Cited by 1,638Substance Abuse Treatment and OutcomesNeurotransmitter Receptor Influence on BehaviorGambling Behavior and Treatments

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Meta‐analysis of cue‐reactivity in addiction research

Carter, Brian L., Tiffany, Stephen T.·1999·Addiction

DOI 10.1046/j.1360-0443.1999.9433273.x

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Abstract

Aims. The cue‐reactivity procedure exposes addicts to a variety of drug‐related stimuli while self‐report of craving and physiological responses are monitored. The present review sought to determine the magnitude and overall pattern of responses typically found in cue‐reactivity research and which, if any, learning‐based model of cue reactivity is best supported by the findings. Design. Meta‐analytical techniques were used to select and evaluate results from 41 cue‐reactivity studies that compared responses of alcoholics, cigarette smokers, cocaine addicts or heroin addicts to drug‐related versus neutral stimuli. Effect sizes were calculated, separately by addict type, for self‐report of craving and physiological responses (heart rate, sweat gland activity and skin temperature). Findings. Across all addict groups, the effect size for craving was +0.92. Alcoholics had a significantly smaller craving effect size (+0.53) compared to other addict groups (+1.18 to +1.29). Relatively smaller effect sizes were found for physiological responses. The general profile of effect sizes across all addict groups was increased heart rate (+0.26) and sweat gland activity (+0.40) and decreased skin temperature (‐0.24) when addicts were presented with drug‐related stimuli. Conclusions. The cuereactivity paradigm can produce a stable profile of significant effects and, therefore, has a number of potential applications for investigating addictive phenomena. The implications of these findings for conditioning‐based models of cue‐reactivity phenomena are discussed.

