Drinking to distraction: does alcohol increase attentional bias in adults with ADHD?

The impact of transcranial direct current stimulation on attention bias modification in children with ADHD

Individuals with attention deficit-hyperactivity disorder (ADHD) struggle with the interaction of attention and emotion. The ventromedial prefrontal cortex (vmPFC) and dorsolateral prefrontal cortex (dlPFC) are assumed to be involved in this interaction. In the present study, we aimed to explore the effect of stimulation applied over the dlPFC and vmPFC on attention bias in individuals with ADHD. Twenty-three children with ADHD performed the emotional Stroop and dot probe tasks during transcranial direct current stimulation (tDCS) in 3 conditions: anodal dlPFC (F3)/cathodal vmPFC (Fp2), anodal vmPFC (Fp2)/cathodal dlPFC (F3), and sham stimulation. Findings suggest reduction of attention bias in both real conditions based on emotional Stroop task and not dot probe task. These results were independent of emotional states. The dlPFC and vmPFC are involved in attention bias in ADHD. tDCS can be used for attention bias modification in children with ADHD.

Late-stage Attentional Bias towards Food Cues Varies According to Weight Status

The Current food environment has become increasingly obesogenic, with rates of obesity and related conditions continually rising. Advertisements for energy-dense foods are abundant and promote unhealthy eating behaviors by capitalizing on one's attentional bias towards food cues, a cognitive process resulting from the sensitization of highly reinforcing food. A heightened awareness towards food cues may promote overconsumption of energy-dense foods. The current study employed novel eye-tracking methodology to capture sustained, or late-stage, attentional bias towards food cues. Late-stage attentional bias is the aspect of attentional bias under conscious control and likely more prone to modification compared to initial/ early-stage attentional bias, which reflects automatic processes. The present study hypothesized late-stage attentional bias towards food cues is greater among individuals classified as overweight/obese than those classified as normal weight. Thirty (30) participants classified as overweight/obese (BMI ≥25) and 47 classified as normal weight (BMI <25) were assessed for late-stage attentional bias towards food cues, conceptualized as the percentage of time fixated on food cues when both food and neutral images were presented during a food-specific visual probe procedure task. Percentage of time fixated on food cues was 51.25 ± 1.27 (mean + SE) among individuals classified as overweight to obese while those classified as normal weight had a percent fixation of 47.26 ± 0.87 (P=0.03). In conclusion, individuals classified as overweight to obese have greater late-stage attentional bias towards food cues. This establishes an important factor influencing energy intake that may be modified in future clinical trials.

Exercise Increases Attentional Bias Towards Food Cues in Individuals Classified as Overweight to Obese

BACKGROUND

The obesity epidemic continues to be a major public health concern. Although exercise is the most common weight loss recommendation, weight loss outcomes from an exercise program are often suboptimal. The human body compensates for a large percentage of the energy expended through exercise to maintain energy homeostasis and body weight. Increases in energy intake appear to be the most impactful compensatory behavior. Research on the mechanisms driving this behavior has not been fully elucidated.

PURPOSE

To determine if exercise influences the attentional processing towards food cues (attentional bias) and inhibitory control for food cues among individuals classified as overweight to obese who do not exercise.

METHODS

Thirty adults classified as overweight to obese participated in a counterbalanced, crossover trial featuring two assessment visits on separate days separated by at least one week. Attentional bias and inhibitory control towards food cues was assessed prior to and after a bout of exercise where participants expended 500 kcal (one assessment visit) and before and after a 60 min bout of watching television (second assessment visit). Attentional bias was conceptualized as the percentage of time fixated on food cues when both food and neutral (non-food) cues were presented during a food-specific dot-probe task. Inhibitory control, specifically motor impulsivity, was assessed as percentage of inhibitory failures during a food-specific Go/NoGo task.

RESULTS

A significant condition by time effect was observed for attentional bias towards food cues, independent of hunger, whereas attentional bias towards food cues was increased pre-post exercise but not after watching TV. Inhibitory control was not affected by exercise or related to attentional bias for food cues.

