Alcohol cue reactivity and mood induction in male and female alcoholics

The purpose of this study was twofold: to investigate gender differences in alcohol cue reactivity, and to study the effect of individualized mood induction on cue reactivity. Male (n = 38) and female (n = 19) alcoholics were exposed to an alcoholic beverage before and after mood induction to assess their reactivity to the beverage cues. The mood induction was based on a situation the subject had identified as being high risk for relapse. Subjects showed urge and salivary reactivity in response to alcohol beverage cues prior to mood induction, and the induction of mood enhanced urge reactivity in both men and women. Analyses with alcohol urge reactors (subjects that demonstrate an increased urge to drink alcohol in response to an alcoholic beverage cue) suggested that women show more urge reactivity in response to negative moods than do men. No gender differences were seen in reactivity to beverage cues alone. These results identify an important gender difference in the effect of negative moods on cue reactivity and suggest that negative mood situations may place women at a higher risk for relapse than men.     

The cue-availability paradigm: The effects of cigarette availability on cue reactivity in smokers.

Researchers have hypothesized that drug availability should influence addicts' reactions to drug-related stimuli. but manipulation of the extent to which drug users have access to their drugs following a session of exposure to drug cues have not produced strong availability effects. This study used within-session manipulations of drug availability to examine cigarette smokers' reactions to smoking cues. Smokers (N?=?60) were exposed to 48 trials of either a lit cigarette or a class of water while they were informed of the probability (0%, 50%, or 100%) that they would be able to consume the cue on each trial. Results from measures of craving, mood, skin conductance, and latency to access the cues indicated that the trial-by-trial manipulation of drug availability had a pronounced impact on reactivity to cigarette cues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effect of stage of change on cue reactivity in continuing smokers.

Three classical conditioning models (the conditioned compensatory response, conditioned withdrawal, and conditioned appetitive motivational models) postulate that drug cues evoke physiological and emotional responses associated with motivational states that prompt drug use. There is accumulating evidence to suggest that factors other than classical conditioning can influence emotional and physiological reactivity to drug stimuli. This study tested whether stage of change affects the nature of reactivity to smoking cues among continuing smokers. Precontemplators (smokers not considering quitting) and contemplators (smokers considering quitting in the near future) watched videotapes containing smoking cues. Emotional and physiological responses to the smoking video were contrasted with responses to a neutral videotape. Precontemplators had lower heart rates than did contemplators in response to the smoking videotape. Both contemplators and precontemplators evinced increased positive affect in response to the smoking cue. A comparison sample of nonsmokers did not show any reactivity to the smoking cue. Implications of these findings for conditioning theories of smoking are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relevance of cue reactivity to understanding alcohol and smoking relapse.

Several learning-based theories have been forwarded to account for the problem of drug relapse, including conditioned withdrawal, conditioned compensatory responding, appetitive motivational models, and social learning models. The various models are compared and evaluated against available evidence from studies with humans pertaining to alcohol and tobacco addiction. Studies that are reviewed focus primarily on the antecedents and consequences of alcohol and smoking relapse, as well as on reactions to cues that have been associated with prior drug ingestion, in an attempt to understand their motivational relevance. Problems in evaluating the various relapse models in humans are discussed. It is concluded that the appetitive model is better supported than the withdrawal model, and the compensatory model is least supported. Reactions to substance use stimuli may play an important role in alcohol and smoking relapse. Concepts drawn from the various theoretical models are linked tentatively in a schematic diagram of a hypothesized sequence of cognitive/affective, physiological, and behavioral events that lead to initial drug use after a period of abstinence (slip) and then to continued use (a relapse). The treatment implications of some of the cue reactivity models are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of cue exposure and deprivation on cognitive resources in smokers.

Examines the effects of manipulations designed to induce an urge to smoke on cognitive resources. Two cue-exposure experiments were conducted in which current smokers' reported urge to smoke and cognitive resources, as measured by a secondary reaction time (RT) probe, were assessed. In each study, Ss came to the laboratory twice, once while deprived of smoking for 12 hrs and once when they were nondeprived. During each session, Ss were exposed to both smoking and control cues. Results indicated that experimental manipulations designed to elicit a strong urge to smoke led to an increase in self-reported urge to smoke and a decrease of available cognitive resources, as measured by RT. In addition, these 2 measures were significantly correlated. These data, in conjunction with previous findings (M. A. Sayette et al, 1994) using alcohol-dependent Ss, lend support to the validity of RT as an objective measure of the effects of cue exposure on cognitive resources. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex differences in cue perception in a visual scene: Investigation of cue type.

