the development and initial validation of a questionnaire to measure craving for amphetamine

RESEARCH REPORT

© 2004 Society for the Study of Addiction doi:10.1111/j.1360-0443.2004.00819.x Addiction, 99, 1181–1188

Blackwell Science, LtdOxford, UKADDAddiction0965-2140© 2004 Society for the Study of Addiction

99Original ArticleDevelopment of an amphetamine questionnaireDarren James et al.

Correspondence to:

Dr Darren JamesDepartment of Clinical PsychologyWhitchurch HospitalWhitchurchCardiff CF14 7XBUKE-mail: [email protected]

Submitted 14 March 2003; initial review completed 4 July 2003; final version accepted 17 May 2004

RESEARCH REPORT

The development and initial validation of a questionnaire to measure craving for amphetamine

Darren James1, Gareth Davies2 & Paul Willner3

St Georges Hospital Medical School, London,1 Department of Psychology Education and Careers, HLaSS, University of Glamorgan, Pontypridd2 and Department of Psychology, University of Wales Swansea, Swansea, UK3

ABSTRACT

Aim To develop and initially validate a multi-dimensional questionnaire tomeasure cravings for amphetamine (speed).Design, setting and participants The design of the Desires for Speed Question-naire (DSQ) was based on the Desires for Alcohol Questionnaire and was admin-istered to 174 amphetamine users. Exploratory factor analyses were carried outon the data and relationships between questionnaire score and other variableswere assessed. Further analyses were carried out to assess the sensitivity of thefactor scores of the DSQ to various methods of amphetamine ingestion.Findings Factor analysis revealed that a four-factor solution best described thedata and that each of these factors were differentially sensitive to methods ofamphetamine ingestion, with greater craving on all measures in intravenousamphetamine users. The factor structure identified from the present analysiswas almost identical to that identified in recreational drinkers by Love et al.(1998).Conclusions The results validate and extend the findings of the work of Loveet al. (1998) and provide support for a multifactorial account of amphetaminecraving.

KEYWORDS Amphetamine, craving, multidimensional, positive/negativereinforcement, psychometric instruments, withdrawal.

INTRODUCTION

During recent decades the term ‘craving’ has attracted agreat deal of attention and debate. However, despite therecent popularity and widespread use of the term, theconcept of craving has attracted little conceptual orempirical analysis (Tiffany 1990).

Drug-cravings are subjective motivational states inwhich an individual experiences an intense desire toengage in drug-taking (Mardones 1955; Ludwig &Wikler 1974; Baker et al. 1987; Kozlowski & Wilkinson1987; UNDCP & WHO Report 1992). Cravings are usu-ally thought to arise from either the positive-reinforcing(incentive) properties of the drug (McAuliffe & Gordon1974; Marlat 1985; Niaura et al. 1988; Wise 1988), thenegative-reinforcing properties related to withdrawaleffects (Jellinek 1955; Ludwig & Wikler 1974; Poulos

et al. 1981; West & Schnneider 1987) or from a combi-nation of both positive and negative reinforcement pro-cesses (Baker et al. 1987). Such theories propose anintimate association between drug craving and reinforce-ment mechanisms. However, some authors have arguedthat craving is independent of reinforcement mecha-nisms (Kozlowski & Wilkinson 1987; Robinson & Ber-ridge 1993). Furthermore, there is some recent evidenceto suggest that a cognitive account of craving may beappropriate (Tiffany 1990, 1992).

Most studies have relied on assessment scales withone, sometimes two, face-valid items (Ludwig & Wikler1974; Cooney et al. 1984; Glassman et al. 1984; West &Russell 1985; Childress, McLellan & O’Brien 1986). Suchan approach assumes a unidimensional view of cravingand thus precludes the possibility that craving couldbe better construed as a multi-dimensional construct,

© 2004 Society for the Study of Addiction Addiction, 99, 1181–1188

1182 Darren James et al.

perhaps related to both positive and negative reinforce-ment processes (Baker et al. 1987) or more complex cog-nitive structures (Tiffany 1990, 1992).