CONCLUSIONS

An acute bout of exercise increased attentional bias for food cues, pointing to a mechanism that may contribute to the weight loss resistance observed with exercise. Future trials are needed to evaluate attentional bias towards food cues over a longitudinal exercise intervention.

Disentangling the Association between ADHD and Alcohol Use Disorder in Individuals Suffering from Bipolar Disorder: A Systematic Review and Meta-Analysis

Attention Deficit-Hyperactivity disorder (ADHD) may influence rates of Alcohol Use Disorder (AUD) among individuals suffering from Bipolar Disorder (BD). The aim of this systematic review and meta-analysis was to estimate the strength and consistency of the potential association between ADHD and AUD in BD. We searched main electronic databases for studies indexed up to November 2020. We included observational studies investigating the association between ADHD and AUD among individuals with BD. The association between ADHD and AUD was estimated using odds ratios (ORs) with 95% Confidence Intervals (CIs). Eleven studies, involving 2734 individuals with BD (516 with ADHD), were included in the meta-analysis. Individuals with both BD and ADHD had higher rates of AUD as compared with subjects with BD only (34.0% vs. 18.3%). The estimated OR of AUD for ADHD was 2.50 (95% CI: 1.91 to 3.27; I2 = 13.0%). Study-level characteristics did not influence the effect size. No risk of publication bias was estimated. Despite some limitations, this meta-analysis estimated an association between ADHD and AUD among individuals suffering from BD. At least a portion of the high rates of AUD in BD may, thereby, be related to comorbid ADHD. Longitudinal studies are needed to clarify the nature of this relationship.

Persistent attention-deficit/hyperactivity disorder predicts socially oriented, but not physical/physiologically oriented, alcohol problems in early adulthood

BACKGROUND

Although individuals with histories of childhood attention-deficit/hyperactivity disorder (ADHD) report more alcohol-related problems in adulthood than those without ADHD, it is unknown whether there are group differences in certain types of alcohol problems. We tested whether the nature of alcohol problems differed for individuals with and without childhood ADHD, as well as adulthood-persistent ADHD, to facilitate a personalized medicine approach for alcohol problems in this high-risk group.

METHODS

Data were drawn from a prospective, observational study. Children diagnosed with ADHD and demographically similar individuals without childhood ADHD were followed prospectively through young adulthood (N = 453; 87.6% male). ADHD symptom persistence was assessed using self-reports and parent reports. Alcohol problems and heavy drinking were assessed repeatedly from 18-30 years old to construct lifetime measures.

RESULTS

Full-sample confirmatory factor analyses identified 5 alcohol problem "types:" interpersonal problems/risky behaviors, occupational/academic impairment, impaired control/treatment seeking, tolerance/withdrawal, and drinking to blackout. Latent class analyses of items within each type yielded the best fit for 3-class solutions for all sets of items except blackout drinking, for which 2 classes emerged. Children with ADHD were more likely than those without ADHD to belong to high-risk latent classes for interpersonal problems/risky behaviors, occupational/academic problems, and impaired control (the high-risk class that indexed treatment-seeking behavior). These effects were driven by individuals whose ADHD symptoms persisted into adulthood. Few group differences emerged for tolerance/withdrawal and blackout drinking, except that individuals with only childhood ADHD (no persistence) were more likely to belong to the low-risk groups than those with adulthood-persistent ADHD and without ADHD.

CONCLUSIONS

Individuals with ADHD histories whose symptoms persist into adulthood may be more likely to experience socially oriented alcohol problems and impaired control/treatment seeking than individuals without an ADHD history and those with childhood ADHD only. Tailored alcohol prevention and treatment programs may benefit this high-risk population.

