Alcohol and cognitive control: implications for regulation of behavior during response conflict

Alcohol reduces cross-frequency theta-phase gamma-amplitude coupling in resting electroencephalography

BACKGROUND

The electrophysiological inhibitory mechanism of cognitive control for alcohol remains largely unknown. The purpose of the study was to compare electroencephalogram (EEG) power spectra and cross-frequency phase-amplitude coupling (CFPAC) at rest and during a simple subtraction task after acute alcohol ingestion.

METHODS

Twenty-one healthy subjects participated in this study. Two experiments were performed 1 week apart, and the order of the experiments was randomly assigned to each subject. During the experiments, each subject was provided with orange juice containing alcohol or orange juice only. We recorded EEG activity and analyzed power spectra and CFPAC data.

RESULTS

The results showed prominent theta-phase gamma-amplitude coupling at the frontal and parietal electrodes at rest. This effect was significantly reduced after alcohol ingestion.

CONCLUSIONS

Our findings suggest that theta-phase gamma-amplitude coupling is deficiently synchronized at rest after alcohol ingestion. Therefore, cross-frequency coupling could be a useful tool for studying the effects of alcohol on the brain and investigating alcohol addiction.

How bad could it be? Alcohol dampens stress responses to threat of uncertain intensity

Stress response dampening is an important motive for alcohol use. However, stress reduction via alcohol (alcohol SRD) is observed inconsistently in the laboratory, and this has raised questions about the precise mechanisms and boundary conditions for these effects. Emerging evidence indicates that alcohol SRD may be observed selectively during uncertain but not certain threats. In a final sample of 89 participants, we measured stress response via potentiation of defensive startle reflex in response to threat of shock in blocks with certain (low and high) and uncertain shock intensity. Our alcohol-administration procedure produced blood alcohol concentrations (BACs) across a broad range (0.00%-0.12%) across participants. Increasing BACs were associated with linearly decreasing startle potentiation and self-reported anxiety. This SRD effect was greater during uncertain than certain threat. More broadly, these results suggest that distinct mechanisms are involved in response to threats of uncertain intensity and threats of certain intensity.

Alcohol and violence in the emergency room: a review and perspectives from psychological and social sciences

Our objective is to present a focused review of the scientific literature on the effect of alcohol consumption on violence related-injuries assessed in the emergency room (ER) and to show how psychological and behavioral sciences could lead to a better understanding of the factors contributing to alcohol-related injuries in the ER. We retrieved published literature through a detailed search in Academic Search Premier, MEDLINE with Full Text PsycARTICLES, Psychology and Behavioral Sciences Collection, PsycINFO, PUBMed and SocINDEX with Full Text for articles related to emergency rooms, medical problems and sociocognitive models addressing alcohol intoxication articles. The first search was conducted in June 2011 and updated until August 2013. Literature shows that compared to uninjured patients; injured ones have a higher probability of: (i) having an elevated blood-alcohol concentration upon arrival at the ER; (ii) reporting having drunk alcohol during the six hours preceding the event; and (iii) suffering from drinking-related consequences that adversely affect their social life. The main neurocognitive and sociocognitive models on alcohol and aggression are also discussed in order to understand the aetiology of violence-related injuries in emergency rooms. Suggestions are made for future research and prevention.

The acute effects of alcohol on sleep architecture in late adolescence

BACKGROUND

Alcohol consumption is prevalent in late adolescence; however, little is known about its effect on sleep in this group. In mature adults, alcohol decreases sleep onset latency (SOL) and sleep efficiency (SE) and increases wake after sleep onset (WASO). It also increases slow wave sleep (SWS) and decreases rapid eye movement (REM) sleep in the first half of the night, with the inverse occurring in the second half. Alcohol's effect on sleep during late adolescence is of interest given that this age group shows both dramatic increases in alcohol consumption and significant developmental changes in the central nervous system. This study examined the effect of alcohol on sleep architecture in women and men aged 18 to 21 years and whether previously reported sleep architecture effects may have been as an artificial result of changes to sleep cycle length.

METHODS

Twenty-four (12 women) healthy 18- to 21-year-old light social drinkers (19.1 ± 1.0 years) underwent 2 conditions: presleep alcohol (target breath alcohol concentration [BAC] 0.10%) and placebo-administered under controlled conditions, followed by standard polysomnography.

RESULTS

In the alcohol condition, mean BAC at lights out was 0.084 ± 0.016%. Time in bed, total sleep time, and SOL (all p > 0.05) did not differ between conditions. However, there was less REM (p = 0.011) and more stage-2 sleep (p = 0.035) in the alcohol condition. Further, alcohol increased SWS (p = 0.02) and decreased REM sleep (p < 0.001) in the first half of the night and disrupted sleep in the second half, with increased WASO (interaction: p = 0.034), and decreased SE (p = 0.04) and SWS (p = 0.01) and no REM sleep rebound in the second half of the night (p = 0.262). Additionally, alcohol had no effect on sleep cycle length (p = 0.598).

CONCLUSIONS

The results were broadly consistent with the adult literature with the novel extension that half night sleep architecture effects could not be attributed to changes in sleep cycle length. However, alcohol did not reduce SOL, or result in a REM rebound following reduced REM in the first half of the night. The results suggest that the effects of alcohol on sleep are modified by sleep's prevailing developmental stage.

Joint consideration of distal and proximal predictors of premature mortality among serious juvenile offenders

PURPOSE

Juvenile offenders are at heightened risk of death in adolescence and young adulthood compared to adolescents in the general population. The current study extends previous research by testing the joint contributions of distal (historical and demographic characteristics) and proximal (closer to the time of the death) predictors of mortality. We also tested whether proximal variables were potential mediators of the effects of distal variables on mortality.

METHODS

Participants were 1,354 serious juvenile offenders, 45 (3.32%) of whom were deceased by the completion of the study. Data were collected through self-reports and official records.

RESULTS

Significant distal predictors of mortality were being African-American and having a history of substance use disorder. Proximal predictors that added significantly to prediction included gun carrying, gang membership, and substance use problems. Potential mediators of the effects of substance use disorder history were continuing substance use problems and gang membership. However, proximal variables could not explain the heightened risk for African-Americans.

CONCLUSIONS

Gang membership, gun carrying, and substance use problems are risk factors for early mortality among juvenile offenders, but they do not explain the elevated risk for death among African-Americans. Thus, further research is needed to understand the mechanisms underlying risk for premature death among African-American adolescent offenders.

