Cue elicited urge to drink and salivation in alcoholics: Relationship to individual differences

Social learning models of relapse have included a focus on the learned reactions of substance abusers to the presence of substance use cues, but the relative roles played by cue-elicited psychophysiological reactions and urges to use have been unclear. The relationships of these kinds of cue-elicited reactions to each other, to measures of individual differences, to attentional processes, and to relapse are reviewed across three recent studies (published or to be published elsewhere). Alcoholic males who participated in one of three studies were assessed for cue reactivity (salivation and urge to drink while sniffing an alcoholic beverage versus water) as well as individual difference measures. Salivation and urge to drink have a weak or nonsignificant relationship to each other. Cue-elicited urge to drink generally correlates with negative mood, awareness of somatic reactions, attention to alcohol, and enjoyment of the sight and smell of alcohol. Salivation tends not to be related to these conscious processes although it is greater among those who expect more positive effects from alcohol, and among those with more alcohol dependence. Salivation but not urge to drink was predictive of quantity and frequency of drinking during the first three months post-detoxification. Results are generally consistent with appetitive-motivation models of alcohol use and with Tiffany's (1990) hypothesis that automatic processes are more important than conscious processes in drug-use behavior.