9
The American Journal of Drug and Alcohol Abuse, 34: 703–711, 2008 Copyright © Informa Healthcare USA, Inc. ISSN: 0095-2990 print / 1097-9891 online DOI: 10.1080/00952990802308247 Alcohol Consumption Primes Automatic Alcohol-Approach Associations Suzan R. Farris and Brian D. Ostafin Department of Psychology, North Dakota State University, Fargo, North Dakota, USA Abstract: Objective: There is increasing evidence that automatic mental processes play a role in problematic alcohol use. Although previous research has shown that alcohol consumption can prime alcohol-seeking behavior in animals and humans, little research has examined whether alcohol consumption activates automatic alcohol-related cogni- tions. The current study was designed to examine the effects of alcohol consumption on the activation of automatic alcohol motivation as measured by a reaction time task. Method: Eighty-five at-risk drinkers participated in the study, which began with a base- line measure of automatic alcohol motivation, after which participants completed a taste-test in which they could consume as much beer as they liked for 10 minutes. Following an absorption period, participants completed the measure of automatic al- cohol motivation for a second time. Results: A partial correlation analysis indicated that amount of alcohol consumed predicted stronger automatic alcohol motivation when controlling for the baseline level of automatic alcohol motivation. Conclusion: The findings suggest that alcohol consumption may prime the automatic mental processes that have been shown to contribute to problematic alcohol use. Keywords: Alcohol use, automatic processes Why do people consume alcohol? From a motivational perspective, indi- viduals will drink if the appetitive associations to alcohol outweigh the aversive associations (1). A number of researchers have additionally noted that moti- vational influences on drinking behavior often occur without the mediation of conscious introspection (2, 3). Addiction researchers have increasingly used concepts and methods from cognitive psychology to model automatic motiva- tional processes in substance use behavior (4). Automatic processes are commonly defined as being unintentional, ef- ficient (i.e., effortless), difficult to control, and not involving awareness, in Address correspondence to Brian D. Ostafin, North Dakota State University, Department of Psychology, P. O. Box 5075, Fargo, 58105, ND, USA. E-mail: brian.ostafi[email protected] 703 Am J Drug Alcohol Abuse Downloaded from informahealthcare.com by Mercer University on 10/28/14 For personal use only.

Alcohol Consumption Primes Automatic Alcohol-Approach Associations

  • Upload
    brian-d

  • View
    216

  • Download
    3

Embed Size (px)

Citation preview

Page 1: Alcohol Consumption Primes Automatic Alcohol-Approach Associations

The American Journal of Drug and Alcohol Abuse, 34: 703–711, 2008Copyright © Informa Healthcare USA, Inc.ISSN: 0095-2990 print / 1097-9891 onlineDOI: 10.1080/00952990802308247

Alcohol Consumption Primes AutomaticAlcohol-Approach Associations

Suzan R. Farris and Brian D. OstafinDepartment of Psychology, North Dakota State University, Fargo, North Dakota, USA

Abstract: Objective: There is increasing evidence that automatic mental processes playa role in problematic alcohol use. Although previous research has shown that alcoholconsumption can prime alcohol-seeking behavior in animals and humans, little researchhas examined whether alcohol consumption activates automatic alcohol-related cogni-tions. The current study was designed to examine the effects of alcohol consumptionon the activation of automatic alcohol motivation as measured by a reaction time task.Method: Eighty-five at-risk drinkers participated in the study, which began with a base-line measure of automatic alcohol motivation, after which participants completed ataste-test in which they could consume as much beer as they liked for 10 minutes.Following an absorption period, participants completed the measure of automatic al-cohol motivation for a second time. Results: A partial correlation analysis indicatedthat amount of alcohol consumed predicted stronger automatic alcohol motivation whencontrolling for the baseline level of automatic alcohol motivation. Conclusion: Thefindings suggest that alcohol consumption may prime the automatic mental processesthat have been shown to contribute to problematic alcohol use.

Keywords: Alcohol use, automatic processes

Why do people consume alcohol? From a motivational perspective, indi-viduals will drink if the appetitive associations to alcohol outweigh the aversiveassociations (1). A number of researchers have additionally noted that moti-vational influences on drinking behavior often occur without the mediation ofconscious introspection (2, 3). Addiction researchers have increasingly usedconcepts and methods from cognitive psychology to model automatic motiva-tional processes in substance use behavior (4).