Brain modifications after acute alcohol consumption analyzed by resting state fMRI

Resting-state functional magnetic resonance imaging (fMRI) is a recent breakthrough in neuroimaging research able to describe "in vivo" the spontaneous baseline neuronal activity characterized by blood oxygen level dependent (BOLD) signal fluctuations at slow frequency (0.01-0.1Hz) that, in the absence of any task, forms spatially distributed functional connectivity networks, called resting state networks (RSNs). The aim of this study was to investigate, in the young and healthy population, the changing of the RSNs after acute ingestion of an alcohol dose able to determine a blood concentration (0.5g/L) that barely exceeds the legal limits for driving in the majority of European Countries. Fifteen healthy volunteers underwent two fMRI sessions using a 1.5T MR scanner before and after alcohol oral consumption. The main sequence acquired was EPI 2D BOLD, one per each session. To prevent the excessive alcohol consumption the subjects underwent the estimation of blood rate by breath test and after the stabilization of blood alcohol level (BAL) at 0.5g/L the subjects underwent the second fMRI session. Functional data elaboration was carried out using the probabilistic independent component analysis (PICA). Spatial maps so obtained were further organized, with MELODIC multisession temporal concatenation FSL option, in a cluster representing the group of pre-alcohol sessions and the group of post-alcohol sessions, followed by the dual regression approach in order to evaluate the increase or decrease in terms of connectivity in the RSNs between the two sessions at group level. The results we obtained reveal that acute consumption of alcohol reduces in a significant way the BOLD signal fluctuations in the resting brain selectively in the sub-callosal cortex (SCC), in left temporal fusiform cortex (TFC) and left inferior temporal gyrus (ITG), which are cognitive regions known to be part of the reward brain network and the ventral visual system.

Alcohol cues, approach bias, and inhibitory control: applying a dual process model of addiction to alcohol sensitivity

Low sensitivity to the acute effects of alcohol is a risk factor for heavy drinking and related problems. However, little research has tested process explanations for such effects. The current study tested the hypothesis that low sensitivity is associated with automatic approach biases for alcohol cues, coupled with deficits inhibiting responses in the presence of such cues. Eighty-five participants varying in alcohol sensitivity completed an Alcohol-Approach Avoidance Task and a Cued Go/No-Go Task while event-related potentials were recorded. Low sensitivity (LS) individuals showed evidence of automatic approach tendencies toward alcohol cues in both tasks, and experienced deficits inhibiting prepotent responses cued by alcohol images. Additionally, the event-related potential data indicated that LS individuals experienced more conflict when attempting to inhibit alcohol-cued responses, but not nonalcohol-cued responses, compared with their high-sensitivity counterparts. Together, these data indicate that alcohol cues elicit an approach bias among LS individuals, translating into greater difficulty inhibiting behavioral responses in the presence of such cues, a pattern generally supportive of dual process models of substance use.

The effect of alcohol and placebo on post-error adjustments

Several studies have shown detrimental effects of alcohol on post-error adjustments. In contrast to previous studies, which focused on only one aspect of post-error adaptive behavior, we compared the effect of alcohol and placebo on post-error slowing (PES), post-error reduction of interference (PERI) and post-error improvement of accuracy (PIA). Moreover, we used a between-subjects design (N = 45) comparing a control condition to both an alcohol and an alcohol-placebo condition as to disentangle physiological and expectancy effects of alcohol. In a standard Stroop congruency task, we found that intoxicated participants as well as participants with the incorrect belief of being intoxicated showed significant decreased PES compared to a control group. Furthermore, we found evidence for a condition-independent post-error increase of interference and post-error decrease of accuracy. The underlying mechanisms of the post-error adaptation effects are discussed in terms of the orienting account (Notebaert et al., 2009).

Psychophysiological responses to stress following alcohol intake in social drinkers who are at risk of hazardous drinking

We examined whether social drinkers whose drinking behavior poses a risk for harmful consequences exhibit altered psychobiological responses to stress following moderate alcohol intake. At risk (n=17) and low risk drinkers (n=27), as identified by the Alcohol Use Disorders Identification Test, completed two laboratory stress sessions, one in which they consumed a drink with alcohol and one without alcohol. Subjective and physiological measures were obtained throughout the study. Reported stimulation following alcohol consumption and sedation post-stress on alcohol day were greater than the no alcohol day in at risk drinkers (ps<.05). Low risk drinkers exhibited stress dampening effects on cortisol levels (p<.05). This was not the case among the high risk drinkers. These results indicate that acute alcohol intake may be associated with enhanced subjective and altered hormonal responses to stress in individuals who are at risk for becoming problem drinkers.

Alcohol-related Cues Promote Automatic Racial Bias

Previous research has shown that alcohol consumption can increase the expression of race bias by impairing control-related processes. The current study tested whether simple exposure to alcohol-related images can also increase bias, but via a different mechanism. Participants viewed magazine ads for either alcoholic or nonalcoholic beverages prior to completing Payne's (2001) Weapons Identification Task (WIT). As predicted, participants primed with alcohol ads exhibited greater race bias in the WIT than participants primed with neutral beverages. Process dissociation analyses indicated that these effects were due to automatic (relative to controlled) processes having a larger influence on behavior among alcohol-primed relative to neutral-primed participants. Structural equation modeling further showed that the alcohol-priming effect was mediated by increases in the influence of automatic associations on behavior. These data suggest an additional pathway by which alcohol can potentially harm inter-racial interactions, even when no beverage is consumed.

Effects of Alcohol Intoxication on Response Conflict in a Flanker Task

Events evoke seamlessly integrated stimulus evaluation and response preparation processing streams, guided by regulative functions that change behavior flexibly in accord with the internal goals and contextual demands. The neural basis of the effects of alcohol intoxication on these processing streams is poorly understood, despite the evidence of alcohol's deleterious effects on both attention and motor control. In an attempt to separate and examine relative susceptibility of these two dimensions, we employed a color version of the Eriksen flanker task that manipulated compatibility at the stimulus- and response-processing levels. Functional magnetic resonance imaging (fMRI) was performed in healthy social drinkers as they participated in both alcohol (0.6 g/kg ethanol for men, 0.55 g/kg for women) and placebo conditions in a counterbalanced design. Alcohol increased reaction times to response-level incongruity and decreased accuracy overall. Relative to the no-conflict condition, the observed brain activity was predominantly evoked by response-related conflict in medial prefrontal and lateral prefrontal cortices under placebo, in agreement with extensive evidence of their role in conflict processing. Activity evoked by response incongruity in the medial frontal cortex and insula was insignificant under alcohol, indicating its interference with response inhibition and preparation. Conversely, activity in ventrolateral prefrontal and premotor areas was relatively greater under alcohol than placebo, suggesting their compensatory engagement. This finding is consistent with the compensatory prefrontal activity increase found in studies with chronic alcoholic individuals, indicating functional reorganization with a goal of optimizing response strategy. These results delineate functional differences and selective susceptibility of a prefrontal network subserving response-level conflict processing. Our findings are incompatible with notions that moderate alcohol primarily affects attentional or stimulus-related processing and argue instead that its primary influence is on response inhibition, selection, and execution, with ramifications for the models of behavioral self-control and the inability to refrain from drinking.

