Craving predicts time to cocaine relapse: further validation of the Now and Brief versions of the cocaine craving questionnaire

Abstract

Background: The 10-item version of the cocaine craving questionnaire (CCQ-Brief) has not been validated in a mixed-gender sample, and predictive validity of the CCQ-Now and CCQ-Brief in terms of their relationship with cocaine relapse has not been demonstrated.

Objective: To further validate the CCQ-Brief in a mixed gender sample and to determine the predictive validity of the CCQ-Now and CCQ-Brief.

Method: Seventy-two men and 51 women (Total N=123) seeking inpatient cocaine dependence treatment were administered assessments upon admission, and a prospective design was employed to assess cocaine relapse outcomes during a 90-day follow-up period after discharge from inpatient treatment. Data were analyzed using Pearson's correlation, Cox proportional hazards regression, and multiple regression.

Findings: The CCQ-Brief demonstrated good internal consistency and construct and concurrent validity. Both the CCQ-Now and the CCQ-Brief summary scores predicted time to cocaine relapse. In addition, the anticipation of a positive outcome from cocaine use, and intent and planning to use cocaine subscales of the CCQ-Now also predicted time to cocaine relapse.

Conclusions: The CCQ-Brief was found to be a reliable and valid measure in a mixed gender sample, and both the CCQ-Now and CCQ-Brief were predictive of cocaine relapse risk. Craving assessments that go beyond desire and take into account intent and planning to use cocaine and the patient's anticipation of a positive outcome from using cocaine are likely to provide a sensitive index of cocaine relapse susceptibility. However, fear of social and clinical consequences could impact accurate reporting of cocaine craving and intent to use cocaine.

Figure 1

(a) Survival Curves for low (0–130) and high craving (>130) groups based on median split of CCQ-Now summary score. Log-rank test indicates survival curves for two groups are significantly different (X² = 4.42; p < 0.036). (b) Survival Curves for low (0–19) and high craving (>19) groups based on median split of CCQ-Brief score. Log-rank test indicates survival curves for two groups are significantly different (X² = 4.197; p < 0.041).

Figure 1

(a) Survival Curves for low (0–130) and high craving (>130) groups based on median split of CCQ-Now summary score. Log-rank test indicates survival curves for two groups are significantly different (X² = 4.42; p < 0.036). (b) Survival Curves for low (0–19) and high craving (>19) groups based on median split of CCQ-Brief score. Log-rank test indicates survival curves for two groups are significantly different (X² = 4.197; p < 0.041).