Acute methylphenidate administration reduces cocaine-cue attentional bias

Mechanistic research on behavioral processes underlying substance use disorder might help identify novel targets for interventions development. Drug-related attentional bias and response inhibition deficits have received a great deal of consideration in substance use research, broadly, and cocaine use research, specifically. Studies investigating pharmacological mechanisms that may ameliorate, or further impair, these behaviors relevant to cocaine use are relatively lacking. This study evaluated the impact of acute administration of methylphenidate, a dopamine-favoring reuptake inhibitor, on both gaze-related cocaine-cue-attentional bias and cocaine-cue related disruptions in response inhibition among individuals with cocaine use disorder. Participants (N = 12; 33% female) completed a within-subject, outpatient, acute dosing study. Two sessions were completed in which methylphenidate (60 mg) or placebo were administered followed by completion of an attentional bias task using eye-tracking technology and neutral-cue and cocaine-cue response inhibition tasks. Subjective and physiological effects were also recorded. Significant cocaine cue attentional bias and response inhibition failures were observed during placebo administration. Acute methylphenidate administration reduced cocaine-cue attentional bias as measured by cocaine-cue gaze fixations (d_z = 1.04; Bayes Factor = 12.37). No statistically significant effects of methylphenidate were observed on response inhibition (Bayes Factors = 0.17-1.04). Methylphenidate produced prototypical subjective and physiological effects. Although the small sample should be considered, these findings indicate acute manipulation of dopaminergic activity reduced cue-related attentional allocation related to cocaine use disorder. Future research evaluating alternative dopaminergic agents and applications within a clinical setting are needed to determine the clinical significance of targeting this neurobehavioral mechanism.

Redundant visual signals reduce the intensity of alcohol impairment

BACKGROUND

Humans interact with multiple stimuli across several modalities each day. The "redundant signal effect" refers to the observation that individuals respond more quickly to stimuli when information is presented as multisensory, redundant stimuli (e.g., aurally and visually), rather than as a single stimulus presented to either modality alone. Studies of alcohol effects on human performance show that alcohol induced impairment is reduced when subjects respond to redundant multisensory stimuli. However, redundant signals do not need to involve multisensory stimuli to facilitate behavior as studies have shown facilitating effects by redundant unisensory signals that are delivered to the "same sensory" (e.g., two visual or two auditory signals).

METHODS

The current study examined the degree to which redundant visual signals would reduce alcohol impairment and compared the magnitude of this effect with that produced by redundant multisensory signals. On repeated test sessions, participants (n = 20) received placebo or 0.65 g/kg alcohol and performed a two-choice reaction time task that measured how quickly participants responded to four different signal conditions. The four conditions differed by the modality of the target presentation: visual, auditory, multisensory, and unisensory.

RESULTS

Alcohol slowed performance in all conditions and reaction times were generally faster in the redundant signal conditions. Both multisensory and unisensory redundant signals reduced the impairing effects of alcohol compared with single signals.

CONCLUSIONS

These findings indicate that the ability of redundant signals to counteract alcohol impairment does not require multisensory input. Duplicate signals to the same modality can also reduce alcohol impairment.

Mobile alcohol biosensors and pharmacotherapy development research

Recent advances in biosensor technology herald a major shift in the way alcohol use will be tracked in humans. Wearable biosensors can passively and continuously monitor wearers' alcohol consumption in real time. An important application of these biosensors is to improve the way medication for alcohol use disorder (AUD) is tested in clinical research. Both laboratory-based screening paradigms and clinical trials have methodological problems that impact their efficiency and predictive validity. Medication screening using laboratory-based methods is a resource-intensive assessment of a single episode of behavior in a non-representative setting. Clinical trials rely on participant self-report to document medication-induced changes in drinking behavior. This review describes how mobile biosensors can be leveraged to improve AUD medication development research. We first review the current state of alcohol biosensor technology with a focus on strengths and limitations of the devices. We describe how multiple biosensors can be combined to create a far more detailed record of drinking compared to single biosensor platforms. We then discuss each phase of the medication development pipeline in turn (i.e., phases 1-4) and describe how mobile biosensors can be incorporated in standard medication testing paradigms to improve efficiency and predictive validity. We conclude with discussion of challenges associated with using currently available biosensors for medication testing and recommendations for researchers wishing to incorporate alcohol biosensors into their own research.