Acute alcohol intoxication impairs top-down regulation of Stroop incongruity as revealed by blood oxygen level-dependent functional magnetic resonance imaging

Functional neuroanatomy of executive functions has been delineated in a large number of neuroimaging studies using conflict-inducing tasks. The neural basis of alcohol's effects on cognitive control is poorly understood despite the evidence of impaired ability to evaluate competing demands and to inhibit maladaptive responses. To investigate the effects of moderate intoxication, healthy social drinkers participated in both alcohol (0.60 g/kg ethanol for men, 0.55 g/kg for women) and placebo conditions while being scanned using blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI). A modified four-color Stroop task combined reading and color naming and used manual responses. Twenty subjects (10 women) were instructed to press a button corresponding to the font color except when a word was written in gray in which case they had to respond to the meaning of the word. Alcohol increased reaction times and a tendency to make more errors on incongruent trials. Behavioral indices of alcohol-induced premature responding correlated with the current drinking levels and impulsivity traits, suggesting an interaction between alcohol effects and personality predispositions. A distributed frontoparietal cortical network was activated by incongruity. However, moderate alcohol inebriation selectively attenuated anterior cingulate cortex (ACC) activation during both high-conflict trials and erroneous responses, indicating vulnerability of the regulative function subserved by the ACC. By disrupting top-down, strategic processing, alcohol may interfere with goal-directed behavior, resulting in poor self control. The present results support models proposing that alcohol-induced prefrontal impairments diminish inhibitory control and are modulated by dispositional risk factors and levels of alcohol consumption.

Alcohol stress response dampening: selective reduction of anxiety in the face of uncertain threat

Problematic alcohol use and stress response dampening (SRD) are intimately interconnected. Recent evidence suggests that alcohol produces selective SRD during uncertain but not certain threat. We systematically varied shock probability in a novel task assessing alcohol SRD during low probable/uncertain threat, while holding temporal precision of threat constant. Intoxicated (0.08% target blood alcohol concentration) and placebo participants completed a cued shock threat task in which probability of shock administration at the offset of brief visual cues varied parametrically. High probability (100%) shock cues represented certain threat as used in earlier research, while lower probability (20% and 60%) shock cues provided novel uncertain threat conditions. Startle potentiation during cues and inter-trial intervals (ITIs) served as the measure of affective response. General linear model analysis indicated that alcohol SRD magnitude increased monotonically as threat uncertainty increased. Alcohol SRD was significantly greater during 20% and 60% shock threat relative to 100% shock threat. Alcohol also significantly reduced startle potentiation during distal threat in shock-free ITIs. Alcohol SRD magnitude during distal/uncertain threat was meaningfully moderated by individual differences in negative affectivity and weekly alcohol consumption. This work advances understanding of which properties of uncertainty are relevant to anxiety and anxiolytic effects of alcohol.

Event-Related Oscillations in Alcoholism Research: A Review

Alcohol dependence is characterized as a multi-factorial disorder caused by a complex interaction between genetic and environmental liabilities across development. A variety of neurocognitive deficits/dysfunctions involving impairments in different brain regions and/or neural circuitries have been associated with chronic alcoholism, as well as with a predisposition to develop alcoholism. Several neurobiological and neurobehavioral approaches and methods of analyses have been used to understand the nature of these neurocognitive impairments/deficits in alcoholism. In the present review, we have examined relatively novel methods of analyses of the brain signals that are collectively referred to as event-related oscillations (EROs) and show promise to further our understanding of human brain dynamics while performing various tasks. These new measures of dynamic brain processes have exquisite temporal resolution and allow the study of neural networks underlying responses to sensory and cognitive events, thus providing a closer link to the physiology underlying them. Here, we have reviewed EROs in the study of alcoholism, their usefulness in understanding dynamical brain functions/dysfunctions associated with alcoholism as well as their utility as effective endophenotypes to identify and understand genes associated with both brain oscillations and alcoholism.

Alcohol affects the emotional modulation of cognitive control: an event-related brain potential study

OBJECTIVE

The present study aimed to determine whether alcohol affects the emotional modulation of cognitive control and its underlying neural mechanisms, which is pivotal to an understanding of the socially maladaptive behaviors frequently seen in alcohol-intoxicated individuals.

METHOD

Event-related potentials (ERPs) were recorded in male participants receiving either a moderate dose of alcohol (0.65 g/kg alcohol; n = 32) or a non-alcoholic placebo beverage (n = 32) while performing an emotional Go/No-Go task that required response execution (Go trials) to pictures of a "target" emotional facial expression (angry, happy, neutral) and response inhibition (No-Go trials) to a different "non-target" expression.

RESULTS

Overall, N200 and P300 amplitudes were more enhanced during No-Go than Go trials. Interestingly, alcohol-intoxicated individuals displayed larger No-Go N200 amplitudes across all emotional conditions than controls, accompanied by decreased task performance (i.e., more errors), particularly in response to angry faces. P300 amplitude in the alcohol group was significantly reduced for both Go and No-Go trials, but only following angry and happy emotional expressions.

CONCLUSIONS

These results suggest that alcohol-intoxicated individuals need to effortfully activate more cognitive resources during the early inhibition process in order to regulate a response than controls. Moreover, alcohol affected the emotional modulation of both response inhibition and execution in the later stages of cognitive control. Alcohol dampened emotional responsiveness, which may restrict the availability of attentional resources for cognitive control. Yet, these findings may underlie the lack of control in alcohol-intoxicated individuals when faced with emotionally or socially challenging situations.

Alcohol dose effects on stress response to cued threat vary by threat intensity

RATIONALE

Clarification of alcohol's effect on stress response during threat is critical to understand motivation for alcohol use and related alcohol-use disorders. Evaluation of stress response dampening (SRD) effects of alcohol has been limited by nonsystematic use of varied experimental methods and measures.