Tiffany & Drobes (1991) addressed this problemdirectly by developing the Questionnaire on SmokingUrges (QSU), which was based on the assumption thaturges and craving for nicotine may have multi-dimensional manifestations. The QSU is a 32-item ques-tionnaire comprised of questions directed at four differentareas relevant to cigarette craving: desire to smoke, antic-ipation of positive outcomes, anticipation of relief of neg-ative affect or withdrawal, and intention to smoke. Thedata were best described by a two-factor solution, inwhich the two factor scales were highly correlated(r = 0.71). Items contributing to Factor 1 were relatedprimarily to intention and desire to smoke and anticipa-tion of pleasure from smoking, suggesting that Factor 1reflects the operation of positive reinforcement. Itemscontributing to Factor 2 were related primarily to anoverwhelming desire to smoke and anticipation of relieffrom negative affect and withdrawal, suggesting that Fac-tor 2 reflects the operation of negative reinforcement.

Several groups of researchers have subsequentlyapplied this multi-dimensional approach to the develop-ment of psychometric instruments to measure cravingsfor alcohol (Singleton & Tiffany 1994; Bohn, Krahn &Staehler 1995; Love et al. 1998). Love et al. (1998) devel-oped the Desires for Alcohol Questionnaire (DAQ), whichis comprised of 36 urge-relevant items and scored on aseven-point Likert-type scale. Items on the DAQ relate toone of four theoretically distinct conceptualizations ofurges for alcohol reflecting (i) anticipation of positivereinforcement; (ii) anticipation of relief of negative affect;(iii) intentions to drink; and (iv) desires to consume alco-hol. Exploratory factor analyses revealed that a three-factor solution best described the data. Factor 1 con-tained 12 items, eight reflecting relief from negative statesthrough drinking and four reflecting anticipation of pos-itive effects through drinking. This factor was labellednegative and positive reinforcement. Factor 2 included 11items, seven reflecting strong desires for alcohol and fourreflecting strong intentions to drink. This factor waslabelled strong intentions and desires to use alcohol. Thethird factor contained five items, three reflecting milddesires for alcohol and two reflecting mild intentions touse alcohol. This factor was labelled mild intentions anddesires to use alcohol.

In addition to its theoretical significance, the develop-ment and validation of reliable psychometric instrumentsto assess cravings also has important practical and clini-cal relevance, given the putative role of craving in theo-ries of relapse (e.g. Tiffany & Carter 1998). More recently,the multi-dimensional approach has been applied to thedevelopment of measurement scales for cravings and

urges for illicit drugs. For example, Franken et al. (2002)have developed the Desires for Drug Questionnaire(DDQ), which was based on the shortened version of theDesires for Alcohol Questionnaire (Love et al. 1998). Todate there has been no such work on the development ofscales to assess urges and cravings for amphetamine.

The aim of the present study was to develop andinitially validate a questionnaire to measure craving foramphetamine based on the assumption that cravingfor amphetamine might have multi-dimensionalmanifestations.

METHODS

Participants

A total of 174 participants were recruited using a varietyof locations (see below). The sample was comprised of123 males and 46 females (five participants did not pro-vide this information) with participants’ ages rangingfrom 14 to 45 years (mean = 23.26, SD = 6.05). Approx-imately one-third of the sample was collected from thelocal drug agency’s ‘drop-in centre’, with the remainderbeing collected from a number of small towns in theMethyr and Swansea valleys. The data were therefore col-lected from a ‘convenience sample’ and included onlythose people who had taken amphetamine (‘speed’)within a 4-week period prior to completing the question-naire. A small number of participants allowed the use oftheir homes as a meeting point, while other participantscompleted the questionnaire on an outdoor park bench,in a local pub or in the researcher’s car. Participants werealso asked to complete the Leeds Dependence Question-naire (LDQ) and a number of questions relating to theirdemographic details and details of their experience withdrugs.

