Craving in Patients' Narrative Reports: Between Temptation and desire thinking

Journal title MISSION
Author/s Francesca Costantini
Publishing Year 2026 Issue 2026/74
Language Italian Pages 7 P. 9-15 File size 0 KB
DOI 10.3280/mis74-2026oa20315
DOI is like a bar code for intellectual property: to have more infomation click here

View article Download Open Access article

FrancoAngeli is member of Publishers International Linking Association, Inc (PILA), a not-for-profit association which run the CrossRef service enabling links to and from online scholarly content.

Craving refers to a subjective experience of intense desire, an urgency to use a substance or  to engage in a behavior [Drummon et al., 2001, Drummond et al. 2002]. Currently, craving is recognized as one of the main criteria for the Diagnosis of Substance-Related Disorders and Addiction Disorders (DSM5, Apa, 2013), included in the grouping of criteria related to the impairment of substance use control and is a central factor in the maintenance of addiction (Hasin et al., 2013; Romanczuk-Seiferth, Van Den Brink, & Goudriaan, 2014). According to the DSM - 5, craving can be defined as an 'intense urgency or desire' readily stimulated by internal and external factors previously associated with the substance, elements capable of playing a 'trigger' role, that is, 'trigger', which initiate through a mechanism of conditioning, and by association of ideas, the desire for chemically obtained gratification (Tiffany and Conklin, 2000).

Two distinct forms of craving from the patient's expectations perspective: on one hand, the concern of taking the substance to avoid withdrawal, referred to as "negative craving"; on the other hand, the compulsion towards the substance driven by the expectation of incentives, of gratification. In this case, the search for a "reward" would produce a "positive craving." (Tiffany and Conklin, 2000) Research has shown that craving is qualitatively similar across all target domains, including alcohol, tobacco (Castellani & Rugle, 1995; Field, Schoenmakers, & Wiers, 2008). Over the past 40 years, several models have been proposed to conceptualize craving; behaviorist models have conceptualized it as an epiphenomenon of classical and operant conditioning processes (e.g., Ludwig & Wikler, 1974; Stewart, Dewit, & Eikelboom, 1984), while cognitive models have emphasized that higher-order cognitive functioning  and the way of processing information is central to the activation of craving (Tiffany, 1999). Among the cognitive constructs proposed in recent years is that of 'desire thinking' or wanting thought, which seems to play a role in the escalation and persistence of craving in dependent individuals (Caselli & Spada, 2010, 2011; Kavanagh et al., 2009). The purpose of this brief article is to stimulate, among clinicians working with patients affected by substance use disorders (SUD), a reflection on the existing analogies between the construct and the mechanism of action of 'desire thinking' and that of 'temptation' as theorized by the Church Fathers. The analogy and comparison between temptation and desire thinking should be understood here as entirely free from ethical-moral and/or religious connotations and considered solely and exclusively as a comparison between two well-defined cognitive-emotional constructs.  In the narrative accounts of patients, both lay and Catholic, collected by clinical therapists (both lay and Catholic), the expressions "temptation" and "liberation" related to craving are often present. At the end of the article, we will discuss the possibility of modifying such dysfunctional and maladaptive coping strategies.

Keywords: craving;cognitive model;behaviorla model;desire thinking;psychoterapy;metacognition;temptation

  1. Anton R.F. (1999). What is craving? Models and implications for treatment. Alcohol Res Health, 23(3): 165-73.
  2. Auriacombe M., Serre F., & Fatséas M. (2016). Le craving: marqueur diagnostique et pronostique des addictions? In: Traité d’addictologie. Vol. 2 ed. Cachan: Lavoisier.
  3. Auriacombe M., Fatséas M., Daulouède J.P., & Tignol J. (2018). Le craving et nouvelle clinique de l’addiction: une perspective simplifiée et opérationnelle [The craving and new clinic of addiction: A simplified andoperational perspective.]. Ann. Méd. Psychol. Rev. Psychiatr., 176(8): 746-749.
  4. Baker T.B., Morse E., & Shermann J.E. (1987). The motivation to use drugs: A psychobiological analysis of urges. In: C. Rivers (Ed.). The Nebraska Symposium on Motivation: Alcohol Use and Abuse (34, pp. 257-323). Lincoln, USA: University of Nebraska Press.
  5. Berridge K.C., & Robinson T.E. (1995). The mind of an addicted brain: Neural sensitization of wanting versus liking. Current Directions in Psychological Science, 4(3): 71-76. Doi: 10.1111/1467-8721.
