Article

Differentiating the Contribution of Pharmacological from Alcohol Expectancy Effects to Changes in Subjective Response and Priming Over Successive Drinks

Authors:
To read the full-text of this research, you can request a copy directly from the authors.

Abstract

Background: Alcohol consumption can prime motivation to continue drinking and may contribute to excessive drinking. Most alcohol administration research assesses the effect of a single alcohol dose on outcome measures; however, this differs from typical drinking occasions in which several drinks are consumed over time. This research tracks priming measures (alcohol urge, latency to first sip, and consumption time) and subjective effects (intoxication, stimulation, and sedation) across consumption of 5 drinks, over a period of 2.5 hours. Alcohol, placebo, and no-alcohol (i.e., soft drink) conditions are compared with isolate the effects of alcohol expectancies and differentiate these from alcohol's pharmacological effects. Methods: Alcohol urge and subjective state were measured before and after an initial drink was consumed (preload: alcohol, placebo, or no-alcohol). Four additional drinking phases followed whereby participants had access to 2 drinks (alcohol/no-alcohol, or placebo/no-alcohol). Experimental priming (urge, latency to first sip, consumption time) and subjective effect (intoxication, stimulation, and sedation) outcomes were recorded after each drink. Results: The pattern of alcohol urge following placebo drinks differed compared with alcohol and no-alcohol consumption, Fs(1, 90) > 4.10, ps < 0.003. There was a linear decrease in urge in the no-alcohol condition, while in the alcohol condition urge increased after the first few drinks before decreasing. Urge ratings showed the opposite pattern in the placebo condition (a decrease followed by an increase). Alcohol produced the highest ratings of lightheadedness, F(5, 440) = 2.8, p < 0.02, but both alcohol and placebo produced increased sedated feelings, Fs ≥ 19.05, ps ≤ 0.001. After placebo, urge was positively related to liking and enjoying the "alcoholic" drinks and feeling more stimulated (rs ≥ 0.31, ps ≤ 0.01). Conclusions: In social drinkers, different factors may affect priming during different stages of a drinking episode. For example, the pharmacological effects of alcohol appear involved in priming during the initial stages of drinking. When alcohol expectancies are activated, blocking access to alcohol can increase urge, supporting Tiffany's cognitive processing model of craving.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

... Furthermore, although the placebo-alcohol increased subjective feelings of lightheadedness supporting previous research (e.g. Rose et al. 2013), there was no difference in beer consumption following the placebo-alcohol and control as predicted. Nevertheless, this replicates the findings of Christiansen et al. (2012) and implies that the pharmacological effects (not the anticipated effects) of alcohol are key to the priming effect on subsequent motivation to consume alcohol. ...
... Although contradictory to our hypothesis and previous findings (e.g. Christiansen et al. 2012;Fatseas et al. 2015;Field and Jones 2017;Rose et al. 2013), this suggests that alcohol seeking can increase without an accompanied increase in self-reported craving, which has also been reported in previous studies (e.g. Wiers et al. 2010; see also Tiffany 1990; Wiers et al. 2007). ...
Article
Full-text available
Rationale Alcohol intoxication and alcohol cue exposure impair ‘reactive’ inhibitory control and increase motivation to drink. However, inhibitory control is a multi-component process that also comprises signal detection and proactive control. It is unknown whether intoxication and cue exposure selectively influence these subprocesses in heavy drinkers. Objectives In two pre-registered studies, we investigated whether exposure to alcohol-related cues (study 1) and alcohol priming (study 2) impair each of these subprocesses of inhibitory control and increase motivation to drink. Methods In study 1, 64 heavy drinkers completed a modified stop-signal task in an alcohol context (with embedded alcohol cues) and a neutral context (with embedded neutral cues) followed by a subjective measure of craving and a bogus taste test to measure ad libitum alcohol consumption. In study 2, 36 heavy drinkers consumed an alcoholic beverage (0.6 g/kg body weight), an alcohol-placebo beverage, and water on a within-subjects basis, followed by the modified stop-signal task and a bogus taste test. Results In study 1, alcohol cue exposure did not impair inhibitory control subprocesses. Reactive control was unexpectedly better following alcohol cue exposure (compared to neutral cue exposure). However, craving and ad libitum consumption increased as expected. In study 2, reactive control was significantly impaired following the alcohol and control primes, relative to the placebo, but there was no effect on proactive slowing or signal detection. As expected, intoxication increased motivation to drink and ad libitum consumption (compared to placebo and control). Conclusions Alcohol intoxication and cue exposure increase motivation to drink in the absence of impairments in subcomponents of inhibitory control.
... However, ad-lib consumption was assessed after an hour-long battery of cognitive tasks, by which time when the placebo effect had dissipated. Rose et al. (2013) attempted to disentangle the anticipated from pharmacological effects of alcohol on alcohol craving and found that craving was increased (compared to a control drink) by both alcohol and placebo; however, the increase following alcohol was immediate and then dissipated, whereas it followed the opposite pattern after the placebo. One other study (Leeman et al. 2009) demonstrated that levels of craving following a placebo (but not alcohol) predicted ad-lib consumption. ...
Article
Full-text available
Rationale: Acute 'priming' doses of alcohol reliably increase alcohol-seeking behaviour in social drinkers. However, the effects of the anticipated (rather than pharmacological) effects of alcohol, and their interaction with contextual alcohol cues, are not well understood. Objectives: This study aims to determine the extent to which an alcohol-placebo drink increases craving, subjective intoxication and beer consumption, while conjointly investigating the impact of contextual alcohol cues. Methods: On a within-subject basis, 64 undergraduate social drinkers consumed both a placebo (which they believed to contain alcohol) and a control drink (which they knew did not contain alcohol) in different sessions. Participants completed the study procedures in a bar laboratory designed to look like a 'pub' or a standard psychology lab containing no alcohol-related cues. Craving (Desires for Alcohol Questionnaire) and subjective intoxication were measured pre- and post-drink, and a bogus taste test to measure ad-lib alcohol consumption was completed at the end of each session. Results: Compared to the control drink, placebo significantly increased craving, ad-lib consumption and subjective intoxication, regardless of environmental context. Conclusions: Increased craving and ad-lib alcohol consumption after consuming a priming dose of alcohol is at least partly attributable to the anticipated rather than the pharmacological effects of the priming dose.