Automatic processes are commonly defined as being unintentional, ef-ficient (i.e., effortless), difficult to control, and not involving awareness, in

Address correspondence to Brian D. Ostafin, North Dakota State University,Department of Psychology, P. O. Box 5075, Fargo, 58105, ND, USA. E-mail:[email protected]

703

Am

J D

rug

Alc

ohol

Abu

se D

ownl

oade

d fr

om in

form

ahea

lthca

re.c

om b

y M

erce

r U

nive

rsity

on

10/2

8/14

For

pers

onal

use

onl

y.

Page 2: Alcohol Consumption Primes Automatic Alcohol-Approach Associations

704 S. R. Farris and B. D. Ostafin

contrast to controlled processes, which are defined as being intentional, ef-fortful, controllable, and occurring in awareness (5). De Houwer (6) proposesthat of these dimensions, the unintentional nature of automatic processes maybe particularly important for understanding compulsive substance use behav-ior. That is, the mere presence of a substance cue may unintentionally (i.e.,spontaneously, without the need for deliberate introspection) activate positiveattitudes (7) and approach behavioral tendencies (8) that will guide substanceuse unless there are self-control resources available to inhibit the automaticprocesses and the motivation to do so (9).

Of the variety of implicit measures used to assess automatic stimulus-affect associations (10), the one that has become most widely used is theImplicit Association Test (IAT) (11). The IAT provides an indirect measure ofthe strength of associations among concepts by having participants categorizestimuli from four categories using one of two response keys. The IAT is basedon the idea that stronger associations between concepts will result in fasterresponse times when they share the same response key than when they do notshare the same response key. In contrast to other implicit measures of stimulus-affect associations, the IAT has relatively strong psychometric properties (10).

Several studies have used the IAT to assess automatic alcohol-affect asso-ciations. This research has found that automatic alcohol-approach associationspredict heavy drinking episodes and urge responses to alcohol cues (12, 13).Other research with the IAT has found that valence and arousal associationssimilarly predict alcohol behavior (14, 15). The value of using implicit measuresof alcohol motivation is further demonstrated by findings that implicit measuresof alcohol motivation predict variance of alcohol behavior over and above thataccounted for by explicit measures (12, 16), that IAT predicts difficulty in con-trolling alcohol use in both cross-sectional and experimental designs (13, 17),and that the IAT predicts prospective alcohol use while controlling for past use(17), suggesting that automatic alcohol motivation influences alcohol behavior,and does not simply represent a proxy measure of typical drinking.

Given the accumulating evidence that automatic motivational processesplay a role in problematic alcohol use, it is important to examine the contextsin which these processes are more likely to be activated. The consumption ofan initial dose of alcohol is one such potential context, as human and animalresearch indicates that compared to placebo, a priming dose of alcohol leads tostronger urges to drink (18), increased alcohol consumption (19), preference ofalcohol over non-alcohol beverage (20) and preference of alcohol over monetaryreinforcers (21).

To our knowledge, only two studies have examined the influence of alco-hol preload on an implicit measure of alcohol motivation. Fillmore and Rush(22) found that compared to placebo, an alcohol preload led to faster reac-tion times on a task performed to earn alcohol. That is, the alcohol preloadincreased approach motivation toward alcohol as measured by response time.Palfai and Ostafin (23) found that compared to placebo, an alcohol preload

Am

J D

rug

Alc

ohol

Abu

se D

ownl

oade

d fr

om in

form

ahea

lthca

re.c

om b

y M

erce

r U

nive

rsity

on

10/2

8/14

For

pers

onal

use

onl

y.

Page 3: Alcohol Consumption Primes Automatic Alcohol-Approach Associations

Automatic Alcohol-Approach Associations 705

led to faster response times in evaluating positive relative to negative alcoholoutcome words.

The current study was designed to examine whether initial alcohol con-sumption would activate automatic alcohol-approach associations in a sampleof at-risk drinkers. Participants completed a baseline IAT, a taste-test in whichthey could consume as much alcohol as they liked for 10 minutes, and asecond IAT after a brief absorption period. We predicted that amount of al-cohol consumed would correlate with stronger post-consumption automaticalcohol-approach associations while controlling for baseline alcohol-approachassociations.