Craving questionnaire development

The development of the questionnaire began with the 36items used in the DAQ (see Love et al. 1998). From these36 items, 33 were used exactly as they appeared in theDAQ with the only difference being the substitution of thedrug type (i.e. changing ‘drinking’ to ‘using speed’).However, three of the items originally appearing in theDAQ were included but were reverse-keyed, i.e. ‘I have nodesire to take speed now’; ‘I would not like any speednow’; ‘If I started taking speed now, I would not be able tostop’. It was predicted that whatever factor structureemerged, these items would show loadings with an oppo-site sign to that of other items loading on the same factor.Four additional items were also included which related tothe control of amphetamine use, e.g. ‘If I had a week’ssupply of speed it would last me for the full week’.

Development of an amphetamine questionnaire 1183


Participants were prompted on a Likert-type scale withscores ranging between 1 and 7 as to how strongly theyagreed or disagreed with each statement.

Dependence questionnaire

In order to determine severity of dependence partici-pants were asked to complete the Leeds DependenceQuestionnaire (LDQ, Raistrick et al. 1994), a 10-itemself-completion questionnaire that yields a dependencescore between 0 and 30 and purports to measure a con-struct of chemical dependence that is independent ofthe pharmacological properties of any particular sub-stance or the quantities of any substance consumed.The processes addressed by the LDQ are not substance-specific: high LDQ scores are associated with cognitivepreoccupation with substance use, compulsion to use,continual use, planning and organizing future use,maximization of the subjective experience of substanceuse and a reduced repertoire of behaviour, with sub-stance use as a primary coping strategy. Thus, althoughthe LDQ was validated initially in alcohol and opiateusers, it should also be suitable to measure dependenceon other drugs. Two recent studies support such usage.Heather et al. (2001) reported that high LDQ scoreswere associated independently not only with alcoholand opiate use but also with ‘other drug use’. Ford(2003) found that high scores on the LDQ were associ-ated strongly with both alcohol use disorder and druguse disorder, as diagnosed by ICD-10, in a random sam-ple of schizophrenic and personality-disordered psychi-atric in-patients. Although the specific drugs used werenot reported, psychostimulant use is likely to have beenmore prominent than opiate use, as psychostimulantuse is highly comorbid with schizophrenia and person-ality disorder, but opiate use is not (e.g. Dalmau et al.1999).

Drug experience questionnaire

Participants were also asked to complete a short ques-tionnaire collecting information about age, sex, the timeof day of completion of the questionnaire, the types ofdrugs they had used in the past month and route ofadministration. Participants were also asked about themain drug they were using; the length of time since lastusing this drug; the usual method of ingestion of thisdrug; the usual amount of drug consumed each time, andwhether they had used any other drugs immediatelyprior to completing the questionnaire.

Some participants failed to complete certain parts ofthe drug experience questionnaire. Furthermore, anyambiguities regarding a participant’s experience withdrugs were omitted from the data.

Statistical analyses

The data from the 40-item questionnaire were analysedinitially by a principal components analysis (PCA).Kaiser’s Measure of Sampling Adequacy (MSA) (Kaiser1974) was determined prior to PCA.

The initial principal components obtained wererotated using both orthogonal (varimax) and oblique(oblimin) rotations (Kaiser 1958; Hendrickson & White1964). Both forms of rotation identified similar factorsfor each type of questionnaire. However, as might beexpected, the oblique rotation provided ‘cleaner’ factorswith fewer cross-loadings, and the results of these analy-ses are reported. Only those items loading at higher than0.4 were retained in the analyses and all items cross-load-ing at higher than 0.4 were removed from the analyses.In addition, for an item to be retained, its loading on onefactor had to be at least 0.2 larger than the next highestloading on a different factor (Stevens 1986; Tiffany &Drobes 1991; Davies et al. 2000). The resulting factorscales were checked for reliability using Cronbach’salpha.

The initial analysis revealed six factors with eigenval-ues over 1, but no items had loadings >0.4 exclusively onfactors 5 and 6, and these two factors were also difficultto interpret. As a result, the latter factors were discardedand the analysis repeated with a four-factor solutionrequested. Using the factor structure obtained from thefactor analysis, mean factor scale scores were calculatedfor each participant, as the mean of the unweightedscores on each of the items contributing to the factor.One-way analysis of variance and Tukey’s post-hoc com-parisons were used to compare LDQ scores and factorscale scores between amphetamine users who adminis-tered the drug orally (n = 55), nasally (n = 67) or intrave-nously (n = 11). Participants who reported using avariety of administration techniques (n = 24) and partic-ipants who did not indicate how they administeredamphetamine (n = 17) were excluded from this part of theanalysis.

