Based on theoretical models of craving and addiction, this study investigated the association between stress-related variables and negatively and positively reinforcing dimensions of craving (relief and reward craving) in 150 opiate addicts, 150 alcohol addicts and 150 non-addicted controls. Stress-distress was the most powerful predictor of both dimensions of craving, followed by a lack of positive coping strategies whereas expectancies of substance effects seemed to be less important. Positive coping strategies were related to reduced craving only when they were accompanied by low stress-distress. In non-addicted subjects, only positive coping strategies were negatively related to craving. This study confirms the important role of stress-distress for the occurrence of craving in addicts.

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