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“First, compared with other drugs of abuse (e.g., nicotine, heroin), the magnitude of cravings elicited for alcohol is smaller in cue reactivity studies (Carter and Tiffany, 1999).”
Background
Subjective and Autonomic Responses to Smoking-Related Visual Cues
Chae, Y., Lee, J., Park, K., Kang, O.-S., Park, H., & Lee, H. (2008) · The Journal of Physiological Sciences · doi:10.2170/physiolsci.rp014207 · Cited by 17
“Numerous laboratory-based cue reactivity studies have found that various drug-related cues elicited strong cravings and physiological responses among addicts, such as alcoholics and smokers [5, 6].”
Background
Correlates of Inserted Object-Assisted Sexual Behaviors in Men: A Model for Development of Paraphilic and Non-Paraphilic Urges
Stroebel, S. S., O’Keefe, S. L., Beard, K. W., Robinett, S. R., Kommor, M. J., & Swindell, S. (2010) · Sexual Addiction & Compulsivity The Journal of Treatment and Prevention · doi:10.1080/10720161003795943 · Cited by 17
“Furthermore, our conclusions with regard to urges parallel those of investigators studying nicotine addiction ( Carter & Tiffany, 1999 ; Lazev, Herzog & Brandon, 1999 ; Niaura et al, 1988 ; Thewissen et al, 2005 ).”
Result
Effects of Oxytocin Administration on Cue‐Induced Craving in Co‐occurring Alcohol Use Disorder and PTSD: A Within‐Participant Randomized Clinical Trial
Stauffer, C. S., Meinzer, N. K., Morrison, T., Wen, J., Radanovich, L., Leung, D., Niles, A. N., O’Donovan, A., Batki, S. L., & Woolley, J. D. (2019) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.14217 · Cited by 19
“Cue-induced craving paradigms using exposure to actual alcohol have been utilized widely in the investigation of new interventions for AUD (Carter and Tiffany, 1999; Reynolds and Monti, 2013), including studies of individuals with comorbid AUD and PTSD (Coffey et al., 2010; Nosen et al., 2014).”
Background
Correlates of Inserted Object-Assisted Sexual Behaviors in Women: A Model for Development of Paraphilic and Non-paraphilic Urges
O’Keefe, S. L., Beard, K. W., Stroebel, S. S., Berhie, G., Bickham, P. J., & Robinett, S. R. (2009) · Sexual Addiction & Compulsivity The Journal of Treatment and Prevention · doi:10.1080/10720160902724418 · Cited by 17
“Furthermore, our conclusions with regard to urges parallel those of investigators studying nicotine addiction (Carter & Tiffany, 1999; Lazev, Herzog & Brandon, 1999; Niaura et al., 1988; Thewissen et al, 2005).”
Result
CLINICAL STUDY: Suppression of cue‐induced heroin craving and cue‐reactivity by single‐trial transcutaneous electrical nerve stimulation at 2 Hz
Zhong, F., Wu, L., & Han, J. (2006) · Addiction Biology · doi:10.1111/j.1369-1600.2006.00020.x · Cited by 17
Early Abstinence in Cocaine Dependence: Influence of Comorbid Major Depression
Rubin, E., Aharonovich, E., Bisaga, A. M., LEVIN, F. R., Raby, W. N., & Nunes, E. V. (2007) · American Journal on Addictions · doi:10.1080/10550490701389880 · Cited by 17
Effects of smoking cues on caffeine urges in heavy smokers and caffeine consumers with and without schizophrenia
Adolfo, A. B., AhnAllen, C. G., & Tidey, J. W. (2008) · Schizophrenia Research · doi:10.1016/j.schres.2008.10.009 · Cited by 17
No untoward effects of smoking cues in anti-smoking public service announcements
Falcone, M., Lerman, C. E., Cappella, J. N., et al. (2013) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2013.05.006 · Cited by 16
Escalating Doses of Transdermal Nicotine in Heavy Smokers
Selby, P. L., Andriash, K., Zawertailo, L. A., Persad, D., Zack, M. H., & Busto, U. E. (2013) · Journal of Clinical Psychopharmacology · doi:10.1097/jcp.0b013e31829a829d · Cited by 16
Effects of T'ai Chi on Serotonin, Nicotine Dependency, Depression, and Anger in Hospitalized Alcohol-Dependent Patients
Oh, C.-U., & Kim, N.-C. (2016) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2016.0246 · Cited by 16
“38 Brain images demonstrating alcohol and nicotine use increase the activity of the mesolimbic dopamine system.”
Increased cortisol levels are associated with low treatment retention in crack cocaine users
Ligabue, K. P., Schuch, J. B., Scherer, J. N., Ornell, F. R., Roglio, V. S., de Assunção, V. A. F., Rebelatto, F. P., Hidalgo, M. P., Pechansky, F., Kessler, F. H. P., et al. (2019) · Addictive Behaviors · doi:10.1016/j.addbeh.2019.106260 · Cited by 17
Psychometric properties of the transaddiction craving triggers questionnaire in alcohol use disorder
von Hammerstein, C., Cornil, A., Rothen, S., Romo, L., Khazaal, Y., Benyamina, A., Billieux, J., & Luquiens, A. (2019) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.1815 · Cited by 16
Advances in smoking cessation pharmacotherapy: Non-nicotinic approaches in animal models
Smith, L. C., & George, O. (2020) · Neuropharmacology · doi:10.1016/j.neuropharm.2020.108225 · Cited by 18
Analgesic opioid use disorders in patients with chronic non-cancer pain: A holistic approach for tailored management
Bertin, C., Delage, N., Rolland, B., Pennel, L., Fatseas, M., Trouvin, A., Delorme, J., Chenaf, C., & Authier, N. (2020) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2020.12.015 · Cited by 17
The Role of Cross-Cue Reactivity in Coexisting Smoking and Gambling Habits
Wulfert, E., Harris, K., & Broussard, J. D. (2016) · Journal of Gambling Issues · doi:10.4309/jgi.2016.32.3 · Cited by 16
“The findings converge, showing that exposure to smoking-related stimuli results in robust increases in urges to smoke and modest increases in physiological reactivity (Carter, Bordnick, Traylor, Day, & Paris, 2008; Carter & Tiffany, 1999).”
BackgroundMethod
Post-traumatic stress and alcohol use disorders: recent advances and future directions in cue reactivity
Vujanovic, A. A., Lebeaut, A., Zegel, M., Smit, T., & Berenz, E. C. (2019) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2019.04.003 · Cited by 16
Vagus nerve stimulation during extinction learning reduces conditioned place preference and context-induced reinstatement of cocaine seeking
Childs, J. E., Kim, S., Driskill, C. M., Hsiu, E., & Kroener, S. (2019) · Brain stimulation · doi:10.1016/j.brs.2019.07.001 · Cited by 19
Dorsolateral striatum dopamine-dependent cocaine seeking is resistant to pavlovian cue extinction in male and female rats
Bender, B. N., & Torregrossa, M. M. (2020) · Neuropharmacology · doi:10.1016/j.neuropharm.2020.108403 · Cited by 17
“Likewise, exposure to drug-associated cues can induce craving and relapse in patients with substance use disorders (SUDs) (Carter and Tiffany, 1999; Grant et al., 1996; Wang et al., 1999).”
Background
An implicit cognition assessment approach to relapse, secondary prevention, and media effects
Stacy, A. W., Ames, S. L., & Leigh, B. C. (2004) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(04)80025-7 · Cited by 16
Deconstructing Demons: The Case of Geoffrey
Mohlman, J., Cedeno, L. A., Price, R. B., Hekler, E. B., Yan, G. W., & Fishman, D. B. (2008) · Pragmatic Case Studies in Psychotherapy · doi:10.14713/pcsp.v4i3.936 · Cited by 15
Prause et al. (2015) the latest falsification of addiction predictions
Prause, N., Steele, V. R., Staley, C., Sabatinelli, D., & Hajcak, G. (2016) · Biological Psychology · doi:10.1016/j.biopsycho.2016.05.007 · Cited by 15
A mindfulness-based, stress and coping model of craving in methamphetamine users
Mutumba, M., Moskowitz, J. T., Neilands, T. B., Lee, J.-Y., Dilworth, S. E., & Carrico, A. W. (2021) · PLoS ONE · doi:10.1371/journal.pone.0249489 · Cited by 17
Eyes on me: how social media use is associated with urban Chinese adolescents’ concerns about their physical appearance
Jin, R., & Le, T.-T. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1445090 · Cited by 19
“It has been observed that individuals who excessively consume addiction-related content tend to exhibit a notably heightened level of “cue reactivity” (51).”
Background
Psychometric Proprities of the Substance Use Risk Profile Scale - Brazilian Version
Canfield, M., Gilvarry, C. M., & Koller, S. H. (2014) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-014-9522-1 · Cited by 14
“Studies that explored the association between personality dimensions and specific substances of use have addressed a much more complex framework to understand this association (see Carter and Tiffany 1999; Hopley and Brunelle 2012; Perry and Carroll 2008; Woicik et al. 2009).”
Background
Skin conductance responses are elicited by the airway sensory effects of puffs from cigarettes
Naqvi, N. H., & Bechara, A. (2006) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2005.10.018 · Cited by 15
“Further evidence for this comes from showing that the behavioral, subjective and autonomic responses to drug cues are correlated with each other (Carter and Tiffany, 1999; Glautier and Remington, 1995).”
BackgroundResult
Model-Free Temporal-Difference Learning and Dopamine in Alcohol Dependence: Examining Concepts From Theory and Animals in Human Imaging
Huys, Q. J. M., Deserno, L., Obermayer, K., Schlagenhauf, F., & Heinz, A. (2016) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2016.06.005 · Cited by 18
“In terms of the first criterion, 1a, drug-associated stimuli lead to higher autonomic activation than stimuli not associated with drugs (74), and this is accompanied by recruitment of the VS, with higher BOLD signals in the VS for alcoholrelated stimuli compared with control stimuli (75,76).”
Background
A Clinical Overview of Nicotine Dependence and Withdrawal
Frandsen, M., Thorpe, M., Shiffman, S. S., & Ferguson, S. G. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-802574-1.00012-0 · Cited by 15
Health in context: New perspectives on healthy thinking and healthy living
Earl, A. N., & Lewis, N. A. (2018) · Journal of Experimental Social Psychology · doi:10.1016/j.jesp.2018.09.001 · Cited by 18
Comparing ABA, AAB, and ABC Renewal of Appetitive Pavlovian Conditioned Responding in Alcohol- and Sucrose-Trained Male Rats
Khoo, S. Y., Sciascia, J. M., Brown, A., & Chaudhri, N. (2020) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2020.00005 · Cited by 15
“However, gains from this approach may be transient and confined to the treatment context (Monti et al., 1993; Drummond and Glautier, 1994; Carter and Tiffany, 1999; Miller et al., 2001; Conklin and Tiffany, 2002; Bouton et al., 2012; Mellentin et al., 2017).”
Background
A randomized controlled trial of a virtual reality based, approach-avoidance training program for alcohol use disorder: a study protocol
Mellentin, A. I., Nielsen, A. S., Ascone, L., Wirtz, J., Samochowiec, J., Kucharska–Mazur, J., Schadow, F., Lebiecka, Z., Skoneczny, T., Mistarz, N., et al. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02739-1 · Cited by 16
Disentangling craving‐ and valence‐related brain responses to smoking cues in individuals with nicotine use disorder
Haugg, A., Manoliu, A., Sladky, R., Hulka, L. M., Kirschner, M., Brühl, A. B., Seifritz, E., Quednow, B. B., Herdener, M., & Scharnowski, F. (2021) · Addiction Biology · doi:10.1111/adb.13083 · Cited by 13
The effects of compound stimulus extinction and inhibition of noradrenaline reuptake on the renewal of alcohol seeking
Furlong, T. M., Pan, M. J., & Corbit, L. H. (2015) · Translational Psychiatry · doi:10.1038/tp.2015.130 · Cited by 17

