The human startle reflex and alcohol cue reactivity: Effects of early versus late abstinence.

This study investigated the human eyeblink startle reflex as a measure of alcohol cue reactivity. Alcohol-dependent participants early (n?=?36) and late (n?=?34) in abstinence received presentations of alcohol and water cues. Consistent with previous research, greater salivation and higher ratings of urge to drink occurred in response to the alcohol cues. Differential salivary and urge responding to alcohol versus water cues did not vary as a function of abstinence duration. Of special interest was the finding that startle response magnitudes were relatively elevated to alcohol cues, but only in individuals early in abstinence. Affective ratings of alcohol cues suggested that alcohol cues were perceived as aversive. Methodological and theoretical implications of the findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interactive effects of alcohol outcome expectancies and alcohol cues on nonconsumptive behavior.

Experimental research and popular belief suggest that, among its many effects, alcohol consumption reduces tension and facilitates aggression. Such observations could result from direct, pharmacological effects of alcohol on neural control of behavior but also may be accounted for by positing that drinking behavior activates mental representations of relaxation-related or aggression-related alcohol expectancies in long-term memory. Building on this latter view, in 2 experiments, the authors investigated whether rudimentary drinking-related cues, which presumably activate encoded alcohol expectancies, facilitate tension reduction and hostility in the complete absence of actual or placebo alcohol consumption. In Experiment 1, following contextual exposure to alcohol-related words, individuals with stronger expectancies that drinking reduces tension showed an increased willingness to meet with an opposite-gender stranger under relatively anxiety-provoking circumstances, suggesting that they experienced less apprehension regarding the meeting. Analogously, in Experiment 2, following near-subliminal exposure to alcohol-related words, individuals with stronger expectancies that drinking fosters aggression showed greater hostility toward a target person following an experimentally engineered provocation. Neither of the latter effects was obtained following exposure to nonalcoholic beverage words, which presumably did not activate alcohol outcome expectancy representations in long-term memory. Moreover, the strength of relevant, content-specific expectancies (i.e., for tension reduction or aggression, respectively) moderated alcohol cue exposure effects, but the strength of other expectancies (e.g., for sociability or sexual arousal) did not. Together, these findings demonstrate that exposure to rudimentary alcohol cues independently engenders expectancy-consistent behavior, thereby attesting to the remarkable breadth and subtlety of the behavioral impact of alcohol expectancy activation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Craving and physiological reactivity to trauma and alcohol cues in posttraumatic stress disorder and alcohol dependence.

The high comorbidity of posttraumatic stress disorder (PTSD) and alcohol dependence (AD) has been firmly established. Although laboratory studies have examined self-reported craving in response to trauma and alcohol cues, no studies have reported on alcohol-related physiological responding in response to trauma cues in PTSD-AD individuals. Using a cue reactivity paradigm, this study examined the impact of personalized trauma-image cues and in vivo alcohol cues on alcohol-related responding (e.g., salivation, craving) in individuals with PTSD and AD (n = 40). Participants displayed reactivity to both trauma and alcohol cues when compared to neutral cues, including increased self-reported craving and distress, as well as greater salivation. These findings suggest that through repeated pairings of trauma memories and alcohol consumption, salivation may become classically conditioned to trauma cues. Moreover, the fact that the trauma-alcohol cue combination elicited greater alcohol craving, salivary responding, distress, and arousal than either the trauma-neutral or neutral-alcohol cue combinations suggests that effects of the trauma and alcohol cues were additive in nature. Evidence that AD individuals with PTSD report increased alcohol craving and display greater salivation in response to trauma memories, supplements prior research indicating that PTSD-related negative emotion and trauma-related alcohol craving may play an important role in the maintenance of AD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol primes, expectancies, and the working self-concept.

Previous research has shown that alcohol consumption can lead to momentary changes in the self-concept (e.g., Steele & Josephs, 1990). In two studies (n = 150), we examined whether the implicit activation of alcohol expectancies (i.e., sociability-related expectancies) would also lead to changes in self-perception. To test this idea, participants first completed a measure of sociability-related alcohol expectancies. In a subsequent laboratory session, participants were exposed to either alcohol-related primes (i.e., pictures or words associated with alcohol) or neutral primes. After the priming task, participants completed an ostensibly unrelated self-concept survey that contained words related to sociability (e.g., “outgoing”) and nonsociability related words (e.g., “clever”). For both studies, results revealed that sociability-related alcohol expectancies were positively associated with sociability-related self-concept ratings for participants exposed to alcohol primes, but not for participants exposed to the neutral primes. Implications for the role implicit self-concept activation may have on drinking behaviors are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of a context shift and multiple context extinction on reactivity to alcohol cues.