... An alternative possibility involves our inclusion of a placebo group. Previous work has shown that alcohol priming measures differ depending on whether real or placebo alcohol has been consumed (Rose et al. 2013). It is possible that the lack of a pharmacological alcohol effect when alcohol was expected may have somehow disrupted BART performance, resulting in the discrepancies observed between our data and others, and this is something for future research to determine. ...
Article
Full-text available
Hazardous drinking has been associated with risk taking and alcohol priming effects. However, the potential relationship between risk taking and priming has not been investigated. The Balloon Analogue Risk Task (BART) is a behavioural measure of risk taking which appears to be associated with drinking behaviour. However, alcohol's acute effects on BART performance are not clear, and the potentially mediating effect of alcohol-induced risk taking on priming has not been tested. To assess the effects of a priming dose of alcohol on BART performance; to determine the predictive utility of the BART on drinking habits; and to identify whether alcohol-induced risk taking mediates alcohol priming (urge to drink). A total of 142 participants provided data on drinking habits and trait-like impulsivity and sensation seeking. The BART was then completed after consuming alcohol (0.6 g/kg) or placebo (between-subjects design). Baseline and post-drink measures of alcohol urge were also taken. Alcohol consumption increased urge to drink (priming) and risk taking on the BART. In the alcohol group only, risk taking on the BART predicted unique variance in weekly alcohol consumption and bingeing. Mediation analysis showed that risk taking following alcohol consumption mediated alcohol priming. This is the first study to show that alcohol acutely increases risk taking on the BART. Results suggest that social drinkers susceptible to alcohol-induced risk taking may be more likely to drink excessively, perhaps due to increased urge to drink (priming).
Article
Background The pharmacological effects of alcohol on executive function, craving and subsequent alcohol-seeking have been well documented. Yet, insufficient methodological controls within existing alcohol administration paradigms have meant that the relative importance of alcohol’s pharmacological and anticipatory effects remains in need of further elucidation. Aim The objective of this study is to disentangle alcohol’s pharmacological effects from its anticipatory effects on alcohol-related cognitions and subsequent consumption. Methods Inhibitory control, attentional bias and craving were assessed pre- and post-consumption in 100 participants who were randomly allocated to one of four beverage conditions in a two by two design: (1) alcohol aware (alcohol with participant knowledge (pharmacological/anticipation effects)), (2) alcohol blind (alcohol without participant knowledge; in a novel grain alcohol masking condition (pharmacological/no anticipation effects)), (3) placebo (no alcohol but participants were deceived (anticipation/non-pharmacological effects)) and (4) pure control (no alcohol with participant knowledge (no anticipation/non-pharmacological effects)). Results Findings suggest that the pharmacological effects of alcohol result in greater inhibitory control impairments compared with anticipated effects. Anticipatory but not the pharmacological effects of alcohol were found to increase attentional bias. Both pharmacology and anticipation resulted in increased craving, though higher levels of craving were observed due to alcohol’s pharmacology. Furthermore, alcohol pharmacology resulted in heightened ad libitum consumption; however, anticipation did not. Changes in craving partially mediated the relationship between initial intoxication and subsequent drinking, while inhibitory control impairments did not. Conclusions Successive alcohol consumption appears driven primarily by the pharmacological effects of alcohol which are exerted via changes in craving.
Article
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.
Article
Background: Positive alcohol expectancy (AE) contributes to excessive drinking. Many imaging studies have examined cerebral responses to alcohol cues and how these regional processes related to problem drinking. However, it remains unclear how AE relates to cue response and whether AE mediates the relationship between cue response and problem drinking. Methods: A total of 61 nondependent drinkers were assessed with the Alcohol Expectancy Questionnaire and Alcohol Use Disorder Identification Test and underwent functional magnetic resonance imaging while exposed to alcohol and neutral cues. Imaging data were processed and analyzed with published routines, and mediation analyses were conducted to examine the interrelationships among global positive score of the Alcohol Expectancy Questionnaire, Alcohol Use Disorder Identification Test score, and regional responses to alcohol versus neutral cues. Results: Alcohol as compared with neutral cues engaged the occipital, retrosplenial, and medial orbitofrontal cortex as well as the left caudate head and red nucleus. The bilateral thalamus showed a significant correlation in cue response and in left superior frontal cortical connectivity with global positive score in a linear regression. Mediation analyses showed that global positive score completely mediated the relationship between thalamic cue activity as well as superior frontal cortical connectivity and Alcohol Use Disorder Identification Test score. The alternative models that AE contributed to problem drinking and, in turn, thalamic cue activity and connectivity were not supported. Conclusions: The findings suggest an important role of the thalamic responses to alcohol cues in contributing to AE and at-risk drinking in nondependent drinkers. AEs may reflect a top-down modulation of the thalamic processing of alcohol cues, influencing the pattern of alcohol use.
Article
A considerable evidence base has demonstrated that priming doses of alcohol impair inhibitory control and activate motivation to consume alcohol. There is, however, a lack of studies investigating the effect of placebo-alcohol on these processes and their association with alcohol outcome expectancies (AOE). We investigated the effect of placebo-alcohol on craving and inhibitory control, and the extent to which placebo effects correlated with AOE in 32 nondependent drinkers. Participants completed questionnaires assessing typical alcohol use (fortnightly alcohol consumption, AUDIT) and AOE (measured using the Alcohol Outcome Expectancy Scale). On a within-subjects basis participants consumed a placebo-alcohol drink and control drink. Measures of craving were taken pre- and postdrink, and participants completed a go/no-go task following the drink. Craving was increased by the placebo-alcohol and, importantly, placebo-alcohol impaired inhibitory control. Furthermore expectancies of cognitive and behavioral impairment were correlated with go/no-go task performance following a placebo. Increases in craving were associated with a range of elevated outcome expectancies. This suggests that the anticipated effects of alcohol can impair inhibitory control and increase craving; therefore studies using placebo versus alcohol comparisons relative to studies using a pure no-alcohol control are underestimating the real-world effect of alcohol on these processes, which is a combination of pharmacological and anticipated effects of alcohol. Furthermore, individual differences in AOE may influence reactivity to the anticipated effects of alcohol. (PsycINFO Database Record
Article
Full-text available
We systematically reviewed randomized controlled trials of interventions to improve the health of people during imprisonment or in the year after release. We searched 14 biomedical and social science databases in 2014, and identified 95 studies. Most studies involved only men or a majority of men (70/83 studies in which gender was specified); only 16 studies focused on adolescents. Most studies were conducted in the United States (n = 57). The risk of bias for outcomes in almost all studies was unclear or high (n = 91). In 59 studies, interventions led to improved mental health, substance use, infectious diseases, or health service utilization outcomes; in 42 of these studies, outcomes were measured in the community after release. Improving the health of people who experience imprisonment requires knowledge generation and knowledge translation, including implementation of effective interventions. (Am J Public Health. Published online ahead of print February 25, 2015: e1-e21. doi:10.2105/AJPH.2014.302498).
