Reactivity to alcohol cues and induced moods in alcoholics (original) (raw)
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Alcohol cue reactivity, negative-mood reactivity, and relapse in treated alcoholic men
Journal of Abnormal Psychology, 1997
Relapsed alcoholic individuals frequently report that negative emotional states trigger their return to drinking. A parametric laboratory study was conducted to assess the separate and combined effects of exposure to alcohol-related stimuli and induced negative moods in abstinent alcoholic persons. The authors also sought to determine if reactivity to alcohol cues or reactivity to negative mood induction predicted relapse soon after treatment. Men with alcoholism (N = 50) undergoing inpatient treatment participated in a guided imagery procedure designed to induce negative moods and were then exposed to either their favorite alcoholic beverage or to spring water. Results indicated that both alcoholic beverage presentation and negative affect imagery led to increased subjective reporting of desire to drink. These effects were additive but not multiplicative (i.e., the interaction of mood state with beverage type was not significant). Reported urge to drink during the trial that combined negative mood imagery with alcoholic beverage exposure predicted time to relapse after inpatient discharge.
No effect of negative mood on the alcohol cue reactivity of in-patient alcoholics
Addictive Behaviors, 2000
Forty in-patient alcoholics were exposed to an alcohol cue (holding and smelling an alcoholic drink) while in a negative mood, and while in a neutral mood. For the negative mood condition either a distressing or depressing Mood Induction Procedure (MIP) was used. In the control condition, a neutral MIP was used. In the negative mood condition, the subjects were found to be more distressed, more irritated, less calm, and less satisfied than in the neutral mood condition. In all conditions, following exposure to the alcohol cue, the desire to drink, systolic blood pressure, and heart rate variability increased, while self-efficacy beliefs to resist the urge to drink, and heart rate decreased. In sum, alcohol cue reactivity was observed, but not in response to a negative as opposed to a neutral mood or a distressed versus a depressed mood.
Pharmacology Biochemistry and Behavior, 1999
Relationship of components of an alcohol interoceptive stimulus to induction of desire for alcohol in social drinkers. PHARMACOL BIOCHEM BEHAV 64 (2) 301-309, 1999.-The ability of a low (0.2 g/kg) oral dose of ethanol to provide a drug discriminative stimulus was studied in young healthy human volunteers, who were social drinkers. Seventeen of 24 subjects acquired the discrimination following 10 trials in which they received aliquots of ethanol or of placebo drink (tonic water mixed with Tabasco sauce). In generalization studies, in which the dose of ethanol was varied, discrimination performance was dose dependent; doses greater than 0.05 g/kg gave rise to significant ethanol-appropriate responding. Concurrent estimates of the subjective effects of doses administered as discriminative stimuli revealed that two factors-taste and light-headedness-were associated with discrimination; at the training dose, 0.2 g/kg, although both the factors taste and light-headedness were significantly increased, only taste predicted discrimination performance. At lower doses, taste did not contribute to discrimination, but the subjective rating light-headedness correlated significantly with discrimination accuracy. Post hoc analyses of the influence of the amount of alcohol regularly drunk by the volunteers, on discrimination performance suggested light-headedness correlated with discriminative performance only in social drinkers drinking more than 20 units per week. In a second experiment, groups of "high" (mean 40 units per week) and "low" (mean 10 units per week) social drinkers were prospectively identified. Discrimination performance of 0.2 g/kg ethanol in orange juice vs. orange juice vehicle indicated that both groups were able to perform the discrimination following a single training trial, and that generalization curves over the range 0.05-0.2 g/kg were dose dependent, and not different between the groups. At the lowest dose, discrimination performance was predicted by taste, stimulation, and light-headedness in the "high" group, but not in the "low" group. The ability of these ethanol doses to induce feelings of craving for ethanol were assessed in parallel, using the Desire for Alcohol Questionnaire (DAQ). "High" drinkers showed higher desire for ethanol on all factors of the DAQ except the "positive negative reinforcement" factor, and sampling ethanol tended to increase desire in these measures. However, at each dose, the induction of feelings of desire for ethanol showed a negative correlation with discrimination performance. These findings are discussed in the context of the ability of animals and humans to use several components of drug-induced stimuli in the performance of drug discrimination, and the role of such discriminative stimuli in priming of ethanol drinking.
Alcohol as an unconditioned stimulus in human classical conditioning
Psychopharmacology, 1994
shown that drug cues (e.g. sight of beer or needle and syringe) elicit different responses than do neutral stimuli. However, because conditioning has not been carried out in the majority of cases, it is not clear why drug cues have different response eliciting capacities; associative and nonassociative mechanisms may both play a part. In this experiment a counterbalanced differential conditioning procedure was used to isolate the role of associative processes in the development of physiological, behavioural, and subjective conditioned responses to cues for alcohol over the course of repeated conditioning sessions. Twelve healthy volunteers took part in the experiment which involved each subject attending for ten sessions. On physiological measures evidence was found for conditioning of skin conductance and cardiac inter-beat interval responses to cues for alcohol delivery. Over the course of conditioning on behavioural measures of drink consumption there were changes in the rate of consumption and number of sips taken as a function of whether or not the drinks contained alcohol. Finally, on subjective measures, there was a differential change in subjective state in response to alcohol and soft drink expectancy as conditioning progressed.
