Cue reactivity in dependent amphetamine users: can monistic conditioning theories advance our understanding of reactivity?

Forty-eight dependent injecting amphetamine users (AUs) and 48 controls were exposed to an amphetamine-related video and three affective control videos, and their amphetamine-related responses (amphetamine symptoms, withdrawal symptoms, and for AUs, "positive" and "negative" craving, based on the desire for positive and negative reinforcement, respectively) were recorded after each one, Both groups responded to the amphetamine video with increased withdrawal symptoms relative to control videos, suggesting that drug-related cues have significant unconditioned aversive properties. Between-group differences in amphetamine symptoms were evident only after the amphetamine video, supporting a conditioned drug agonistic model of cue reactivity, Among AUs, both positive and negative craving increased significantly after the amphetamine video, providing prima facie evidence for both conditioned withdrawal and conditioned drug agonistic accounts of cue reactivity. However, the lack of consistent and strong correlations between the two types of craving and the affective states hypothesized to induce such craving cannot be accommodated by the dominant models of the role of conditioning in maintaining addictive behaviours, This suggests a need to build upon theories of cue reactivity which predict conditioned responses to be either drug-like or drug-opposite.