Effects of multisensory stop signals on alcohol-induced disinhibition in adults with ADHD

Multisensory environments facilitate behavioral functioning in humans. The redundant signal effect (RSE) refers to the observation that individuals respond more quickly to stimuli when information is presented as multisensory, redundant stimuli (e.g., aurally and visually) rather than as a single stimulus presented to either modality alone. RSE appears to be because of specialized multisensory neurons in the superior colliculus and association cortex that allow intersensory coactivation between the visual and auditory channels. Our studies show that the disinhibiting effects of alcohol are attenuated when stop signals are multisensory (e.g., Visual + Auditory stop signals) versus unisensory (Roberts, Monem, & Fillmore, 2016). The present study expanded on this research to test the degree to which multisensory stop signals could also attenuate the disinhibiting effects of alcohol in those with attention-deficit hyperactivity disorder (ADHD), a clinical population characterized by poor impulse control. The study compared young adults with ADHD (n = 22) with healthy controls (n = 22) and examined the acute impairing effect of alcohol on response inhibition to stop signals that were presented as a unisensory (visual) stimulus or a multisensory (Visual + Auditory) stimulus. For controls, results showed alcohol impaired response inhibition to unisensory stop signals but not to multisensory stop signals. Response inhibition of those with ADHD was impaired by alcohol regardless of whether stop signals were unisensory or multisensory. The failure of multisensory stimuli to attenuate alcohol impairment in those with ADHD highlights a specific vulnerability that could account for heightened sensitivity to the disruptive effects of alcohol. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Alcohol, empathy, and morality: acute effects of alcohol consumption on affective empathy and moral decision-making

RATIONALE

Hypothetical moral dilemmas, pitting characteristically utilitarian and non-utilitarian outcomes against each other, have played a central role in investigations of moral decision-making. Preferences for utilitarian over non-utilitarian responses have been explained by two contrasting hypotheses; one implicating increased deliberative reasoning, and the other implicating diminished harm aversion. In recent field experiments, these hypotheses have been investigated using alcohol intoxication to impair both social and cognitive functioning. These studies have found increased utilitarian responding, arguably as a result of alcohol impairing affective empathy.

OBJECTIVES

The present research expands existing investigations by examining the acute effects of alcohol on affective empathy and subsequent moral judgments in traditional vignettes and moral actions in virtual reality, as well as physiological responses in moral dilemmas.

METHODS

Participants (N = 48) were administered either a placebo or alcohol in one of two dosages; low or moderate. Both pre- and post intervention, participants completed a moral action and moral judgment task alongside behavioural measures of affective empathy.

RESULTS

Higher dosages of alcohol consumption resulted in inappropriate empathic responses to facial displays of emotion, mirroring responses of individuals high in trait psychopathy, but empathy for pain was unaffected. Whilst affective empathy was influenced by alcohol consumption in a facial responding task, both moral judgments and moral actions were unaffected.

CONCLUSIONS

These results suggest that facets, beyond or in addition to deficits in affective empathy, might influence the relationship between alcohol consumption and utilitarian endorsements.

Measuring heightened attention to alcohol in a naturalistic setting: A validation study

Attentional bias to alcohol-related stimuli is believed to be an important contributor to the development and maintenance of drug abuse. There is a considerable body of research examining attentional bias, much of which has typically utilized image-display tasks as a means to assess the phenomenon. Little, however, is known about the nature of this bias in an individual's natural environment. The current study sought to implement a novel approach to assessing attentional bias in vivo. Participants wore portable eye-tracking glasses that recorded video from their point of view and measured fixation time to objects they observed. They entered a room that was designed to represent a recreational setting in which both alcohol- and nonalcoholic-neutral beverages were placed along with other stimuli. In two different testing sessions, participants were free to visually explore the room. Participants showed similar fixation times to alcohol and neutral beverages during Session 1. Attentional bias to alcoholic beverages was observed in Session 2 because fixation time decreased to neutral but not to alcoholic beverages. The magnitude of attentional bias was positively associated with drinking habits, with heavier drinkers demonstrating a higher degree of bias to alcohol. These findings provide an ecological model of how attentional bias can develop as the net result of attention being sustained to alcoholic stimuli while diminishing to other stimuli over time. (PsycINFO Database Record

