While there is evidence to support the efficacy of mindfulness-based treatment for substance use, the mechanisms through which they lead to therapeutic outcomes have received less attention. A growing body of literature suggests that the ways in which people respond to cravings may be an important mediator of change. Individuals with substance use problems may use them to cope with or avoid negative experiences, which could include the experience of craving itself. Thought suppression in particular has been investigated as a specific form of experiential avoidance, and findings suggest that thought suppression strategies may interfere with attempts to quit using substances.
While mindfulness training should be expected to reduce the tendency to suppress or avoid cravings, evidence to support this expectation is limited, largely because no measures yet exist that assess the suppression of craving. Therefore, the purpose of the present study was to develop a self-report measure of the suppression of craving.
Existing measures of other types of thought suppression and experiential avoidance were examined to identify items that could be adapted for use in the Craving Suppression Scale (CSS). To assist with the item development process, a focus group was also conducted at a local residential treatment facility. Participants were asked to discuss what they do when they are experiencing cravings and what thoughts go through their minds when cravings come up. Their responses were used to guide content development for the CSS items. Items were developed for two sub-scales: suppression of craving and beliefs about craving.
Items were administered to a sample of inpatients in substance use treatment and an online sample of individuals reporting current or previous substance use problems (total N = 208). Factor analysis of the remaining items supported a two-factor structure for the CSS as hypothesized. Relationships were examined between the CSS and other measures of other forms of experiential avoidance/suppression, craving, and emotional distress. The CSS scales correlated well with other measures of suppression but had mixed relationships with other constructs of interest. Evidence for the validity and potential utility of the CSS are discussed along with theoretical and treatment implications