Cognitive Biases for Social Alcohol-Related Pictures and Alcohol Use in Specific Social Settings: An Event-Level Study

Attentional bias in alcohol drinkers: A systematic review of its link with consumption variables

In severe alcohol use disorder (SAUD), attentional bias refers to the preferential allocation of attentional resources toward alcohol-related cues. Dominant models consider that this bias plays a key role in the emergence and maintenance of SAUD. We evaluate the available experimental support for this assumption through a systematic literature review, providing a critical synthesis of studies exploring the links between alcohol consumption and attentional bias. Using PRISMA guidelines, we explored three databases (PsycINFO, PubMed, Scopus) and extracted 95 papers. We assessed their methodological quality and categorized them based on the population targeted, namely patients with SAUD or subclinical populations with various drinking patterns. We also classified papers according to the measures used (i.e., behavioral or eye-tracking measures). Overall, subclinical populations present an alcohol-related bias, but many studies in SAUD did not find such bias, nor approach/avoidance patterns. Moreover, attentional bias fluctuates alongside motivational states rather than according to alcohol use severity, which questions its stability. We provide recommendations to develop further theoretical knowledge and overcome methodological shortcomings.

Protocol of the Healthy Brain Study: An accessible resource for understanding the human brain and how it dynamically and individually operates in its bio-social context

The endeavor to understand the human brain has seen more progress in the last few decades than in the previous two millennia. Still, our understanding of how the human brain relates to behavior in the real world and how this link is modulated by biological, social, and environmental factors is limited. To address this, we designed the Healthy Brain Study (HBS), an interdisciplinary, longitudinal, cohort study based on multidimensional, dynamic assessments in both the laboratory and the real world. Here, we describe the rationale and design of the currently ongoing HBS. The HBS is examining a population-based sample of 1,000 healthy participants (age 30–39) who are thoroughly studied across an entire year. Data are collected through cognitive, affective, behavioral, and physiological testing, neuroimaging, bio-sampling, questionnaires, ecological momentary assessment, and real-world assessments using wearable devices. These data will become an accessible resource for the scientific community enabling the next step in understanding the human brain and how it dynamically and individually operates in its bio-social context. An access procedure to the collected data and bio-samples is in place and published on https://www.healthybrainstudy.nl/en/data-and-methods/access.

Trail registration:https://www.trialregister.nl/trial/7955.

How interindividual differences shape approach-avoidance behavior: Relating self-report and diagnostic measures of interindividual differences to behavioral measurements of approach and avoidance

Responding to stimuli in ambiguous environments is partially governed by approach-avoidance tendencies. Imbalances in these approach-avoidance behaviors are implicated in many mental disorders including anxiety disorders, phobias and substance use disorders. While factors biasing human behavior in approach-avoidance conflicts have been researched in numerous experiments, a much-needed comprehensive overview integrating those findings is missing. Here, we systematically searched the existing literature on individual differences in task-based approach-avoidance behavior and aggregated the current evidence for the effect of self-reported approach/avoidance traits, anxiety and anxiety disorders, specific phobias, depression, aggression, anger and psychopathy, substance use and related disorders, eating disorders and habits, trauma, acute stress and, finally, hormone levels (mainly testosterone, oxytocin). We highlight consistent findings, underrepresented research areas and unexpected results, and detail the amount of controversy between studies. We discuss potential reasons for ambiguous results in some research areas, offer practical advice for future studies and highlight potential variables such as task-related researcher decisions that may influence how interindividual differences and disorders drive automatic approach-avoidance biases in behavioral experiments.

Conflicting rewards: effects of task goals on attention for alcohol cues

Research has shown that temporary task goals capture more attention than negative, threatening cues, even in anxious individuals. In the current study, we investigated whether temporary task goals would also capture more attention than alcohol-related cues. In Experiment 1, 59 hazardous drinkers performed both a modified dot-probe and a flanker task in which temporary goal- and alcohol-relevant stimuli were presented together. Results of the dot-probe task confirmed an attentional bias towards goal-relevant stimuli in the presence of alcohol cues. This effect was absent in a modified flanker task, although there was a general slowing when the targets appeared on top of goal-relevant stimuli, suggesting that goal-related backgrounds captured more attention than alcohol backgrounds. In Experiment 2, we replicated the dot-probe procedure in 29 hazardous drinkers who had been exposed to a prime dose of alcohol prior to performing the task. Our findings indicate that temporary goal stimuli are more salient than alcohol cues, which might lead the way to novel clinical applications.