  6. Bonner J., AKatsikitis M., Love S., & Dymand L.K. (2022). Metacognition, Desire Thinking and Craving in Problematic Video Game Use. J Technol Behav Sci., 22 Aug, 7(4): 532-546. Doi: 10.1007/s41347-022-00272-4.
  7. Bosc E., Fatséas M., Alexandre J.M., & Auriacombe M. (2012). Similitudes et différences entre le jeu pathologique et la dépendance aux substances: qu’en Est-Il? [Similarities and differences between pathological gambling and substance dependance: A clarification]. L’Encephale, October, 38(5): 433-439. Doi: 10.1016/j.encep.2012.02.004.
  8. Bywaters M., Andrade J., & Turpin G. (2004). Determinants of the vividness of visual imagery: The effects of delayed recall, stimulus affect and individual differences. Memory, Jul, 12(4): 479-488. Doi: 10.1080/09658210444000160.
  9. Brandtner A., & Wegmann E. (2023) The fear in desire: linking desire thinking and fear of missing out in the social media context. BMC Psychol., Jun 3, 11(1): 176. Doi: 10.1186/s40359-023-01216-0.
  10. Breese G.R., Sinha R., & Heilig M. (2011). Chronic alcohol neuroadaptation and stress contribute to susceptibility for alcohol craving and relapse. Pharmacol Ther, Feb, 129(2): 149-71. Doi: 10.1016/j.pharmthera.2010.09.007.
  11. Brousse G., & de Chazeron I. (2014). Le craving: des clés pour comprendre [Craving: keys to understanding]. Alcoologie Addictologie, Juin, 36(2): 105-115.
  12. Carroll K.M. (2000). Implications of recent research for program quality in cocaine dependence treatment. Substance Use & Misuse, 35: 2011-2030. Doi: 10.3109/10826080009148248.
  13. Caselli G., & Spada M.M. (2011). The Desire Thinking Questionnaire: Development and psychometric properties. Addictive Behaviors, 36: 1061-1067. Doi: 10.1016/j.addbeh.2011.06.013.
  14. Caselli G., Ferla M., Mezzaluna C., Rovetto F., & Spada M.M. (2012). Desire thinking across the continuum of drinking behaviour. European Addiction Research, 18: 64-69. Doi: 10.1159/000333601.
  15. Caselli G., Nikcevic A., Fiore F., Mezzaluna C., & Spada M.M. (2012). Desire thinking across the continuum of nicotine dependence. Addiction Research & Theory, 20(5): 382-388. Doi: 10.3109/16066359.2011.644842.
  16. Caselli G., & Spada M.M. (2013). The metacognitions about desire thinking questionnaire: Development and psychometric properties. Journal of Clinical Psychology, 69(12): 1284-1298. Doi: 10.1002/jclp.21999.
  17. Caselli G., Soliani M., & Spada M.M. (2013). The effect of desire thinking on craving: an experimental investigation. Psychology ofAddictive behaviors, 27(1): 301-306. Doi: 10.1037/a0027981.
  18. Caselli G., & Spada M.M. (2014). Desire thinking: What is it and what drives it? Addic Behav., May, 44: 71-79. Doi: 10.1016/j.addbeh.2014.07.021.
  19. Caselli G., Gemelli A., & Spada M.M. (2017). The experimental manipulation of Desite Thinking in Alcohol Use Disorder. Clin Psychol Psychother., Mar, 24(2): 569-573. Doi: 10.1002/cpp.2038.
  20. Climaco G.S. (1874). La Scala del Paradiso. Collezione di Opere inedite o rare dei primi tre secoli della lingua. Pubblicata per cura della R. Commissione Pe’ Testi di Lingua nelle province dell’Emilia. Bologna. Presso Gaetano Romagnoli. Libraio Editore della R. Commissione Pe’ Testi di Lingua.
  21. Cropley M., Ussher M., & Charitou E. (2007). Acute effects of a guided relaxation routine (bodyscan) on tobacco withdrawal symptoms and cravings in abstinent smokers. Addiction, Jun., 102(6): 989-93. Doi: 10.1111/j.1360-0443.2007.01832.x.
  22. Dennis F. (2016). Encountering “Triggers” Drug-Body-World entanglements of injecting drug use. Contemporary Drug Problems, 43(2): 126-141. Doi: 10.1177/0091450916636379.
