Cognitive content and processes related to cravings for alcohol

This thesis reports on the relationships between craving, craving metacognitions, and craving-related cognitive processes. Processes around alcohol craving and metacognitions are poorly understood. Application of metacognitive theories suggests that the craving and metacognitions are related, yet to date no research has tested this assumption.Four studies of individuals' responses to and beliefs about craving are presented here. The first investigated the effect of craving on metacognition by manipulating conditions of actual and perceived intoxication. Craving and metacognition were not predictive of one another; however, perceived consumption of alcohol was significantly related to metacognition about craving usefulness. As the metacognition measure used contained a limited metacognition range, the second study involved the development of a new scale, the Craving Metacognition Scale (CMS). This measure addresses the perceived antecedents and consequences of craving.For the third study, improvements were made to the initial study, including testing a larger sample with a wider range of drinkers, applying the new metacognitions measure, and expanding craving measurement to include physiological responsiveness to cue via heart rate and galvanic skin response. Cues were provided for an earlier phase of the consumption cycle, whereby participants did not consume alcohol, thus removing any effects of alcohol on cognition, and water was provided as a neutral stimulus to avoid confounding by appetitive responses to stimuli.Given the limited and highly specific relationships observed between craving and metacognition in my first three studies, my final study focuses on the cognitive processes related to craving. In this final study, the predictions of anxiety sensitivity and elaborated intrusions were tested against one another, to determine the role interoceptive ability plays in craving. Although craving did not interfere with an interoceptive accuracy task, this task interfered with subsequent craving, providing support for EI Theory over anxiety sensitivity models.Overall, by using experimental designs in three of four studies, and with the inclusion of either problematic or treatment-seeking drinkers in every study, this thesis demonstrates that craving and metacognition share relationships, but that these can be quite specific and must involve careful measurement and conceptualisation of craving and metacognition. Both craving content and processes should be considered in craving research.