Brain responses and approach bias to social alcohol cues and their association with drinking in a social setting in young adult males

Alcohol is mainly consumed in social settings, in which people often adapt their drinking behaviour to that of others, also called imitation of drinking. Yet, it remains unclear what drives this drinking in a social setting. In this study, we expected to see stronger brain and behavioural responses to social compared to non-social alcohol cues, and these responses to be associated with drinking in a social setting. The sample consisted of 153 beer-drinking males, aged 18-25 years. Brain responses to social alcohol cues were measured during an alcohol cue-exposure task performed in an fMRI scanner. Behavioural responses to social alcohol cues were measured using a stimulus-response compatibility task, providing an index of approach bias towards these cues. Drinking in a social setting was measured in a laboratory mimicking a bar environment. Specific brain responses to social alcohol cues were observed in the bilateral superior temporal sulcus and the left inferior parietal lobe. There was no approach bias towards social alcohol cues specifically; however, we did find an approach bias towards alcohol (versus soda) cues in general. Brain responses and approach bias towards social alcohol cues were unrelated and not associated with actual drinking. Thus, we found no support for a relation between drinking in a social setting on the one hand, and brain cue-reactivity or behavioural approach biases to social alcohol cues on the other hand. This suggests that, in contrast to our hypothesis, drinking in a social setting may not be driven by brain or behavioural responses to social alcohol cues.

Interactive Effects of Naturalistic Drinking Context and Alcohol Sensitivity on Neural Alcohol Cue-Reactivity Responses

BACKGROUND

Considerable evidence indicates that a low level of subjective response to alcohol's acute effects (i.e., low sensitivity) is associated with enhanced risk for alcohol use disorder (AUD). Recent work suggests that the highest risk response profile consists of blunted sensitivity to alcohol's sedation-like effects, coupled with enhanced sensitivity to alcohol's stimulation-like effects (i.e., differential sensitivity). A largely separate body of work indicates that enhanced reactivity to alcohol-related cues is associated with increased AUD risk.

AIMS

The current research examined the extent to which variability in alcohol response phenotypes is associated with enhanced P3 event-related potential (ERP) responses to alcohol-related pictures (ACR-P3), and whether this reactivity varies according to depicted drinking contexts.

METHODS

Eighty young adults (aged 18 to 33 years) completed a self-report measure of alcohol sensitivity (the Alcohol Sensitivity Questionnaire) and viewed images depicting drinking in naturalistic contexts, alcohol and nonalcohol beverages in isolation (devoid of naturalistic drinking context), and neutral nonbeverage control images while ERPs were recorded.

RESULTS

Results indicated that blunted sensitivity to alcohol's sedative-like effects was differentially associated with enhanced ACR-P3 but reduced P3 reactivity to nonalcohol cues. Variation in sensitivity to alcohol's stimulant-like effects was not associated with differential ACR-P3. Contrary to predictions, these effects were not potentiated by drinking contexts.

CONCLUSIONS

The current results replicate and extend previous work linking low alcohol sensitivity with enhanced incentive salience for alcohol-related cues and suggest that cues depicting drinking contexts are less likely to differentiate high-risk from low-risk drinkers.

The contexts of heavy drinking: A systematic review of the combinations of context-related factors associated with heavy drinking occasions

Background

The amount of alcohol consumed during an occasion can be influenced by physical and social attributes of the setting, characteristics and state of individuals, and the interactions of these components. This systematic review identifies and describes the specific combinations and sequences of context-related factors that are associated with heavy drinking occasions.

Materials and methods

We conducted a systematic literature search of MEDLINE, Embase and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Eligible articles were event-level and event-based studies that quantitatively analysed associations of sequences or combinations of context-related factors with event-level alcohol consumption. We extracted information on study design, sample, variables, effect estimates and analytical methods. We compiled a list of combinations and sequences associated with heavier drinking (i.e., ‘risky contexts’) and with lighter drinking (‘protective contexts’). The review protocol was registered with PROSPERO (registration number: CRD42018089500).