METHOD

Participants

Eighty-seven participants were recruited from advertisements that re-quested regular alcohol drinkers. Inclusion criteria included: (a) at-risk drinkingbehavior (≥ 15 drinks/week and ≥ 5 drinks/occasion at least once per week formales and ≥ 8 drinks/week and ≥ 4 drinks/occasion at least once per week forfemales) as defined by NIAAA (24); (b) regular beer consumption (at least 25%of alcohol consumed); (c) age between 21 and 40 years old; and (d) English asa first language. Two participants were dropped because English was not theirfirst language. Extremely heavy drinkers (more than 40 drinks per week) wereexcluded from the study, as were females known to be pregnant and individualsreporting a history of problem drinking or medical conditions and medicationsthat would contraindicate alcohol consumption. Heavy drinkers and those re-porting a history of problem drinking were offered a list of counseling resourcesfor managing drinking.

The final sample reported a mean age of 27.04 years (SD = 5.71). Partic-ipants reported drinking a mean of 4.69 (SD = 1.59) days per week and 5.17(SD = 2.09) drinks per occasion over the previous month. The sample wasprimarily male (n = 61) and Caucasian (n = 64).

Measures

Typical Drinking Behavior. A calendar-based measure was used to assesspatterns of drinking, including frequency and intensity of use. Calendar mea-sures of alcohol use have demonstrated good psychometric properties (25).

Automatic Alcohol Motivation. The IAT consisted of having participantscategorize stimuli from four categories—two target categories (e.g., picturesof beer and water) and two attribute categories (e.g., approach and avoidance-related words). The IAT stimuli consisted of five alcohol pictures, five water

Am

J D

rug

Alc

ohol

Abu

se D

ownl

oade

d fr

om in

form

ahea

lthca

re.c

om b

y M

erce

r U

nive

rsity

on

10/2

8/14

For

pers

onal

use

onl

y.

Page 4: Alcohol Consumption Primes Automatic Alcohol-Approach Associations

706 S. R. Farris and B. D. Ostafin

pictures, five approach-related words, and five avoidance-related words. TheIAT was presented in seven blocks: (a) a 14-trial target discrimination block(e.g., left = beer and right = water); (b) a 14-trial attribute discrimination block(left = approach and right = avoid); (c) a 20-trial combination block (left =beer + approach and right = water + avoid); (d) a 40-trial combination blockof the same combination in (c); (e) a 14-trial target discrimination block inwhich the target categories were reversed (left = water and right = beer); (f) a20-trial reversed combination block (left = water + approach and right = beer+ avoid); and (g) a 40-trial combination block of the same combination in (f).If participants made an error, they saw an error message and were required tomake the correct response before the next trial was presented. Two IAT orderswere utilized: one with the beer and approach combination first, and one withthe water and approach combination first. The two IAT orders were counterbal-anced across participants. The IAT score was calculated as a difference scorebetween the mean response times of the beer-approach/water-avoid blocks andthe water-approach/beer-avoid blocks, with larger scores indicating strongerautomatic approach motivation towards alcohol. The IAT score was calculatedaccording to the D-measure algorithm suggested by Greenwald et al. (26).

Taste Test. The taste-test was modified from Marlatt, Demming, and Reid(27). Participants were instructed that they would make taste ratings on threebrands of beer. Three glasses were presented to each participant, each of whichcontained 350 ml of beer. The first glass contained the beer that participantsendorsed as being their favorite brand during the phone screen, the second glasscontained Budweiser beer, and the third glass contained O’Doul’s Amber non-alcoholic beer. Participants were not told the identity of the brands they weredrinking. Participants rated each of the three beers on a number of adjectives(e.g., “crisp,” “bitter”) that were presented one at a time on a computer screenusing a scale ranging from 1 (strongly disagree) to 4 (strongly agree). Partic-ipants were instructed that they could take as much time as they needed foreach rating and that they could drink as much of the beers as they liked for eachrating. Participants were given 10 minutes to sample the beers and make theirratings, although they were not informed of the time limitation beforehand.

Procedure

Participants were screened by phone to determine their eligibility. Eligiblecallers were instructed to not consume alcohol the day of the study, to arrangea ride to and from the study, and to not eat for 3 hours prior to the study.Participants were run individually in a laboratory space constructed to resemblea real bar. Participants completed the consent form, presented proof of age (e.g.,driver’s license) and had their BAC assessed. All participants met the criterionof a zero BAC. All female participants completed a pregnancy test with negativeresults.

Am

J D

rug

Alc

ohol

Abu

se D

ownl

oade

d fr

om in

form

ahea

lthca

re.c

om b

y M

erce

r U

nive

rsity

on

10/2

8/14

For

pers

onal

use

onl

y.

