Alcohol urges in alcohol-dependent drinkers: Further validation of the Alcohol Urge Questionnaire in an untreated community clinical population

Background: Alcohol craving is a key element of the alcohol dependence syndrome. However, there is a lack of consensus about the precise nature of craving and the most appropriate method of measurement. Alcohol urges measured by the Alcohol Urge Questionnaire showed a unidimensional structure and evidence of validity and reliability in a US clinical population. The main aim of this study was to establish the validity of the AUQ in an untreated UK clinical population, and its relationships to drinking and personality factors. Subjects: All subjects (n=80) were alcohol-dependent (DSM-IV) and presenting for pre-treatment assessment at a community alcohol team in South-west London. Method: All subjects completed the AUQ, Severity of Alcohol Dependence Questionnaire (SADQ), Spielberger's State Trait Anxiety Inventory (STAI) and Eysenck Personality Questionnaire (EPQ) and provided a breath specimen for alcohol analysis (BAL). Results: Principal components analysis of AUQ revealed one factor which accounted for 69% of variance with high interitem correlations, and an alpha reliability of 0.93. AUQ was significantly correlated with SADQ, BAC, state and trait anxiety and negatively correlated with time since last drink. There were no significant correlations between AUQ and any of the EPQ subscales. SADQ was correlated with neuroticism, but not other EPQ subscales. A regression analysis showed that only SADQ, time since last drink and BAL were significant predictors of alcohol urges. Conclusions: This study confirmed the AUQ factor structure and provided further evidence for the validity of AUQ. The relationship between BAL and urges deserves further research. The results did not support the contention that anxiety and personality factors predict urges when drinking-related variables, which also predict urges, are controlled for. The AUQ is a useful measure for clinical and experimental alcohol craving research