  23. Diagnostic and Statistical Manual of Mental Disorders (DSM-5) 5thed. Arlington, VA: American Psychiatric Publishing, Inc; 2013.
  24. Drummond D.C., Litten R.Z., Lowman C., & Hunt W.A. (2000). Craving research:future directions. Addiction, Aug., 95, Suppl 2: S247-S255. Doi: 10.1080/09652140050111816.
  25. Drummond D.C. (2001). Theories of drug craving, ancient and modern. Addiction, Jan, 96(1): 33-46. Doi: 10.1046/j.1360-0443.2001.961333.x.
  26. Ferrario F. (2006). La lettera di Giacomo. Editore Claudiana.
  27. Fraser S. (2016). Articulating addiction in alcohol and other drug policy: A multiverse of habits. International Journal of Drug Policy, May, 31: 6-14. Doi: 10.1016/j.drugpo.2015.10.014.
  28. Fumagalli A. (2a Edizione 2020). Il Cristiano nel Mondo. Introduzione alla teologia morale. Edizioni Ancora. Prima edizione 2010.
  29. Galimberti U. (1992). Dizionario di Psicologia. Torino: UTET.
  30. Goldman M.S., & Rather B C. (1993). Substance use disorders: cognitive models and architecture. In: K.S. Dobson, & P.C. Kendall (Eds.). Psychopathology and Cognition (pp. 246-292). San Diego, USA: Academic Press.
  31. Green M., Rogers P., & Elliman N. (2000). Dietary restraint and addictive behaviour: The generalisability of Tyffany’s cue reactivity model. International Journal of Eating Disorder, May, 27(4): 419-427. Doi: 10.1002/(sici)1098-108x(200005)27:4<419::aid-eat6>3.0.co;2-z.
  32. Hasin D.S., O’Brien C.P., Auriacombe M., Borges G., Bucholz K., Budney A., Compton W.M., Crowley T., Ling W., Petry N.M., Schuckit M., & Grant B.F. (2013). DSM-5 criteria for substance use disorders: Recommendations and rationale. Am J of Psychiatry, Aug., 107(8): 834-851. Doi: 10.1176/appi.ajp.2013.12060782.DSM-5.
  33. Jellinek E.M. (1960). The Disease Concept of Alcoholism. New Haven: Hillhouse Press.
  34. Kavanagh D.J., Andrade J., & May J. (2004). Beating the urge: Implications of research into substance-related desires. Addictive behaviors, 29(7): 1399-1372. Doi: 10.1016/j.addbeh.2004.06.009.
  35. Kavanagh D.J., Andrade J., & May J. (2005). Imaginary Relish and Exquisite Torture: The Elaborated Intrusion Theory of Desire. Psychol Rev, Apr, 112(2): 446-467. Doi: 10.1037/0033-295X.112.2.446.
  36. Kavanagh D.J., May J., & Andrade J. (2009). Tests of the elaborated intrusion theory of craving and desire: Feature of alcohol craving during treatment for an alcohol disorder. Br J Clin Psychol, Sep, 48 (Pt3): 241-254. Doi: 10.1348/014466508X387071.
  37. Kozlowski L., & Wilkinson D. (1987). Use and misuse of the concept of craving by alcohol, tobacco, and drug researchers. Br J Addict., Jan, 82(1): 31-45. Doi: 10.1111/j.1360-0443.1987.tb01430.x.
  38. Ludwig A.M., & Wikler A. (1974). “Craving” and relapse to drink. Quarterly Journal of Studies on Alcohol., Mar, 35(1-A): 108-130.
  39. Ludwig A.M. (1988). Understanding the Alcoholic’s Mind: The Nature of Craving and How to Control It. New York: Oxford University Press.
  40. MacKillop J., & Monti P. (2007). Advances in the scientific study of craving for alcohol and tobacco. In: P. Miller, D. Kavanagh (Eds.). Translation of Addictions Science into practice (pp. 189-209). Oxford: Elsevier Science. Doi: 10.1016/B978-008044927-2/50059-6.
  41. Månsson V., Andrade K., Nitya Jayaram-Lindström N., Anne H., & Berman A.H. (2022). “I see myself”: Craving imagery among individuals with addictive disorders. Journal of Addictive Diseases, Jan-Mar, 41(1): 64-77. Doi: 10.1080/10550887.2022.2058299.
  42. Marino C., Caselli G., Lenzi M., Monaci M.G., Vieno A., Nikcˇevic´ A.V., & Spada M.M. (2019). Emotion regulation and Desire thinking as predictors of problematic Facebook Use. Psychiatr Q., Jun, 90(2): 405-411. Doi: 10.1007/S11126-019-09628-1.