Cue exposure treatment (CET) attempts to reduce the influence of conditioned substance cues on addictive behavior via extinction, but has received only modest empirical support in clinical trials. This may be because extinction learning appears to be context dependent and a change in context may result in a return of conditioned responding (i.e., renewal), although this has received only limited empirical examination. The current study used a 4-session laboratory analogue of CET to examine whether a change in context following 3 sessions of alcohol cue exposure with response prevention would result in renewal of conditioned responding. In addition, this study examined whether conducting extinction in multiple contexts would attenuate renewal of conditioned responding. In one-way between-subjects design, 73 heavy drinkers (71% men) were randomized to 3 conditions: (a) single context extinction (extinction to alcohol cues in the same context for 3 sessions followed by a context shift at the fourth session), (b) multiple context extinction (extinction to alcohol cues in different contexts each day for all 4 sessions), and (c) pseudoextinction control condition (exposure to neutral cues in the same context for 3 sessions followed by exposure to alcohol cues at the fourth session). The results revealed the predicted cue reactivity and extinction effects, but the hypotheses that a context shift would generate renewed cue reactivity and that multiple contexts would enhance extinction were not supported. Methodological aspects of the study and the need for parametric data on the context dependency of extinction to alcohol cues are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol outcome expectancies as socially shared and socialized beliefs.

Alcohol expectancies are important predictors of alcohol involvement in both adolescents and adults, yet little research has examined the social origins and transmission of these beliefs. This paper examined alcohol outcome expectancies collected in a cohort-sequential longitudinal study of 452 families with children followed over seven waves. Children completed interviews every 6 months, and parents completed interviews annually. Eighteen of 27 alcohol expectancies were highly consensual, being endorsed by significantly more than 67% of the mothers and fathers. These consensual expectancies were also highly stable over a 3-year period. Over the same period, children increased their adoption of both the positive and negative consensual alcohol expectancies. Unconditional latent growth modeling showed that piece-wise growth models with a transition at age 12 fit the data best. Both the positive and negative consensual expectancies were adopted at a faster rate between ages 8.5 and 11.5 than between ages 12 and 13.5. For negative expectancies, there was no further growth between ages 12 and 13.5. Taken together, these findings support the conceptualization of alcohol outcome expectancies as socially shared and transmitted beliefs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of alcohol sensitivity on P3 event-related potential reactivity to alcohol cues.

Although alcoholics and individuals at risk for alcoholism often show smaller amplitude of the P3 event-related brain potential (ERP), recent data (K. Namkoong, E. Lee, C. H. Lee, B. O. Lee, & S. K. An, 2004) indicate that alcohol-related cues elicit larger P3 amplitude in alcoholics than in controls. Little is known concerning the ERP profiles or alcohol cue reactivity of social drinkers at risk for alcoholism due to low sensitivity to alcohol's effects. Participants differing in alcohol sensitivity viewed images of alcoholic and nonalcoholic beverages while ERPs were recorded and provided information about their alcohol use patterns at baseline and 4 months later. Compared to high-sensitivity participants, those low in sensitivity showed larger P3s to alcohol cues, even when recent alcohol use was statistically controlled for. Moreover, the P3 elicited by alcohol cues predicted alcohol use at follow-up, a finding supporting the idea that P3 amplitude reflects the motivational significance of substance-related cues. These findings point to risk status, not consumption history, as an important predictor of cue reactivity effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attentional bias for smoking and affective stimuli: A Stroop task study.

Prior research has demonstrated attentional biases to smoking-related cues among smokers, and several lines of research suggest strong ties between smoking and negative affect. The authors tested attentional biases to both smoking and affective cues in 27 smokers using an emotional Stroop paradigm, and examined the relationship between these forms of attentional bias. Findings indicated significant attentional biases to smoking-related and negative-affect words, but not positive-affect words. In addition, there was a significant correlation between the degree of attentional bias to smoking and negative-affect words. These data provide evidence of a close association between smoking-related and affective cue processing from a cognitive perspective. Potential theoretical and clinical implications for these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of extinction context and retrieval cues on alcohol cue reactivity among nonalcoholic drinkers.