RESULTS

Factor analysis

The analysis revealed four factors, with eigenvalues of16.64, 3.76, 2.84 and 1.72. These factors accounted for62.4% of the overall variance (41.59%, 9.40%, 7.09%and 4.29%, respectively). Cronbach’s alpha of 0.92,0.93, 0.89 and 0.64 were found for the scales of factors 1,2, 3 and 4, respectively. Subsequently, the factors wererotated using both an orthogonal (varimax) and anoblique (promax) method. The solution providedby promax was ‘cleaner’, i.e. items tended to load



predominantly on one of the factors. Of the original 40items, 24 were retained and 16 were discarded. The fac-tor structure after promax rotation is shown in Table 1.

The first factor had significant loadings of eight items;seven of these items reflected the anticipation of relieffrom negative states (e.g. ‘Taking speed now would makeme feel less stressed’), with the remaining item reflecting

the anticipation of positive outcomes through amphet-amine use (e.g. ‘Taking speed now would make thingsseem just perfect’). The first factor was therefore labelled‘Expectancy of positive and negative reinforcement’.

Ten items loaded exclusively on Factor 2; six of theseitems reflected strong desires to use amphetamine (e.g.‘My desire for speed now seems overwhelming’), with the

Table 1 Promax rotated factor pattern for the 40-item Desires for Speed Questionnaire (DSQ).

Factor 1 Factor 2 Factor 3 Factor 4

Factor 104. It would feel as if the bad things in my life had completely disappeared if I took some

speed now0.750 0.412 0.260 0.307

10. Even major problems in my life would not bother me now if I took some speed 0.705 0.462 0.324 0.29616. Taking speed now would make the bad things in my life seem less bad 0.845 0.459 0.387 0.24224. If I took some speed now the small daily hassles would feel less important 0.802 0.326 0.443 0.17930. I would probably feel less worried about my daily problems if I took some speed now 0.765 0.381 0.366 0.28534. Taking speed now would make me feel less stressed 0.810 0.369 0.515 0.11137. Taking speed now would make things seem just perfect 0.805 0.512 0.389 0.30540. All my tension would completely disappear if I took some speed now 0.833 0.470 0.333 0.247

Factor 207. I need some speed now 0.511 0.759 0.475 0.33909. My desire for speed now seems overwhelming 0.491 0.751 0.339 0.43411. I am making plans to take some speed now 0.289 0.690 0.371 0.24515. I would do almost anything to take some speed now 0.478 0.869 0.313 0.32917. I crave some speed now 0.475 0.878 0.383 0.37226. I have an urge to take speed now 0.481 0.821 0.499 0.34727. I want some speed so much I can almost feel it 0.447 0.810 0.345 0.49432. I am thinking of ways to get speed 0.370 0.776 0.451 0.24135. I will have some speed now whatever gets in the way 0.472 0.794 0.368 0.24738. I am going to have some speed as soon as I possibly can 0.551 0.810 0.513 0.362

Factor 301. I would accept some speed if it was offered to me now 0.300 0.223 0.685 -0.00119. I would consider taking some speed now 0.377 0.457 0.860 0.00821. I might like some speed now 0.431 0.460 0.886 0.00925. If I had the chance to use speed now, I think I would 0.511 0.463 0.854 0.237

Factor 406. I could easily limit how much speed I would take if I started taking some now. -0.005 -0.311 -0.130 -0.71908. If I had a week’s supply of speed, it would last me for the full week -0.253 -0.211 -0.008 -0.832

