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Investigating tonic and phasic craving in currently drinking and abstinent individuals with alcohol use disorder: A preliminary case-control study

Year: 2026

Type: article

Abstract: Craving is a complex construct that is not fully understood. Craving for alcohol is an important motivator of alcohol use, a known risk factor for return-to-drinking, and one of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) diagnostic criteria for alcohol use disorder (AUD). Craving can be assessed retrospectively over a defined period (tonic) or in response to alcohol cues in real-time, e.g., through alcohol cue exposure (CE) paradigms (phasic). We conducted exploratory analyses of a clinical study including three matched groups: currently drinking (CD, N=9) and abstinent (AB, N=10) people with AUD and healthy controls (HC, N=12). Tonic craving was assessed using the Penn Alcohol Craving Scale (PACS) and the Obsessive-Compulsive Drinking Scale (OCDS). Phasic craving was assessed using the Alcohol Urge Questionnaire (AUQ) alongside the Alcohol Attention Scale (AAS) during two alcohol CE sessions (CE1, CE2). The CD group showed higher AUQ and AAS than AB and HC groups (main effect of group, CE1: P =.048; CE2: P =.047). Group differences were also observed for tonic craving: the CD group reported higher PACS scores than HC ( P =.001), while AB and CD groups showed higher OCDS scores than HC (HC vs . CD P <.0001, HC vs. AB P =.015). PACS scores correlated positively with OCDS (r=0.565, P =.001) and AUQ (r=0.595, P =.0004) scores in the full sample; within-group analyses showed a positive correlation between PACS and AUQ only in the AB group. Given the small sample size, these exploratory results should be considered preliminary and require confirmation in larger studies.

Source: Addiction Neuroscience

DOI: 10.1016/j.addicn.2026.100279

Authors: Carlotta Vizioli, Jennifer J. Barb, Ryan E. Tyler, Lorenzo Leggio, Mehdi Farokhnia