OBJECTIVES

This experiment parametrically varied alcohol dose and shock threat intensity among social drinkers to examine their effects on startle potentiation, a physiological measure of the affective component of the stress response.

METHODS

Ninety-six participants were assigned to one of four beverage groups: placebo and target blood alcohol concentration (BAC) groups of 0.04%, 0.075%, and 0.11%. Participants viewed colored cues presented in shock and no-shock blocks. Distinct colored cues predicted imminent low, moderate, or high intensity electric shock administration. Startle potentiation during shock threat relative to no-shock cues indexed affective response.

RESULTS

High threat increased startle potentiation relative to moderate/low intensity threat. Startle potentiation decreased as BAC increased. Threat intensity moderated this BAC effect with the strongest BAC effect observed during high threat. Analysis of individual difference moderators revealed reduced effect of BAC among heavier, more problematic drinkers.

CONCLUSIONS

Clear alcohol SRD effects were observed. These SRD effects were greatest at higher BACs and during more potent threat. Failure to account for these factors may partially explain inconsistent findings in past laboratory SRD research. Furthermore, they suggest greater reinforcement from alcohol at higher doses and among individuals with greater stress. Moderation of SRD effects by alcohol consumption and problems point to possible important risk factors.

Alcohol impairs brain reactivity to explicit loss feedback

RATIONALE

Alcohol impairs the brain's detection of performance errors as evidenced by attenuated error-related negativity (ERN), an event-related potential (ERP) thought to reflect a brain system that monitors one's behavior. However, it remains unclear whether alcohol impairs performance-monitoring capacity across a broader range of contexts, including those entailing external feedback.

OBJECTIVE

This study sought to determine whether alcohol-related monitoring deficits are specific to internal recognition of errors (reflected by the ERN) or occur also in external cuing contexts. We evaluated the impact of alcohol consumption on the feedback-related negativity (FRN), an ERP thought to engage a similar process as the ERN but elicited by negative performance feedback in the environment.

METHODS

In an undergraduate sample randomly assigned to drink alcohol (n = 37; average peak BAC = 0.087 g/100 ml, estimated from breath alcohol sampling) or placebo beverages (n = 42), ERP responses to gain and loss feedback were measured during a two-choice gambling task. Time-frequency analysis was used to parse the overlapping theta-FRN and delta-P3 and clarified the effects of alcohol on the measures.

RESULTS

Alcohol intoxication attenuated both the theta-FRN and delta-P3 brain responses to feedback. The theta-FRN attenuation was stronger following loss than gain feedback.

CONCLUSIONS

Attenuation of both theta-FRN and delta-P3 components indicates that alcohol pervasively attenuates the brain's response to feedback in this task. That theta-FRN attenuation was stronger following loss trials is consistent with prior ERN findings and suggests that alcohol broadly impairs the brain's recognition of negative performance outcomes across differing contexts.

Neurocognitive deficits in male alcoholics: an ERP/sLORETA analysis of the N2 component in an equal probability Go/NoGo task

In alcoholism research, studies concerning time-locked electrophysiological aspects of response inhibition have concentrated mainly on the P3 component of the event-related potential (ERP). The objective of the present study was to investigate the N2 component of the ERP to elucidate possible brain dysfunction related to the motor response and its inhibition using a Go/NoGo task in alcoholics. The sample consisted of 78 abstinent alcoholic males and 58 healthy male controls. The N2 peak was compared across group and task conditions. Alcoholics showed significantly reduced N2 peak amplitudes compared to normal controls for Go as well as NoGo task conditions. Control subjects showed significantly larger NoGo than Go N2 amplitudes at frontal regions, whereas alcoholics did not show any differences between task conditions at frontal regions. Standardized low resolution electromagnetic tomography analysis (sLORETA) indicated that alcoholics had significantly lower current density at the source than control subjects for the NoGo condition at bilateral anterior prefrontal regions, whereas the differences between groups during the Go trials were not statistically significant. Furthermore, NoGo current density across both groups revealed significantly more activation in bilateral anterior cingulate cortical (ACC) areas, with the maximum activation in the right cingulate regions. However, the magnitude of this difference was much less in alcoholics compared to control subjects. These findings suggest that alcoholics may have deficits in effortful processing during the motor response and its inhibition, suggestive of possible frontal lobe dysfunction.

HIV Risk Behavior among Youth in the Dominican Republic: The Role of Alcohol and Other Drugs

Existing literature related to HIV in the Dominican Republic has tended to neglect the unique role of tourism areas as distinct ecologies facilitative of sexual risk behavior, particularly HIV vulnerability and transmission. Furthermore, limited attention has focused on Dominican adolescents living in close proximity to tourism areas who have become increasingly exposed to alcohol due to the expanding tourism industry in the Dominican Republic. While most previous analyses of the effects of alcohol on adolescent sexual risk behavior have focused on the transient effects of alcohol on judgment and decision making, the effects of chronic alcohol use on sexual behavior has been a neglected area of research. Our study explores the relationship between chronic alcohol use, the parent-adolescent relationship, affective factors such as self-esteem, and intentions to engage in sex. We examine the above factors within the context of tourism areas which represent a unique ecology of alcohol availability and consumption and HIV risk. We discuss implications for developing applied family-based programs to target Dominican adolescent alcohol use and sexual risk behavior in tourism areas of high alcohol exposure.

Drunk, Powerful, and in the Dark

Social power, alcohol intoxication, and anonymity all have strong influences on human cognition and behavior. However, the social consequences of each of these conditions can be diverse, sometimes producing prosocial outcomes and other times enabling antisocial behavior. We present a general model of disinhibition to explain how these seemingly contradictory effects emerge from a single underlying mechanism: The decreased salience of competing response options prevents activation of the Behavioral Inhibition System (BIS). As a result, the most salient response in any given situation is expressed, regardless of whether it has prosocial or antisocial consequences. We review three distinct routes through which power, alcohol intoxication, and anonymity reduce the salience of competing response options, namely, through Behavioral Approach System (BAS) activation, cognitive depletion, and reduced social desirability concerns. We further discuss how these states can both reveal and shape the person. Overall, our approach allows for multiple domain-specific models to be unified within a common conceptual framework that explains how both situational and dispositional factors can influence the expression of disinhibited behavior, producing both prosocial and antisocial outcomes.

