Interest in female smoking behaviors has grown due to research that has highlighted gender differences in smoking cessation trends. Specifically, female smokers tend to lag behind men in their success in smoking cessation and are more likely to report weight gain concerns. The first goal of this project is to examine the effect of smoking deprivation on smoking and chocolate cravings. In examining smoking deprivation and cravings, the goal is to also determine the affective motivational system underlying craving. Female cigarette smokers (N = 42) were recruited and randomly assigned to either a 10-hour smoking abstinence group or a control group. We examined both self-reported cravings and startle-eye blink responses to visual smoking and chocolate cues. Our results indicated that smoking and chocolate cravings are appetitive for both abstinent and non-abstinent female smokers. Both the psychophysiological and self-report data also indicate that female smokers who abstain from smoking for a short duration seem to be less sensitive to positive reinforcing stimuli than those who continued to smoke. The implications of these findings are discussed.

Alkoholabhängigkeit ist weltweit ein prävalentes Problem und Alkohol-Craving stellt einen wichtigen Faktor für die Entstehung und Aufrechterhaltung der Abhängigkeit und für einen Rückfall dar. Craving kann mithilfe subjektiver Messmethoden, bildgebenden Verfahren und mithilfe der Cue-Reaktivität gemessen werden. Ein Paradigma hierfür ist die Messung der Alkohol-Cue-Reaktivität mithilfe des akustisch induzierten Startle Reflexes während der Präsentation alkoholrelevanter und anderer emotional erregender Bilder. Bei alkoholabhängigen Patienten wurde eine erhöhte Aktivität des Dorsolateralen Präfrontalen Kortex (DLPFC) beobachtet, einem Hirnareal, das für exekutive Funktionen zuständig ist und dem eine große Rolle im Prozess des Cravings zugeschrieben wird. In der Literatur wurde gezeigt, dass eine veränderte Aktivität im DLPFC mit einem erhöhten Craving einhergeht. Zur Modulation der Aktivität des DLPFC kann die transkranielle Gleichstromstimulation (tDCS), eine Form der nichtinvasiven Neurostimulation, eingesetzt werden. Hierbei führt eine kathodale tDC Stimulation zu einer Verringerung der neuronalen Exzitabilität, während anodale Stimulation diese steigert. In unserer Studie sollte überprüft werden, ob durch die Modulation der Aktivität in Richtung einer Inaktivierung des DLPFC die Cue Reaktivität auf Alkoholreize im Startle Test verändert werden kann und das Craving hierdurch reduziert werden kann. Hierfür wurde eine kathodale Stimulation gewählt. In einer doppelblinden randomisiert-kontrollierten Studie untersuchten wir den Effekt von tDCS an 30 alkoholabhängigen stationären Patienten, die sich direkt nach dem akuten Entzug befanden. Die Probanden wurden zwei Gruppen randomisiert zugeteilt, eine Gruppe mit links kathodaler Verum-Stimulation und eine Gruppe mit Sham-Stimulation. Während einer 20-minütigen tDCS-Stimulation über dem DLPFC wurden emotional positive, neutrale und negative Bilder sowie Alkohol-Bilder präsentiert und parallel der akustische Startle-Response gemessen. In unserer Untersuchung konnte gezeigt werden, dass Alkohol-Bilder im Startle Test aversiv verarbeitet werden. Zudem konnte ein signifikanter Effekt der tDCS Intervention gezeigt werden. TDCS führte zu einer noch negativeren Modulation des Startle Responses. Auch für das subjektive Craving konnte ein mittlerer Effekt in Richtung einer Reduktion des Cravings durch tDCS gezeigt werden. Im subjektiven Bilder-Rating nach Arousal zeigte sich ein appetitiver Effekt von Alkoholreizen, jedoch kein Effekt durch die Intervention. Zusammenfassend konnte diese Studie einen signifikanten Effekt durch transkranielle Stimulation mit tDCS auf die Cue-Reaktivität alkoholrelevanter Reize und das subjektive Craving zeigen und unterstreicht damit die Wirksamkeit der tDC Stimulation als neuromodulatorische Methode. Dies eröffnet neue Perspektiven für die zukünftige Modulation des Cravings durch eine Veränderung der neuronalen Exzitabilität. Trotzdem werden weitere Studien notwendig sein, die den Effekt der tDCS auf die Cue-Reaktivität und das Craving prüfen. Zudem wäre es wichtig, standardisierte Stimulations- und Messprotokolle zu entwickeln, um eine bessere Vergleichbarkeit der Studien zu ermöglichen. Das Ziel weiterer Untersuchungen könnte sein, die tDCS als mögliche Therapieoption zur Unterstützung der Therapie bei Alkoholabhängigkeit in den klinischen Einsatz zu etablieren. Hierzu werden multimodale klinische Therapiestudien nötig sein, die den praktischen Einsatz in der Klinik und zudem Langzeiteffekte prüfen. Diese Studie möchte dazu beitragen, das Phänomen des Alkohol-Cravings und der Cue-Reaktivität besser zu verstehen, die tDCS als neue Herangehensweise zur Reduktion des Cravings zu überprüfen und langfristig die Therapie der Alkoholabhängigkeit zu verbessern. / Alcohol craving has been shown to be an important factor for relapses in alcohol-dependent patients. Additionally, brain