Psychometric Properties of the 5-Item Weiss Cocaine Craving Scale (WCCS) in an Italian Clinical Sample: A Study of Dimensionality, Internal Consistency, Predictive and Nomological Validity

Craving is a core characteristic in Cocaine Use Disorder (CUD) associated to relapse and treatment adherence. The assessment of craving is challenging due to the complexities arising from the various theoretical perspectives. Valid and reliable measures of craving are crucial in research and clinical settings considering the length to minimize the burden of patients. The existing craving assessment tools available in Italy are limited, with most instruments validated for populations other than CUD. This study aimed to validate the Italian adaptation of the 5-item Weiss Cocaine Craving Questionnaire (WCCS), a brief measure of cocaine craving. The sample included 385 CUD patients (359 men; mean age: 37.77 ± 8.46) undergoing multidisciplinary treatment. The Italian WCCS demonstrated a unidimensional factor structure and good internal consistency (Cronbach's alpha and McDonald's omega = 0.86). Nomological validity was assessed through significant associations with the Symptom Checklist-90-Revised (SCL-90-R), particularly with dimensions related to obsessivity-compulsivity, anxiety, and depression. Predictive validity was supported by receiver operating characteristics (ROC) analyses, with specific cutoff points enhancing the scale's utility in classifying cocaine use patterns and predicting cocaine relapses. These findings indicate that the Italian WCCS is a reliable and practical tool for clinical and research settings.