{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T15:06:16Z","timestamp":1779548776005,"version":"3.53.1"},"posted":{"date-parts":[[2026,5,21]]},"group-title":"Public and Global Health","reference-count":61,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,5,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>\n                    Alcohol use disorder (AUD) is marked by high relapse rates often driven by craving, yet less is known about whether\n                    <jats:italic>in vivo<\/jats:italic>\n                    , social, and place-based alcohol cues are differentially associated with craving across affective states. This study examined independent and affect-contingent associations of these cues with momentary craving in adults with AUD enrolled in an alcohol intervention study.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>\n                    Thirty-three adults with AUD completed up to four daily ecological momentary assessments (EMA) for 28 days. EMA prompts assessed craving,\n                    <jats:italic>in vivo<\/jats:italic>\n                    alcohol exposure, being around usual drinking partners, being in usual drinking places, and high-arousal positive affect (PA) and negative affect (NA). Multilevel mixed-effects models adjusted for demographics, intervention phase (1 = post, 0 = pre), AUD severity, and temporal and contextual covariates.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\n                    EMA compliance was high (\n                    <jats:italic>Median<\/jats:italic>\n                    per-participant = 86.6%). Within-person elevations in\n                    <jats:italic>in vivo<\/jats:italic>\n                    alcohol exposure and being around usual drinking partners were independently associated with greater momentary craving, whereas being in usual drinking places was not.\n                    <jats:italic>In vivo<\/jats:italic>\n                    alcohol exposure was more strongly associated with craving during higher-than-usual PA (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    = 0.08,\n                    <jats:italic>p<\/jats:italic>\n                    = .032), whereas being in usual drinking places was more strongly associated with craving during higher-than-usual NA (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    = 0.06,\n                    <jats:italic>p<\/jats:italic>\n                    = .036), adjusting for intervention phase (which was associated with lower craving).\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>\n                    Findings support the need for personalized just-in-time adaptive interventions tailored to high-risk, momentary cue\u2013affect contexts in AUD, beyond low-frequency clinician-delivered feedback that may reduce average craving but not fully address real-time risk.\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                    registration:\n                    <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT05135767\">NCT05135767<\/jats:ext-link>\n                    .\n                  <\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.05.18.26353518","type":"posted-content","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T22:55:24Z","timestamp":1779404124000},"source":"Crossref","is-referenced-by-count":0,"title":["Joint Effects of Real-World Cue Exposure and Affective States on Momentary Alcohol Craving in Adults with Alcohol Use Disorder"],"prefix":"10.64898","author":[{"given":"Abhishek","family":"Aggarwal","sequence":"first","affiliation":[{"name":"Center for Addiction and Disease Risk Exacerbation, Brown University, 121 S. 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