Pavlovian conditioning models have influenced the development of cue exposure treatments for drug abuse. However, poor maintenance of extinction performance (renewal) after treatment is a common problem. A treatment-analogue experiment tested the role of context in renewal, as well as a potential strategy for reducing renewal. Seventy-eight social drinkers completed extinction trials to reduce saliva and urge reactivity to alcohol cues and were randomly assigned to a renewal test in either the same context as extinction, a different context, or the different context containing a cue from the extinction context (E-cue). As predicted, the different context produced greater renewal than the same context and renewal was attenuated when the E-cue was present. These results offer preliminary evidence for the context dependence of extinction to alcohol cues and for the use of an extinction cue to improve the generalizability of exposure therapies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Specific cue reactivity on computer game-related cues in excessive gamers.

It has been posited that excessive computer game playing behavior, referred to as computer game addiction, meets criteria that have been internationally established to define drug addiction. Nevertheless, there have been no psychophysiological investigations of the underlying mechanisms available to support the characterization of excessive computer gaming as behavioral addiction. To investigate whether excessive computer gaming parallels learning processes in development and maintenance (which are assumed to underlie drug addiction), the authors obtained a psychophysiological assessment of the (learned) emotional processing of computer game-relevant and -irrelevant cues. For this purpose, electroencephalographic recordings in excessive and casual computer game players were conducted. Significant between-group differences in event-related potentials evoked by computer game related-cues were found at parietal regions and point to an increased emotional processing of these cues in excessive pathological players compared with casual players. These results are in concordance with the suggestion that addiction is characterized and maintained through sensitization of the mesolimbic dopaminergic system along with incentive salience of specific addiction-associated cues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Measuring alcohol expectancies with the implicit association test.

Researchers have relied primarily on self-report questionnaires to measure alcohol expectancies. These questionnaires assess explicit expectancies about alcohol but do not provide any measure of the implicit processes that might also play an important role in determining drinking. The implicit association test (IAT: A. G. Greenwald, D. E. McGhee, & L. K. Schwartz, 1998), a reaction time task, measures differential associations of 2 target concepts with an attribute. In this study, the IAT provided a measure of the strength of associations of alcohol concepts to positive or negative outcomes in memory. This implicit measure of alcohol expectancies successfully predicted alcohol use in 103 undergraduates. The findings also supported the hypothesis that an implicit measure of expectancy can add to the predictive power of existing questionnaire-based measures. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol use, expectancies, and sexual sensation seeking as correlates of HIV risk behavior in heterosexual young adults.

Most theoretical models of HIV risk behavior have not considered the role of personality factors, and few studies have examined mechanisms accounting for dispositional influences on sexual risk taking. This study elaborated on a conceptual model emphasizing sexual sensation seeking, alcohol expectancies, and drinking before sex as key predictors of HIV risk (S. C. Kalichman, L. Tannenbaum, & D. Nachimson, 1998). Multiple groups structural equation modeling was used to determine whether gender moderated relationships among these variables in a sample of 611 heterosexual, young adult drinkers (49% women, 76% Caucasian, mean age = 25 years). The model provided an excellent fit to the data, and gender differences were not substantiated. Sexual sensation seeking predicted HIV risk directly as well as indirectly via sex-related alcohol expectancies and drinking in sexual contexts. Findings suggest that expectancies and drinking before sex represent proximal mechanisms through which dispositional factors influence sexual risk outcomes. Moreover, these relationships appear to be similar in men and women. Interventions could benefit from targeting alcohol expectancies and drinking before sex in individuals with a dispositional tendency toward sexual risk taking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender, Alcohol Consumption, and Differing Alcohol Expectancy Dimensions in College Drinkers.

Examinations of gender differences in alcohol expectancies among college drinkers typically have used self-report measures to assess single expectancy dimensions and often have been confounded by drinking level. This study examined gender differences in alcohol expectancies using 2 assessment methods. College students (N = 88) completed self-report questionnaires, including expectancy likelihood and subjective evaluation endorsements of expectancies, and a computerized expectancy accessibility task. Expectancy accessibility and endorsement were modestly correlated, with higher alcohol consumption and female gender linked to greater accessibility and endorsement of social enhancement expectancies. Gender moderated the relation between consumption and sociability expectancy accessibility; among men, heavier drinking was associated with more rapid activation of expectancies. Findings suggest complexity in associations among these variables and underscore the need to capture the multidimensionality of the expectancy construct and its relationship to alcohol use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Negative affect combines with smoking outcome expectancies to predict smoking behavior over time.

