Evaluating alcohol demand, craving, and depressive symptoms among women in alcohol treatment

Background: Depression and alcohol craving predict drinking and relapse rates among alcohol treatment seekers. Alcohol demand, or one's valuation of alcohol may be another determinant of drinking. There is little known about alcohol demand and its association with depression, craving, and drinking among treatment-seeking adults. Method: Participants were 71 women with elevated depressive symptoms seeking outpatient treatment for alcohol use disorder (AUD). At baseline, participants self-reported daily drinking amount, alcohol craving, depressive symptoms, and alcohol demand assessed with the alcohol purchase task (APT; a task requesting participants to make hypothetical purchases of drinks at escalating prices). Baseline associations among alcohol demand, depressive symptoms, alcohol craving, and drinking severity were assessed. Results: Participants averaged 40.68 (SD = 11.78) years of age, consumed 8.84 (SD = 5.14) drinks per drinking day and reported 15.45 (SD = 7.51) heavy drinking days in the past 30 days, and had an average PHQ-9 depression score of 13.00 (SD = 4.28). Results suggest that the alcohol demand metrics of intensity (consumption level when drinks are free) and O-max (maximum expenditure on alcohol) were associated with drinks per drinking day, whereas craving and depressive symptoms were not significantly associated with drinking. The number of heavy drinking days were not significantly associated with demand, craving, or depressive symptoms. Conclusions: These results suggest that demand may reflect unique risk for drinking relative to craving or depressive symptoms. These findings provide support for the utility of the APT within a clinical setting to assess individualized valuation of alcohol.