Article
Full-text available
more than two decades ago, the timeline was developed as a procedure to aid recall of past drinking / that method, first referred to as the gathering of daily drinking disposition data and later labeled as the timeline follow-back (TLFB) method, is the focus of this chapter / TLFB appears to provide a relatively accurate portrayal of drinking and has both clinical and research utility administration of the TLFB technique / psychometric properties / test–retest reliability / subject-collateral comparisons / concurrent validity (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Full-text available
Drinking restraint, commonly measured by the Temptation and Restraint Inventory (TRI; Collins & Lapp, 1992), refers to a cycle of temptation to drink alcohol and attempts to control alcohol use that results in excessive consumption. Recent research has examined college drinkers using the TRI, however, it has been validated only in adult samples. This study validated the TRI in two samples of college drinkers, designated as “hazardous” (n= 480) and “harmful” (n= 231) drinkers. Using confirmatory factor analysis, the previously reported higher order two-factor structure was identified in both samples. In addition, multiple regression analyses using derived component scores demonstrated that TRI performance was associated with degree of alcohol dependence in both samples. These data support the use of the TRI in college samples.
Article
Full-text available
The current set of studies compared the psychometric properties of the original Comprehensive Effects of Alcohol Questionnaire (CEOA) to a 15-item version (B-CEOA) in a nonclinical undergraduate sample (N = 581), and attempted to replicate and extend the B-CEOA findings in an undergraduate sample referred to an alcohol intervention (N = 734). Psychometric assessment included construct validity, internal consistency, and concurrent validity, using both positive and negative expectancy items in all analyses. Results provided further support for the empirical validity of the original CEOA, and provided support for the use of the B-CEOA despite the reduction in the number of items. The B-CEOA factor structures obtained using exploratory and confirmatory techniques provided support for a 4-factor structure of expectancies and 3-factor structure of valuations. Findings reveal potential problems with positive and negative expectancy items. Trade-offs regarding factor structure, internal consistency, and administration time should be considered in using the B-CEOA vs. the CEOA.
Article
Full-text available
Dual-process theories of learning and addiction propose that whereas freely elected drug/reward-seeking is goal-directed in being mediated by the expected value of the outcome, cue-elicited drug/reward-seeking is habitual in being elicited directly by antecedent stimuli, without retrieving a representation of outcome value. To substantiate this claim, the current study conducted a human devaluation-transfer procedure in which young adult smokers were first trained on a concurrent choice task to earn tobacco and chocolate points before one outcome was devalued by specific satiety or health warnings against consumption of that outcome. When choice was again tested in extinction, the selective reduction in performance of the action associated with the devalued outcome indicated that choice was controlled by an expectation of outcome value, that is, was goal-directed. Moreover, the presentation of tobacco and chocolate cues enhanced selection of the response associated with that outcome, indicating that transfer was also mediated by the retrieval of the outcome representation. Paradoxically, however, the magnitude of this transfer effect was unaffected by devaluation, indicating that the stimulus retrieved a representation of outcome identity but not current incentive value. Individual differences in tobacco dependence in the young adult sample were associated with tobacco preference in the concurrent choice task but not with the devaluation or transfer effects. These data accord with dual-process theories in suggesting that drug/reward-seeking are mediated by goal-directed and habitual controllers under freely elected and cued conditions, respectively, and that initial uptake of drug use is associated with hyper-valuation of the drug as an outcome of goal-directed drug-seeking rather than with accelerated habit formation.
Article
Full-text available
Contemporary urge models assume that urges are necessary but not sufficient for the production of drug use in ongoing addicts, are responsible for the initiation of relapse in abstinent addicts, and can be indexed across 3 classes of behavior: verbal report, overt behavior, and somatovisceral response. A review of available data does not provide strong support for these assumptions. An alternative cognitive model of drug use and drug urges is proposed that hypothesizes that drug use in the addict is controlled by automatized action schemata. Urges are conceptualized as responses supported by nonautomatic cognitive processes activated in parallel with drug-use action schemata either in support of the schema or in support of attempts to block the execution of the schema. The implications of this model for the assessment of urge responding and drug-use behavior are presented.
Article
Full-text available
Individual differences in subjective alcohol effects have been shown to differ by risk status (e.g., family history of alcoholism) and to predict future risk for alcohol-related problems. Presumably, individual differences in both stimulant and sedative responses affect the rewarding value of drinking which, in turn, impacts future drinking behavior. Although plausible, this theoretical model is largely untested. The current study attempted to provide experimental evidence for the impact of subjective alcohol responses on within session drinking behavior. Using a placebo-controlled between-subjects alcohol administration paradigm, experiences and evaluations of stimulant and sedative alcohol effects (after a target dose of 0.06 g%) were assessed as predictors of ad-libitum consumption in the context of anticipatory stress. Analyses indicated that an initial dose of alcohol increased experiences of both stimulation and sedation although stimulant effects were evaluated much more positively. In addition, stimulant effects after a priming dose predicted further consumption, whereas sedative effects did not. At least among moderate to heavy drinking college students, stimulant alcohol effects are more reinforcing and predict within session drinking behavior under social stress. Increased attention should be given to stimulant alcohol effects as a risk factor for excessive consumption in this population. Incorporating information about stimulant alcohol effects in prevention and intervention programs may also be important if additional research supports the current results.