Authors: Carter, B. L., & Tiffany, S. T.
Affiliations: Purdue University West Lafayette (US)
Venue: Addiction
Publisher: Wiley
Published: 1999-03
Volume: 94
Issue: 3
Pages: 327-340
ISSN: 0965-2140 (ISSN-L)
1360-0443
DOI: 10.1046/j.1360-0443.1999.9433273.x
OpenAlex: W1988132969
Cited by: 1,638
References: 0
Citations by year: 2026: 41 · 2025: 50 · 2024: 38 · 2023: 59 · 2022: 53 · 2021: 73 · 2020: 145 · 2019: 61 · 2018: 59 · 2017: 58 · 2016: 83 · 2015: 85 · 2014: 90 · 2013: 86 · 2012: 97
FWCI: 16.64
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 1159 d)
Locations: Addiction (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (2r01da004050-09a2)
National Institute on Drug Abuse (R01DA04050)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
Keywords: cue reactivity, drug craving, alcoholism, cigarette smoking, cocaine dependence, heroin addiction, physiological responses, heart rate, sweat gland activity, skin temperature
MeSH terms: Adult, Cues, Female, Heart Rate, Humans, Male, Research, Skin Temperature, Sweating, Randomized Controlled Trials as Topic, Substance-Related Disorders

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Meta‐analysis of cue‐reactivity in addiction research

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