Context and alcohol consumption behaviors affect inhibitory control

Development and standardization of Indian Alcohol Photo Stimuli (IAPS) for cue-reactivity paradigms in patients with alcohol use disorder

Background

The availability of appropriate alcohol-related stimuli is a crucial concern for the evaluation and treatment of patients with alcohol dependence syndrome. The study aimed to standardize alcohol-related images with cultural relevance to the Indian setting.

Methods

We produced an extensive database of 203 pictures, the Indian Alcohol Photo Stimuli (IAPS), portraying different categories and types of alcoholic beverages, after removing the confounding effects of low-level stimulus parameters (e.g. brightness and blurriness). Thirty patients with alcohol dependence syndrome, currently abstinent, rated each image on visual analog scale (VAS) ranging from 0 (no craving) to 10 (extreme), to determine how typical the stimuli served as craving-relevant stimuli.

Results

The mean VAS scores across beverages (ordered from highest to lowest) were whiskey >rum >beer >wine >vodka. Repeated-measures analysis of variance (ANOVA) showed a significant difference in mean VAS scores across beverages (F = 2.93, df = 2.9/86.3, P = 0.039, Greenhouse-Geisser corrected); the effect size for the difference was small (ηp2 = 0.092). A post hoc Bonferroni shows significantly higher VAS scores with whiskey compared with vodka (P = 0.029), whereas the scores were similar across other beverages. A two-way repeated-measures ANOVA for interaction between type of alcoholic beverages and activity was not significant (F = 2.67, df = 2.6/76.6, P = 0.061, Greenhouse-Geisser corrected).

Conclusions

We created a standardized alcohol-related image database for studying cue-reactivity paradigms in individuals with alcohol use disorder (AUD). Further research is needed to validate the impact of image features on cue reactivity.

Does the smell of alcohol make it harder to resist? The impact of olfactory cues on inhibitory control and attentional bias

BACKGROUND

It is well known that, owing to associative processing, olfactory cues can impact memory, emotion and behaviour. Research also points to a link between the smells of particular substances and craving. Yet, to date, little research has investigated how smell may impact other cognitive processes that are known to drive alcohol consumption.

AIM

To assess how exposure to alcohol-related (vodka) relative to neutral (citrus) olfactory cues impacts inhibitory control and attentional bias.

METHOD

Participants took part in a go/no-go (Study 1) and Stroop task (Study 2) while wearing masks that were pre-treated with vodka or citrus oil of equivalent intensity. STUDY 1 RESULTS: Response error rates were higher in participants in the alcohol-related (versus neutral) olfactory condition, with no interaction between olfactory and visual cue. STUDY 2 RESULTS: Responses to alcohol-related versus neutral words were similar, while performance appeared significantly impaired among participants wearing alcohol (relative to citrus) infused masks. Conclusion The smell of alcohol may impair signal detection performance on the go/no-go and Stroop task. As inhibitory control and attentional processes are known to be associated with decisions to drink or exercise restraint, these results may have implications for our understanding of alcohol consumption and for tailoring interventions.

The Effects of Placebo and Moderate Dose Alcohol on Attentional Bias, Inhibitory Control and Subjective Craving

AIMS

Previous research indicates that acute alcohol intoxication and placebo can inhibit people's control over consumption behaviour and heighten attentional bias (AB) towards alcohol-related stimuli and craving. We designed a study to disentangle anticipated from pharmacological effects of alcohol in order to gain a clearer view of their relative contributions to alcohol consumption.

METHODS

In a within-participants design (moderate alcohol dose, placebo and control), and over a minimum 2-week period, participants completed a battery of questionnaires and cognitive tasks, followed by a bogus taste task to measure ad libitum consumption.

RESULTS

Both alcohol preload and placebo resulted in cognitive and psychological changes, including impaired inhibitory control, heightened AB and craving. However, ad libitum consumption only increased following alcohol and not placebo. Furthermore, inhibitory control impairments did not mediate the relationship between initial intoxication and ad libitum consumption, and findings indicate that increases in craving may mediate this association.

CONCLUSION

Psychological processes such as craving may be more important in driving consummatory behaviour relative to transient changes in cognitive processes, such as inhibitory control.

Alcohol-related attentional bias in a gaze contingency task: Comparing appetitive and non-appetitive cues

BACKGROUND

Non-problem drinkers attend automatically to alcohol-related cues compared to non-alcohol related cues on tests of inhibitory control. Moreover, attentional bias for alcohol-related cues varies between problem and non-problem drinkers.

AIM

To examine attentional bias towards alcoholic and non-alcoholic appetitive cues between problem and non-problem drinkers.

METHOD

Forty-one university students (9 male, 32 female; Mage = 21.50) completed an eye-tracking gaze contingency paradigm, measuring the number of times participants looked at peripherally and centrally located stimuli (break frequency) when instructed to maintain focus on a target object. Stimuli consisted of appetitive alcohol-related (e.g., wine), appetitive non-alcohol-related (e.g., cola) and non-appetitive (e.g., fabric softener) stimuli. Participants were split using the Alcohol Use Disorders Identification Test (AUDIT) into non-problem (M AUDIT = 3.86) and problematic drinkers (M AUDIT = 11.59).