The present study examined whether the tendency to experience negative affective states combines with smoking outcome expectancies to predict smoking behavior over time. Participants were 121 young adults and resource people recruited from 3 alcohol and drug treatment programs and through community advertisements. Each participant completed 3 interviews over a 4-year period. Results indicated that dispositional negative affect and positive smoking expectancies were significantly correlated with smoking behavior both within and across time. Expectations of positive and negative reinforcement partially mediated negative affect's relation with smoking across time. Positive expectancies did not function as a moderator of negative affect's relation with smoking behavior. These results represent an important step in incorporating smoking outcome expectancies into multivariate models of smoking risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reactivity to Alcohol Cues: Isolating the Role of Perceived Availability.

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 × 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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Common and distinct patterns of affective response in dimensions of anxiety and depression.

The authors examined the time course of affective responding associated with different affective dimensions--anxious apprehension, anxious arousal, and anhedonic depression--using an emotion-modulated startle paradigm. Participants high on 1 of these 3 dimensions and nonsymptomatic control participants viewed a series of affective pictures with acoustic startle probes presented before, during, and after the stimuli. All groups exhibited startle potentiation during unpleasant pictures and in anticipation of both pleasant and unpleasant pictures. Compared with control participants, symptomatic participants exhibited sustained potentiation following the offset of unpleasant stimuli and a lack of blink attenuation during and following pleasant stimuli. Common and unique patterns of affective responses in the 3 types of mood symptoms are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress exposure and affective modulation of aggressive behavior in men and women.

To study differences in the effects of stress exposure and affective responding on aggression in men and women, the authors examined the effects of an acute stressor (air blast) on subsequent aggressive behavior, measured as the intensity of shocks men and women delivered to a putative employee. The authors measured participants' affective responding using the startle reflex. Results showed that although men and women did not differ in their startle responses to the actual stressor, high stress led to contrasting patterns of subsequent aggressive behavior. Women under high stress responded with less aggression than women under low stress, whereas men exposed to high stress exhibited increases in aggression relative to those under low stress. Affective responding during the stressor differentially modulated aggression in men and women: Startle responses predicted increasing levels of aggression in men and less aggression in women. These findings suggest that although men and women show similar basic affective processing in response to stressors, the behavioral profiles associated with stress differ in men and women. These findings have implications for understanding gender differences in the prevalence of internalizing and externalizing psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Facial reactions to smoking cues relate to ambivalence about smoking.

In this study, the authors used the Facial Action Coding System (FACS; P. Ekman & W. V. Friesen, 1978) to examine the immediate facial responses of abstinent smokers exposed to smoking cues. The aim was to investigate whether facial expressions thought to be linked to ambivalence would relate to more traditional measures of ambivalence about smoking. The authors adapted N. A. Heather's (1998) definition of ambivalence about smoking, which emphasizes difficulty in refraining from smoking despite intentions to do so. Ambivalence expressed during smoking cue exposure was operationalized as the simultaneous occurrence of positive and negative affect-related facial expressions. Thirty-four nicotine-deprived dependent smokers were presented with in vivo smoking cues, and their facial expressions were coded using FACS. Participants also completed self-report measures related to ambivalence about smoking. Smokers who displayed ambivalent facial expressions during smoking cue exposure reported significantly higher scores on measures of smoking ambivalence than did those who did not display ambivalent facial expressions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of naltrexone on alcohol consumption and affect reactivity to daily interpersonal events among heavy drinkers.

The authors examined whether the associations among daily positive and negative interpersonal events, alcohol consumption, and affect varied as a function of naltrexone or placebo administered in a targeted (in anticipation of or in response to high-risk drinking situations) or daily fashion. Heavy drinkers (N = 149) received 4 sessions of brief coping skills counseling in addition to 8 weeks of naltrexone treatment. They recorded for 8 weeks in structured nightly diaries their interpersonal interactions, affect, and alcohol consumption. The authors predicted that participants receiving naltrexone, compared with those taking placebo, would drink less in response to interpersonal encounters and that naltrexone administration would attenuate the link between positive interpersonal events and positive affective states. Results indicated that both positive and negative interpersonal interactions were associated with an increased probability of engaging in any drinking and that positive daily social celebratory events were associated with an increased probability of engaging in heavy drinking. Participants taking naltrexone in a targeted fashion showed the strongest positive association between the number of positive social celebratory events and drinking. Although this finding was inconsistent with the overall reduction in drinking that has been generally reported for those treated with naltrexone, positive social celebratory events occurred on only a minority of days. Participants taking naltrexone, compared with those taking placebo, showed weaker associations between positive social celebratory events and positive and negative affective states. Findings are discussed in terms of naltrexone's dampening effects on the rewarding properties of alcohol use and certain positively valenced stimuli. (PsycINFO Database Record (c) 2010 APA, all rights reserved)