activity in reward-related areas in response to alcohol-related cues is positively related to the amount of post-relapse alcohol consumption. Transcranial direct current stimulation (tdcs) has been used as a method to modulate brain activity. The question of this study was, whether it is possible to change cue-reactivity and subjective craving by applying bilateral prefrontal tDCS. We stimulated 30 detoxified alcohol-dependent patients (50 % with a sham and 50 % with left cathodal/right anodal stimulation) and presented emotional as well as alcohol-related pictures. The emotional startle modulation was measured and significantly increased startle amplitudes in the verum stimulation condition for alcohol-related cues were found, indicating a more negative processing of this cues in alcohol-dependent patients after verum tDC-stimulation. Furthermore we found tendencies for stronger reduction in subjective craving in verum-stimulated patients. Therefore our study underscores the positive value of DCS in reducing craving and might help to improve the understanding and therapy of alcohol dependence.

The elaborated intrusion (EI) theory of desire is a cognitive model that describes the processes involved in craving as intrusive thoughts that are elaborated upon leading to dissonance when desires are not met. While the theory is based on a wide body of research, certain theoretical predictions have not been fully examined. Specifically, EI theory argues that mental imagery has a central role in craving, and predicts that attempts to suppress substance-related intrusive thoughts and mental imagery is related to increased craving. Further, EI theory suggests that elaboration of craving imagery is related to attention and working memory processes, however, there are questions about whether differential performance in these domains is related to craving. The current study examined the relationship between attention/working memory performance and alcohol craving in a sample of 119 young adult males. Additionally, metacognition was examined to clarify the phenomenological aspects of craving within EI theory. Attention and working memory performance did not significantly predict intrusive thought and mental imagery elaboration. Individuals with high craving reported significantly higher levels of anxiety, thought suppression, and greater strength and frequency of craving-related mental imagery. They were also more likely to try to control their own thoughts and make negative judgments on their ability to do so. The strength of craving-related intrusive thoughts, not mental imagery, was the most significant predictor of craving. Implications for the understanding of craving and treatment recommendations based on the findings are discussed.

O estudo teve por objetivo avaliar o us o de c ocaína e/ou de crack e suas possíveis relações com os aspectos biológicos, psicológicos e sociais. Trata-se de um estudo do tipo transversal, de ab ordagem quantitativa. O estudo foi desenvolvido no CAPSad de Ribeirão Preto, SP, por meio de uma amostra de conveniência composta por 95 clientes do serviço, sendo 42 (44,2%) usuários de cocaína e 53 (55,8%) de crack. Os instrumentos de coleta de dados foram: Informações sociodemográficas, Escala de Severidade da D ependência de Drogas (SDS), Cocaine Craving Questionnaire-Brief (CCQ-B), Severity Alcohol Dependence Data (SADD), Inventário das Consequências do Beber (DrInC) e o Addiction Severity Índex (ASI6). A análise de dados foi realizada empregando- se os testes t de Student, para amostras independentes, o de correlação de Pearson e S pearman. A amostra foi composta predominantemente por usuários do sexo masculino, adultos, solteiros, cor branca, com baixo nível de escolaridade, religião católica e t rabalhos informais, sem diferença entre os grupos. Não houve diferenças entre usuários de cocaína e de crack para droga de maior uso, idade do primeiro uso, tempo, em anos e dias, de consumo da droga, uso de álcool no padr ão binge (na vida), níveis de gr avidade da dependência do álcool e da f issura. Os usuários de crack apresentaram maiores níveis de s everidade da de pendência da droga, avaliada tanto segundo a escala SDS quanto do ASI6. O uso de drogas e o suporte familiar e social constituíram as áreas mais prejudicadas entre esses usuários (p<=,005). Correlações entre os escores das áreas: uso de drogas (r=0,33, p<,000), psiquiátrica (r=0,27, p.