Category: Addictive Behaviors

PS1- #A11 - Drinking Behavior and Implicit Approach/Avoidance Toward Alcohol Cues During Motivational Treatment

Friday, Nov 17
8:30 AM – 9:30 AM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Alcohol | Cognitive Processes | Motivational Interviewing

Introduction: Problematic alcohol users have implicit cognitive biases towards alcohol cues, which are thought to influence drinking behavior. However, previous analyses (Braunstein et al., 2016) in a subset of participants (n=60) from a randomized clinical trial of motivational treatment for problematic alcohol use, found that severity of drinking behavior, but not implicit approach/avoidance tendencies, shifted during trial participation. The current analyses examined the effects of treatment condition in the full sample of participants that completed both outcome measures. Methods: Participants were 98 adult (55% female) problematic drinkers (M=31.3 weekly drinks [SD=15.0]; 92% with Alcohol Use Disorders). They completed a computerized Alcohol Approach Avoidance task (AAT) and self-report measures of drinking behavior (Timeline Follow Back Procedure) at baseline and following treatment. The AAT measured reaction time (RT) to execute joystick movements in response to alcohol and neutral visual cues, under Approach and Avoid instructional sets (which differ in motor directional requirements). Following baseline assessment, participants were randomized to 1 of 3 treatment conditions: 1) Motivational Interviewing (MI; n=33); 2) Spirit-only MI (SOMI; n=35); and 3) Wait-list Control (WLC; n=30). The active treatments consisted of 4 sessions over 8 weeks, and outcome assessment occurred at week 12. The data were analyzed with repeated-measures ANOVA. Results: There was a stimulus type × instructional set × time interaction (F1,95 = 4.8, p < 0.05). At baseline, participants exhibited faster RTs towards alcohol cues than to neutral cues under the approach condition (p < 0.05), without differences between cue types under the avoid condition (p>0.05). At week 12, participants exhibited faster RTs towards alcohol cues than to neutral cues under the avoid condition (p < 0.05), without differences between cue types under the avoid condition (p>0.05). There was a main effect of time on drinking behavior (F3,93 = 17.3, p < 0.05), with participants reducing their reported weekly number of drinks and drinking days from baseline to trial end (all p’s < 0.05). There was no effect of treatment condition on either AAT performance or reported drinking behavior (p>0.05). Conclusion: A sample of problematic drinkers exhibited an implicit alcohol approach tendency at clinical trial baseline, but an implicit alcohol avoid tendency following trial participation. This sample also exhibited a decrease in reported drinking behavior during trial participation (e.g., 30% reduction in drinks/week). Thus, implicit biases and reported drinking shifted in a consistent manner over the same time period, in the context of clinical challenge to drinking. Future research should assess alcohol approach/avoid tendencies as candidate mechanisms for behavior change by examining their direct longitudinal association with drinking behavior. Funding: 1R01AA020077

Nehal P. Vadhan

Assistant Professor
Feinstein Institute for Medical Research & Hofstra Northwell School of Medicine

Laura Braunstein

Columbia University

Svetlana Levak

Feinstein Institute for Medical Research, Northwell Health

Alexis Kuerbis

Hunter College, City University of New York

Morgenstern Jonathan

Feinstein Institute for Medical Research & Hofstra Northwell School of Medicine