Results

We screened 1902 retrieved records and identified a final sample of 65 eligible studies. Daily mood, day of week, location and drinking group characteristics are important drivers of whether an individual engages in a heavy drinking occasion. The direction and magnitude of some associations differed by gender, age, personality and motives, such that in particular social or physical contexts, some people may feel compelled to drink more while others are compelled to drink less. Very few sequences of factors were reported as being associated with event-level alcohol consumption.

Conclusions

Contexts or factors are experienced in specific sequences that shape the broader drinking context and influence drinking behaviours and consequences but are under-studied. Event-level studies such as those using ecological momentary assessment can harness new technologies for data collection and analysis to improve understandings of why people engage in heavy drinking. Continued event-level research will facilitate public health interventions and policies that reduce heavy drinking and alcohol-related harms.

Acceleration of drinking pace throughout the evening among frequently drinking young adults in the Netherlands

BACKGROUND AND AIMS

Previous studies have found that in some countries 'drinking pace' (number of drinks consumed per hour) increases during the course of an evening. We aimed to provide evidence of this acceleration from a culture in which binge drinking is prevalent and to test whether this is consistent across gender, day of week and in high-risk drinkers.

DESIGN

Event-level data collected on Thursday, Friday and Saturday evenings over 5 consecutive weeks.

SETTING

The Netherlands.

PARTICIPANTS

A total of 197 young adult frequent drinkers (48.7% women, mean age = 20.8).

MEASUREMENTS

High-risk drinking (assessed by the Alcohol Use Disorders Identification Test) and gender were measured at baseline, and questionnaires were sent to participants' smartphones every hour between 9 p.m. and 1 a.m. A total of 7185 questionnaires during 1589 evenings were used for the analyses.

FINDINGS

Multi-level latent growth curve models revealed an acceleration in drinking on days of the week tested [throughout all evenings; b = 0.430, standard error (SE) = 0.045, P < 0.001], which stabilized as the evening progressed (b = -0.072, SE = 0.008, P < 0.001). The temporal pattern did not differ between the days or gender, but men started with a higher number of drinks at the beginning of the evening (b = 0.465, SE = 0.099, P < 0.001). High-risk drinking was related to more alcoholic drinks at the beginning of an evening (b = 0.032, SE = 0.011, P = 0.003) and a steeper acceleration during the subsequent hours (b = 0.021, SE = 0.009, P = 0.024).

CONCLUSIONS

Young adults in the Netherlands appear to show an increase in drinking pace during the course of an evening's drinking, with high-risk drinkers showing a greater increase.

Failed attempts to improve the reliability of the alcohol visual probe task following empirical recommendations

The visual probe task (VPT) is a computerized task used to measure attentional bias to substance-related stimuli. Little research has examined the psychometric properties of the VPT, despite concerns it demonstrates poor test-retest reliability and internal consistency. These issues can reduce confidence in inferences based on VPT performance. As such, we attempted to identify parameters under which the reliability of the alcohol VPT might be improved by applying recent empirical recommendations for outlier handling, bias calculation, and task design from the anxiety literature. We reanalyzed data from 3 previously published studies in our laboratory and 2 newly collected data sets. We compared tasks which presented images on the left/right of the screen to above/below, whether participants responded to the location or content of the probe, and whether general alcohol-related images or images personalized to the individual were used. In each VPT we also applied a priori outlier removal (2 and 3 standard deviations and median absolute difference) and data-driven outlier removal (winsorizing), in addition to calculating trial-level bias scores. Across all studies and tasks internal consistency and test-retest reliability of attentional bias measures were inadequate. There was no consistent improvement in internal consistency or test-retest reliability as a function of outlier removal methods. We were unable to demonstrate adequate reliability of the alcohol VPT, which further supports observations that these tasks may not yield reliable measures. Future research should focus on improving the reliability of these tasks or abandoning them in favor of more reliable alternatives. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

All drinking is not equal: how a social practice theory lens could enhance public health research on alcohol and other health behaviours

BACKGROUND

The social meanings, settings and habitual nature of health-related activities and their integration into our daily lives are often overlooked in quantitative public health research. This reflects an overly individualized approach to epidemiological surveillance and evaluations of public health interventions, based on models of behaviour that are rooted in social cognition and rational choice theories. This paper calls for a new approach to alcohol epidemiology and intervention research informed by theories of practice.