<,007), legal/justiça (r=0,23, p<,024), suporte familiar/social do ASI e os escores do SDS foram baixas e estatisticamente significativas. Encontrou-se ainda uma correlação negativa entre as áreas do ASI-6: uso de dr ogas (r=-,36, p<,000), uso de álcool (r=-0,29, p<,003), legal/justiça (r=-,23, p<,024), e, positiva, entre a área família (r=0,24,p<,005) e o nível de gravidade da fissura. A escala DrInC correlacionou apenas com a área uso do álcool (ASI6). Correlações também foram identificadas entre a maioria das áreas do ASI6; no entanto, foram exceções as áreas família e emprego/financeira. A idade correlacionou com as áreas, uso de drogas (r=- 0,25, p<,014), legal/justiça (r=-0,21, p<,04) de forma negativa; e, positiva entre com a área médica do ASI6 (r=0,43, p<,000). As consequências do beber não se diferenciaram entre os usuários de cocaína e crack. Houve uma correlação positiva entre o escore total do ASI, a SDS e do DrinC, mas contrariamente aos escores do CCQ-B total. A idade correlacionou com as consequencas do beber (DrInC) e com os níveis de gravidade da dependência do álcool (SADD). Pode se concluir que a relação entre o uso de cocaína e/ou crack e os aspectos biológicos, psicológicos e s ociais são complexas e multidimensionais. Assim, avaliar as peculiaridades relacionadas ao uso de cocaína e crack possibilitou identificar elementos cruciais nos aspectos de saúde e sociais que podem contribuir, de maneira mais apropriada, no norteamento e planejamento da assistência com qualidade a essa população. / The aim in this study was to evaluate cocaine and/or crack use and its possible relations with biological, psychological and social aspects. A cross-sectional study with a quantitative approach was undertaken. The research was developed at the CAPSad in Ribeirão Preto, SP, Brazil, using a convenience sample of 95 service clients, 42 (44.2%) of whom were cocaine users and 53 (55.8%) crack users. The data collection instruments were: Sociodemographic information, Severity of Dependence Scale (SDS), Cocaine Craving Questionnaire-Brief (CCQ-B), Severity Alcohol Dependence Data (SADD), Drinker Inventory of Consequences (DrInC) and t he Addiction Severity Index (ASI-6). For data analysis, Student\'s t-test was used, and Pearson and Spearman\'s correlation test for independent samples. The sample predominantly included male, adult, white users with low education levels, Catholic and active in informal work, without any difference between the groups. No differences were found between cocaine and crack users with regard to the most used drug, age of first use, duration of drug consumption, in years and days, binge drinking (in life), severity levels of alcohol dependence and craving. Crack users showed higher severity levels of drug dependence, assessed according to the SDS and ASI6. Drugs use and family and social support were the most impaired areas among these users (p<=.005). Correlations between area scores: drugs use (r=0.33, p<.000), psychiatric (r=0.27, p<.007), legal/justice (r=0.23, p<.024), family/social support on the ASI and SDS scores were low and s tatistically significant. In addition, a neg ative correlation was found between ASI-6 areas: drugs use (r=-.36, p<.000), alcohol use (r=-0.29, p<.003), legal/justice (r=-.23, p<.024), and a positive correlation between the family area (r=0.24,p<.005) and the severity level of the craving. The DrInC scale was only correlated with the alcohol use area (ASI-6). Correlations were also identified among most ASI-6 areas; exceptions were the family and employment/financial areas. Age was negatively correlated with drugs use (r=- 0.25, p<.014), legal/justice (r=-0.21, p<.04), and positively with the medical area of the ASI-6 (r=0.43, p<.000). No distinctions in drinking consequences were found between cocaine and crack users. A positive correlation was found between total ASI score, SDS and DrInC, but opposed to total CCQ-B scores. Age was correlated with drinking consequences (DrInC) and with alcohol dependence severity levels (SADD). In conclusion, the relation between cocaine and/or crack use and biological, psychological and social aspects are complex and multidimensional. Therefore, assessing the peculiarities of cocaine and crack use permitted the identification of crucial elements in health and social aspects, which can contribute more appropriately to guide and plan quality care to this population

L’addiction aux drogues d’abus se caractérise par une prise compulsive de drogue et par des épisodes récurrents de rechute après abstinence. Ces épisodes de rechute, parfois mortels, sont généralement précédés par un désir intense et irrépressible pour la drogue, appelé aussi craving. Bien que le rôle causal du craving dans la rechute reste encore à démontrer, la prévention du craving est devenue récemment un enjeu important des recherches clinique et préclinique. Chez l’homme l’amorçage du craving s’effectue après exposition ou réexposition à la drogue elle-même, à un stress, ou à des stimuli conditionnés à la prise de drogue. Chez l’animal, cet amorçage peut être modélisé par la reprise du comportement de recherche de drogue après arrêt du renforcement. Cette reprise peut être amorcée par les mêmes facteurs amorçant le craving chez l’homme, notamment par la réexposition à la drogue elle-même, ce qui suggère qu’elle exprime un état ressemblant au craving. Selon une hypothèse récente, l’amorçage du craving par la drogue serait dû à un conditionnement intéroceptif. Ce conditionnement se formerait au cours de l’acquisition où les animaux apprendraient à associer les stimuli intéroceptifs périphériques de la drogue avec la disponibilité du renforcement. Après