Page 5: Alcohol Consumption Primes Automatic Alcohol-Approach Associations

Automatic Alcohol-Approach Associations 707

After participants reviewed and signed the informed consent, the experi-menter administered the baseline IAT. After completing the IAT, participantscompleted demographic and alcohol-related measures and were then randomlyassigned into one of two groups consisting of different self-control tasks1. Af-ter the taste-test beers were brought out, participants completed the taste-test.After 10 minutes elapsed, the experimenter removed the glasses and instructedthe participants to wait quietly until the next phase began. Fifteen minutes afterthe conclusion of the taste-test, the experimenter administered the IAT a secondtime. Once participants’ breath alcohol level fell below .03, they were debriefedand allowed to leave.

RESULTS

Alcohol Consumption. Participants consumed a mean of 442.16 ml (SD =183.69) of alcohol with a range between 100 ml and 875 ml.

Influence of Alcohol Consumption on Automatic Alcohol Motivation. Thestudy examined whether alcohol consumption would prime automatic alcohol-approach associations. Several analyses were conducted to examine this pre-diction. A zero-order correlation demonstrated a relation between alcohol con-sumption and the post-drinking IAT (r[85] = .28, p = .01). This finding sug-gests that the consumption of alcohol activates automatic alcohol-approachassociations. However, this result could simply indicate that individuals whodrink more tend to have stronger alcohol-approach associations, a point sug-gested by the correlation between the baseline IAT and alcohol consumption inthe current study (r[85] = .22, p = .04) and by past research (12). In order todetermine whether alcohol consumption influenced the strength of automaticalcohol-approach associations, we conducted a partial correlation between al-cohol consumption and the post-drinking IAT while controlling for the baselineIAT. The results indicated that greater alcohol consumption leads to strongerautomatic alcohol-approach associations (pr [82] = .22, p = .04).

DISCUSSION

The results of the current study indicate that in a sample of at-risk drinkers,alcohol consumption primes automatic alcohol-approach associations in a dose-dependent manner. That is, the more alcohol consumed by participants in a 10-minute ad lib drinking task, the greater the increase in the strength of automaticassociations between alcohol and approach behavior concepts. These results

1Participants were given reasons not to drink and were involved in an additionalmanipulation designed to deplete self-control; this manipulation did not moderate therelation between beer consumed and pre- to posttest differences in IAT scores.

Am

J D

rug

Alc

ohol

Abu

se D

ownl

oade

d fr

om in

form

ahea

lthca

re.c

om b

y M

erce

r U

nive

rsity

on

10/2

8/14

For

pers

onal

use

onl

y.

Page 6: Alcohol Consumption Primes Automatic Alcohol-Approach Associations

708 S. R. Farris and B. D. Ostafin

are consistent with research indicating that consuming an initial dose of alco-hol activates appetitive responses to alcohol, including increased self-reportedmotivation to consume (18), choosing alcohol over monetary reinforcers (21),and increased alcohol consumption (19). The current study also supports pre-vious findings that the effects of alcohol ingestion on alcohol-related approachbehavior may occur in a dose-dependent manner (21).

There is increasing evidence for the role of automatic motivational pro-cesses in alcohol behavior (12, 14, 28). Additionally, it appears that automaticalcohol motivation is involved in dyscontrolled alcohol use—consuming de-spite intentions to restrain (29). Two components leading to behavioral dyscon-trol are insufficient inhibitory (self-control) resources and excessive appeti-tive (temptation) responses (30). There is evidence that depleting inhibitoryresources leads to greater alcohol consumption (17, 31) and that alcohol con-sumption impairs inhibitory resources (32). There is also evidence of a re-lation between automatic alcohol-appetitive motivation and self-report (13)and experimental measures (17) of alcohol dyscontrol. The current study pro-vides evidence that alcohol consumption increases the strength of automaticalcohol-approach associations. This suggests that initial consumption may leadto dyscontrolled use in part through its effects on automatic appetitive pro-cesses. However, the method used in this study limits the ability to makethis inference, as participants did not have a second free-drinking period aftermeasuring the influence of initial consumption on appetitive motivation. Fu-ture research would benefit by examining the extent to which initial alcoholconsumption leads to dyscontrolled use as a function of increased strength ofautomatic alcohol motivation.

