ArticleBMC psychiatry2026
Predictors of subjective and physiological craving during VR-cue exposure in alcohol use disorder: an explorative single-arm clinical study.
Article in BMC psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05861843 (Craving Assessment in Patients With Alcohol Use Disorder Using Virtual Reality Exposure), which is not on this map. Not yet cited in PubMed.
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Craving Assessment in Patients With Alcohol Use Disorder Using Virtual Reality Exposure
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14 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundCraving is a diagnostic criterion and predictive factor in alcohol use disorder (AUD). In Virtual Reality Cue Exposure (VR-CE), it is intentionally induced as a basis for Virtual Reality Cue Exposure Therapy. As the underlying subjective and physiological factors and predictors of craving are still incompletely understood, we aim to identify factors associated with craving responses during VR-CE in patients with AUD.
methodsCraving responses of 61 patients with AUD during VR-CE were measured using subjective ratings (visual analogue scale, VAS) and physiological parameters, including electrodermal activity (EDA, non-specific skin conductance responses (NS.SCR) and skin conductance level (SCL)), heart rate (HR), heart rate variability (HRV), brightness corrected pupil diameter (BCPD) and respiration rate (RR). To determine factors associated with craving responses, VR-related characteristics, patients' AUD characteristics and patients' pre-VR craving characteristics were analyzed using linear mixed-effects models.
resultsThe VR-related characteristic drink choice (p = .038), several AUD-characteristics (AUDIT score: p = .019; ADS score: p < .001; amount of alcohol consumed in the past five years: p = .031) and pre-VR craving characteristics (AUQ score: p < .001; OCDS score: p < .001) significantly influenced subjective craving during VR-CE. The VR-related characteristic type of risk scenario (p = .005) influenced the HRV parameter Very Low Frequency Band (VLFB). Several AUD-characteristics (AUDIT score: p = .007; ADS score, p = .003; days since last alcohol consumption: p = .018) and the pre-VR OCDS score (p = .015) were associated with changes in RR.
conclusionsClinical characteristics, particularly AUD severity and pre-VR craving were more consistently associated with craving responses than VR-specific factors. The limited overlap between subjective and physiological measures highlights the complexity of the concept craving and underlines the importance of using multidimensional assessments. This study contributes to a better understanding of predictors on craving and may inform the further development of optimized VR-based interventions for AUD.
trial registrationThis study followed a pre-published study protocol and was preregistered on ClinicalTrials.gov (NCT05861843, Registration Date: 2023-04-24).
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