arrêt du renforcement, la réexposition à ces stimuli intéroceptifs conditionnés provoquerait la reprise de la recherche de drogue en signalant (faussement) aux animaux le retour du renforcement. Cette hypothèse a permis le développement et la validation récente d’une stratégie anti-craving basée sur l’extinction de ces stimuli conditionnés de la cocaïne. Dans ce contexte, mon travail de thèse a eu pour but principal d’évaluer l’efficacité potentielle de cette stratégie à prévenir la rechute proprement dite, c’est-à-dire le retour aux niveaux de prise de cocaïne avant l’extinction. Ce travail a permis de démontrer : 1) qu’il est possible d’éteindre complètement l’amorçage du craving par la cocaïne chez l’animal ; 2) que cette extinction est accompagnée par une perte des réponses neuronales à la cocaïne dans les régions du cerveau causalement impliquées dans l’amorçage du craving (i.e., cortex préfrontal prélimbique et partie « core » du noyau accumbens); 3) mais que malgré nos attentes initiales, l’extinction complète et prolongée de l’amorçage du craving par la cocaïne n’a aucun effet préventif majeur sur la rechute, suggérant une dissociation entre craving et rechute, du moins chez l’animal ; enfin, 4) que cet échec relatif est dû en grande partie à l’existence d’une forme résiduelle de recherche de cocaïne résistante à l’extinction, fréquemment rapportée dans la littérature mais généralement ignorée. Cibler cette résistance à l’extinction afin de l’éradiquer devrait représenter un enjeu majeur pour la recherche future dans le domaine. / Craving often precedes relapse into cocaine addiction. This explains why considerable research effort is being expended to try to develop anti-craving strategies for relapse prevention. Recently, we discovered using the classic reinstatement model of cocaine craving that the reinstating or priming effect of cocaine can be extinguished with repeated priming – a phenomenon dubbed extinction of cocaine priming. Such extinction has been interpreted as evidence that the priming effect of cocaine on reinstatement of cocaine seeking depends on an interoceptive drug conditioning mechanism whereby the interoceptive cues of cocaine become reliable conditioned Pavlovian predictors of the availability of cocaine reinforcement. Regardless of the underlying mechanisms, however, extinction of drug priming has been proposed as a potential cocaine exposure therapy for relapse prevention that may complement other, more traditional exteroceptive cue exposure therapies. The goal of my PhD thesis was to measure the potential beneficial effect of this novel extinction strategy on subsequent relapse (i.e., return to the pre-extinction pattern of cocaine self-administration once the drug is made again available after extinction). Overall and contrary to our initial hope, extensive and complete extinction of cocaine priming had no major impact on relapse. This lack of effect occurred despite evidence for post-extinction loss of neuronal responsiveness to cocaine priming in brain regions causally involved in cocaine-induced reinstatement (i.e., the anterior cingulate and prelimbic prefrontal cortex, and the core of the nucleus accumbens). An effect of extinction of cocaine priming on relapse was only observed when cocaine was available for self-administration under more demanding conditions. However, this effect was modest and short-lived. Finally, we were able to trace the origin of our failure to prevent relapse to an extinction-resistant form of cocaine seeking that is commonly reported, though often overlooked, in other reinstatement studies. We propose that this behavior should become a novel target for future preclinical research on anti-craving strategies for relapse prevention.

This study examined the motivational state associated with smoking craving specifically among women and the effect of deprivation and smoking status on the relationship between responses to appetitive cues. Utilizing both psychophysiological (startle EMG, skin conductance) and self-report measures, we compared cue reactivity to positive, neutral, aversive, smoking, and chocolate pictures among groups of 10 hr. smoking deprived smokers, non-deprived smokers, and non-smokers. Smokers responded to smoking cues similar to pleasant affect cues with more inhibited startle and high arousal, while responses from non-smoking females indicated a neutral state. However, deprivation also significantly increased startle responses to smoking cues when compared to non-deprived smokers. Furthermore, a closer look at skin conductance responses to aversive cues suggest that smoking status (deprived and non-deprived groups) significantly inhibited one?s ability to habituate to negative affect stimuli. When responses to chocolate cues were examined, psychophysiological and self-report data seemed to indicate that smoking deprivation influenced one's ability to attend to other appetitive/rewarding cues. Implications of these results on female smoking craving and sensitivity to appetitive cues are discussed.