Another limitation of the current study is that placebo was not used. As thebelief that a beverage contains alcohol may influence a variety of dependentvariables (27, 33), it is possible that the current results are due to expectancyeffects. However, as past research indicates that the effect of alcohol consump-tion on affect-related reaction time measures occurs for alcohol but not forplacebo (22, 23), it is likely that the current results are a function of the phar-macological properties of alcohol. In any case, future research should examinewhether placebo consumption leads to similar effects.

In sum, the current study examined the extent to which alcohol consump-tion primed appetitive motivation states. The results indicate that a primingdose of alcohol activates automatic alcohol-approach associations. These find-ings suggest that excessive drinking behavior may be a function of the effectsof initial consumption on the relation between alcohol and approach memoryelements.

ACKNOWLEDGMENTS

This research was supported by grant F32 AA15228-01 provided by the Na-tional Institute on Alcohol Abuse and Alcoholism of the National Institutes

Am

J D

rug

Alc

ohol

Abu

se D

ownl

oade

d fr

om in

form

ahea

lthca

re.c

om b

y M

erce

r U

nive

rsity

on

10/2

8/14

For

pers

onal

use

onl

y.

Page 7: Alcohol Consumption Primes Automatic Alcohol-Approach Associations

Automatic Alcohol-Approach Associations 709

of Health and grant 05-8161-G-01 provided by the Alcohol and Drug AbuseInstitute at the University of Washington, awarded to Brian D. Ostafin.

Declaration of Interest

The authors report no conflict of interest. The authors alone are responsible forthe content and writing of the paper.

REFERENCES

1. Cox WM, Klinger E. A motivational model of alcohol use. J Abnormal Psychology1988; 97:168–180.

2. Stacy AW. Memory activation and expectancy as prospective predictors of alcoholand marijuana use. J Abnormal Psychology 1997; 106:61–73.

3. Tiffany ST. A cognitive model of drug urges and drug-use behavior: Role of auto-matic and nonautomatic processes. Psychological Review 1990; 97:147–168.

4. Wiers RW, Stacy AW (Eds.). Handbook of Implicit Cognition and Addiction.Thousand Oaks, CA: Sage, 2006.

5. Bargh JA. The four horsemen of automaticity: Awareness, intention, efficiency, andcontrol in social cognition. In Handbook of Social Cognition. Wyer RS, Srull TK,eds. Hillsdale, NJ: Erlbaum, 1994; 1–40.

6. De Houwer J. What are implicit measures and why are we using them? In Handbookof Implicit Cognition and Addiction. Wiers RW, Stacy AW eds. Thousand Oaks,CA: Sage Publications Inc., 2006; 11–28.

7. Fazio RH, Sanbonmatsu DM, Powell MC, Kardes FR. On the automatic activationof attitudes. J Personality and Social Psychology 1986; 50:229–238.

8. Chen M, Bargh JA. Consequences of automatic evaluation: Immediate behavioralpredispositions to approach or avoid the stimulus. Personality and Social Psychol-ogy Bulletin 1999; 25:215–224.

9. Fazio RH. Multiple processes by which attitudes guide behavior: The MODE modelas an integrative framework. In Advances in Experimental Social Psychology.Zanna MP, ed. New York: Academic Press, 1990; Vol. 23, pp. 75–109.

10. Fazio RH, Olson MA. Implicit measures in social cognition research: Their meaningand uses. Annual Revi Psych 2003; 54:297–327.

11. Greenwald AG, McGhee DE, Schwartz JLK. Measuring individual differences inimplicit cognition: the Implicit Association Test. J Personality and Social Psychol-ogy 1998; 74:1464–1480.

12. Ostafin BD, Palfai TB. Compelled to consume: The Implicit Association Test andautomatic alcohol motivation. Psychology of Addictive Behaviors 2006; 20:322–327.

13. Palfai TB, Ostafin BD. Alcohol-related motivational tendencies in hazardousdrinkers: Assessing implicit response tendencies using the modified-IAT. BehaviourResearch and Therapy 2003; 41:1149–1162.

14. Jajodia A, Earleywine M. Measuring alcohol expectancies with the implicit asso-ciation test. Psychology of Addictive Behaviors 2003; 17:126–133.

Am

J D

rug

Alc

ohol

Abu

se D

ownl

oade

d fr

om in

form

ahea

lthca

re.c

om b

y M

erce

r U

nive

rsity

on

10/2

8/14

For

pers

onal

use

onl

y.