Article
A comprehensive measure of alcohol outcome expectancies was developed through the use of exploratory and confirmatory factor analyses. The questionnaire assesses both positive and negative expected effects of alcohol as well as the subjective evaluation of those effects. The measure was found to demonstrate adequate internal consistency, temporal stability, and construct validity. Criterion validity was demonstrated through structural regression analyses of the independent and combined influences of outcome expectancies and subjective evaluation on 3 measures of alcohol use. Information on Ss' dose-related expectancies provided further validation of the expectancy construct and yielded information about the effects people associate with drinking different amounts of alcohol. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Social-learning models of drug motivation and relapse often include the constructs of affect and drug expectancies. Most research has taken a molar approach to examining relations between these constructs and level of drug use. An experiment examined the roles of affect and expectancies in multiple measures of situation-specific motivation to smoke tobacco. Undergraduate smokers ( n = 101) received either a positive or negative mood manipulation (false feedback on an intelligence test). Self-reported urge was influenced by both negative affect and expectancies for positive reinforcement from smoking. Actual consumption was related only to smoking expectancies and only among abstaining smokers. affect by expectancy interactions were also found. Findings support a limited role of affect and expectancies in smoking motivation. Poor coherence among the motivational indexes challenges the assumptions of existing models of drug motivation. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Ethanol (ETOH) preference was measured following ETOH preload doses in normal social drinkers. 11 Ss participated in a 5-session, double-blind choice study. In Session 1, Ss sampled an ETOH beverage (0.8 g/kg). In Sessions 2–5, they consumed a preload beverage containing placebo or ETOH (0.25 or 0.5 g/kg). One hour later, they responded on 2 concurrent random-ratio (RR) schedules. One schedule was associated with ETOH as the reinforcer and the other with money. When the probability of earning money was low, Ss responded more on the ETOH schedule following both ETOH preloads compared with placebo. Consistent with the increased responding for ETOH, Ss reported increased desire for ETOH. These data demonstrate a priming effect of ETOH preloads in normal social drinkers. They also illustrate the use of concurrent RR schedules to quantify ETOH preference. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
The objective of this study was to compare alcohol urge, drinking behaviour and mood across two beverage conditions (alcohol/soft drink), over multiple drinks. Forty-five (22 men) participants completed two conditions (alcohol/soft-drink). Baseline alcohol urge and mood was measured before an initial drink consumed (0.2 g/kg alcohol or lemonade). Four drinking phases, which provided alcohol and lemonade, followed. Alcohol urge, mood and liking/enjoyment of beverages were measured. Participants' typical drinking habits were recorded, allowing comparisons across drinking factors. Alcohol urge was greater in the alcohol condition (P<0.03), which positively correlated with liking and drinking enjoyment of the alcohol beverage (P<0.04). Binge drinking and weekly alcohol consumption positively related to alcohol urge during the first half of the alcohol condition (P<0.02). Feeling stimulated was positively related to alcohol urge (P<0.01). Sip latency was quickest for alcohol in the alcohol condition (P<0.001) and did not increase over time as in the soft-drink condition (P<0.001). This study presents a paradigm in which alcohol motivation can be assessed within more typical drinking occasion parameters. Urge related to alcohol's positive reinforcing effects. As more alcohol was consumed, a disassociation of liking and wanting alcohol occurred, indicating that different processes may underlie behaviour during different periods of a drinking occasion.
Article
Although drinking urges and cravings are commonly reported by alcoholics, prospective studies have found inconsistent associations between such urges and drinking relapses. Previous studies have measured drinking urges by use of single-item ratings of alcohol craving or other measures of unknown reliability and validity. To permit improved evaluation of hypotheses regarding alcohol craving, a 49-item questionnaire that reflects several urge-related domains was developed and pretested. Items assessed subjects'desire for a drink, expectations of positive effects following drinking, relief of withdrawal and negative affect following drinking, and intention to drink. Exploratory and confirmatory factor analyses of the responses of 351 abstinent, treatment-seeking alcoholics indicated that alcohol urges are best described by a single factor. Based on these analyses, an internally consistent, reliable, and psychometrically valid 8-item scale, the Alcohol Urge Questionnaire (AUQ), was developed. Data indicated that AUQ scores were strongly related to alcohol dependence severity and to cognitive preoccupation with alcohol, and that they declined with prolonged abstinence. The AUQ may be useful in alcoholism treatment research and in laboratory studies of reactivity to alcohol or other manipulations.
Article
The concepts of loss of control and craving are reviewed and relevant experimental findings are discussed. Speed of drinking is proposed as a behavioural measure of craving and an experiment is described to test the hypothesis that craving is primed by a moderate dose of alcohol (45 gm). The hypothesis was confirmed, but only for the severely dependent alcoholics. The results indicated that the behavioural measure of craving and the assessment of severity of dependence were crucial. Failure to measure either of them would have resulted in failure to identify a priming effect.
Article
Tiffany's (1990) cognitive processing model postulates that craving will only occur when access to alcohol is blocked. To test a hypothesis based on this model, we analyzed data from a naturalistic laboratory alcohol challenge study involving moderate-to-heavy drinking young adults (N = 174) with a focus on the placebo beverage condition of this study. Our hypothesis was that self-reports of "wanting more alcohol" (i.e., craving) in the lab, following placebo, would predict subsequent ad libitum consumption because placebo administration would constitute partial blocking of access to alcohol. We also tested the possibility that craving might mediate associations between personality traits and ad libitum consumption. Both trait disinhibition and reports of craving following the placebo beverage significantly predicted ad libitum consumption. Further, craving partially mediated the association between trait disinhibition and ad libitum consumption. Potential implications of these findings are discussed.
