Kimberly A. Fleming

Alcohol Cues, Approach Bias, and Inhibitory Control: Applying a Dual Process Model of Addiction to Alcohol Sensitivity

Low sensitivity to the acute effects of alcohol is a risk factor for heavy drinking and related problems. However, little research has tested process explanations for such effects. The current study tested the hypothesis that low sensitivity is associated with automatic approach biases for alcohol cues, coupled with deficits inhibiting responses in the presence of such cues. Eighty-five participants varying in alcohol sensitivity completed an Alcohol-Approach Avoidance Task and a Cued Go/No-Go Task while event-related potentials were recorded. Low sensitivity (LS) individuals showed evidence of automatic approach tendencies toward alcohol cues in both tasks, and experienced deficits inhibiting prepotent responses cued by alcohol images. Additionally, the event-related potential data indicated that LS individuals experienced more conflict when attempting to inhibit alcohol-cued responses, but not nonalcohol-cued responses, compared with their high-sensitivity counterparts. Together, these data indicate that alcohol cues elicit an approach bias among LS individuals, translating into greater difficulty inhibiting behavioral responses in the presence of such cues, a pattern generally supportive of dual process models of substance use.

Specifying Associations Between Conscientiousness and Executive Functioning: Mental Set Shifting, Not Prepotent Response Inhibition or Working Memory Updating.

Conscientiousness is characterized by self-control, organization, and goal orientation and is positively related to a number of health and professional outcomes. Thus, it is commonly suggested that conscientiousness should be related to superior executive functioning (EF) abilities, especially prepotent response inhibition. However, little empirical support for this notion has emerged, perhaps due to oversimplified and underspecified modeling of EF. The current study sought to fill this gap by testing relations between conscientiousness and three facets of EF using a nested factors latent variable approach. Participants (N = 420; Mage  = 22.5; 50% male; 91% Caucasian) completed a measure of conscientiousness and nine EF tasks designed to tap three related yet distinguishable facets of EF: working memory updating, mental set shifting, and prepotent response inhibition. Structural equation models showed that conscientiousness is positively associated with the EF facet of mental set shifting but not response inhibition or working memory updating. Despite the common notion that conscientiousness is associated with cognitive abilities related to rigid control over impulses (i.e., inhibition), the current results suggest the cognitive ability most associated with conscientiousness is characterized by flexibility and the ability to adapt to changing environmental contingencies and task demands.

Working memory as a moderator of impulsivity and alcohol involvement: Testing the cognitive-motivational theory of alcohol use with prospective and working memory updating data

Research consistently shows that individuals high in impulsivity are at increased risk for excessive alcohol use and alcohol-related problems including alcohol use disorders (AUDs). Recent theorizing posits that working memory (WM) ability might moderate this association, but extant studies have suffered from methodological shortcomings, particularly mischaracterizing WM as a single, unitary construct and using only cross-sectional designs. This paper reports two studies that attempted to replicate and extend previous investigations of the relationship between WM, impulsivity, and alcohol involvement using two independent samples. Study 1 used a large (N=489 at baseline), prospective cohort of college students at high and low risk for AUD to investigate interactions between WM capacity and impulsivity on cross-sectional and prospective alcohol involvement. Study 2 used a large (N=420), cross-sectional sample of participants in an alcohol challenge study to investigate similar interactions between WM updating and impulsivity on recent alcohol involvement. Whereas Study 1 found that WM capacity moderates the relationship between some measures of impulsivity and alcohol involvement, with effects prospectively predicting alcohol involvement for up to three years, Study 2 did not find similar moderation effects when using measures of WM updating. These findings highlight the multifaceted nature of WM, which is often overlooked in the alcohol and impulsivity literature.

