Social pressure-induced craving in patients with alcohol dependence: Application of virtual reality to coping skill training

Objective: This study was conducted to assess the interaction between alcohol cues and social pressure in the induction of alcohol craving. Methods: Fourteen male patients with alcohol dependence and 14 age-matched social drinkers completed a virtual reality coping skill training program composed of four blocks according to the presence of alcohol cues (×2) and social pressure (×2). Before and after each block, the craving levels were measured using a visual analogue scale. Results: Patients with alcohol dependence reported extremely high levels of craving immediately upon exposure to a virtual environment with alcohol cues, regardless of social pressure. In contrast, the craving levels of social drinkers were influenced by social pressure from virtual avatars. Conclusion: Our findings imply that an alcohol cue-laden environment should interfere with the ability to use coping skills against social pressure in real-life situations.