O estudo teve por objetivo avaliar o us o de c ocaína e/ou de crack e suas possíveis relações com os aspectos biológicos, psicológicos e sociais. Trata-se de um estudo do tipo transversal, de ab ordagem quantitativa. O estudo foi desenvolvido no CAPSad de Ribeirão Preto, SP, por meio de uma amostra de conveniência composta por 95 clientes do serviço, sendo 42 (44,2%) usuários de cocaína e 53 (55,8%) de crack. Os instrumentos de coleta de dados foram: Informações sociodemográficas, Escala de Severidade da D ependência de Drogas (SDS), Cocaine Craving Questionnaire-Brief (CCQ-B), Severity Alcohol Dependence Data (SADD), Inventário das Consequências do Beber (DrInC) e o Addiction Severity Índex (ASI6). A análise de dados foi realizada empregando- se os testes t de Student, para amostras independentes, o de correlação de Pearson e S pearman. A amostra foi composta predominantemente por usuários do sexo masculino, adultos, solteiros, cor branca, com baixo nível de escolaridade, religião católica e t rabalhos informais, sem diferença entre os grupos. Não houve diferenças entre usuários de cocaína e de crack para droga de maior uso, idade do primeiro uso, tempo, em anos e dias, de consumo da droga, uso de álcool no padr ão binge (na vida), níveis de gr avidade da dependência do álcool e da f issura. Os usuários de crack apresentaram maiores níveis de s everidade da de pendência da droga, avaliada tanto segundo a escala SDS quanto do ASI6. O uso de drogas e o suporte familiar e social constituíram as áreas mais prejudicadas entre esses usuários (p<=,005). Correlações entre os escores das áreas: uso de drogas (r=0,33, p<,000), psiquiátrica (r=0,27, p.<,007), legal/justiça (r=0,23, p<,024), suporte familiar/social do ASI e os escores do SDS foram baixas e estatisticamente significativas. Encontrou-se ainda uma correlação negativa entre as áreas do ASI-6: uso de dr ogas (r=-,36, p<,000), uso de álcool (r=-0,29, p<,003), legal/justiça (r=-,23, p<,024), e, positiva, entre a área família (r=0,24,p<,005) e o nível de gravidade da fissura. A escala DrInC correlacionou apenas com a área uso do álcool (ASI6). Correlações também foram identificadas entre a maioria das áreas do ASI6; no entanto, foram exceções as áreas família e emprego/financeira. A idade correlacionou com as áreas, uso de drogas (r=- 0,25, p<,014), legal/justiça (r=-0,21, p<,04) de forma negativa; e, positiva entre com a área médica do ASI6 (r=0,43, p<,000). As consequências do beber não se diferenciaram entre os usuários de cocaína e crack. Houve uma correlação positiva entre o escore total do ASI, a SDS e do DrinC, mas contrariamente aos escores do CCQ-B total. A idade correlacionou com as consequencas do beber (DrInC) e com os níveis de gravidade da dependência do álcool (SADD). Pode se concluir que a relação entre o uso de cocaína e/ou crack e os aspectos biológicos, psicológicos e s ociais são complexas e multidimensionais. Assim, avaliar as peculiaridades relacionadas ao uso de cocaína e crack possibilitou identificar elementos cruciais nos aspectos de saúde e sociais que podem contribuir, de maneira mais apropriada, no norteamento e planejamento da assistência com qualidade a essa população. / The aim in this study was to evaluate cocaine and/or crack use and its possible relations with biological, psychological and social aspects. A cross-sectional study with a quantitative approach was undertaken. The research was developed at the CAPSad in Ribeirão Preto, SP, Brazil, using a convenience sample of 95 service clients, 42 (44.2%) of whom were cocaine users and 53 (55.8%) crack users. The data collection instruments were: Sociodemographic information, Severity of Dependence Scale (SDS), Cocaine Craving Questionnaire-Brief (CCQ-B), Severity Alcohol Dependence Data (SADD), Drinker Inventory of Consequences (DrInC) and t he Addiction Severity Index (ASI-6). For data analysis, Student\'s t-test was used, and Pearson and Spearman\'s correlation test for independent samples. The sample predominantly included male, adult, white users with low education levels, Catholic and active in informal work, without any difference between the groups. No differences were found between cocaine and crack users with regard to the most used drug, age of first use, duration of drug consumption, in years and days, binge drinking (in life), severity levels of alcohol dependence and craving. Crack users showed higher severity levels of drug dependence, assessed according to the SDS and ASI6. Drugs use and family and social support were the most impaired areas among these users (p<=.005). Correlations between area scores: drugs use (r=0.33, p<.000), psychiatric (r=0.27, p<.007), legal/justice (r=0.23, p<.024), family/social support on the ASI and SDS scores were low and s tatistically significant. In addition, a neg ative correlation was found between ASI-6 areas: drugs use (r=-.36, p<.000), alcohol use (r=-0.29, p<.003), legal/justice (r=-.23, p<.024), and a positive correlation between the family area (r=0.24,p<.005) and the severity level of the craving. The DrInC scale was only correlated with the alcohol use area (ASI-6). Correlations were also identified among most ASI-6 areas; exceptions were the family and employment/financial areas. Age was negatively correlated with drugs use (r=- 0.25, p<.014), legal/justice (r=-0.21, p<.04), and positively with the medical area of the ASI-6 (r=0.43, p<.000). No distinctions in drinking consequences were found between cocaine and crack users. A positive correlation was found between total ASI score, SDS and DrInC, but opposed to total CCQ-B scores. Age was correlated with drinking consequences (DrInC) and with alcohol dependence severity levels (SADD). In conclusion, the relation between cocaine and/or crack use and biological, psychological and social aspects are complex and multidimensional. Therefore, assessing the peculiarities of cocaine and crack use permitted the identification of crucial elements in health and social aspects, which can contribute more appropriately to guide and plan quality care to this population

No description available.

Background: Food craving refers to an intense desire to consume a specific kind of food of which chocolate is the most often craved one. It is this intensity and specificity that differentiates food craving from feelings of hunger. Although food craving and hunger often co-occur, an energy deficit is not a prerequisite for experiencing food craving, that is, it can also occur without being hungry. Food craving often precedes and predicts over- or binge eating which makes it a reasonable target in the treatment of eating disorders or obesity. One of the arguably most extensively validated measures for the assessment of food craving are the Food Cravings Questionnaires (FCQs), which measure food craving on a state (FCQ-S) and trait (FCQ-T) level. Specifically, the FCQ-S measures the intensity of current food craving whereas the FCQ-T measures the frequency of food craving experiences in general. The aims of the present thesis were to provide a German measure for the assessment of food craving and to investigate cognitive, behavioral, and physiological correlates of food craving. For this purpose, a German version of the FCQs was presented and its reliability and validity was evaluated. Using self-reports, relationships between trait food craving and dieting were examined. Cognitive-behavioral correlates of food craving were investigated using food-related tasks assessing executive functions. Psychophysiological correlates of food craving were investigated using event-related potentials (ERPs) in the electroencephalogram and heart rate variability (HRV). Possible intervention approaches to reduce food craving were derived from results of those studies. Methods: The FCQs were translated into German and their psychometric properties and correlates were investigated in a questionnaire-based study (articles #1 & #2). The relationship between state and trait food craving with executive functioning was examined with behavioral tasks measuring working memory performance and behavioral inhibition which involved highly palatable food-cues (articles #3 & #4). Electrophysiological correlates of food craving were tested with ERPs during a craving regulation task (article #5). Finally, a pilot study on the effects of HRV-biofeedback for reducing food craving was conducted (article #6). Results: The FCQs demonstrated high internal consistency while their factorial structure could only partially be replicated. The FCQ-T also had high retest-reliability which, expectedly, was lower for the FCQ-S. Validity of the FCQ-S was shown by positive relationships with current food deprivation and negative affect. Validity of the FCQ-T was shown by positive correlations with related constructs. Importantly, scores on the subscales of the FCQ-T were able to discriminate between non-dieters and successful and unsuccessful dieters (article #1). Furthermore, scores on the FCQ-T mediated the relationship between rigid dietary control strategies and low dieting success (article #2). With regard to executive functioning, high-calorie food-cues impaired working memory performance, yet this was independent of trait food craving and rarely related to state food craving (article #3). Behavioral disinhibition in