participants. Multilevel models tested whether (1) within-person deviations in subjective effects predicted within-person deviations in craving, (2) between-person levels of subjective effects predicted between-person levels of craving, and (3) effects were dependent upon experimental condition.

Results

At the within-person level, increases in high arousal positive/stimulant effects were associated with within-person increases in alcohol craving, regardless of experimental condition. At the between-person level, interactions were observed between high arousal positive/stimulant (and low arousal positive/relaxing) effects and condition. Probing suggested that the association between person-level high arousal positive/stimulant effects and craving was statistically significant in the alcohol but not the placebo condition. Conversely, the association between person-level low arousal positive/relaxing effects and craving was positive and statistically significant in the placebo but negative in the alcohol condition.

Conclusions

Findings suggest expectancy-like relations among high arousal positive/stimulant effects and craving within-person. However, alcohol-induced positive reinforcement (i.e., stimulation) facilitated heightened person-level craving, whereas expectancy-like negative reinforcement (i.e., relaxation) attenuated person-level craving.

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Data availability

Data is available from the corresponding author upon reasonable request.

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Funding

This study was supported by funding from the National Institute on Alcohol Abuse and Alcoholism grants R01-AA021148 (PI: William R. Corbin) and F31-AA030167 (PI: Jack T. Waddell).

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  1. Department of Psychology, Arizona State University, 900 S McAllister, Tempe, AZ, 85287-1104, USA

    Jack T. Waddell, Scott E. King & William R. Corbin

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  1. Jack T. Waddell
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  2. Scott E. King
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Correspondence to Jack T. Waddell.

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Waddell, J.T., King, S.E. & Corbin, W.R. Disentangling between- and within-person alcohol and expectancy effects on acute alcohol craving. Psychopharmacology 240, 1333–1342 (2023). https://doi.org/10.1007/s00213-023-06372-0

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