Sex differences in spatial navigation indicate that women may focus on positional, landmark cues whereas men favor Euclidean, directional cues. Some studies have investigated sex differences in proximal and distal cue use; however, sex differences in gradient (i.e., graded features) and pinpoint (i.e., single, defined) cue perception remain unexamined. In the current experiments, paired photographs were presented in which the 2nd photograph showed the same scene with cues removed (Experiment 1) or isolated (Experiment 2) from the 1st photograph. In Experiment 1, women showed less disruption of task performance than men showed following cue removal but were slowest after proximal pinpoint cue removal. Male performance was slowed by distal gradient and proximal pinpoint cue removal. In Experiment 2, women were faster than men at identifying isolated proximal and distal pinpoint cues and were more accurate at identifying isolated distal gradient and distal pinpoint cues. Better pinpoint cue perception and memory in women indicates one possible mechanism underlying female preference for landmark-based navigation strategies. Findings also show that whereas men may preferentially rely on distal gradient cues they are not better at perceiving those cues than are women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reactivity of alcoholics and nonalcoholics to drinking cues.

An interest in reducing relapse among alcoholics has led to a consideration of stimulus control factors in drinking. Research suggests that through classical conditioning alcoholics may develop reactions to cues previously associated with drinking and that these reactions might be an important determinant of relapse. Although this model indicates the potential for cue exposure treatment methods to alter conditioned reactions, data on reactivity to alcohol cues by alcoholics and nonalcoholics are scarce. Two studies are presented that address this issue and provide evidence for the validity of salivation as a measure of cue reactivity. Alcoholics and nonalcoholics were presented with the sight and smell of their preferred brand of alcohol and a control beverage. Self-report, behavioral, and psychophysiological data were collected. Alcoholics salivated more than nonalcoholics to alcohol cues and more to alcohol than to the control beverage. Alcoholics salivated differentially to cues, whereas nonalcoholics did not. Patterns of reactivity were consistent with a conditioning model. Both groups reported greater urges to drink alcohol in the presence of alcohol, but neither group reported more thoughts about alcohol in the presence of alcohol as compared with the control beverage. Implications of salivary reactivity for theory and treatment are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of alcohol on cigarette craving in heavy smokers and tobacco chippers.

The authors examined the effects of alcohol consumption on cigarette craving in heavy smokers and tobacco chippers (n = 138) who were instructed not to smoke for 12 hr. Participants were exposed to both smoking cues (a lit cigarette) and control cues. Half received a moderate dose of alcohol, adjusted for gender, and half received a placebo. Results indicated that alcohol consumption produced an increase in urge-to-smoke ratings before smoking cue exposure. Moreover, during cue exposure, alcohol consumption produced a sharper increase in urge ratings than did the placebo. In addition, during smoking cue exposure, alcohol increased the likelihood of displaying facial expressions associated with positive affect. These findings suggest that alcohol consumption influences both the magnitude and the emotional valence of cigarette cravings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cue-Provoked Craving and Nicotine Replacement Therapy in Smoking Cessation.

Cue exposure paradigms have been used to examine reactivity to smoking cues. However, it is not known whether cue-provoked craving is associated with smoking cessation outcomes or whether cue reactivity can be attenuated by nicotine replacement therapy (NRT) in clinical samples. Cue-provoked craving ratings and reaction time responses were measured on the 1st day of abstinence among 158 smokers who had been randomized to high-dose nicotine (35 mg) or placebo patch. The nicotine patch reduced overall levels of craving but did not attenuate cue-provoked craving increases or reaction time responses. Cue-provoked craving predicted relapse among participants on the nicotine patch but not among those on placebo. In summary, NRT users could benefit from treatment that attenuates cue-provoked craving. (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)     

Correction to Janes et al. (2009).

