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2025-11-15T20:47:01ZDevelopment and initial validation of a cue encounters and a cue salience questionnaire in an alcohol dependent population
/library/oar/handle/123456789/32085
Title: Development and initial validation of a cue encounters and a cue salience questionnaire in an alcohol dependent population
Abstract: Research on alcohol dependence has yielded considerable evidence that cues associated
with drinking play a role in the maintenance of alcohol-seeking behaviour, even after long
periods of abstinence. Classical conditioning models of addiction support the view that
addiction develops and persists because different alcohol-related cues become salient to the
individual and elicit conditioned responses even if the person has stopped drinking.
The objective of the current research was to develop two 'naturalistic' cue exposure self-report
questionnaires that measure how salient different cues are to an individual (Cue
Salience Questionnaire - CSQ) and the frequency with which these cues are encountered
(Cue Encounters Questionnaire - CEQ). The validity of the CSQ and CEQ was assessed
amongst a UK and Maltese sample of alcoholics. In both samples, scores on the CSQ and
CEQ correlated positively with a person's abstinence levels and Alcohol Urge
Questionnaire (AUQ), and Beck Depression Inventory (BDI) scores. Severity of Alcohol
Dependence Questionnaire (SADQ) scores only correlated with CSQ and CEQ scores in
the UK sample, which was a more severely dependent sample than the Malta one.
Exploratory principal component analysis indicated that although incorporating multiple
domains, both cue salience and cue encounters are best described by a single factor. From a
classical conditioning perspective, this finding would seem to imply that after years of
pervasive drinking, an individual's associations with alcohol-related cues become
generalized to a wider range of situations, thereby increasing the salience and the likelihood
of more frequent encounters with conditioned cues, even after the person has stopped
drinking.
Based on these analyses, 25-item versions of both the CSQ and CEQ were developed and
proposed for further investigation as shorter and more clinically practical versions. The
study also examined prospectively whether CSQ and CEQ baseline scores and other
influential variables would predict the probability of drinking during a 12-month follow-up
period. The results of a multinomial logistic regression analysis provided an initial
indication that individuals who did not drink during the 12-month follow-up period had
lower baseline CSQ and CEQ scores and lower BDI and AUQ scores. The strongest
predictor for drinking outcome was baseline abstinence levels. In effect, those with longer
periods of abstinence at baseline, scored lower on the BDI, AUQ, CSQ and CEQ. The
question of whether these scores really do decline with increased abstinence or whether
different abstinent levels and stages of recovery amongst the sample confounded the
results, was not determined in the current study and warrants further investigation. Future
research implications and replicability of findings are discussed.
Keywords: alcohol dependence, cue exposure, naturalistic, cue salience, cue encounters, drink,
follow-up.
Description: PH.D.2009-01-01T00:00:00Z