Day: November 6, 2008

Craving and Compulsive Involvement Scales

By Daniel Lende

In the previous post Wanting to Craving: Understanding Compulsive Involvement with Drugs, I wrote:

Different domains of subjective involvement can be linked to dopamine [function] – wanting more and more, the sense of an urge or push to use (often not a conscious desire), and the heightened focus on places and actions and times that lead to using. The scale I developed showed good internal consistency, adding support that these three senses of compulsive involvement are linked. If you want to know more about the scale, I have done a separate post detailing the compulsive involvement scale in both Spanish and English versions.

So this post gives you those scales! But first a little information. The scale in Spanish consists of eight items and shows good consistency. For the English version I have not fullly tested the scale, and have deliberately included more items there (a total of 13). One aim of future research (collaboration, anyone?) would be to test the items and hopefully winnow the size down.

So without further ado, here are the scales themselves:

Lende Craving-Salience General

Lende Deseo-Salience en Espanol

If you don’t want to click on any version, some typical statements in English include: (a) At times I have started to use and use without thinking about anything else; (b) At times I have felt a powerful impulse or urge to go use; and (c) At times using feels like you want more and more.

If you do want to use these scales, please contact me (Daniel Lende) at dlende@nd.edu. I’d like to hear more!

Results with the Spanish version originally appeared in my 2005 article Wanting and Drug Use: A Biocultural Approach to Addiction (Lende Wanting pdf). Here are excerpts from that article that relate directly to creating the original scale and its use in my study:

Construction of the Incentive Salience Scale
Ethnographic Results
The incentive salience scale was created by drawing on the results of the questionnaire and the first interview. The first step in this process was identifying the common dimensions related to wanting and seeking drugs in the adolescents’ descriptions. One important thing that emerged early in this review process was that the dimensions of wanting, shifts in attention, and behavioral engagement applied to more than just anticipating and seeking out drugs, the main focus of Robinson & Berridge’s theory. The dimensions of incentive salience applied to both seeking out and using drugs, leading to a wider focus on how drugs and drug use were salient to users.

Based on this wider view of salience, six common elements were then identified in the adolescents’ descriptions. First, one of the most typical ways of describing addictive experiences in Colombia was “querer más y más,” to want more and more drugs. During my ethnographic research, this emphasis on wanting—the Colombian’s summary description of what addiction was—took on more relevance as I realized the diversity in positive appraisals and “rewards” from substance use, ranging from “forgetting everything” to riding a skateboard better. Other ways used to describe this experience included “deseo” and “sentir ganas,” to feel a desire to consume drugs. Overall, the emphasis on wanting and desire provided a clear indication of the relevance of the incentive salience approach to understanding drug abuse in this population.

Continue reading “Craving and Compulsive Involvement Scales”

Wanting to Craving: Understanding Compulsive Involvement with Drugs

By Daniel Lende

A long-time research project of mine has been to understand how adolescents get hooked on drugs. Querer más y más, as they say in Colombia, to want more and more. When people get addicted – whatever the substance may be – they often report urges, cravings, and obsessive thinking as a primary force in why they keep using or relapse. Knowing the consequences often doesn’t matter, especially in those moments when that desire feels hot as a knife.

The easiest analogy for me to help people understand this type of desire is to ask people to think about that one time they really craved something to eat. Yes, that time, when you just had to have it. Most people have experienced this one time or another. With substance abuse, craving like this often becomes an unpredictable constant, something that comes on in the morning or while walking by a favorite bar or seeing a friend who has that gleam in his eye and a crooked smile on his face.

So here is what I found in Colombia, reported in a 2005 Ethos article entitled Wanting and Drug Use: A Biocultural Approach to Addiction (click for the full paper: Lende Wanting pdf). The abstract goes:

The integration of neurobiology into ethnographic research represents one fruitful way of doing biocultural research. Based on animal research, incentive salience has been proposed as the proximate function of the mesolimbic dopamine system, the main brain system implicated in drug abuse (Robinson and Berridge 2001). The research presented here examines incentive salience as the mediator of the wanting and seeking seen in drug abuse. Based on field work with adolescents at a school and a drug treatment center in Bogotá, Colombia, this article addresses: 1) the development of a scale to measure the amount of incentive salience felt for drugs and drug use; 2) the results from a risk-factor survey that examined the role of incentive salience and other risk factors in addiction; and 3) the ethnographic results from in-depth interviews with Colombian adolescents examining dimensions of salience in the reported experiences of drug use. Incentive salience proved to be a significant predictor of addicted status in logistic regression analysis of data from 267 adolescents. Ethnographic results indicated that incentive salience applies both to drug seeking and drug use, and confirmed the importance of wanting, a sense of engagement, and shifts in attention as central dimensions of experiences related to drug use.

Several years later, I like to highlight several things about this research. First, different domains of subjective involvement can be linked to dopamine –wanting more and more, the sense of an urge or push to use (often not a conscious desire), and the heightened focus on places and actions and times that lead to using. The scale I developed showed good internal consistency, adding support that these three senses of compulsive involvement are linked. If you want to know more about the scale, I have done a separate post detailing the compulsive involvement scale in both Spanish and English versions.

Continue reading “Wanting to Craving: Understanding Compulsive Involvement with Drugs”