Page 8: Alcohol Consumption Primes Automatic Alcohol-Approach Associations

710 S. R. Farris and B. D. Ostafin

15. Wiers RW, van Woerden N, Smulders TY, de Jong PJ. Implicit and explicit alcohol-related cognitions in heavy and light drinkers. J Abnormal Psychology 2002;111:648–658.

16. McCarthy DM, Thompsen DM. Implicit and explicit measures of alcohol andsmoking cognitions. Psychology of Addictive Behaviors 2006; 20:436–444.

17. Ostafin BD, Marlatt GA, Greenwald AG. Drinking without thinking: An implicitmeasure of alcohol motivation predicts failure to control alcohol use. in press.Behaviour Research and Therapy.

18. Fillmore MT. Cognitive Preoccupation with alcohol and binge drinking in col-lege students: alcohol-induced priming of the motivation to drink. Psychology ofAddictive Behaviors 2001; 15:325–332.

19. Hobbs M, Remington B, Glautier S. Dissociation of wanting and liking for alcoholin humans: A test of the incentive-sensitisation theory. Psychopharmacology 2005;178:493–499.

20. Rose AK, Duka T. Effects of dose and time on the ability of alcohol to prime socialdrinkers. Behavioural Pharmacology 2006; 17:61–70.

21. Chutuape MA, Mitchell SH, de Wit H. Ethanol preloads increase ethanol prefer-ence under concurrent random-ratio schedules in social drinkers. Experimental andClinical Psychopharmacology 1994; 2:310–318.

22. Fillmore MT, Rush CR. Alcohol effects on inhibitory and activational responsestrategies in the acquisition of alcohol and other reinforcers: priming the motivationto drink. Journal of Studies on Alcohol 2001; 62:646–657.

23. Palfai TB, Ostafin BD. The influence of alcohol on the activation of outcomeexpectancies: the role of evaluative expectancy activation in drinking behavior.Journal of Studies on Alcohol 2003; 64:111–119.

24. US Department of Health and Human Services, National Institute on AlcoholAbuse and Alcoholism. The physician’s guide to helping patients with alcohol prob-lems. NIH Publication No95-3796. National Institutes of Health, Bethesda, Md.,1995.

25. Sobell LC, Maisto SA, Sobell MB, Cooper MA. Reliability of alcohol abusers’self-reports of drinking behavior. Behaviour Research and Therapy 1979; 17:157–160.

26. Greenwald AG, Nosek BA, Banaji MR. Understanding and using the ImplicitAssociation Test: I. An improved scoring algorithm. Journal of Personality andSocial Psychology 2003; 85:197–216.

27. Marlatt GA, Demming B, Reid JB. Loss of control drinking in alcoholics: Anexperimental analogue. Journal of Abnormal Psychology 1973; 81:233–241.

28. Thush C, Wiers RW. Explicit and implicit alcohol-related cognitions and the predic-tion of future drinking in adolescents. Addictive Behaviors 2007; 32:1367–1383.

29. Widiger TA, Smith GT. Substance use disorder: Abuse, dependence and dyscontrol.Addiction 1994; 89:267–282.

30. Herman CP, Polivy J. The self-regulation of eating: Theoretical and practical prob-lems. In The Handbook of Self-Regulation: Research, Theory, and Applications.Baumeister RF, Vohs KD eds. New York: Guilford, 2004; pp. 492–508.

31. Muraven M, Collins RL, Neinhaus K. Self-control and alcohol restraint: An initialapplication of the Self-Control Strength Model. Psychology of Addictive Behaviors2002; 16:113–120.

Am

J D

rug

Alc

ohol

Abu

se D

ownl

oade

d fr

om in

form

ahea

lthca

re.c

om b

y M

erce

r U

nive

rsity

on

10/2

8/14

For

pers

onal

use

onl

y.

Page 9: Alcohol Consumption Primes Automatic Alcohol-Approach Associations

Automatic Alcohol-Approach Associations 711

32. Marczinski CA, Fillmore MT. Preresponse cues reduce the impairing effects ofalcohol on the execution and suppression of responses. Experimental and ClinicalPsychopharmacology 2003; 11:110–117.

33. Assefi SL, Garry M. Absolut R©memory distortions: Alcohol placebos influence themisinformation effect. Psychological Science 2003; 14:77–80.

Am

J D

rug

Alc

ohol

Abu

se D

ownl

oade

d fr

om in

form

ahea

lthca

re.c

om b

y M

erce

r U

nive

rsity

on

10/2

8/14

For

pers

onal

use

onl

y.