Toward a Phenomenology of Urge to Drink: A Future Prospect for the Cue-reactivity Paradigm
Numerous studies have shown that alcohol-related environmental stimuli (e.g., the sight of alcohol) can produce emotional responses such as craving in regular drinkers, termed cue-reactivity. The cue-reactivity paradigm grew out of the behaviorist tradition with a focus on reinforcement mechanisms. However, subsequent studies have focused on personality traits as predictors of craving and most recently cognitive states associated with craving. We advocate more rigorous process-oriented research to determine why exposure to an alcohol-related stimulus facilitates one's urge to drink. It is argued here that previous research has attempted to delineate the etiology of subjective craving or 'urge to drink' whilst simultaneously neglecting to adequately operationally define the phenomenology of urge to drink states. We try to resolve this issue by advocating the use of a novel retrospective phenomenological assessment instrument that, to date has not been applied within the c...
The Phenomenology of Alcohol Cue-Reactivity: A Partial Replication and Extension
Imagination, Cognition and Personality, 2012
Addiction researchers have emphasized that an important element of the subjective craving construct is phenomenology. A recent study conducted by experimentally investigated individual differences in the phenomenology of alcohol cue-reactivity and found that various phenomenological effects were significantly more intense for the neutral (i.e., water) cue compared to the alcohol cue (i.e., the participant's favorite beverage). These results appear incongruent with the ostensibly neutral nature of the water cue and may be an artefact of sequencing effects associated with standard cue-reactivity protocols. The aim of the present study, therefore, was to partially replicate Kambouropoulos and Rock's study by experimentally assessing individual variation in the phenomenology of alcohol cue-reactivity using counterbalanced sequences of neutral cue and alcohol cue presentation. Fifty-eight participants were exposed to counterbalanced sequences of neutral and alcohol cues, and urge to drink and phenomenological responses were measured. Findings indicated that exposure to the alcohol stimulus produced significant changes in volitional control, altered awareness, attention, and joy. These results suggest that examining the phenomenology of alcohol cue presentation may provide additional insights into the nature of alcohol cue responses. Finally, the results appeared to provide preliminary support for the utility of counterbalancing neutral cue and alcohol cue presentation.
Conditioned alcohol-like and alcohol-opposite responses in humans
Psychopharmacology, 1988
Conditioned heart rate and skin temperature responses of 12 social drinkers were observed following repeated exposure to alcohol. Each subject received alcohol for four sessions in one room and a non-alcoholic drink for four sessions in a room of quite different appearance. Alcoholic and non-alcoholic drinks were distinctive and the alcoholic content could not be determined on the basis of taste. In the final three testing sessions, placebos were presented in order to test the influence of room and drink cues separately and in combination. A conditioned heart rate response opposite in direction to the alcohol effect was elicited by room and drink cues in combination and by the room cue in isolation. These results were in accordance with the predictions of the conditioning model of tolerance. A conditioned heart rate response in the same direction as the drug effect was elicited by the drink cue presented in isolation. Similar, but non-significant changes were also obtained with skin temperature. In addition, conditioned responses occurred independently of any expectancy. The results demonstrated that the direction of conditioned drug responses may depend on the type of stimulus presented.
European Addiction Research, 2001
The role of aggressivity and cue exposure in induction of craving were investigated in a clinical setting. Thirty abstinent alcoholic patients were divided into a low and a high aggressive group based on scores on the physical aggression subscale of the Buss-Durkee Hostility Inventory and exposed to alcohol cues. Craving was measured by means of the Alcohol Craving Questionnaire (ACQ) and Visual Analogue Scales (VAS). Important findings are: (1) main effects of aggressivity on ‘emotionality’, ‘purposefulness’ and ‘expectancy’ of ACQ were very significant; (2) on ‘drinking intention’ and ‘craving for alcohol’ of VAS, aggressivity and cue exposure showed a significant interaction; (3) the main effect of cue exposure on heart rate also reached a significance level of 0.007. The results were discussed in the context of the Classical, Operant Conditioning Theory, the Cognitive Craving Theory of Tiffany, Gilbert’s STAR Model, and the Self-Medication Hypothesis
Alcohol Withdrawal and Conditioning
Alcoholism-clinical and Experimental Research, 2005
This review contains the proceedings from a symposium held at the RSA conference in 2003 on "Alcohol Withdrawal and Conditioning." The presentations covered a range of interactions between conditioning and alcohol withdrawal, in both animal behavior and the clinic. Dr. D.N. Stephens first described his studies exploring the consequences of alcohol dependence and repeated experience of withdrawal on the conditioning process. His data suggested that repeated withdrawal from moderate alcohol intake impairs amygdala-dependent mechanisms for learning about aversive events. Dr. H. Becker then detailed studies examining the consequences of repeated ethanol withdrawal experience on subsequent ethanol drinking behavior in mice, and conditions in which motivational properties of odor cues that are associated with different phases of ethanol withdrawal influence such relapse behavior. The data suggested that cues associated with acute withdrawal or "recovery" from withdrawal may serve as modulating factors in influencing subsequent ethanol drinking behavior, and that the timing of the cues determines their consequences. Dr. F. Weiss described recent findings from animal models of relapse that suggested the efficacy of alcohol-associated contextual stimuli in eliciting alcohol-seeking behavior resembles the endurance of conditioned cue reactivity and cue-induced cocaine craving in humans. The interactive effects of stress and ethanol-related environmental stimuli were found to be dependent on concurrent activation of endogenous opioid and corticotropin-releasing factor systems. Conditioning factors (i.e., exposure to drug-associated stimuli) and stress could therefore interact to augment vulnerability to relapse. Dr. C. Drummond then addressed the clinical aspects of conditioning during alcohol withdrawal and described studies showing exposure of alcoholics to alcohol-related cues elicited greater subjective and physiological responses than exposure to neutral cues. The former responsivity showed a relationship with a measure of motivation to drink alcohol. Finally, Dr. C. Cunningham provided a summary of the concepts involved in the presentations and discussed the conditioning processes that affect behavior during and after alcohol withdrawal.