Ambiguous items02. Taking speed now would make the good things in my life appear even better 0.608 0.335 0.422 0.00303. I am missing using speed now 0.484 0.656 0.400 0.39505. If I had a supply of speed I would stay high until it ran out 0.621 0.563 0.504 0.50112. Taking speed now would make me feel on top of the world 0.717 0.419 0.562 0.23713. Taking speed now would make me feel less tense 0.709 0.342 0.586 0.18314. Taking speed would be satisfying now 0.643 0.466 0.757 0.27818. I would feel more in control of things if I took some speed now 0.759 0.573 0.370 0.34720. Taking some speed would be wonderful now 0.696 0.582 0.779 0.32422. Nothing would be better than taking some speed now 0.683 0.766 0.519 0.39523. Taking some speed now would make me feel good 0.701 0.309 0.670 0.27328. I can control my speed use -0.113 -0.540 -0.001 -0.53929. Taking speed would be pleasant now 0.630 0.362 0.793 0.19431. I have no desire to take speed now -0.245 -0.363 -0.446 -0.30533. I would not like any speed now -0.161 -0.301 -0.519 -0.34836. If I started using speed now I wouldn’t stop until I’d used up my whole supply 0.651 0.681 0.374 0.65939. If I started taking speed now I would not be able to stop 0.523 0.595 0.196 0.668



remaining four items reflecting strong intentions to useamphetamine (e.g. ‘I will have some speed now whatevergets in the way’). The items ‘I crave some speed now’ and‘I have an urge to take speed now’ both loaded exclusivelyon this factor. This factor was therefore labelled ‘Strongdesires and intentions to use amphetamine’.

The third factor contained four items reflecting mildintentions and desires to use amphetamine (e.g. ‘I wouldaccept some speed if it was offered to me now’). This fac-tor was labelled ‘Mild desires and intentions to useamphetamine’.

The fourth factor consisted of two items, both withnegative loadings, classified originally as intentions. Bothof these items, however, also related to the control ofamphetamine use once the behaviour is initiated (e.g. Icould easily limit how much speed I would take if I startedtaking some now). Consequently, this factor was labelledas ‘Control’.

The three reverse-key items all had a loading >0.4 onmore than one factor and were therefore not included inany of the factors. However, as predicted, all threereverse-key items displayed the opposite sign to the otheritems included in the factor on which they loaded high-est, i.e. ‘I have no desire to take speed now’ and ‘I wouldnot like any speed now’ both loaded negatively and high-est on Factor 3 and ‘If I started taking speed now I wouldnot be able to stop’ loaded positively and highest onFactor 4.

Reliability analysis of the Leeds Dependence Questionnaire

A Cronbach’s alpha of 0.82 was found for the LDQ in thepresent study, indicating an acceptable level of internalconsistency.

Inter-factor correlations

Correlational analyses, conducted on the unweightedfactor-scale scores, revealed that all four factors wereintercorrelated, with the exception of the correlation

between Factor 3 (mild intentions and desires) and Factor4 (control), which failed to reach significance (Table 2).Furthermore, all factor scale scores showed significantcorrelations with dependence scores on the Leeds Depen-dence Questionnaire. Factors 1, 2 and 3 showed signifi-cant positive correlations with dependence and Factor 4showed a highly significant negative correlation withdependence, implying that the self-reported ability tocontrol amphetamine use falls as dependence on thedrug, as measured by the LDQ, increases (Table 2, belowthe diagonal). Partial correlations controlling for LDQscore were also computed (Table 2, above the diagonal).This analysis revealed that four of the five significant cor-relations remained significant after controlling for LDQscore, suggesting that the factor intercorrelations involvesome degree of specificity.

Method of amphetamine administration

Participants reported using amphetamine orally, nasallyor intravenously. LDQ scores for these three groups ofusers (mean ± SD) were 12.78 (±8.57), 14.43 (±7.77)and 22.73 (±4.56), respectively (F2,130 = 7.20,P < 0.001). Tukey’s post-hoc comparisons revealed thatintravenous users scored significantly higher than oralusers (P < 0.001) and nasal users (P < 0.005). Oral andnasal users did not differ significantly on LDQ scores.