Sexual assault perpetrators' tactics: associations with their personal characteristics and aspects of the incident

Past theory and empirical research have consistently associated a number of risk factors with sexual assault perpetration. This study extends past research by considering if the tactics which perpetrators use to obtain sex are associated with these risk factors or with characteristics of the sexual assault. Audio computer-assisted self-interviews were completed with a community sample of young, single men. Few participants reported using physical force as a tactic to obtain sex, thus this article focuses on 457 participants who used verbal coercion ( n = 152) or the victim's impairment (n = 39) to obtain sex or who were nonperpetrators (n = 266). Discriminant function analysis correctly classified 70% of participants. As hypothesized, analysis of covariance indicated that both groups of perpetrators scored higher than nonperpetrators on measures of negative attitudes toward women, positive attitudes about casual sex, personality traits associated with nonclinical levels of psychopathy, antisocial behavior, and alcohol problems. As compared to nonperpetrators describing their worst date, perpetrators knew the woman longer, used more isolating and controlling behaviors, misperceived her sexual intentions for a longer period of time, and engaged in more consensual sexual activities with the woman. Perpetrators who used impairment tactics did not usually consume more alcohol than other participants; however, they consumed much more alcohol during the incident. Although verbal coercion and taking advantage of an impaired victim are sometimes viewed as less serious tactics than the use of force, these findings demonstrate that perpetrators who use these strategies have personality, attitude, and experience profiles that distinguish them from nonperpetrators.

Risk factors for sexual aggression in young men: an expansion of the confluence model

There are many explanations for high rates of sexual aggression, with no one theory dominating the field. This study extends past research by evaluating an expanded version of the confluence model with a community sample. One-hour audio computer-assisted self-interviews were completed by 470 young single men. Using structural equation analyses, delinquency, hostile masculinity, impersonal sex, and misperception of women's sexual cues were positively and directly associated with the number of sexually aggressive acts committed. There were also indirect effects of childhood victimization, personality traits associated with subclinical levels of psychopathy, and alcohol consumption. These findings demonstrate the usefulness of the confluence model, as well as the importance of broadening this theory to include additional constructs.

Alcohol's role in sexual violence perpetration: theoretical explanations, existing evidence and future directions

ISSUES

There is controversy regarding the extent to which alcohol plays a causal role in sexual assault perpetration.

APPROACH

This paper critically reviews the relevant alcohol administration and survey research literature.

KEY FINDINGS

Alcohol administration researchers have randomly assigned male participants to drink conditions prior to exposure to an acquaintance rape scenario. As compared to sober participants, intoxicated participants find the male character's use of force to obtain sex more acceptable and express greater willingness to act in a similar manner. In several studies, these effects are strongest for intoxicated men with hostile attitudes toward women. Survey researchers have asked male participants to describe incidents in which they behaved in a sexually aggressive manner. Men who commit sexual assault when drinking report having traits, attitudes and experiences similar to those of other perpetrators except in the alcohol domain. Perpetrators who commit sexual assault when drinking tend to drink more than other perpetrators in sexual situations and have stronger expectancies regarding alcohol's effects on sexual behaviour.

IMPLICATIONS

Overall, research suggests that alcohol interacts with personality and aspects of the situation, adding to the risk of perpetration among men already predisposed to engaging in sexual aggression.

CONCLUSIONS

Although there are no simple answers to questions about alcohol's role in sexual assault, research suggests that intoxication may be a more important determinant of when some men commit sexual aggression, rather than who becomes sexually aggressive.

Event-level associations between objective and subjective alcohol intoxication and driving after drinking across the college years

Heavy episodic drinking is strongly associated with driving after drinking, yet there has been mixed evidence regarding whether the disinhibiting effects of alcohol intoxication contribute to the decision to drive after drinking. This investigation tested whether greater alcohol intoxication increased the probability of driving after drinking particularly during drinking episodes in which students experienced reduced subjective feelings of intoxication. A sample of 1,350 college students completed up to 30 days of web-based daily diary monitoring in each of 4 consecutive years. Participants reported daily on their alcohol consumption, subjective intoxication, and whether they drove after drinking on the previous day or night. In generalized estimating equation models, daily estimated blood alcohol concentration (eBAC) was more strongly associated with driving after drinking during episodes in which subjective intoxication was lower. That is, students were most likely to drive after drinking when they were objectively more intoxicated but perceived themselves as less intoxicated. These event-level associations did not change over time nor did they differ as a function of gender. Further, the effects persisted when predicting driving at eBACs above the legal limit for operating a motor vehicle. Greater subjective intoxication may serve to inhibit driving after drinking, particularly when students are objectively more intoxicated. In the absence of subjective intoxication, however, other salient pressures might impel driving after drinking. Prevention efforts should incorporate the importance of variability in subjective intoxication.

The effects of induced state negative affect on performance monitoring processes

Previous research suggests that performance-monitoring processes are related to personality traits; relationships with affective states, however, remain unclear. The purpose of this study was to replicate and extend previous findings that induced state negative affect alters electrophysiological reflections of performance monitoring. High-density event-related potentials (ERPs) were obtained from 69 healthy individuals (41 female, 28 male) who completed an Eriksen flanker task and received either encouraging or derogatory feedback based on mean reaction times (RTs) for 30-trial sub-blocks. Affective state, behavioral measures (i.e. error rates, RTs) and ERP measures [i.e. error-related negativity (ERN), post-error positivity (Pe) and N2] were assessed. Reaction times did not differ between feedback groups. Participants who received derogatory feedback committed more errors over time. Despite changes in affect, no significant group differences were demonstrated for behavioral or ERP measures of performance monitoring. Increases in vigilance were associated with more negative N2 amplitudes; no other changes in affective state were associated with changes in ERP measures. Results are consistent with findings suggesting performance-monitoring processes are only slightly affected by changes in affective state and fail to replicate previous studies suggesting the ERN is related to state changes in affect-supporting the possibility of the ERN as an endophenotype.

Alcohol effects on performance monitoring and adjustment: affect modulation and impairment of evaluative cognitive control

Alcohol is known to impair self-regulatory control of behavior, though mechanisms for this effect remain unclear. Here, we tested the hypothesis that alcohol's reduction of negative affect (NA) is a key mechanism for such impairment. This hypothesis was tested by measuring the amplitude of the error-related negativity (ERN), a component of the event-related brain potential (ERP) posited to reflect the extent to which behavioral control failures are experienced as distressing, while participants completed a laboratory task requiring self-regulatory control. Alcohol reduced both the ERN and error positivity (Pe) components of the ERP following errors and impaired typical posterror behavioral adjustment. Structural equation modeling indicated that effects of alcohol on both the ERN and posterror adjustment were significantly mediated by reductions in NA. Effects of alcohol on Pe amplitude were unrelated to posterror adjustment, however. These findings indicate a role for affect modulation in understanding alcohol's effects on self-regulatory impairment and more generally support theories linking the ERN with a distress-related response to control failures.

