A conditioning reinterpretation of cognitive events in alcohol and drug cue exposure

Cue exposure treatments of alcohol and substance abuse disorders are based on a classical conditioning model of drug use and relapse. Recently, social learning theory has been utilized to explain the relationship of cognitive constructs (i.e., self-efficacy, outcome expectations) to measures of cue reactivity. However, social learning theory has not provided clear and testable mechanisms by which cognitions influence behavior. This paper proposes a mechanism, based on principles of classical conditioning, whereby cognitions may influence reactivity to alcohol and drug cues. This view of cognitions within a conditioning framework has several important implications for cue exposure research and treatment.