RESULTS

Problematic drinkers had higher break frequencies towards peripheral appetitive stimuli than towards non-appetitive stimuli, while break frequency was equivalent between appetitive cues presented centrally (alcohol and non-alcohol-related). In contrast, there were no differences in break frequency across stimuli type or cue presentation location (central or peripheral) for non-problem drinkers.

CONCLUSION

In contrast to non-problem drinkers, people displaying more problematic consumption practices may find it more difficult to inhibit eye movements towards appetitive stimuli, particularly when in peripheral vision. This may suggest that attentional biases, as measured in terms of overt eye movements, in problem drinkers may be most powerful when the alcoholic and appetitive stimuli are not directly in field of view. An uncertainty reduction process in the allocation of attention to appetitive cues may help explain the patterns of results observed.

Identifying Triggers of Alcohol Craving to Develop Effective Virtual Environments for Cue Exposure Therapy

Background: Many studies have indicated that alcohol craving is a core mechanism in the acquisition, maintenance, and precipitation of relapse in alcohol use disorder (AUD). A common treatment approach in AUD is cue exposure therapy (CET). New technologies like virtual reality (VR) have the potential to enhance the effectiveness of CET by creating realistic scenarios in naturalistic environments. In this study, we aimed to determine relevant triggers of alcohol craving in patients with AUD.

Methods: We enrolled 75 outpatients diagnosed with AUD according to the DSM-5 criteria Participants completed the Alcohol Use Disorder Identification Test and a self-administered questionnaire to assess alcohol craving. The variables included in the craving questionnaire were as follows: presence of others, situations, time of the day, day of the week, mood, and type of alcoholic beverage.

Results: Greater levels of alcohol craving were seen in many situations, including being at a party, in a restaurant, in a bar or pub, and at home. Drinking alone and drinking with two or more friends were equally associated with higher levels of craving. Drinking at night and drinking at weekends also emerged as triggers for alcohol craving. Emotional states like anxiety or tension, sadness, stress, frustration, or irritability were highly associated with urges to drink alcohol. The alcoholic drinks most highly associated with increased levels of craving were beer, wine, and whisky. Gender and age implications were discussed.

Conclusion: This study is part of a larger project aiming to develop and validate CET based on VR technology for patients with AUD who are resistant to classical treatment. The identified triggers have been used to develop relevant VR environments for CET, and further research is ongoing to implement our findings.

Beer? Over here! Examining attentional bias towards alcoholic and appetitive stimuli in a visual search eye-tracking task

RATIONALE

Experimental tasks that demonstrate alcohol-related attentional bias typically expose participants to single-stimulus targets (e.g. addiction Stroop, visual probe, anti-saccade task), which may not correspond fully with real-world contexts where alcoholic and non-alcoholic cues simultaneously compete for attention. Moreover, alcoholic stimuli are rarely matched to other appetitive non-alcoholic stimuli.

OBJECTIVES

To address these limitations by utilising a conjunction search eye-tracking task and matched stimuli to examine alcohol-related attentional bias.

METHODS

Thirty social drinkers (Mage = 19.87, SD = 1.74) were asked to detect whether alcoholic (beer), non-alcoholic (water) or non-appetitive (detergent) targets were present or absent amongst a visual array of matching and non-matching distractors. Both behavioural response times and eye-movement dwell time were measured.

RESULTS

Social drinkers were significantly quicker to detect alcoholic and non-alcoholic appetitive targets relative to non-appetitive targets in an array of matching and mismatching distractors. Similarly, proportional dwell time was lower for both alcoholic and non-alcoholic appetitive distractors relative to non-appetitive distractors, suggesting that appetitive targets were relatively easier to detect.

CONCLUSIONS

Social drinkers may exhibit generalised attentional bias towards alcoholic and non-alcoholic appetitive cues. This adds to emergent research suggesting that the mechanisms driving these individual's attention towards alcoholic cues might 'spill over' to other appetitive cues, possibly due to associative learning.

Perfect for a Gin and Tonic: How Context Drives Consumption Within a Modified Bogus Taste Test

Aim

To implement a modified bogus taste test (BTT) and to examine the interactive effects of environmental and social contexts on levels of 'alcohol' consumption.

Method

University students (Study 1 n = 38, Study 2 n = 80), recruited via opportunity sampling, completed a modified BTT under the pretence of assessing garnish preference for gin and tonic. All participants were tested alone or as part of an existing friendship group. In Study 1 participants were in a laboratory setting but were exposed to different contextual cues (alcohol-related or neutral) by way of posters displayed on the walls. In Study 2, participants assessed the drinks in either a pub or a library setting.

Results

In Study 1 participants tested in a group consumed significantly more when exposed to pub-related stimuli in contrast to those who were exposed to library-related stimuli. Participants who were alone and exposed to library-related cues consumed significantly more than those in a group and exposed to these cues. In Study 2, as in Study 1, participants tested in a group condition consumed significantly more of what they believed to be alcohol when in the pub compared to those who were tested in the library. Higher group consumption was also evident in the library condition, although the size of this difference was not as large as in the pub testing condition.

Conclusion

In the absence of any pharmacological effects of alcohol, social and environmental context have an interactive impact on shaping consumption.