Regulation of Cocaine Craving by Cognitive Strategies in an Online Sample of Cocaine Users

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Emphasis on the negative consequences of drug use is a critical component of cognitive–behavioral therapy (CBT) skills to regulate craving. Despite the relative success of CBT for treating substance use disorders, effective human laboratory models of CBT are lacking. Recent reports have indicated that the regulation of craving (ROC) task provides a valid model of craving regulation for nicotine, alcohol, and methamphetamine use. The present study examined ROC in an online sample of regular cocaine users (n = 44) recruited from’s Mechanical Turk. In the ROC task, cognitive regulation strategies were manipulated by instructing participants to think about either the positive or negative consequences of consuming cocaine. Participants were then presented with cocaine images while engaging in each cognitive regulation strategy and asked to report current craving that was then compared to neutral look conditions. Food images served as a control. A cocaine purchase task was also completed to assess economic demand for cocaine and its relationship with cocaine craving. The use of negative appraisal strategies that model those used in CBT significantly attenuated craving for cocaine. Cocaine craving was also stimulus-specific, with greater smoked cocaine craving reported by individuals with a history of smoked cocaine use. This online extension of the ROC task provides converging evidence for its use as a model of CBT cocaine-craving regulation. Futures studies can use this model to examine the mechanisms underlying the effectiveness of CBT for cocaine use and the relationship between craving regulation and drug-use behavior.

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