Cue-elicited affect and craving: advancement of the conceptualization of craving in co-occurring posttraumatic stress disorder and alcohol dependence.
Good moods, not just bad ones, can spark alcohol craving in adults with PTSD.
01Research in Context
What this study did
Nosen et al. (2012) watched adults who have both PTSD and alcohol problems.
The team showed each person trauma cues and alcohol cues, then asked how they felt and how much they wanted a drink.
They also measured tiny changes in saliva, a body sign of craving.
What they found
Good feelings, not just bad ones, pushed up craving when trauma cues were absent.
When people felt both good and bad at the same time, craving shot up the most.
Saliva followed the same pattern, showing the body was on board.
How this fits with other research
Zegel et al. (2022) later asked firefighters the same two questions and found the PTSD-plus-alcohol group had the worst mental-health scores.
Together the studies show: the lab pattern you see in Nosen et al. (2012) shows up in real fire stations too.
van Duijvenbode et al. (2012) built a picture set for clients with mild ID; their work gives you ready-made cues if you want to copy Elizabeth’s lab task with new groups.
Why it matters
If you treat clients who drink and carry trauma, don’t only watch for sadness or anger. Ask when they feel upbeat, relaxed, or excited—those states can also light the fuse for drinking. Add a quick mood check before and after sessions; it may catch a craving spike you would have missed.
Want CEUs on This Topic?
The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.
Join Free →Start your session with a 0-10 ‘right now’ rating for positive and negative mood, then watch if craving words follow the positive score.
02At a glance
03Original abstract
Posttraumatic stress disorder (PTSD) commonly co-occurs with alcohol dependence (AD) and negatively affects treatment outcomes. Trauma-related negative affect enhances substance craving in laboratory cue-reactivity studies of AD individuals, but the role of positive affect has not been established. In this study, 108 AD treatment-seeking adults with current PTSD and AD were presented with four counterbalanced trials consisting of an audio cue (personalized trauma or neutral script) followed by a beverage cue (alcohol or water). Results revealed alcohol cues increased positive and negative affect, and positive affective responses explained significant incremental variance in self-reported craving and salivation, but only when cues were accompanied by neutral not trauma imagery. Ambivalent (high negative and positive) responses were associated with strongest craving. Findings advance the conceptualization of craving in individuals with PTSD-AD and highlight the importance of independently assessing positive and negative affective responses to cues in individuals with co-occurring PTSD-AD.
Behavior modification, 2012 · doi:10.1177/0145445512446741