Factor scores for the three groups of amphetamineusers are shown in Fig. 1. One-way analyses of each ofthe four factors by route of administration (oral, nasal,intravenous) revealed significant main effects of route ofadministration for the factors ‘Positive and negative rein-forcement’ (F2,130 = 5.3, P < 0.01), ‘Strong desires andintentions’ (F2,130 = 12.93, P < 0.001), ‘Mild desires andintentions’ (F2,130 = 4.52, P < 0.02) and ‘Control’(F2,130 = 3.86, P < 0.05). Tukey’s post-hoc comparisonsrevealed that for the Factors ‘Positive and negative rein-forcement’, ‘Strong desires and intentions’ and ‘Milddesires and intentions’, intravenous amphetamine usersscored significantly higher than oral users (P < 0.02,P < 0.001, P < 0.05, respectively) and nasal users

Table 2 Inter-factor correlations.1

ReinforcementStrong desiresand intentions

Mild desiresand intentions Controllability

Reinforcement – 0.442*** 0.345*** -0.064Strong desires and intentions 0.552** – 0.419*** -0.159*Mild desires and intentions 0.423** 0.505*** – 0.005Controllability -0.162** -0.261*** -0.085 –Dependence 0.408** 0.488** 0.313** -0.274**

1Below the diagonal: zero-order interfactor correlations, and correlations with dependence (LDQ score); above the diagonal, partial correlations controlling forlevel of dependence. *P < 0.05; **P < 0.01; ***P < 0.001.



(P < 0.005, P < 0.005, P < 0.01, respectively). For thefactor ‘Control’, Tukey’s post-hoc comparisons revealedthat intravenous users scored significantly lower thanoral users (P < 0.05) and nasal users (P < 0.05). Oral andnasal users did not differ significantly on any of thefactors.

DISCUSSION

The present study describes the development and initialvalidation of a multi-dimensional questionnaire to assesscravings and urges to use amphetamine. The Desires forSpeed Questionnaire (DSQ) was based on the Desires forAlcohol Questionnaire (DAQ) and was developed with theassumption that urges and craving for amphetaminemight have multi-dimensional manifestations. Similar toTiffany & Drobes’s (1991) report on smoking urges, thepresent study identifies the multi-dimensional nature ofself-reports relevant to amphetamine. Principal compo-nents analysis was conducted on the data, followed bypromax rotation. This analysis revealed that a four-factorsolution best described the data.

Some limitations of the study should be noted, regard-ing the sampling frame, the content of the questionnaireand thus the generalizabilty of the findings. As noted inthe Methods section, data were collected from a conve-nience sample with no specific sampling frame. Cautionshould therefore be exercised when making generaliza-tions beyond the current study population. Furthermore,it would be premature at this stage to completely dismissthe items that were not assigned to any of the factors (seebelow). We also note that the LDQ, used to measuredependence in the present study, was validated in alcoholand opiate users. However, two previous studies havereported that high LDQ scores were associated with highlevels of ‘other drug use’ (Heather et al. 2001) and with‘drug use disorder’ (Ford 2003), with psychostimulants

the most likely drug implicated in both cases. These twosets of findings, taken together with the present observa-tion that intravenous amphetamine users had substan-tially higher LDQ scores than oral or nasal amphetamineusers, suggest that the LDQ may also be a valid measureof dependence on psychostimulants.

The factor structure identified from the present anal-ysis was almost identical to that identified by Love et al.(1998) in recreational drinkers except that the controlfactor was absent in the Love et al. (1998) study of recre-ational drinkers. It is important to note, however, that acontrol factor did emerge when the short form of the DAQwas administered to recovering alcoholics. Furthermore,a control factor also emerged in the initial study of theDAQ, which was carried out with recreational drinkers(James 2000). Thus, the control factor was present in twoof the three studies that have examined the factor struc-ture of the DAQ. Given the small number of items thatcontribute to the ‘Control’ factor and the small amount ofvariance explained by it, it is possible that this factorcould represent an artefact of the questionnaire design.Further empirical investigation is therefore required todetermine its validity.

Franken et al. (2002) have described a Desires forDrug Questionnaire (DDQ), which is modelled on theshort form of the DAQ, and measures desires for heroin.They too reported a very similar factor structure, withthree factors: desires and intentions, negative reinforce-ment and controllability. The fact that this study in her-oin users did not distinguish between strong and milddesires/intentions may reflect the fact that the study wascarried out in opiate-dependent patients, for whom the‘take it or leave it’ character of the ‘mild desires/inten-tions’ factor may not have been a salient dimension. Itshould be noted, however, that given the differences inthe number of items on the DSQ, DDQ and DAQ, the dif-ference in drug type and the different populations inwhich they were validated, direct comparison can only bespeculative without further empirical investigation.