The effects of acute ethanol consumption on sexual response and sexual risk-taking intent

Two theories of sexual risk taking (disinhibition and alcohol myopia) were tested using genital measures of sexual response and computer measures of sexual risk propensity. A total of 44 men and women completed two sessions comparing responses to erotic films while consuming alcohol (breath alcohol doses were .025 g/kg and .08 g/kg) or juice alone. After consuming alcohol, more sexual arousal was reported in response to neutral films and at a breath alcohol level of .08 g/kg as compared to no alcohol. Genital responses for men and women increased during sexual films, but men did not respond as strongly when breath alcohol level was .08 g/kg. Intentions to have intercourse with a new partner at baseline predicted the level of sexual arousal reported. As self-reported sexual arousal increased in response to sexual films and higher alcohol dose, the intent to engage in intercourse with a new partner increased. Alcohol dose was not related to later sexual intercourse intentions. With no direct relationship of alcohol and intercourse intentions, results appear more consistent with a disinhibition model of sexual arousal.

Effects of alcohol on the processing of social threat-related stimuli in socially phobic women

BACKGROUND

Social phobics are at a higher risk of developing alcohol problems. The mechanism promoting this association is not clear. According to Sayette (1993b), alcohol attenuates anxiety responses by disrupting initial appraisal of threatening stimuli. We used the emotional Stroop test and an implicit memory test to investigate whether alcohol hinders appraisal of social threat words in patients diagnosed with social phobia.

PROCEDURE

Thirty-two women with social phobia (DSM-IV) and 32 female controls performed an emotional Stroop test either after drinking alcohol resulting in a blood alcohol levels (BAL) of 0.6%. or after drinking a non-alcoholic beverage. The emotional Stroop test contained social anxiety-related and neutral stimuli. Implicit memory for the words presented was tested with a word-stem completion test.

RESULTS

Without alcohol, both controls and socially-phobic participants took longer to name the colour of socially-threatening stimuli than of neutral stimuli. Alcohol levelled response latencies to the two stimulus categories only in controls. Socially-phobic participants responded more slowly to social anxiety-related stimuli than to neutral stimuli, irrespective of their BAL. In contrast to controls, social phobics showed an implicit memory bias for social threat words. This bias was attenuated by alcohol.

DISCUSSION

Alcohol disrupts appraisal of social anxiety-related stimuli in controls but not in social phobics; in these it hinders the consolidation of memory. This also suggests that social phobics experience similar anxiety with and without alcohol, but remember this experienced anxiety less precisely. This effect might act as a reinforcer for the use of alcohol for the purpose of self-medication in future situations.

The acute impact of ethanol on cognitive performance in rhesus macaques

Decreased cognitive control over prepotent responses has been hypothesized to contribute to ethanol-induced behavioral disinhibition. However, the effects of ethanol on specific cognitive domains associated with decision making have not been extensively studied. We examined the impact of acute ethanol administration on cognitive performance of nonhuman primates. Studies were conducted using 0.2, 0.5, and 1 g/kg intravenous ethanol in rhesus macaques performing touch screen-based tasks examining stimulus discrimination, stimulus reversal, and stimulus response performance. The impact on attentional processing was also evaluated. Ethanol reduced the accuracy of reversal performance marginally at 0.2 g/kg and significantly at 0.5 g/kg. This effect was selective given an absence of impairment on the stimulus discrimination and stimulus response tasks at these doses. Performance on stimulus discrimination was impaired at 1.0 g/kg, which prevented determination of reversal performance. Analysis of post-error response times demonstrated that error processing was impaired at both 0.2 and 0.5 g/kg. Ethanol also increased the number of omissions and delayed responses on an attentional task, suggesting more frequent attentional lapses. These data demonstrate that cognitive function mediated by specific prefrontal cortical brain regions is particularly sensitive to ethanol and suggest specific cognitive mechanisms that may underlie harmful decisions made at low doses of ethanol.

Predictors and outcomes of variability in subjective alcohol intoxication among college students: an event-level analysis across 4 years

BACKGROUND

Individual differences in subjective alcohol intoxication, as measured by laboratory-based alcohol challenge, have been identified as a phenotypic risk factor for alcohol use disorders. Further, recent evidence indicates that subjective alcohol response is also associated with event-level physiological consequences among college students, including blackouts and hangovers.

METHODS

The current investigation tested predictors of and outcomes associated with subjective intoxication in the natural drinking environment. In a preliminary laboratory alcohol-challenge study (n = 53), we developed a brief measure of subjective alcohol intoxication for use in event-level research. Participating students in the principal study (n = 1,867; 63% women; 54% Caucasian) completed 30 days of Web-based self-monitoring in each of the 4 college years.

RESULTS

In the principal study, generalized estimating equation analyses revealed that both lighter drinking and a family history of alcohol problems predicted greater subjective intoxication after accounting for estimated blood alcohol concentration (eBAC). Moreover, greater subjective intoxication during a given drinking episode was associated with negative alcohol-related consequences, illicit drug use, and unsafe sex, and at higher eBACs, was associated with aggression, sex, and property crime. Students who on average experienced greater subjective intoxication were also more likely to experience negative consequences and engage in illicit drug use, sex, unsafe sex, and aggression.

CONCLUSIONS

These findings suggest that both within-person variability and between-person individual differences in subjective intoxication may be risk factors for adverse drinking outcomes at the event level. Intervention efforts aimed at reducing problems associated with collegiate drinking may benefit from consideration both of who experiences greater subjective intoxication and of the situations in which they are more likely to do so.

Tolerance to the impairing effects of alcohol on the inhibition and activation of behavior

RATIONALE

Moderate doses of alcohol impair response inhibition and slow response activation, and some recent work has shown that during a single dose, response inhibition recovers from the impairing effects of alcohol more slowly than response activation. Evidence for a possible lag in tolerance development to inhibitory versus activational mechanisms suggests that as blood alcohol declines, drinkers' response inhibition might continue to be impaired despite having an unimpaired ability to activate responses; however, this effect has not been studied across repeated doses.

OBJECTIVE

The present study examined how cross-session tolerance to the impairing effects of alcohol develops differentially between response activation and inhibition.

METHODS

Thirty-two healthy adults performed a cued go/no-go task that measured response activation and inhibition. The study tested the degree to which response activation and inhibition developed acute and cross-session tolerances to a moderate dose of alcohol (0.65 g/kg) administered twice on separate days.