ARGUMENT

Practices are conceptualized as routinized types of human activity that are made up of, and can be recognized by, the coming together of several interwoven elements in the same situation (e.g. materials, meanings, skills, locations, timings). Different practices are interconnected-they can occur simultaneously (e.g. drinking and eating), hold each other in place (e.g. after-work drinks) or compete for time (e.g. parenting versus socializing). Applying these principles to alcohol research means shifting attention away from individuals and their behaviours and instead making drinking practices an important unit of analysis. Studying how drinking practices emerge, persist and decay over time, how they spread through populations and local or social networks and how they relate to other activities of everyday life promises new insights into how, why, where, when and with whom drinking and getting drunk occur.

CONCLUSIONS

Theories of practice provide a framework for generating new explanations of stability and change in alcohol consumption and other health behaviours. This framework offers potential for novel insights into the persistence of health inequalities, unanticipated consequences of policies and interventions and new interventions targets through understanding which elements of problematic practices are likely to be most modifiable. We hope this will generate novel insights into the emergence and decay of drinking practices over time and into the geographical and socio-demographic patterning of drinking. Theories of practice-informed research would consider how alcohol policies and population-level interventions might differentially affect different drinking practices.

Adolescent resilience to addiction: a social plasticity hypothesis

The prevalence of substance use disorders is highest during adolescence; however, many adolescents experience a natural resolution of their substance use by early adulthood, without any formal intervention. Something appears to be unique and adaptive about the adolescent brain. In this Review, we examine the roles of the social environment and neurocognitive development in adolescents' natural resilience to substance use disorders. At present, little is known about the neurocognitive mechanisms that underlie this adaptive phenomenon, since neurodevelopmental studies have mainly focused on the risk side of the substance use equation: escalation of substance use. To provide a framework for future studies, we put forth a social plasticity model that includes developmentally limited enhanced social attunement (ie, the need to harmonise with the social environment), affective processing, and brain plasticity, which underlie adolescents' capacity to learn from and adapt to their constantly evolving social environments.

Implicit and Explicit Alcohol Cognitions: The Moderating Effect of Executive Functions

Aims

Research informed by dual-process models of addictions has clearly demonstrated an association between implicit and explicit alcohol-related cognitions and alcohol consumption. However, the literature is limited with respect to examination of the cognitive abilities that may moderate these associations across populations. This study examined relations among alcohol associations, inhibition and alcohol consumption in a sample of college students. It was hypothesized that the executive ability of response inhibition would moderate relations between alcohol-related cognitions and alcohol consumption, such that individuals with weaker response inhibition would demonstrate stronger relations between implicit cognitions and use, while individuals with stronger response inhibition would demonstrate more robust relations between explicit cognitions and use.

Methods

Research participants (N  = 205, age 19.0 years (standard deviation = 1.1)) mostly female (n  = 150, 73.2%) completed two implicit association tasks measuring alcohol-related positive/arousal and relaxation associations. In addition, participants completed questionnaires regarding alcohol expectancies, alcohol consumption and problems, and various measures of inhibition. We tested study hypotheses using structural equation modeling and probed significant interactions using simple slope analyses.

Results

We found support for a moderating effect of response inhibition on relations between implicit relaxation associations and alcohol consumption. We did not find a moderating effect of working memory capacity on relations between alcohol-related associations and use.

Conclusions

Findings from this study further our understanding of differential cognitive and inhibition factors that contribute to underage alcohol consumption with implications for preventive interventions to reduce alcohol misuse and consequences.

Short summary

We investigated whether the effect of implicit and explicit alcohol associations on alcohol consumption was moderated by response inhibition and working memory among college students. Response inhibition moderated the effect of implicit relaxation associations on consumption. We did not obtain support for moderation by working memory, or of explicit associations.