  43. Martino F., Caselli G., Felicetti F., Rampioni M., Romanelli P., Troiani L., Sassaroli S., Albery I.P., & Spada M.M. (2017). Desire thinking as a predictor of craving and binge drinking. A longitudinal study. Addict Behav., Jan, (64): 118-122. Doi: 10.1016/j.addbeh.2016.08.046.
  44. May J., Andrade J., Panabokke N., & Kavanagh D. (2004). Images of desire: Cognitive models of craving. Memory, Jul, 12(4): 447-461. Doi: 10.1080/09658210444000061.
  45. Marlatt G.A. (1978). Craving for alcohol, loss of control, and relapse: A cognitive-behavioral analysis. In: P.E. Nathan, G.A. Marlatt, & T. Loberg (Eds.). Alcoholism: New directions in research and treatment (pp. 271-314). New York, USA: Plenum Press.
  46. Marlatt G.A., & Gordon J. (1985). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. New York, USA: The Guildford Press.
  47. Marlatt G.A. (1987). Craving notes. British Journal of Addiction, 82(1): 42-44. Doi: 10.1111/j.1360-0443.1987.tb01434.x.
  48. McCrady B.S. (2000). Alcohol use disorders and the Division 12 Task force of the American Psychological Association. Psychology of Addictive Behaviors, 14(3): 267-276. Doi: 10.1037/0893-164X.14.3.267.
  49. McGovern M.P., & Carroll K.M. (2003). Evidence-based practices for substance use disorders. Psychiatr Clin North Am., Dec, 26(4): 991-1010. Doi: 10.1016/s0193-953x(03)00073-x.
  50. O’Malley S.S., Krishnan-Sarin S., Farren C., Sinha R., & Kreek J. (2002). Naltrexone decreases craving and alcohol self-administration in alcohol-dependent subjects and activates the hypothalamopituitary-adrenocortical axis. Psychopharmacology, Feb., 160(1): 19-29. Doi: 10.1007/s002130100919.
  51. Oei T.P., Raylu N., & Casey L.M. (2010). Effectiveness of group and individual formats of a combined motivational interviewing and cognitive behavioral treatment program for problem gambling: a randomised controlled trial. Behav Cogn Psychother., Mar, 38(2): 233-238. Doi: 10.1017/S1352465809990701.
  52. Opuscoli religiosi, letterali e morali. Tomo XII. Fascicolo trigesimo quarto, 1862. Modena. Tipografia degli Eredi Soriani.
  53. Paille F.M., Guelfi J.D., Perkins A.C., Royer R.J., Stern L., & Parot P. (1995). Double-blind randomised multicentre trial of acamprosate in maintaining abstinence from alcohol. Alcohol Alcohol., Mar, 30(2): 239-247.
  54. Rankin H., Hodgson R., & Stockwell T. (1979). The concept of craving and its measurement. Behav Res Ther., 17(4): 389-396. Doi: 10.1016/0005-7967(79)90010-X.
  55. Rosenberg H. (2009). Clinical and laboratory assessment of the subjectiveexperience of drug craving. Clin Psychol Rev., Aug, 29(6): 519-34. Doi: 10.1016/j.cpr.2009.06.002.
  56. Sayette M.A. (2016). The role of craving in substance use disorders: Theoretical and methodological issues. Annual Review of Clinical Psychology, 12: 407-33. Doi: 10.1146/annurev-clinpsy-021815-093351.
  57. Schlam T.R., & Baker T.B. (2020). Playing Around with Quitting Smoking: A Randomized Pilot Trial of Mobile Games as a Craving Response Strategy. Games Health J., Feb 3, 9(1): 64-70. Doi: 10.1089/g4h.2019.003.
  58. Shadel W.G., Martino S.C., Setodji C., Cervone D., Witkiewitz K., Beckjord E.B., & Shih R. (2011). Lapse-induced surges in craving influence relapse in adult smokers: An experimental investigation. Health Psychology, 30(5): 588-596. Doi: 10.1037/a0023445.
  59. Sharifi B.F., Spada M.M., Khosravani V., & Samimi Ardestani S.M. (2022). The independent contribution of desire thinking to problematic social media use. Curr Psychol., May, 6: 1-10. Doi: 10.1007/s12144-022-03158-z.