response to high-calorie food-cues was predicted by trait food craving, particularly when participants were also impulsive (article #4). Downregulation of food craving by cognitive strategies in response to high-calorie food-cues increased early, but not later, segments of the Late Positive Potential (LPP) (article #5). Few sessions of HRV-biofeedback reduced self-reported food cravings and eating and weight concerns in high trait food cravers (article #6). Conclusions: The German FCQs represent sound measures with good psychometric properties for the assessment of state and trait food craving. Although state food craving increases during cognitive tasks involving highly palatable food-cues, impairment of task performance does not appear to be mediated by current food craving experiences. Instead, trait food craving is associated with low behavioral inhibition in response to high-calorie food-cues, but not with impaired working memory performance. Future studies need to examine if trait food craving and, subsequently, food-cue affected behavioral inhibition can be reduced by using food-related inhibition tasks as a training. Current food craving and ERPs in response to food-cues can easily be modulated by cognitive strategies, yet the LPP probably does not represent a direct index of food craving. Finally, HRV-biofeedback may be a useful add-on element in the treatment of disorders in which food cravings are elevated. To conclude, the current thesis provided measures for the assessment of food craving in German and showed differential relationships between state and trait food craving with self-reported dieting behavior, food-cue affected executive functioning, ERPs and HRV-biofeedback. These results provide promising starting points for interventions to reduce food craving based on (1) food-cue-related behavioral trainings of executive functions, (2) cognitive craving regulation strategies, and (3) physiological parameters such as HRV-biofeedback. / Hintergrund: Craving nach Essen bezeichnet ein starkes Verlangen ein bestimmtes Nahrungsmittel zu konsumieren, welches sich meist auf Schokolade bezieht. Diese Intensität und Spezifität unterscheidet Craving nach Nahrungsmitteln von generellen Hungergefühlen. Obwohl Craving und Hunger häufig Hand in Hand gehen, ist ein Energiedefizit keine Voraussetzung dafür, Craving zu erleben; das bedeutet, es kann ebenfalls auftreten, obwohl man nicht hungrig ist. Craving geht häufig Überessen oder Essanfällen voraus, was es zu einem plausiblen Ansatzpunkt in der Therapie von Essstörungen und Adipositas macht. Eines der wohl am umfangreichsten validierten Maße zur Erfassung von Craving nach Nahrungsmitteln sind die Food Cravings Questionnaires (FCQs), die Craving als momentanen Zustand (engl. state, FCQ-S) und überdauerndes Merkmal (engl. trait, FCQ-T) erfassen. Genauer gesagt misst der FCQ-S die Intensität von aktuellem Craving nach Nahrungsmitteln, während der FCQ-T die Häufigkeit des Erlebens von Craving im Allgemeinen erfasst. Die Ziele der vorliegenden Arbeit waren die Bereitstellung eines deutschen Fragebogens zur Erfassung von Craving nach Nahrungsmitteln und die Untersuchung von kognitiven, behavioralen, und physiologischen Korrelaten von Craving. Hierfür wurde eine deutsche Version der FCQs präsentiert und deren Reliabilität und Validität überprüft. Zusammenhänge zwischen der Häufigkeit des Erlebens von Craving und Diätverhalten wurden mit Selbstberichtsfragebögen getestet. Kognitiv-behaviorale Korrelate von Craving wurden anhand von essensbezogenen Aufgaben zur Erfassung von exekutiven Funktionen untersucht. Psychophysiologische Korrelate von Craving wurden anhand von ereigniskorrelierten Potentialen (EKPs) im Elektroenzephalogramm und der Herzratenvariabilität (HRV) erforscht. Mögliche Interventionsansätze zur Reduktion von Craving wurden aus den Ergebnissen dieser Studien abgeleitet. Methoden: Die FCQs wurden auf Deutsch übersetzt und deren psychometrische Eigenschaften und Korrelate wurden in einer Fragebogenstudie untersucht (Artikel #1 & #2). Der Zusammenhang zwischen momentanem und habituellem Craving mit exekutiven Funktionen wurde anhand von behavioralen Aufgaben zur Erfassung der Arbeitsgedächtnisleistung und Verhaltenshemmung, die sehr schmackhafte Essensreize enthielten, überprüft (Artikel #3 & #4). Elektrophysiologische Korrelate von Craving wurden mit Hilfe von EKPs während einer Aufgabe zur Regulation von Craving getestet (Artikel #5). Schließlich wurde eine Pilotstudie zu den Effekten von HRV-Biofeedback zur Reduktion von Craving durchgeführt (Artikel #6). Ergebnisse: Die FCQs zeigten eine sehr hohe interne Konsistenz, wohingegen deren