N-Acetylcysteine reduces cocaine-cue attentional bias and differentially alters cocaine self-administration based on dosing order

BACKGROUND

Disrupted glutamate homeostasis is thought to contribute to cocaine-use disorder, in particular, by enhancing the incentive salience of cocaine stimuli. n-Acetylcysteine might be useful in cocaine-use disorder by normalizing glutamate function. In prior studies, n-acetylcysteine blocked the reinstatement of cocaine seeking in laboratory animals and reduced the salience of cocaine stimuli and delayed relapse in humans.

METHODS

The present study determined the ability of maintenance on n-acetylcysteine (0 or 2400mg/day, counterbalanced) to reduce the incentive salience of cocaine stimuli, as measured by an attentional bias task, and attenuate intranasal cocaine self-administration (0, 30, and 60mg). Fourteen individuals (N=14) who met criteria for cocaine abuse or dependence completed this within-subjects, double-blind, crossover-design study.

RESULTS

Cocaine-cue attentional bias was greatest following administration of 0mg cocaine during placebo maintenance, and was attenuated by n-acetylcysteine. Cocaine maintained responding during placebo and n-acetylcysteine maintenance, but the reinforcing effects of cocaine were significantly attenuated across both maintenance conditions in participants maintained on n-acetylcysteine first compared to participants maintained on placebo first.

CONCLUSIONS

These results collectively suggest that a reduction in the incentive salience of cocaine-related stimuli during n-acetylcysteine maintenance may be accompanied by reductions in cocaine self-administration. These results are in agreement with, and link, prior preclinical and clinical trial results suggesting that n-acetylcysteine might be useful for preventing cocaine relapse by attenuating the incentive salience of cocaine cues.

Alcohol Administration Increases Cocaine Craving But Not Cocaine Cue Attentional Bias

BACKGROUND

Alcohol consumption is a known antecedent to cocaine relapse. Through associative conditioning, it is hypothesized that alcohol increases incentive motivation for cocaine and thus the salience of cocaine-related cues, which are important in maintaining drug-taking behavior. Cocaine-using individuals display a robust cocaine cue attentional bias as measured by fixation time during the visual probe task. The purpose of this study was to evaluate the influence of alcohol administration on cocaine cue attentional bias using eye-tracking technology to directly measure attentional allocation.

METHODS

Twenty current cocaine users completed a double-blind, placebo-controlled, within-subjects study that tested the effect of 3 doses of alcohol (0.00, 0.325, and 0.65 g/kg) on cocaine cue attentional bias using the visual probe task with eye-tracking technology. The participant-rated and physiological effects of alcohol were also assessed.

RESULTS

Participants displayed a robust cocaine cue attentional bias following both placebo and alcohol administration as measured by fixation time, but not response time. Alcohol administration did not influence cocaine cue attentional bias, but increased craving for cocaine in a dose-dependent manner. Alcohol produced prototypic psychomotor and participant-rated effects.

CONCLUSIONS

Alcohol administration increases cocaine craving but not cocaine cue attentional bias. Alcohol-induced cocaine craving suggests that alcohol increases incentive motivation for cocaine but not the salience of cocaine-related cues.

The Effects of Preresponse Cues on Inhibitory Control and Response Time in Adults With ADHD

OBJECTIVE

The purpose of this study was to examine the effects of preresponse cues on behavioral control in adults with ADHD.

METHOD

Eighty-eight adults with ADHD and 67 adults with no history of ADHD completed a cued go/no-go task. This task requires participants to respond or inhibit a response to go and no-go targets, respectively, and preresponse cues provide participants with predictive information about the upcoming target.

RESULTS

Overall, participants with ADHD made more inhibitory failures and responded more slowly than controls. These group differences were only present in the valid-cue condition, and there were no significant group differences in the invalid-cue conditions.

CONCLUSION

These findings suggest that adults with ADHD are less able to utilize predictive environmental information to facilitate behavioral control.

