Relation of Craving and Appetitive Behavior

The phenomenon of craving has been a core focus of dependence research for many decades. The push to understand and treat craving is born out of the prominence of craving in addicts’ experience of their addiction, and the wealth of evidence that suggests that the experience of craving can motivate behaviors such as smoking, gambling, or eating, even in the presence of a conscious desire to avoid the behavior in question. The ability of cravings to induce or promote behaviors, seemingly against the initial intention of those who experience them, is the core characteristic of craving and the one that most attracts the attention of researchers and theoreticians. We also discuss some of the reasons why some studies may have failed to find a relationship between craving and behavior.

Arguably the most intensive investigations on the nature and function of craving have taken place in the context of drug dependence, the findings from which are the focus of this review. As we discuss in detail below, across substances of dependence, drug craving has consistently been found to motivate drug-seeking behaviors and, hence, to disrupt efforts by users to achieve and maintain abstinence. Below we explore the nature and experience of craving, starting with the definition and measurement of craving. The evidence relating to the role of craving in maintaining appetitive behaviors is then examined. Although we have chosen to focus on findings from the drug dependency literature, craving has also been documented in relation to appetitive behaviors that are not substance related (e.g. gambling). The principles and knowledge gleaned from studies of substance abuse are also likely to be applicable to the experience of craving in these fields.