The present factor structure suggests a number ofimportant implications, which are consistent with thefindings of Love et al. (1998) and Franken et al. (2002).First, the analysis provides evidence of a single reinforce-ment factor, which contains items relating to both posi-tive and negative expectations. This argues againstaccounts of craving expressed exclusively in terms of oneor the other of these processes and supports the involve-ment of both (Baker et al. 1987). It should be noted, how-ever, that seven of the eight items contributing to Factor 1represented negative reinforcement with only one itemrepresenting positive reinforcement. This is consistentwith the findings of the short version of the DAQ, whichwas developed in an attempt to reduce item redundancy(Love et al. 1998) and also with the DDQ (Franken et al.

Figure 1 DAQ factor scale scores by method of amphetamineingestion

Effect of route of administration on factor scores

0

1

2

3

4

5

6

7

Fac

tor

scor

e

Oral Nasal Intravenous

Factor 1

+ve and -ve reinforcement

Factor 2

Strong desires and intentions

Factor 3

Mild desires and intentions

Factor 4

Controllability



2002). The retention of only the items representing neg-ative reinforcement in the short versions of the DAQ andDDQ, coupled with the predominance of items reflectingnegative reinforcement within the combined reinforce-ment factor of the DSQ, suggests that negative reinforce-ment may be more salient than positive reinforcement inrelation to urges and cravings for all three of alcohol, her-oin and amphetamine. This is perhaps more surprisingfor amphetamine, where physical dependence is far lessprominent, than for alcohol and heroin. However, severalother ‘positive reinforcement’ items also loaded highly onFactor 1, but were excluded because they also cross-loaded on other factors (see Table 1: Ambiguous items).Thus, Factor 1 contains both positive and negative rein-forcement items, and the predominance of negative itemsis to some extent an artefact of the statistical methodol-ogy used.

Secondly, in the present study, the items ‘I crave somespeed now’ and ‘I have an urge to take speed now’ bothloaded exclusively on Factor 2 (strong intentions anddesires), which contains no reinforcement items of anykind. Data from the present study therefore suggest thatthe expressions ‘craving for amphetamine’ and ‘urges foramphetamine’ should both be limited to a state of strongand urgent desires for amphetamine as well as strongintentions to use the drug. Such findings are in contrastto other researchers (e.g. McAuliffe & Gordon 1974; Mar-latt 1985; Baker, Sherman & Morse 1987; Niaura et al.1988; Wise 1988) who claim that drug cravings are inti-mately associated with the anticipation of the positivelyreinforcing effects of the drug or their ability to relievenegative affect or withdrawal symptoms (Jellinek 1955;Ludwig & Wikler 1974; Poulos, Hinson & Siegel 1981;Baker, Sherman & Morse 1987; West & Schneider 1987).Thus the present study and the findings of Love et al.(1998) and Franken et al. (2002) provide support for the-oretical positions that argue that urges to engage in drugtaking are distinct from reinforcement processes (e.g. Tif-fany 1990, 1992; Robinson & Berridge 1993).

The low correlation between mild intentions/desiresand control suggests that the components of desires foramphetamine are independent yet related phenomena.After controlling for level of dependence, strong desires/intentions (‘cravings’) remained correlated with bothreinforcement and loss of control but these latter two fac-tors were uncorrelated with one another. Furtherresearch will be needed to determine the practical valueof the multi-factorial approach to drug craving; in partic-ular, whether experimental or demographic variables canbe identified that affect the factors differentially.

The results of this study validate and extend the find-ings of the work of Love et al. (1998) and Franken et al.(2002), as almost identical factor structures were foundfor the alcohol, heroin and amphetamine questionnaires.

Such results suggest two important implications; first,this type of questionnaire has practical relevance in thatit is useful for drugs other than alcohol and, secondly,identification of the same factor structure as identifiedpreviously for alcohol suggests that the dimensions ofcraving found for alcohol may be more general, ratherthan alcohol-specific.

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