Multisensory Stop Signals Can Reduce the Disinhibiting Effects of Alcohol in Adults

BACKGROUND

Alcohol impairs drinkers' abilities to inhibit inappropriate responses. Certain stimulus conditions have been shown to facilitate behavioral control. Under conditions where individuals are presented with multiple inhibitory signals, the speed and consistency with which they are able to inhibit a response is improved. Recent research has shown that multisensory signals might protect against the disruptive effects of alcohol on mechanisms of behavioral control. This study examined whether multisensory stop signals can be used to improve inhibitory control, possibly by speeding attentional shifts toward inhibitory "stop" signals in the environment.

METHODS

Twenty adult social drinkers performed a modified cued go/no-go task that measured the ability to inhibit prepotent responses following 0.64 g/kg alcohol and placebo. Response targets were presented as unimodal (visual) and as multisensory (visual + aural) stimuli.

RESULTS

Results showed that during unimodal response target trials, participants made more inhibitory failures under 0.64 g/kg alcohol compared to placebo. During multisensory trials, however, there was no significant effect of alcohol on inhibitory control.

CONCLUSIONS

These findings identify multisensory inhibitory signals as a potentially important environmental factor that can reduce the degree to which alcohol disinhibits behavior possibly by intersensory co-activation between the visual and auditory pathways.

The patient's perspective on the link between ADHD and substance use: a qualitative interview study

OBJECTIVE

The primary aim of this study was to investigate how adult individuals with ADHD perceive the role of alcohol and drugs in their lives. A secondary aim was to identify factors that those individuals consider useful in the treatment and prevention of co-occurring ADHD and substance use disorders (SUDs).

METHOD

A qualitative interview study with ADHD outpatients (n = 14) at a psychiatric clinic. Data were analyzed based on pre-defined areas of interest using a deductive content analysis method.

RESULTS

The yearning for belongingness was identified as an important driving force underlying substance use. The participants felt that alcohol/drugs helped them being normal and thus respected and accepted. Early diagnosis of ADHD was perceived essential to avoid SUD.

CONCLUSION

Adults with ADHD may have strong rational and emotional reasons for the use of alcohol and drugs. When planning for the treatment of adult ADHD, investigation of personal reasons for alcohol/drug use deserves a place.

Attentional bias to alcohol-related stimuli as an indicator of changes in motivation to drink

Heavy drinkers show an attentional bias toward alcohol-related visual cues. A recent study in our laboratory (Weafer & Fillmore, 2013) showed that alcohol decreases attentional bias among heavy drinkers, suggesting that alcohol satiates motivation to drink in heavy drinkers. Little is known, however, about how this satiety effect might change across the time course of the blood alcohol concentration (BAC) curve. It is possible that attentional bias may return later in the time course if the satiety effect begins to diminish. The current study tested this hypothesis in a group of high-risk binge drinkers (n = 20). Participants completed a visual-probe task to measure their attentional bias and a self-report measure of their desire for alcohol after receiving 0.64 g/kg and 0.0 g/kg alcohol (placebo) during separate dose challenge sessions. The measures were obtained during the ascending limb of the BAC curve under alcohol (Test 1) and again during the descending limb (Test 2) at a comparable BAC. The measures also were obtained at the same times following placebo. Under alcohol, no attentional bias was observed during Test 1, but drinkers reported increased desire to drink. During Test 2, attentional bias was evident, but participants reported less desire to drink. Attentional bias was not correlated with desire to drink at any time point. Following placebo, attentional bias was evident during both tests. These findings show that alcohol causes a temporary reduction of attentional bias among heavy drinkers. These changes do not correspond with their self-reported motivation to drink.

Fixation time is a sensitive measure of cocaine cue attentional bias

BACKGROUND AND AIMS

Attentional bias has been demonstrated to a variety of substances. Evidence suggests that fixation time is a more direct measure of attentional bias than response time. The aims of this experiment were to demonstrate that fixation time during the visual probe task is a sensitive and stable measure of cocaine cue attentional bias in cocaine-using adults compared to controls.