Article
In the present study, the measurement of drinking restraint was broadened by developing new items that better characterized its cognitive nature as well as by testing a factor structure which represents restraint as including both the regulation and the failure to regulate alcohol intake. A previously observed (Collins, George & Lapp, 1989) three-component structure of the Restrained Drinking Scale (RDS; Ruderman & McKirnan, 1984) was confirmed. In addition, two factors were extracted from the new set of cognitive items, which when combined with the RDS clusters formed a new measure of drinking restraint, the Temptation and Restraint Inventory (TRI). The factor structure of the TRI matched the conceptualization of drinking restraint as involving successful and unsuccessful regulation of alcohol intake, and differentially predicted self-reported weekly consumption and alcohol-related problems.
Article
Thirty male subjects, 10 severely and 10 moderately alcohol dependent, along with 10 non-dependent controls, were studied in four experimental drinking conditions. Each subject participated in each condition. All subjects received a priming dose of 2 ml 40% vodka/kg or placebo, and a drinking test of 1 ml 40% vodka/kg 45 minutes later. Subjects were told that the priming dose contained ‘alcohol’ in two conditions and ‘soft drinks’ in the two other conditions of the Balanced placebo design. Self-reported desire for a drink and experienced effects from alcohol were more influenced by instructions than by the actual presence of alcohol, although a peak BAG of 0.11% were reached if all available alcohol were consumed (not all subjects did so). Severely dependent subjects demonstrated more craning than the other groups, this difference was observed in the presence of information about alcohol, regardless of whether alcohol was present or not. No differences in speed of drinking were found. The severely dependent subjects showed a higher general arousal than moderately and non-dependent subjects in this experimental setting, as measured by skin conductance level, and they displayed a higher skin conductance response to the instruction that alcohol was to be given. Severely dependent subjects showed a hypothermic response to alcohol. The results confirm our previous findings that expectations of alcohol exerts greater influence on craving than pharmacological effects of alcohol, but the severely dependent subjects are reacting more strongly to alcohol cues than less dependent alcoholics. In addition, the experiment demonstrates that psychophysiological responses are elicited by alcohol cues, and supports a classical conditioning model of alcohol dependence.
Article
Examined the alcohol expectancies of 321 17–40 yr old undergraduates as a function of Ss' drinking patterns and Ss' expectancies to demographic/background variables for their ability to predict problematic and nonproblematic drinking patterns. Ss completed a demographic data sheet, alcohol expectancy questionnaire, and customary drinking record. Factor analysis of Ss' self-reported drinking yielded 3 drinking styles: nonproblematic social drinking, frequent drinking with alcohol-related problems, and contextually determined alcohol consumption. Optimal alcohol expectancy and demographic/background predictors of each drinking style were selected and compared via multiple regression procedures. Predictor equation efficiency was then examined in a new cross-validation sample of 176 Ss. Results indicate that alcohol expectancies increased the predictability of college drinking patterns and that alcohol expectancies were differentially related to problematic and nonproblematic features of college drinking. (12 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
Presented 2 groups of 32 male 23-65 yr old nonabstinent alcoholics and social drinkers with an ad-lib supply of either alcoholic or nonalcoholic beverages in a taste-rating task. Ss were assigned to 1 of 2 instructional set conditions in which they were led to expect that the beverage to be rated contained alcohol (vodka and tonic) or consisted only of tonic. The actual beverage administered consisted of either vodka and tonic or tonic only. Results show that instructional set is a significant determinant of the amount of beverage consumed and posttask estimates of the alcoholic content of the drinks. The actual beverage administered did not significantly affect the drinking rates of either alcoholics or social drinkers. Loss-of-control drinking, in the form of increased consumption by alcoholics who were administered alcohol, did not occur during the drinking task. Results are discussed in terms of implications for treatment and for the conception of alcoholism as a disease.
Article
Twenty hospitalized alcoholics served as their own controls in a study which sought to compare psychophysiological and cognitive factors as mediating influences on the priming effect of alcohol. Ten subjects were independently assessed by a psychiatrist as being severely dependent on alcohol and ten as mildly or moderately alcohol dependent. Physiological, behavioural and subjective indices of the motivation to drink alcohol were employed 15 and 60 min after subjects had consumed beverages on four separate occasions corresponding to four priming conditions. These priming drinks contained either 60 ml vodka in heavy dilution or just tonic water, and in each of these conditions subjects were either led to believe that the beverages contained alcohol or they had no alcohol. The severely-dependent group displayed a degree of concordance between the indices of motivation to drink, and the levels of these tended to be significantly higher than in the less-dependent subjects. The results suggest that severely alcohol-dependent subjects were more disposed to drink 60 min after consuming alcoholic drinks than after soft drinks, regardless of whether they believed that the priming drinks had contained alcohol. Cognitive factors assumed greater importance for the drinking behaviour of less-dependent subjects, although there was evidence of discordance across behavioural, physiological and subjective measures for this group.
Article
Although drinking urges and cravings are commonly reported by alcoholics, prospective studies have found inconsistent associations between such urges and drinking relapses. Previous studies have measured drinking urges by use of single-item ratings of alcohol craving or other measures of unknown reliability and validity. To permit improved evaluation of hypotheses regarding alcohol craving, a 49-item questionnaire that reflects several urge-related domains was developed and pretested. Items assessed subjects' desire for a drink, expectations of positive effects following drinking, relief of withdrawal and negative affect following drinking, and intention to drink. Exploratory and confirmatory factor analyses of the responses of 351 abstinent, treatment-seeking alcoholics indicated that alcohol urges are best described by a single factor. Based on these analyses, an internally consistent, reliable, and psychometrically valid 8-item scale, the Alcohol Urge Questionnaire (AUQ), was developed. Data indicated that AUQ scores were strongly related to alcohol dependence severity and to cognitive preoccupation with alcohol, and that they declined with prolonged abstinence. The AUQ may be useful in alcoholism treatment research and in laboratory studies of reactivity to alcohol or other manipulations.
Article
Results from a study using the balanced placebo design to assess alcohol's effects on anxiety raise serious doubts about the utility of the design even at moderate blood alcohol concentrations. Despite being informed that they were not drinking alcohol, 44% of the subjects who were administered alcohol reported consuming at least some alcohol. Moreover, subjects' scores on the Marlowe-Crowne Social Desirability Index (MCSD) were associated with deception success, suggesting that individual differences in reporting bias influence the manipulation. In contrast, only 6% of subjects who were told that they had consumed alcohol but were given tonic water were not deceived. Among subjects in this placebo condition, scores on the MCSD were not associated with success of the deception. These data suggest that at a moderate dose of alcohol, drink deception in the antiplacebo condition is much more difficult to execute than in the placebo condition, and that deception in the former condition may be confounded with experimenter demand.