Faktorenstruktur nur teilweise repliziert werden konnte. Der FCQ-T hatte außerdem eine hohe Retest-Reliabilität, welche erwartungsgemäß geringer für den FCQ-S ausfiel. Validität des FCQ-S zeigte sich durch positive Zusammenhänge mit aktueller Essensdeprivation und momentaner negativer Stimmung. Validität des FCQ-T zeigte sich durch positive Korrelationen mit verwandten Konstrukten. Zudem konnte anhand der Subskalen des FCQ-T zwischen nicht-diäthaltenden und erfolgreichen und erfolglosen diäthaltenden Personen diskriminiert werden (Artikel #1). Weiterhin zeigte sich, dass der Zusammenhang zwischen rigiden Diätstrategien und geringem Diäterfolg durch Werte des FCQ-T vermittelt wurde (Artikel #2). Bezüglich der exekutiven Funktionen ergab sich, dass die Arbeitsgedächtnisleistung durch das darbieten von hochkalorischen Essensreizen vermindert wurde, allerdings war dies unabhängig von habituellem Craving und stand kaum mit momentanem Craving in Verbindung (Artikel #3). Häufiges Erleben von Craving konnte dahingegen eine behaviorale Enthemmung als Reaktion auf hochkalorische Essensreize vorhersagen, insbesondere wenn die Teilnehmer ebenfalls eine hohe Impulsivität berichteten (Artikel #4). Die Herunterregulierung von Craving während der Präsentation hochkalorischer Essensreize mit Hilfe kognitiver Strategien führte zu einer Erhöhung von früheren, nicht jedoch von späteren, Abschnitten des Late Positive Potential (LPP) (Artikel #5). Bereits wenige Übungssitzungen von HRV-Biofeedback resultierten in einer Reduktion selbstberichteter Cravings sowie essens- und gewichtsbezogener Sorgen bei Menschen mit häufigem Erleben von Cravings (Artikel #6). Schlussfolgerungen: Die deutschen FCQs stellen brauchbare Maße mit guten psychometrischen Eigenschaften zur Erfassung von Craving auf aktueller und habitueller Ebene dar. Obwohl momentanes Craving während kognitiven Aufgaben, die sehr schmackhafte Essensreize beinhalten, ansteigt, scheint eine Verminderung der Aufgabenleistung nicht durch das momentane Erleben solcher Cravings vermittelt zu sein. Habituelles Erleben von Craving ist dahingegen mit einer geringen Inhibitionsleistung auf hochkalorische Essensreize assoziiert, allerdings nicht mit einer eingeschränkten Arbeitsgedächtnisleistung. Zukünftige Studien sollten sich der Frage widmen, ob häufiges Erleben von Craving, und entsprechend auch der Einfluss von Essensreizen auf die Verhaltenshemmung, durch essensbezogene Inhibitionstrainings reduziert werden kann. Momentanes Craving und EKPs während der Präsentation von Essensreizen können leicht durch kognitive Strategien moduliert werden. Die LPP stellt hier wohl allerdings kein direktes Maß des Erlebens von Craving dar. Zu guter Letzt könnte HRV-Biofeedback ein nützliches, zusätzliches Therapieelement bei Störungen, die mit häufigem und intensivem Craving nach Nahrungsmitteln einhergehen, darstellen. Zusammenfassend lässt sich sagen, dass die vorliegende Arbeit Instrumente zur Erfassung von Craving nach Nahrungsmitteln im deutschen Sprachraum bereitgestellt hat und differenzielle Zusammenhänge zwischen momentanem und habituellem Craving mit selbstberichtetem Diätverhalten, durch Essensreize beeinträchtige exekutive Funktionen, EKPs und HRV-Biofeedback, aufgezeigt wurden. Diese Ergebnisse stellen vielversprechende Ansatzpunkte für Interventionen zur Reduktion von Craving nach Nahrungsmitteln dar, die auf (1) essensbezogenen Verhaltenstrainings der exekutiven Funktionen, (2) kognitiven Craving-Regulationsstrategien, und (3) physiologischen Parametern wie beispielsweise HRV-Biofeedback, basieren.

Varenicline is used to treat tobacco dependence. While varenicline decreases craving during a quit attempt, no studies have investigated its effect on cue-induced craving. Varenicline has also been shown to decrease alcohol consumption in animal and humans. This double-blind, randomized, placebo-controlled trial investigated the effect of varenicline on tobacco and alcohol cue-induced craving and alcohol consumption in dependent smokers/light drinkers. Tobacco and alcohol craving were assessed at baseline and after 2-weeks of drug administration using the QSU and ACQ. Significant decreases in cigarette and alcohol craving were observed between the pre- and post-drug session in the varenicline group on QSU Factor 1(87.5811.66 vs.70.5820.79, p=0.008) and ACQ Total (3.371.16 vs. 2.661.15, p=0.004) scores. This effect remained significant after correction for craving during neutral cues in the alcohol but not tobacco condition. No significant decreases in alcohol consumption were seen. These results suggest varenicline decreases overall craving, but not cue-induced craving specifically.