Entwicklung und Validierung eines Instrumentes zur substanzunabhängigen Erfassung von Craving: Die Mannheimer Craving Scale (MaCS)

Zusammenfassung

Anliegen Ausgehend von der Obsessive Compulsive Drinking Scale entwickelten wir mit der Mannheimer Craving Scale (MaCS) ein substanzunabhängiges Instrument zur Erfassung des Verlangens nach unterschiedlichen Suchtmitteln, geeignet auch bei multiplem Substanzgebrauch. Methode Die MaCS erfasst anhand von 12 Items zwangsähnliche Symptome des abhängigen Substanzkonsums. Die Validierung erfolgte an n = 292 Patienten. Ergebnisse Die MaCS zeigte hohe Messzuverlässigkeit und korrelierte hochsignifikant mit der auf visuellen Analogskalen erfassten Craving-Intensität und -Häufigkeit (jeweils p < 0,0001). Schlussfolgerungen Die MaCS zeigt hohe Reliabilität und Validität, ist einfach und universell aufgebaut und deswegen gut klinisch anwendbar.

Abstract

Objective Based on the Obsessive Compulsive Drinking Scale (OCDS) we developed and validated the Mannheimer Craving Scale (MaCS) for quantitative measurements of craving across different substances and suitable for multiple substance abuse. Methods The MaCS questionnaire measures obsessive-compulsive symptoms in the context of substance abuse and dependence similar to the OCDS. The MaCS consists of 12 items and 4 additional items. Validation of the instrument was performed by means of 3 assessments of each subject within a project for the evaluation of a detox treatment on n = 292 alcohol and drug-dependent patients with multiple substance abuse. Results: The MaCS showed a very high measurement reliability (0.87 < α < 0.93). The MaCS total score correlated highly significant with the mean intensity of craving (0.47 < r_tc < 0.64, p < 0.0001), with the maximum of craving (0.52 < r_tc < 0.69, p < 0.0001), and with the frequency of craving (0.43 < r_tc < 0.65, p < 0.0001) measured by means of analogue scales. Conclusions: The MaCS for overall measurements of craving across multiple substances showed very good reliability and validity. In combination with a simple and universal feasibility of the MaCS these results indicate the applicability in everyday clinical settings as well as scientific settings.