Article
Alcohol produces stimulant and sedative effects, and both types of effect are thought to influence drinking practices. This article describes the development and preliminary validation of the Biphasic Alcohol Effects Scale (BAES), a self-report, unipolar adjective rating scale designed to measure both stimulant and sedative effects of alcohol. An initial pool of 12 stimulant and 12 sedative items was derived from previous alcohol effect measures, and from descriptors of intoxication generated by subjects during interviews conducted on both the ascending and descending limbs of the blood alcohol curve. This item pool was administered to a sample of sober college students twice, with a 2-week inter-test interval. Items that were difficult to comprehend, or that had high ratings or low test-retest reliability, were eliminated, resulting in a seven-item stimulant subscale and a seven-item sedative subscale. These subscales showed high internal consistency in a sober state, which was not improved by additional item deletion. The data from this study also provided a basis for revising the instructions for the BAES. The new 14-item instrument was then given to 30 male and 12 female nonalcoholics on the ascending and descending limbs of the blood alcohol curve, after the administration of either 0.75 ml/kg alcohol (males) or 0.65 ml/kg alcohol (females). Internal consistency was high for both BAES subscales on both limbs of the blood alcohol curve (Cronbach's alpha = 0.85 to 0.94), and was not improved by additional item deletion. Factor analyses conducted on both limbs of the blood alcohol curve supported the proposed factor structure of the BAES.(ABSTRACT TRUNCATED AT 250 WORDS)
Article
Alcohol and illicit drug use are increasing among school children and young adults in the UK. Such increases have also been noted among university students and there is a need for a large survey across different universities and faculties. We report such a survey. Information about drinking, use of cannabis and other illicit drugs, other lifestyle variables, and subjective ratings of anxiety and depression was obtained by questionnaire in a cross-faculty sample of 3075 second-year university students (1610 men, 1447 women, 18 sex not stated) from ten UK universities. The questionnaire was personally administered during scheduled lecture hours and almost all the students participated. The sample reflected the interfaculty and sex distribution and the proportion of non-white students at UK universities. 11% of the students were non-drinkers. Among drinkers, 61% of the men and 48% of the women exceeded "sensible" limits of 14 units per week for women and 21 for men. Hazardous drinking (> or = 36 units per week for women, > or = 51 for men) was reported by 15% of the drinkers. Binge drinking was declared by 28% of drinkers. 60% of the men and 55% of the women reported having used cannabis once or twice and 20% of the sample reported regular cannabis use (weekly or more often). Experience with other illicit drugs was reported by 33% of the sample, most commonly LSD (lysergic acid diethylamide), amphetamines, Ecstasy (methylenedioxymethamphetamine), and amyl/butyl nitrate which had each been used by 13-18% of students. 34% of these had used several drugs. Drug use had started at school in 46% of the sample; 13% began after entering university. The overwhelming reason given for taking alcohol or drugs was pleasure. Subjective ratings of anxiety on the hospital anxiety depression scale were high, and sleep difficulties were common, but neither related to alcohol or drug use. There is a need for better education about alcohol, drugs, and general health in universities. Such education should include all faculties. It remains unclear whether university students' lifestyles are carried over into later life.
Article
Discriminative stimulus properties of low doses of ethanol were evaluated in humans using established behavioural drug discrimination procedures. Twenty-five moderate drinkers (12 females and 13 males) were trained to discriminate placebo from 0.2 g/kg ethanol in 200 ml tonic water mixed with Tabasco sauce and drunk in portions of 50 ml every 15 s. Seventeen of the subjects (ten females and seven males) were able to reach criterion performance (at least 80% correct responses). Generalisation responding across ethanol doses of 0 (placebo), 0.025, 0.05, 0.1 and 0.2 g/kg was examined the day after training using a procedure in which subjects reported the extent to which the test stimulus resembled the training dose. At the end of each generalisation session, self ratings of mood changes, physiological responses and performance in a working memory and a time estimation task were evaluated. Subjects were able to distinguish the three higher doses of ethanol from placebo. Self ratings indicated that subjects' ability to distinguish ethanol from placebo was related, at the highest dose, to change of taste, but to feelings of light-headedness at the lower doses. Ethanol administration influenced skin conductance measurements but there was no relationship found between changes in skin conductance and the ethanol discriminative stimulus. These data suggest a difference in the nature of the discriminative stimulus of ethanol between high (training) and low (generalising) doses as indicated in the subjective reports.
Article
Research is reviewed on the association between alcohol outcome expectancies and consumption which has led many to argue that manipulating expectancies might be a route to manipulating consumption for problem prevention and treatment. Studies indirectly and directly evaluating this latter position are reviewed. Expectancies predicting treatment outcome: two studies have shown that the more positive expectancies held at treatment, the poorer is treatment outcome, but five other studies have failed to find this. Three related studies have shown that the more negative expectancies held at treatment, the better the treatment outcome. This evaluation provides evidence inconsistent with the main position for positive expectancy and limited support for negative. Expectancy manipulations and ad libitum consumption: three studies in the laboratory have shown that increasing positive expectancies through word priming increases subsequent consumption and two studies have shown that increasing negative expectancies decreases it. A single study in the field showed a similar relationship. This evaluation provides evidence consistent with the main position but is limited by measuring consumption changes over only 1-2 hours. Prevention programmes with expectancy components: seven projects are reviewed in which positive expectancies were targeted, but only two report an expectancy change analysis and in both cases the expectancy change did not relate to subsequent consumption. This evaluation provides evidence inconsistent with the main position. Expectancy challenge: two related studies are reviewed in which positive expectancy challenges reduce subsequent consumption but changes in expectancy were not evaluated as predictors of consumption change. Two studies are reviewed which found a reduction in positive expectancy following expectancy challenge but no reduction in consumption. One study is reviewed in which when negative expectancy was increased in treatment there was a better treatment outcome at 3 months follow-up than when it was not. This evaluation provides evidence inconsistent with the main position for positive expectancy and limited consistent evidence for negative. It is concluded that the research has still to be done that securely links expectancy manipulations with subsequent changes in consumption, and fulfils the early promise from association studies.