RESULTS

Alcohol slowed response activation and decreased response inhibition during both administrations. Response activation displayed acute tolerance to alcohol impairment during both administrations and cross-session tolerance from the first to second administration. By contrast, response inhibition showed no acute or cross-session tolerance.

CONCLUSION

Biased recovery of response activation over inhibition during a single dose and as doses are repeated could contribute to some of the impulsive behavior commonly observed under alcohol.

Effects of alcohol on tests of executive functioning in men and women: a dose response examination

Alcohol has been shown to affect performance on tasks associated with executive functioning. However, studies in this area have generally been limited to a single dose or gender or have used small sample sizes. The purpose of this study was to provide a more nuanced and systematic examination of alcohol's effects on commonly used tests of executive functioning at multiple dosages in both men and women. Research volunteers (91 women and 94 men) were randomly assigned to one of four drink conditions (alcohol doses associated with target blood alcohol concentrations of .000%, .050%, .075%, and .100%). Participants then completed three tasks comprising two domains of executive functioning: two set shifting tasks, the Trail Making Test and a computerized version of the Wisconsin Card Sorting Task, and a response inhibition task, the GoStop Impulsivity Paradigm. Impaired performance on set shifting tasks was found at the .100% and .075% dosages, but alcohol intoxication did not impair performance on the GoStop. No gender effects emerged. Thus, alcohol negatively affects set shifting at moderately high levels of intoxication in both men and women, likely attributable to alcohol's interference with prefrontal cortex function. Although it is well established that alcohol negatively affects response inhibition as measured by auditory stop-signal tasks, alcohol does not appear to exert a negative effect on response inhibition as measured by the GoStop, a visual stop-signal task.

On the role of conflict and control in social cognition: event-related brain potential investigations

Numerous social-cognitive models posit that social behavior largely is driven by links between constructs in long-term memory that automatically become activated when relevant stimuli are encountered. Various response biases have been understood in terms of the influence of such "implicit" processes on behavior. This article reviews event-related potential (ERP) studies investigating the role played by cognitive control and conflict resolution processes in social-cognitive phenomena typically deemed automatic. Neurocognitive responses associated with response activation and conflict often are sensitive to the same stimulus manipulations that produce differential behavioral responses on social-cognitive tasks and that often are attributed to the role of automatic associations. Findings are discussed in the context of an overarching social cognitive neuroscience model in which physiological data are used to constrain social-cognitive theories.

Time course of attentional bias in anxiety: emotion and gender specificity

Anxiety is characterized by cognitive biases, including attentional bias to emotional (especially threatening) stimuli. Accounts differ on the time course of attention to threat, but the literature generally confounds emotional valence and arousal and overlooks gender effects, both addressed in the present study. Nonpatients high in self-reported anxious apprehension, anxious arousal, or neither completed an emotion-word Stroop task during event-related potential (ERP) recording. Hypotheses differentiated time course of preferential attention to emotional stimuli. Individuals high in anxious apprehension and anxious arousal showed distinct early ERP evidence of preferential processing of emotionally arousing stimuli along with some evidence for gender differences in processing. Healthy controls showed gender differences at both early and later processing stages. The conjunction of valence, arousal, and gender is critical in the time course of attentional bias.

Attentional bias to negative emotion as a function of approach and withdrawal anger styles: an ERP investigation

Although models of emotion have focused on the relationship between anger and approach motivation associated with aggression, anger is also related to withdrawal motivation. Anger-out and anger-in styles are associated with psychopathology and may disrupt the control of attention within the context of negatively valenced information. The present study used event-related brain potentials (ERPs) to examine whether anger styles uniquely predict attentional bias to negative stimuli during an emotion-word Stroop task. High anger-out predicted larger N200, P300, and N400 to negative words, suggesting that aggressive individuals exert more effort to override attention to negative information. In contrast, high anger-in predicted smaller N400 amplitude to negative words, indicating that negative information may be readily available (primed) for anger suppressors, requiring fewer resources. Individuals with an anger-out style might benefit from being directed away from provocative stimuli that might otherwise consume their attention and foster overt aggression. Findings indicating that anger-out and anger-in were associated with divergent patterns of brain activity provide support for distinguishing approach- and withdrawal-related anger styles.

Alcohol abuse and dependence symptoms: a multidimensional model of common and specific etiology

This study tested a theoretical model hypothesizing differential pathways from 5 predictors to alcohol abuse and dependence symptoms. The participants were college students (N = 2,270) surveyed on 2 occasions in a 6-month prospective design. Social norms, perceived utility of alcohol use, and family history of alcohol problems were indirectly associated with Time 2 abuse and dependence symptoms through influencing level of alcohol consumption. Poor behavioral control had a direct effect on alcohol abuse but not on dependence symptoms at Time 2, whereas affective lability exhibited a direct prospective effect on alcohol dependence but not on abuse symptoms. A multigroup analysis showed that high levels of poor control increased the strength of paths from both consumption level and affective lability to abuse symptoms. Implications for prevention of alcohol problems among college students are discussed.

Alcohol selectively reduces anxiety but not fear: startle response during unpredictable versus predictable threat

Recent theory and empirical research have suggested that fear and anxiety are distinct processes with separable neurobiological substrates. Furthermore, a laboratory procedure has been developed to manipulate fear versus anxiety independently via administration of predictable or unpredictable electric shock, respectively. Benzodiazepines appear to selectively reduce anxiety but not fear in this procedure. The primary aim of this experiment was to determine if alcohol produced a similar selective reduction in anxiety. Intoxicated (target blood alcohol concentration of .08%) and nonintoxicated participants viewed a series of colored squares separated by variable intertrial intervals (ITIs) in 3 conditions. In the predictable shock condition, shocks were administered contingently during every square. In the unpredictable shock condition, shocks were administered noncontingently during both squares and ITIs. In the no-shock condition, no shocks were administered at any time. Alcohol significantly reduced startle potentiation during cues signaling unpredictable but not predictable shock, consistent with the thesis that alcohol selectively reduces anxiety but not fear. In addition, alcohol's effect on startle potentiation during unpredictable shock was mediated by vigilance. This anxiolytic effect may clarify the nature of alcohol's reinforcing effects in social and problem drinkers.