DESIGN

A between-subject, repeated-measures experiment.

SETTING

An out-patient research unit.

PARTICIPANTS

Fifteen cocaine using and 15 non-cocaine-using adults recruited from the community.

MEASUREMENTS

Participants completed a visual probe task with eye tracking and a modified Stroop during two experimental sessions.

FINDINGS

A significant interaction between cue type and group (F = 13.5; P < 0.05) indicated that cocaine users, but not controls, displayed an attentional bias to cocaine-related images as measured by fixation time. There were no changes in the magnitude of attentional bias across sessions (F = 3.4; P > 0.05) and attentional bias correlated with self-reported life-time cocaine use (r = 0.64, P < 0.05). Response time on the visual probe (F = 1.1; P > 0.05) as well as on the modified Stroop (F = 0.1; P > 0.05) failed to detect an attentional bias.

CONCLUSIONS

Fixation time on cocaine-related stimuli (propensity to remain focused on the stimulus) is a sensitive and stable measure of cocaine cue attentional bias in cocaine-using adults.

Heavy drinking and the role of inhibitory control of attention

Alcohol can disrupt goal-directed behavior by impairing the ability to inhibit attentional shifts toward salient but goal-irrelevant stimuli. Individuals who are highly sensitive to this effect of the drug may be at increased risk for problematic drinking, especially among those whose attention is drawn to alcohol-related cues in the environment (i.e., attentional bias). The current study examined the acute impairing effect of alcohol on inhibitory mechanisms of attentional control in a group of healthy social drinkers. We then examined whether increased sensitivity to this disinhibiting effect of alcohol was associated with heavy drinking, especially among those who have an attentional bias toward alcohol-related stimuli. Eighty nondependent social drinkers performed a delayed ocular response task that measured their inhibitory control of attention by their ability to suppress attentional shifts to irrelevant stimuli. Attentional bias was measured using a visual probe task. Inhibitory control was assessed following a moderate dose of alcohol (0.64 g/kg) and a placebo. Participants made more inhibitory failures (i.e., premature saccades) following 0.64 g/kg alcohol compared with placebo and the relation of this effect to their drinking habits did depend on the level of the drinker's attentional bias to alcohol-related stimuli. Among drinkers with higher attentional bias, greater impairment of inhibitory control was associated with heavier drinking. In contrast, drinkers with little or no attentional bias showed no relation between their sensitivity to the disinhibiting effects of alcohol and drinking habits. These findings have implications for understanding how heightened incentive-salience of alcohol cues and impaired attentional control can interactively contribute to excessive alcohol use.

Reduced acute recovery from alcohol impairment in adults with ADHD

RATIONALE

Prior research has found that adults with attention-deficit/hyperactivity disorder (ADHD) show increased sensitivity to the impairing effects of alcohol (Weafer et al., Exp Clin Psychopharmacol 17: 113-121, 2009). However, these studies have focused exclusively on the ascending limb of the blood alcohol concentration (BAC) curve, and it is unclear whether these adults continue to show increased sensitivity during the later phase of the dose as BAC is declining.

OBJECTIVE

This study tested the hypothesis that those with ADHD would display increased response to alcohol during the ascending limb of the BAC curve and less recovery from the impairing effects during the descending limb.

METHODS

Adult social drinkers with ADHD and control adults completed measures of motor coordination, reaction time (RT), and subjective intoxication twice following 0.64 g/kg alcohol and placebo. The measures were administered during the ascending limb of the BAC curve and again during the descending limb.

RESULTS

During the ascending limb, alcohol reduced motor coordination, slowed RT, and increased self-reports of subjective intoxication. Those with ADHD displayed greater impairment of motor coordination compared with controls. During the descending limb, controls reported diminished subjective intoxication and showed recovery from the impairing effects of alcohol on both their motor coordination and their RT. Those with ADHD showed reduced subjective intoxication and faster RT during this time, but they did not recover motor control.

CONCLUSIONS

The protracted time course of motor impairment in adults with ADHD despite reductions in subjective intoxication may contribute to poor decision making and diminished behavioral control in this group.