  60. Skorka-Brown J., Andrade J., & May J. (2014). Playing ‘Tetris’ reduces the strength, frequency and vividness of naturally occurring cravings. Appetite, May, 76: 161-165. Doi: 10.1016/j.appet.2014.01.073.
  61. Skinner M.D., & Aubin H.J. (2010). Craving’s place in addiction theory: Contributions of the major models. Neurosci Biobehav Rev., Mar, 34(4): 606-623. Doi: 10.1016/j.neubiorev.2009.11.024.
  62. Spada M.M., Caselli G., Slaifer M., Nikcˇevic´ A.V., & Sassaroli S. (2014). Desire thinking as a predictor of problematic internet use. Soc Sci Comput Rev., Aug, 32(4): 474-483. Doi: 10.1177/0894439313511318.
  63. Stacy A.W. (1997). Memory activation and expectancy as prospective predictors of alcohol and marijuana use. J Abnorm Psychol., Feb, 106(1): 61-73. Doi: 10.1037//0021-843x.106.1.61.
  64. Statham D.J., Connor J.P., Kavanagh D.J., Feeney G.F.X., Young R. Mc. D., May J., & Andrade J. (2011). Measuring alcohol craving: development of the Alcohol Craving Experience questionnaire. Addiction, Jul, 106(7): 1230-1238. Doi: 10.1111/j.1360-0443.2011.03442.x.
  65. Stewart J., Dewit H., & Eikelboom R. (1984). Role of unconditioned and conditioned drug effects in the self-administration of opiates and stimulants. Psychological Review, 91(2): 251-268. Doi: 10.1037/0033-295X.91.2.251.
  66. Tiffany S.T., & Drobes D.J. (1990). Imagery and smoking urges: the manipulation of affective content. Addict Behav., 15(6): 531-539. Doi: 10.1016/0306-4603(90)90053-z.
  67. Tiffany S.T. (1995). Potential functions of classical conditioning in drug addiction. In: D.C. Drummond, S.T. Tiffany, S.P. Glautier, & B. Remington B. (Eds.). Addictive Behaviour: Cue Exposure, Theory and Practice (pp. 47-71). Chichester, England: John Wiley, 1995a.
  68. Tiffany S.T. (1999). Cognitive Concepts of Craving. Alcohol Res Health., 23(3): 215-224.
  69. Tiffany S.T., & Wray J.M. (2012). The clinical signifi cance of drug craving. Annals of the New York Academy of Sciences, 1248(1): 1-17. Doi: 10.1111/j.1749-6632.2011.06298.x.
  70. Tiffany S.T., & Conklin C.A. (2000). A cognitive processing model of alcohol craving and compulsive alcohol use. Addiction, Aug, 95(8 Supplement 2): 145-153. Doi: 10.1080/09652140050111717.
  71. Vafaie N., & Kober H. (2022). Association of drug cues and craving with druguse and relapse: a systematic review and metaanalysis. JAMA Psychiatry, Jul 1, 79(7): 641-50. Doi: 10.1001/jamapsychiatry.2022.1240.
  72. Valva d’Ayala L. (2009). Il cammino del monaco. La vita monastica secondo la tradizione dei padri. Editore: Qiqajon Collana: Padri della Chiesa.
  73. Wells A., & Matthews G. (1996). Modelling cognition in emotional disorder: The S-REF model. Behaviour Research and Therapy, 34(11-12): 881-888. Doi: 10.1016/S0005-7967(96)00050-2.
  74. Wikler A. (1948). Recent progress in research on the neurophysiological basis of morphine addiction. Am J Psychiatry, Nov, 105(5): 329-338. Doi: 10.1176/ajp.105.5.329.
  75. Wise R.A. (1988). The neurobiology of craving: Implications for understanding and treatment of addiction. Journal of Abnormal Psychology, 97(2): 118-132. Doi: 10.1037/0021-843X.97.2.118.
  76. Witvliet C.V., & Vrana S.R. (1995). Psychophysiological responses as indices of affective dimensions, Psychophysiology, Sep, 32(5): 436-443. doi: 10.1111/j.1469-8986.1995.tb02094.x.
  77. Zuppi M. (2019). Ecco. Sto alla porta e busso: Commento ai vangeli del giorno del Tempo Ordinario I-IX Settimana: Vangeli di Marco. Independently Published.

Francesca Costantini, Il craving nei resoconti narrativi dei pazienti: tra "tentazione" e "pensiero desiderante" in "MISSION" 74/2026, pp 9-15, DOI: 10.3280/mis74-2026oa20315