Desire and Coping Self-Efficacy as Craving Measures in Addiction: The Self-Efficacy and Desire Scale (SAD)

ABSTRACT

Craving is closely interconnected with substance addiction. Its precise role of mediator or indicator is frequently discussed, although it has also been identified as a relevant factor in continued substance use and relapse after stopping. The assessment of craving is particularly complex because different theories adopt different methodologies and measures. Desire to use and the loss of control of use are frequently adopted as constructs within instruments.

The control of substance use can conceptually be developed in Coping self-efficacy, defined as ability to resist substance use in high-risk situations. There is strong evidence in literature about craving as an important factor that supports remission and reduces relapse risk. More specifically, a high sense of coping self-efficacy to resist substance use at treatment intake, during treatment, and/or after treatment discharge, is a stable predictor of better results in alcohol and substance use.

The Self-efficacy scale and desire (SAD) is an Italian language self-report instrument with 27 items assessing desire for a specific substance of abuse (heroin, cocaine) and the perceived ability to resist use (Coping self-efficacy). It is possible to calculate a score for Desire scale and for Coping self-efficacy scale and a score for three sub-scales: Positive emotions and social situations, Negative emotions and potentially critical situations, Habit and abstinence, each with nine items.

Results of validation process highlight an excellent internal consistency measured by Cronbach coefficient for both scales. Split-half reliability and convergent validity with Visual Analogue Scale for craving measurement were also explored. Structural Equation Modelling with inductive/confirmative validation approach showed an excellent data adjustment.