Objectives：To study the mechanism of alcohol craving is difficult because it involves both cognitive and emotional processes, which are discordamtly influenced by patients’ avoidance and denial. The objective of this study is to examine the mechanism of craving by evaluating responses of emotional component of alcohol-related stimuli, explicitly and implicitly. Methods：The subject group was composed of 19 patients with alcohol dependence, 25 heavy drinkers, and 20 social drinkers. An implicit association test (IAT) measuring differential association of 2 target concepts (alcohol versus beverage) with 2 attribute dimensions (positive versus negative) was completed. Explicit evaluation of emotional valence and arousal for alcohol-related and control stimuli was also completed. Results：The patient group reported alcohol-related stimuli more negatively on both implicit and explicit evaluation. In explicit arousal evaluation, they evaluated alcohol-related stimuli more arousing than control stimuli, whereos control groups did not. While the strength of alcohol-negativity association was not related to any clinical variables, the strength of alcoholpositivity association was related to the arousal level of alcohol related stimuli, the severity of alcohol dependence, and the mean drinking amount per occasion. Conclusion：Alcohol craving can be regarded as negative emotion on both explicit and implicit levels in alcoholics. It seems that craving induced by alcohol-related stimuli may not be recognized by the patients but related to increased arousal or positive implicit evaluation of alcohol.
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