Reversing the sequence: reducing alcohol consumption by overcoming alcohol attentional bias

The aims of the research were to (a) compare the alcohol attentional bias (AAB) of social, hazardous, and harmful drinkers and (b) assess the effects of alcohol attention-control training on the AAB and alcohol consumption of hazardous and harmful drinkers. Participants were social drinkers (N=40), hazardous drinkers (N=89), and harmful drinkers (N=92). Paper-and-pencil measures were used to collect information about participants' socio-demographic characteristics, health status, motivational structure, drinking-related locus of control and situational self-confidence, readiness to change, affect, and alcohol consumption. Computerized classic, alcohol- and concerns-Stroop tests were administered. All participants were tested individually, with the order of tests counterbalanced across participants. After the baseline assessment, the hazardous and harmful drinkers were trained with the Alcohol Attention-Control Training Program (AACTP) for two and four sessions, respectively. Both samples completed a post-training assessment, and the harmful drinkers also completed 3-month follow-up. Results indicated that (a) the harmful drinkers had larger AAB than the hazardous and the social drinkers; (b) the attentional training reduced the hazardous and harmful drinkers' AAB; and (c) the harmful drinkers showed post-training reductions in alcohol consumption and improvements on the other drinking-related indices. The harmful drinkers' improvements were maintained at the 3-month follow-up.

Lost in the sauce: the effects of alcohol on mind wandering

Alcohol consumption alters consciousness in ways that make drinking both alluring and hazardous. Recent advances in the study of consciousness using a mind-wandering paradigm permit a rigorous examination of the effects of alcohol on experiential consciousness and metaconsciousness. Fifty-four male social drinkers consumed alcohol (0.82 g/kg) or a placebo beverage and then performed a mind-wandering reading task. This task indexed both self-caught and probe-caught zone-outs to distinguish between mind wandering inside and outside of awareness. Compared with participants who drank the placebo, those who drank alcohol were significantly more likely to report that they were zoning out when probed. After this increase in mind wandering was accounted for, alcohol also lowered the probability of catching oneself zoning out. The results suggest that alcohol increases mind wandering while simultaneously reducing the likelihood of noticing one's mind wandering. Findings are discussed with regard to theories of alcohol and theories of consciousness.

Alcohol's role in men's use of coercion to obtain unprotected sex

Past sexual victimization has been identified as a predictor of women's sexual risk-taking. In order to develop effective prevention and treatment programs, research is needed that examines perpetrators' characteristics. Thus, the goal of this study was to examine predictors of men's willingness to use coercive strategies to obtain sex without a condom. Male college students (n = 72) completed a survey that assessed past sexual assault perpetration, hostility, past misperception of women's sexual cues, usual alcohol consumption, and usual condom use. One month later, they participated in an alcohol administration study and watched a video about a couple in a consensual sexual situation. Participants were asked to evaluate how justified they would be in using a variety of coercive strategies to make the woman have unprotected sex. In hierarchical multiple regression analyses, there was a significant main effect of past perpetration such that men who had previously committed sexual assault felt more justified using coercive strategies to obtain unprotected sex than did nonperpetrators. Acute alcohol consumption did not have a main effect; however, it interacted with hostility and misperception. Among participants who consumed alcohol prior to watching the video, the greater their preexisting hostility, the more justified they felt in using coercion. Similarly, the more frequently drinkers had misperceived women's sexual intentions in the past, the more justified they felt in using coercion. Based on these findings, several specific suggestions are made for prevention and treatment programs, including targeted communication skills and normative feedback interventions.

Self-reported attentional control differentiates the major factors of psychopathy

The dual-deficit model identifies unique correlates of the two major factors associated with psychopathy (Patrick, 2007). Factor 1 is associated with deficits in amygdala-mediated emotion, while Factor 2 is related to deficits in higher-order cognitive processes. Research suggests that attention to environmental and contextual cues is critical for emotion and cognition (Ochsner & Gross, 2005). Therefore, and by extension, attention may also be important to deficits in both Factor 1 and Factor 2. The present study utilizes a sample of male prisoners in order to examine the relationship between self-reported attentional control (Derryberry & Reed, 2002) and the major factors of psychopathy, as assessed by three different methods. Across all three measures, Factor 1 is associated with superior attentional control, whereas Factor 2 is related to inferior attentional control. Furthermore, results provide support for the external validity of three commonly used methods for assessing psychopathy. We propose that anomalous attentional control may contribute to both major symptom clusters associated with psychopathy.

DOES ALCOHOL CONTRIBUTE TO THE CONFLUENCE MODEL OF SEXUAL ASSAULT PERPETRATION?

The confluence model of sexual assault provides a useful theoretical integration of factors that influence men's likelihood of committing sexual assault (Malamuth, Sockloskie, Koss, & Tanaka, 1991). This study replicates and extends the confluence model by including alcohol at multiple levels. Participants' usual alcohol consumption and alcohol consumption in sexual situations were included as predictor variables. The number of sexually aggressive acts that participants committed after consuming alcohol and the number of sexually aggressive acts participants committed when sober were separately calculated so that the predictors of each could be distinguished. Participants were 356 men who completed a survey that included measures that assessed the key components of the confluence model. Results of path analyses indicated that the expanded model fit the data well, with both general and situational measures of alcohol use predicting frequency of sexual assault when drinking alcohol. These findings highlight the importance of developing universal and targeted prevention programs for young men.

Acute disinhibiting effects of alcohol as a factor in risky driving behavior

Automobile crash reports show that up to 40% of fatal crashes in the United States involve alcohol and that younger drivers are over-represented. Alcohol use among young drivers is associated with impulsive and risky driving behaviors, such as speeding, which could contribute to their over-representation in alcohol-related crash statistics. Recent laboratory studies show that alcohol increases impulsive behaviors by impairing the drinker's ability to inhibit inappropriate actions and that this effect can be exacerbated in conflict situations where the expression and inhibition of behavior are equally motivating. The present study tested the hypothesis that this response conflict might also intensify the disruptive effects of alcohol on driving performance. Fourteen subjects performed a simulated driving and a cued go/no-go task that measured their inhibitory control. Conflict was motivated in these tasks by providing equal monetary incentives for slow, careful behavior (e.g., slow driving, inhibiting impulses) and for quick, abrupt behavior (fast driving, disinhibition). Subjects were tested under two alcohol doses (0.65 g/kg and a placebo) that were administered twice: when conflict was present and when conflict was absent. Alcohol interacted with conflict to impair inhibitory control and to increase risky and impaired driving behavior on the drive task. Also, individuals whose inhibitory control was most impaired by alcohol displayed the poorest driving performance under the drug. The study demonstrates potentially serious disruptions to driving performance as a function of alcohol intoxication and response conflict, and points to inhibitory control as an important underlying mechanism.