Craving: desire and imagination

By Cristiano Antonino On Nov 23, 2022

Craving is a term that refers to the compulsive desire for a psychoactive substance/behaviour (e.g. gambling), is among the diagnostic criteria for substance use disorder (DSM V) and is a central factor in the maintenance of addiction

Craving: what kind of experience is it?

A recent Swedish qualitative study (2022) analysed the experience of craving in a sample of 21 people, of whom 10 had an alcohol use disorder and 11 were diagnosed with pathological gambling (GAP).

Through a semi-structured interview, an attempt was made to gain a more precise understanding of the patients’ experience and specifically the following elements characterising craving were explored: mode of thought (imaginative or verbal); content; coping strategies; context.

Results of the craving study

Thematic analysis showed that craving is initially supported by imagery relating to preparatory rituals and anticipation of the perceptual sensations associated with the use of the substance or the addictive behaviour.

Some subjects, on the other hand, describe craving as a symptom of an illness and cope with it (coping) through distraction, remembering the negative consequences of the desired behaviour or avoiding the stimuli associated with the behaviour (stimulus control strategies).

The contexts imagined during the craving experience are typical places where gambling takes place or alcoholic beverages are accessed and both positive and negative emotions are experienced.

In particular, alcohol craving is described as the expectation of relief from a negative internal stimulus, such as stress or anxiety, while gambling craving is more associated with the expectation of obtaining a reward.

In conclusion, the craving experience is largely characterised by mental images related to the routine actions that characterise addictive behaviour and the outcomes that the individual expects to obtain after using the substance or gambling.

Such more detailed knowledge of craving may be helpful in better understanding the individual’s experience and more effectively setting up the treatment plan.