CRAVING AND CUE REACTIVITY IN ADOLESCENT ALCOHOLICS

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APPLICANT'S ABSTRACT: Alcohol abuse and alcoholism are problems that are becoming increasingly more prevalent in adolescents. While continued efforts are being made to prevent alcohol use among youth, thereby preventing abuse and/or dependence, there is also the need to provide effective treatments for adolescents who have already become dependent on alcohol. Treatment for adult alcoholics has made substantial progress in the past two decades. For example, there are specific psychotherapies (e.g., cue-exposure therapy) and pharmacotherapies (e.g., opiate antagonists) that may reduce craving and help the adult alcoholic resist urges to drink. These treatments have not been widely used in adolescent alcoholics, in part because it is not known whether adolescents crave alcohol as adults do. The present study is proposed to address this void by first developing the alcohol cues needed to assess craving and cue-induced reactivity in adolescents. The goal of Phase 1 is to gather information about visual cues that may elicit urges to drink in adolescent alcoholics. These cues will be photographed and developed into 35 mm slides. The slides will be tested in Phase 2, and adolescent alcoholics will report which subset of the slides produced the greatest urge to drink. In Phase 3, alcoholic adolescents and matched controls will be compared on how they respond to these photographic slides. It is hypothesized that the alcoholic group will show greater cue-induced reactivity and report greater subjective craving than will the control group. The results of the study will guide future efforts to understand the nature of adolescent alcoholism, whether adolescents crave, and if so, possible treatments for this population.