Reports an error in "Brain fMRI reactivity to smoking-related images before and during extended smoking abstinence" by Amy C. Janes, Blaise deB. Frederick, Sarah Richardt, Caitlin Burbridge, Emilio Merlo-Pich, Perry F. Renshaw, A. Eden Evins, Maurizio Fava and Marc J. Kaufman (Experimental and Clinical Psychopharmacology, 2009[Dec], Vol 17[6], 365-373). In the article the authors find it necessary to redefine the thresholding procedure used for data analyses, due to problems in the Brain Voyager software. This does not affect the main findings of the paper. (The following abstract of the original article appeared in record 2009-23091-001.) Reactivity to smoking-related cues may play a role in the maintenance of smoking behavior and may change depending on smoking status. Whether smoking cue-related functional MRI (fMRI) reactivity differs between active smoking and extended smoking abstinence states currently is unknown. We used fMRI to measure brain reactivity in response to smoking-related versus neutral images in 13 tobacco-dependent subjects before a smoking cessation attempt and again during extended smoking abstinence (52 ± 11 days) aided by nicotine replacement therapy. Prequit smoking cue induced fMRI activity patterns paralleled those reported in prior smoking cue reactivity fMRI studies. Greater fMRI activity was detected during extended smoking abstinence than during the prequit assessment subcortically in the caudate nucleus and cortically in prefrontal (BA 6, 9, 44, 46), primary somatosensory (BA 1, 2, 3), temporal (BA 22, 41, 42), parietal (BA 7, 40) anterior cingulate (BA 24, 32), and posterior cingulate (BA 31) cortex. These data suggest that during extended smoking abstinence, fMRI reactivity to smoking versus neutral stimuli persists in brain areas involved in attention, somatosensory processing, motor planning, and conditioned cue responding. In some brain regions, fMRI smoking cue reactivity is increased during extended smoking abstinence in comparison to the prequit state, which may contribute to persisting relapse vulnerability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brain fMRI reactivity to smoking-related images before and during extended smoking abstinence.

[Correction Notice: An erratum for this article was reported in Vol 18(3) of Experimental and Clinical Psychopharmacology (see record 2010-11933-011). In the article the authors find it necessary to redefine the thresholding procedure used for data analyses, due to problems in the Brain Voyager software. This does not affect the main findings of the paper.] Reactivity to smoking-related cues may play a role in the maintenance of smoking behavior and may change depending on smoking status. Whether smoking cue-related functional MRI (fMRI) reactivity differs between active smoking and extended smoking abstinence states currently is unknown. We used fMRI to measure brain reactivity in response to smoking-related versus neutral images in 13 tobacco-dependent subjects before a smoking cessation attempt and again during extended smoking abstinence (52 ± 11 days) aided by nicotine replacement therapy. Prequit smoking cue induced fMRI activity patterns paralleled those reported in prior smoking cue reactivity fMRI studies. Greater fMRI activity was detected during extended smoking abstinence than during the prequit assessment subcortically in the caudate nucleus and cortically in prefrontal (BA 6, 9, 44, 46), primary somatosensory (BA 1, 2, 3), temporal (BA 22, 41, 42), parietal (BA 7, 40) anterior cingulate (BA 24, 32), and posterior cingulate (BA 31) cortex. These data suggest that during extended smoking abstinence, fMRI reactivity to smoking versus neutral stimuli persists in brain areas involved in attention, somatosensory processing, motor planning, and conditioned cue responding. In some brain regions, fMRI smoking cue reactivity is increased during extended smoking abstinence in comparison to the prequit state, which may contribute to persisting relapse vulnerability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive changes after alcohol cue exposure.

A study was conducted to examine cognitive changes in alcoholics and nonalcoholics after alcohol cue exposure. Forty-nine alcoholics in treatment and 26 nonalcoholics recruited from the community were exposed to a neutral stimulus and to their favorite alcoholic beverage. They held and sniffed the beverage but were not allowed to consume it. Results indicated that both alcoholic and nonalcoholic subjects showed the following changes after alcohol cue exposure: increased desire to drink, increased expectations of pleasant alcohol effects, decreased expectations of arousal, and decreased expectations of behavioral impairment from drinking. Alcoholic subjects responded to alcohol cues with reports of increased physical symptoms, decreased confidence about coping with future temptation, and increased guilt. These results are consistent with Marlatt's hypothesis that an alcoholic in a high-risk relapse situation experiences an increase in positive outcome expectations and a decrease in self-efficacy. The results are also consistent with a respondent conditioning model of craving. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A controlled trial of cue exposure treatment in alcohol dependence.