Article
This study showed that normal social drinkers were more likely to consume ethanol after receiving a "priming" (preload) dose of ethanol. Twenty-eight non-problem drinkers (average consumption 9 drinks/week) participated in a six-session, double-blind choice procedure. On the first two sessions they sampled beverages containing ethanol (0.8g/kg) or placebo (mix alone), between which they would choose on subsequent choice sessions. On the third session ("dummy" choice session) subjects were first asked to indicate verbally which beverage they preferred. If they chose the ethanol-containing beverage the experimenter negotiated with each subject to determine the minimum amount of money (from $1 to $30) needed to switch his or her choice from ethanol to placebo. Once this amount was determined it remained fixed for the subsequent three preload/choice sessions. Thus, on choice sessions subjects chose between the beverage which contained ethanol, and placebo plus the amount of money established in Session 3. On the preload/choice test sessions (Sessions 4-6) subjects received preloads of ethanol (0, 0.25 or 0.5g/kg) 1h before being given the choice between the sampled ethanol beverage and the placebo beverage plus money. The frequency of ethanol choice was the primary dependent variable. Subjective drug effects, including ratings of desire for the sampled substances, were also measured. Twenty subjects initially chose ethanol on Session 3 and switched their choice with a monetary incentive. Of these 20 subjects, four chose ethanol after the placebo preload, seven chose ethanol after the low-dose ethanol preload, and 11 chose ethanol after the higher ethanol preload (significant linear trend, Mantel-Haenszel test, p < 0.03). Ratings of desire for the ethanol-containing beverage increased after the higher preload. These results suggest that ingestion of a moderate dose of ethanol increases the tendency to continue drinking, even among normal social drinkers.
Article
This research examined alcohol-induced motivation to drink as a factor that contributes to preoccupation with drinking. Forty undergraduates rated their degree of preoccupation with drinking. The author determined the relationship between the undergraduates' preoccupation and the degree to which alcohol primed their motivation to drink by having them rate their desire for alcohol after they consumed a dose of alcohol or a placebo. Results showed that individual differences in preoccupation were predicted by the priming effects displayed after alcohol was consumed. More preoccupied individuals reported greater priming effects. Priming effects following placebo were minimal and were not related to preoccupation. The research shows that reinforcing effects of alcohol may contribute to cognitive preoccupation with drinking and promote patterns of alcohol abuse.
Article
Most studies of risk factors for alcohol-related problems have focused on biological family history as a primary risk factor. However, other factors, such as early-age heavy drinking, are also risk factors for sustained or progressive heavy consumption. Little is currently known about the mechanisms underlying binge or heavy drinking. This study examined the acute subjective and objective effects of ethanol in heavy drinkers versus light drinkers. Thirty-four subjects participated in this within-subjects study consisting of three early-evening testing sessions in which subjects consumed a beverage containing either 0.8 or 0.4 g/kg ethanol or placebo. Compared with lighter drinkers, heavy drinkers were more sensitive to the positive stimulant-like effects of ethanol (p < 0.05), especially during the increasing limb of the blood alcohol curve. Heavy drinkers also showed less sedation and cortisol response after alcohol than the light drinkers (p < 0.05). The results indicate that young adult binge drinkers show a biphasic alcohol response, with heightened sensitivity to stimulant-like alcohol effects and greater tolerance to sedative alcohol effects compared with their light-drinking counterparts.
Article
Two key aspects of alcohol expectancy theory--(a) that memories about alcohol effects are stored as relatively cohesive templates of information and (b) that these templates are automatically activated in alcohol-related contexts--were tested using the Deese-Roediger- McDermott false memory paradigm. Alcohol expectancy adjectives were studied, and false memory for expectancy target words was tested in neutral and alcohol contexts. Results indicated that in the alcohol context heavier drinkers showed more false memory for alcohol expectancy words than they did in a neutral context. Differences were not found for lighter drinkers. These results were consistent with alcohol expectancy theory, which was then compared with various forms of association theory in explaining these results and larger issues in the addiction field.
Article
The Alcohol Use Disorders Identification Test (AUDIT) was examined by employing confirmatory factor analytic techniques to data from two samples collected 1998-1999: college students (n = 465) and court-referred, substance use treatment outpatients (clinical sample; n = 135). Despite the fact that the AUDIT was originally designed as a three-factor measure (consumption, dependence, and consequences), previous studies have lent support to one- and two-factor models. The results of this study support a two-factor model (alcohol consumption and dependence/consequences) in both samples. As further evidence that the two-factor model is appropriate, a psychometric evaluation suggested that the AUDIT generated reliable scores in both groups when used as either a one- or two-factor measure, but not when three scores are derived in the student sample.
Article
Research with non-Latinos has shown that alcohol expectancies ("the anticipated effects of alcohol use") are associated with drinking behaviors; however, prior studies have not fully examined such relations in Latino college students. This investigation examines positive alcohol expectancies and their association with contextual drinking and alcohol-related problem behaviors in a sample of 107 Mexican American college students (mean age=25; 54% female) who completed self-report surveys. Results showed that students who endorsed expectancies of physical and social pleasure and increased social assertiveness were likely to engage in frequent heavy drinking and imbibe in less personal settings. Furthermore, gender (being male) and the expectancy of enhanced sexual performance and experience were associated with involvement in risk behaviors due to drinking. This study highlights the link between specific alcohol expectancies and alcohol-related problem behaviors in Mexican American college students. Intervention approaches aimed at modifying drinking expectancies in physical, social, and sexual domains could prove useful in this population.
