The Mini Alcohol Craving Experience questionnaire : Development and clinical 2 application 3 4

26 Background: Standardised alcohol craving scales are rarely used outside of research 27 environments despite recognised clinical utility. Scale length is a key barrier to more 28 widespread application. A brief measure of alcohol craving is needed to improve research and 29 treatment of Alcohol Use Disorders (AUDs). Grounded in the Elaborated Intrusion Theory of 30 Desire, the Alcohol Craving Experience (ACE) questionnaire comprises two 11-item self31 report scales which assess past-week frequency and maximum strength of alcohol craving. 32 This study aimed to create a brief version of the ACE while maintaining psychometric 33 integrity and clinical utility. 34 Methods: Patients attending a university hospital alcohol and drug out-patient service 35 for treatment of AUD completed the ACE as part of a questionnaire battery. Three patient 36 samples were utilised: 519 patients with pre-treatment and outcome data; 228 patients with 37 pre-treatment data; and 66 patients who completed the ACE at treatment sessions one and 38 two. 39 Results: The Frequency scale of the ACE possessed greater clinical utility and 40 predictive validity than the Strength scale. Revision of the Frequency measure produced a 541 item ‘Mini Alcohol Craving Experience’ (MACE) questionnaire. Satisfactory validity 42 (construct, predictive, concurrent, convergent, and incremental) and reliability (internal and 43 test-retest) was maintained. A one standard deviation increase in pre-treatment MACE score 44 was associated with a 54 percent increase in the odds of patient lapse or dropout. 45 Conclusions: The MACE provides a brief, theoretically and psychometrically robust 46 measure of alcohol craving suitable for use with AUD populations in time-limited clinical 47 and research settings. 48