The clinical effectiveness of cue exposure (CE) treatment in alcohol dependence was evaluated in a controlled trial. 35 men who were detoxified and severely alcohol dependent received either CE or relaxation control (RC) treatment. CE Ss had 400 min exposure to the sight and smell of preferred drinks over 10 days in a laboratory setting. RC Ss spent identical time in the laboratory but had relaxation therapy and only 20 min exposure to alcohol cues. During 6-mo follow-up, personal interview was achieved with 91% of Ss. CE Ss had a more favorable outcome than the RC Ss in terms of latency (length of time) to relapse of heavy drinking (p?     

Testing the influence of external and internal cues on smoking motivation using a community sample.

Exposing smokers to either external cues (e.g., pictures of cigarettes) or internal cues (e.g., negative affect induction) can induce urge to smoke and other behavioral and physiological responses. However, little is known about whether the two types of cues interact when presented in close proximity, as is likely the case in the real word. Additionally, potential moderators of cue reactivity have rarely been examined. Finally, few cue-reactivity studies have used representative samples of smokers. In a randomized 2 × 2 crossed factorial between-subjects design, the current study tested the effects of a negative affect cue intended to produce anxiety (speech preparation task) and an external smoking cue on urge and behavioral reactivity in a community sample of adult smokers (N = 175), and whether trait impulsivity moderated the effects. Both types of cues produced main effects on urges to smoke, despite the speech task failing to increase anxiety significantly. The speech task increased smoking urge related to anticipation of negative affect relief, whereas the external smoking cues increased urges related to anticipation of pleasure; however, the cues did not interact. Impulsivity measures predicted urge and other smoking-related variables, but did not moderate cue-reactivity. Results suggest independent rather than synergistic effects of these contributors to smoking motivation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Time of conditioning selectively influences contextual fear conditioning: further support for a multiple-memory systems view of fear conditioning

Three classical conditioning models (the conditioned compensatory response, conditioned withdrawal, and conditioned appetitive motivational models) postulate that drug cues evoke physiological and emotional responses associated with motivational states that prompt drug use. There is accumulating evidence to suggest that factors other than classical conditioning can influence emotional and physiological reactivity to drug stimuli. This study tested whether stage of change affects the nature of reactivity to smoking cues among continuing smokers. Precontemplators (smokers not considering quitting) and contemplators (smokers considering quitting in the near future) watched videotapes containing smoking cues. Emotional and physiological responses to the smoking video were contrasted with responses to a neutral videotape. Precontemplators had lower heart rates than did contemplators in response to the smoking videotape. Both contemplators and precontemplators evinced increased positive affect in response to the smoking cue. A comparison sample of nonsmokers did not show any reactivity to the smoking cue. Implications of these findings for conditioning theories of smoking are discussed.     

Environments as cues to smoke: Implications for human extinction-based research and treatment.

Animal research has shown that the environments, or contexts, in which drug use occurs can play a key role in how animals respond to drug-related cues. Less is known about the role of environmental contexts in human drug-dependence research. Traditionally, cue-based studies and treatments focus on conditioned cues most proximal to drug administration (e.g., lit cigarettes, pictorial stimuli of drug paraphernalia). However, there is reason to believe that more distal cues, such as the environments in which drugs were previously used, might similarly gain associative control over human responding. This article describes a body of systematic research aimed at identifying and studying the impact of environmental contexts on smokers' cue reactivity in the laboratory. Overall, results of this program of research demonstrate that exposure to environments associated with smoking, but completely devoid of proximal smoking cues, can function as conditioned stimuli capable of evoking strong subjective responding from abstinent smokers. Furthermore, more robust reactivity can be achieved if environmental context cues are personalized using novel techniques described in this article. (PsycINFO Database Record (c) 2010 APA, all rights reserved)