Article
Perceived availability of a substance has been proposed to play a role in cue reactivity by both traditional classical conditioning models and S. T. Tiffany's (1990) cognitive processing model (CPM) of substance use. This study investigated the role of availability information on alcohol cue reactivity. Subjects were 134 heavy drinkers in a 2 x 2 between-subjects design, crossing cues (alcohol vs. neutral) and availability information (availability vs. unavailability). The results indicated significant main effects for cue type, with alcohol cues eliciting greater reactivity on multiple measures, and an interaction effect on the Alcohol Urge Questionnaire (M. J. Bohn, D. D. Krahn, & B. B. Staehler, 1995), such that exposure to alcohol cues in conjunction with unavailability information elicited a greater urge. This was largely a result of changes in self-reported craving and was interpreted as consistent with the CPM. Alternative methodologies and limitations are discussed.
Article
Interoceptive drug cues, through associations with the drug's reinforcing properties, may act as conditioned stimuli and elicit conditioned responses. For instance, a dose of alcohol, given to alcohol-experienced people, can lead to an enhancement of alcohol drinking, a phenomenon known as the priming effect. The present study aimed to investigate the alcohol priming effect in non-dependent social drinkers with respect to the dose of alcohol preload and the time of testing after preload. Fifteen social drinkers participated in five daily consecutive sessions. On days 1 and 2 (training sessions), participants consumed a 500 ml beverage of either 0.6 g/kg of alcohol or placebo (50 ml aliquots) presented in 10 colour-coded cups. During days 3, 4 and 5 (testing sessions), a preload of placebo, 0.3 or 0.6 g/kg of alcohol was given (in randomized sequence) in 10 opaque colourless cups. Thirty, 60 and 90 min following the preload, participants responded to an imagery script referring to the drinks sampled at training including a question on the number of aliquots participants would consume from each of the drinks if given the opportunity (hypothetical choice). Participants completed questionnaires evaluating mood and alcohol desires at baseline (before the beverages were given) and after the hypothetical choice. The hypothetical choice showed significant interactions between dose and time: the greatest number of alcohol aliquots were wanted 30 min following the 0.6 g/kg dose of alcohol preload. Ratings from the Desires for Alcohol Questionnaire also showed that alcohol desires peaked 30 min following the 0.6 g/kg of alcohol preload. These data support previous evidence that priming with alcohol can occur and indicate that dose of, and time after preload might affect the strength of, the priming effect for alcohol-related behaviours.
Article
The Alcohol Urge Questionnaire (AUQ) is a promising multi-item measure of self-reported urges to drink in human laboratory studies; however, its factor structure has not been examined during an acute urge state. This study sought to validate the AUQ's factor structure under neutral conditions and during a cue-elicited urge state in heavy drinkers. Participants (248 heavy drinkers; 70% male) completed the AUQ, the Alcohol Dependence Scale (ADS), and the Positive and Negative Affect Scale (PANAS) under neutral conditions. A randomly selected subsample (n=61; 74% male) then underwent a multimodal alcohol cue exposure and completed the AUQ and PANAS a second time. Under neutral conditions, confirmatory factor analysis (CFA) replicated the previously reported single-factor structure, on which all items significantly loaded (p<0.001). Alcohol urges, as measured by the AUQ, exhibited significant positive associations with drinks per week and severity of dependence. Following the alcohol cue exposure, participants exhibited a significant increase in urge on the AUQ. Confirmatory factor analysis of the AUQ during the cue-elicited urge state also supported the single factor structure, on which all items significantly loaded (p<0.001). Positive and negative affect were positively associated with urges across the experimental protocol, but at greater magnitudes during an acutely elevated urge state. These results further validate the use of the AUQ for real-time measurement of alcohol craving in human laboratory research.
Article
Evidence suggests that alcohol-related problems are associated with impulsivity and disinhibited behavior. Less certain is whether disinhibited behavior is due to an impulsive disposition or alcohol's ability to disinhibit some people more than others. There are a range of disinhibited behaviors associated with alcohol, including excessive alcohol consumption, bingeing. The study tested whether nondependent alcohol bingers showed more disinhibition after placebo and/or alcohol relative to nonbingers and whether this was related to enhanced motivation to drink following a priming dose of alcohol. Twenty participants (10 bingers) attended the laboratory twice. Baseline measures included impulsivity, alcohol-related cognitions, alcohol urge, and mood. Participants were preloaded with alcohol (male: 0.6 g/kg, female: 0.5 g/kg) and placebo (counterbalanced). After a 20-minute rest, participants completed 2 impulsivity tasks (Two Choice & Time Estimation) separated by second urge and mood ratings. Bingers did not show greater impulsivity characteristics but were more concerned about their drinking (p = 0.02) and ability to control drinking (p = 0.04). A priming effect was found: alcohol urge increased after alcohol but not placebo (p = 0.006). Bingers reported greater tolerance to the sedative (p = 0.05) and lightheaded (p = 0.04) effects of alcohol, relative to nonbingers. Binge status was not associated with impulsivity task performance, while preload type (alcohol/placebo) supported only marginal associations. Risk of binge drinking in nondependent individuals is not strongly affected by impulsive personality characteristics or alcohol's ability to induce behavioral disinhibition. However, alcohol did lead to a priming effect and bingers were more tolerant to the sedative and lightheaded effects of alcohol relative to placebo. Risk of binge drinking is associated with the subjective effects of a priming dose of alcohol.
Cognitive preoccupation with alcohol and binge drink-ingin college students: alcohol-induced priming of the motivationtodrink Comprehensive effects of alcohol: development and psychometric assessment of a new expectancy question-naire
  • Rose Fillmore
  • Al Rfromme K
  • E Stroot
  • Kaplan
Fillmore MT (2001) Cognitive preoccupation with alcohol and binge drink-ingin college students: alcohol-induced priming of the motivationtodrink. Psychol Addict Behav 15:325–332. 8 ROSE ET AL. rFromme K, Stroot E, Kaplan D (1993) Comprehensive effects of alcohol: development and psychometric assessment of a new expectancy question-naire. Psychol Assess 5:19–26
Statistic on Alcohol: England , 2012. The Information Centre for Health and Social Care
Health and Social Care Information Centre (2012) Statistic on Alcohol: England, 2012. The Information Centre for Health and Social Care, UK.
Biphasic alcohol response differs in heavy versus light drinkers
  • King
A review of expectancy theory and alcohol consumption
  • Jones