Schlüsselwörter

Craving - Fragebogen - OCDS - Substanzmissbrauch - Testvalidierung

Key words

craving - OCDS - questionnaire - substance abuse - test validation

Literatur

• 1 Heinz A, Lober S, Georgi A. et al . Reward craving and withdrawal relief craving: assessment of different motivational pathways to alcohol intake.  Alcohol Alcohol. 2003;  38 35-39
• 2 Tiffany S T. A cognitive model of drug urges and drug-use behavior: role of automatic and nonautomatic processes.  Psychol Rev. 1990;  97 147-168
• 3 Anton R F, Moak D H, Latham P. The Obsessive Compulsive Drinking Scale: a self-rated instrument for the quantification of thoughts about alcohol and drinking behavior.  Alcohol Clin Exp Res. 1995;  19 92-99
• 4 Mann K, Diehl A, Hein J. et al . Alkoholabhängigkeit. In: Voderholzer U, Hohagen F Alkoholabhängigkeit, Therapie psychischer Erkrankungen – State of the Art. München, Jena; Urban & Fischer 2006: 19-33
• 5 Wise R A. The neurobiology of craving: implications for the understanding and treatment of addiction.  J Abnorm Psychol. 1988;  97 118-132
• 6 Monti P M, Abrams D B, Binkoff J A. et al . Communication skills training, communication skills training with family and cognitive behavioral mood management training for alcoholics.  J Stud Alcohol. 1990;  51 263-270
• 7 Johann M, Bobbe G, Franke E. et al . Relapse prevention group for alcohol dependent patients.  Psychiat Prax. 2003;  30, Suppl. 2 S125-S128
• 8 Anton R F, Moak D H, Latham P K. The obsessive compulsive drinking scale: A new method of assessing outcome in alcoholism treatment studies.  Arch Gen Psychiatry. 1996;  53 225-231
• 9 Modell J G, Glaser F B, Cyr L. et al . Obsessive and compulsive characteristics of craving for alcohol in alcohol abuse and dependence.  Alcohol Clin Exp Res. 1992;  16 272-274
• 10 Janiri L, Calvosa F, Dario T. et al . The Italian version of the Obsessive-Compulsive Drinking Scale: validation, comparison with the other versions, and difference between type 1- and type 2-like alcoholics.  Drug Alcohol Depend. 2004;  74 187-195
• 11 Chignon J M, Jacquesy L, Mennad M. et al . Self-assessment questionnaire of alcoholic craving (ECCA Questionnaire: Behavior and Cognition in Relation to Alcohol: French translation and validation of the Obsessive-Compulsive Drinking Scale.  Encephale. 1998;  24 426-434
• 12 Mann K, Ackermann K. Die OCDS-G: Psychometrische Kennwerte der deutschen Version der Obsessive Compulsive Drinking Scale.  Sucht. 2000;  46 90-100
• 13 Moak D H, Anton R F, Latham P K. Further validation of the Obsessive-Compulsive Drinking Scale (OCDS). Relationship to alcoholism severity.  Am J Addict. 1998;  7 14-23
• 14 Flannery B A, Poole S A, Gallop R J. et al . Alcohol craving predicts drinking during treatment: an analysis of three assessment instruments.  J Stud Alcohol. 2003;  64 120-126
• 15 Bohn M J, Krahn D D, Staehler B A. Development and initial validation of a measure of drinking urges in abstinent alcoholics.  Alcohol Clin Exp Res. 1995;  19 600-606
• 16 Raabe A, Grusser S M, Wessa M. et al . The assessment of craving: psychometric properties, factor structure and a revised version of the Alcohol Craving Questionnaire (ACQ).  Addiction. 2005;  100 227-234
• 17 Tiffany S T, Drobes D J. The development and initial validation of a questionnaire on smoking urges.  Br J Addict. 1991;  86 1467-1476
• 18 Cox L S, Tiffany S T, Christen A G. Evaluation of the brief questionnaire of smoking urges (QSU-brief) in laboratory and clinical settings.  Nicotine Tob Res. 2001;  3 7-16
• 19 Mol A J, Voshaar R C, Gorgels W J. et al . Development and psychometric evaluation of the Benzodiazepine Craving Questionnaire.  Addiction. 2003;  98 1143-1152
• 20 Diehl A, Scherbaum N. [Nicotine dependence as comorbidity of alcohol dependence – epidemiology, etiology and therapy.].  Fortschr Neurol Psychiatr. 2008;  76 14-18
• 21 Nakovics H, Diehl A, Croissant B. et al . Modifications of the Obsessive Compulsive Drinking Scale (OCDS-G) for use in longitudinal studies.  Addictive Behaviors. 2008;  33 1276-1281
• 22 Batel P, Pessione F, Maitre C, Rueff B. Relationship between alcohol and tobacco dependencies among alcoholics who smoke.  Addiction. 1995;  90 977-980
• 23 Schaflitzel B, Brandes C. Regensburger Skala zur Messung des Entzugssyndroms nach multiplem Substanzgebrauch (RS-EMS). Mannheim; Zentrum für Umfragen, Methoden und Analysen 2003
• 24 Schaflitzel B. Entwicklung und Validierung einer Skala zur Messung der subjektiven Stärke des Entzugssyndroms nach multiplem Substanzgebrauch. Universität Regensburg 1997
• 25 Foa E B, Huppert J D, Leiberg S. et al . The Obsessive-Compulsive Inventory: development and validation of a short version.  Psychol Assess. 2002;  14 485-496
• 26 Taylor S. Assessment of obsessiv-compulsive disorder. In: Swinson RP, Antony MM, Rachman S, Richter MA Obsessive-compulsive disorder: theory, research and treatment. New York; Guilford Press 1998: 229-257
• 27 Woody S R, Steketee G, Chambless D L. Reliability and validity of the Yale-Brown Obsessive-Compulsive Scale.  Behav Res Ther. 1995;  33 597-605
• 28 Gönner S, Leonhart R, Ecker W. [The German version of the obsessive-compulsive inventory-revised: a brief self-report measure for the multidimensional assessment of obsessive-compulsive symptoms].  Psychother Psychosom Med Psychol. 2007;  57 395-404
• 29 Kranzler H R, Mulgrew C L, Modesto-Lowe V. et al . Validity of the Obsessive Compulsive Drinking Scale (OCDS): does craving predict drinking behavior?.  Alcohol Clin Exp Res. 1999;  23 108-114
• 30 Verheul R, van den Brink W, Geerlings P. A three-pathway psychobiological model of craving for alcohol.  Alcohol Alcohol. 1999;  34 197-222
• 31 Veltrup C, Einsle F, Lindenmeyer J. et al . Die Erfassung des Craving bei Alkoholabhängigen.  Suchttherapie. 2001;  2 14-24
• 32 Wetterling T, Veltrup C, Junghanns K. Craving – an adequately defined concept?.  Fortschr Neurol Psychiatr. 1996;  64 142-152

1 geteilte Erstautorenschaft („equal contribution”)