Heavy Drinking in Young Adulthood Increases Risk of Transitioning to Obesity

INTRODUCTION Heavy episodic alcohol use during young adulthood may contribute to excess weight gain and transition from healthy weight to overweight/obesity. This study is the first to evaluate the association between heavy episodic drinking during early adulthood and transition to overweight/obese status 5 years later using data from the U.S. National Longitudinal Study of Adolescent to Adult Health. METHODS The study used data from Waves III and IV, when participants were aged 18-26 and 24-32 years, respectively. The final sample consisted of 7,941 participants with measured height/weight who reported ever drinking alcohol. Multinomial logistic regression models tested the association between heavy episodic drinking and risk of transitioning to an unhealthy weight class. RESULTS Heavy episodic drinking was associated with 41% higher risk of transitioning from normal weight to overweight (relative risk ratio, 1.41; 95% CI=1.13, 1.74; p=0.002) and 36% higher risk of transitioning from overweight to obese by Wave IV (relative risk ratio, 1.36; 95% CI=1.09, 1.71; p=0.008), compared with individuals not drinking heavily, while accounting for covariates. Heavy episodic drinking was associated with 35% higher risk of maintaining obesity (relative risk ratio, 1.35; CI=1.06, 1.72; p=0.016) and gaining excess weight (OR=1.20, 95% CI=1.03, 1.39, p=0.02). CONCLUSIONS Regular heavy episodic drinking in young adulthood is associated with higher risk of gaining excess weight and transitioning to overweight/obesity. Obesity prevention efforts should address heavy drinking as it relates to caloric content and risk of transitioning to an unhealthy weight class.

Effects of alcohol on sequential information processing: evidence for temporal myopia.

Alcohol Myopia Theory (AMT) posits that alcohol restricts the focus of attention, such that behaviors are determined only by highly salient environmental cues. While AMT is most commonly understood in terms of spatial attention, the present study tested the effects of alcohol in the temporal domain of attention. Seventy-one participants consumed either a placebo beverage or one of two doses of alcohol (0.40g/kg or 0.80g/kg ETOH) before performing an auditory discrimination task while event-related potentials (ERPs) were recorded. Consistent with typical sequential effects, placebo participants showed increased P300 amplitude and slowed behavioral responses when the current target differed from the two-back tone. In contrast, alcohol caused increased P300 and response slowing when the target tone differed from the one-back tone. These findings suggest that alcohol increases the salience of more recently encountered information, consistent with the general tenets of AMT.

P3 Event-Related Potential Reactivity to Smoking Cues: Relations With Craving, Tobacco Dependence, and Alcohol Sensitivity in Young Adult Smokers.

The current study tested whether the amplitude of the P3 event-related potential (ERP) elicited by smoking cues is (a) associated with the degree of self-reported craving reactivity, and (b) moderated by degree of tobacco dependence. Because alcohol and cigarettes are frequently used together, and given recent evidence indicating that individual differences in alcohol sensitivity influence reactivity to alcohol cues, we also investigated whether alcohol sensitivity moderated neural responses to smoking cues. ERPs were recorded from young adult smokers (N = 90) while they participated in an evaluative categorization oddball task involving 3 types of targets: neutral images, smoking-related images, and images of drinking straws. Participants showing larger P3 amplitudes to smoking cues and to straw cues (relative to neutral targets) reported greater increases in craving after cue exposure. Neither smoking status (daily vs. occasional use) nor psychometric measures of tobacco dependence consistently or specifically moderated P3 reactivity to smoking cues. Lower alcohol sensitivity was associated with larger P3 to smoking cues but not comparison straw cues (relative to neutral targets). This effect was further moderated by tobacco dependence, with the combination of lower sensitivity and higher dependence associated with especially pronounced P3 reactivity to smoking cues. The findings suggest the smoking-cue elicited P3 ERP component indexes an approach-oriented incentive motivational state accompanied by a subjective sense of cigarette craving. Self-reported low sensitivity to the pharmacologic effects of alcohol may represent a marker of drug cue reactivity and therefore deserves attention as a potential moderator in smoking cue exposure studies.

University-Affiliated Alcohol Marketing Enhances the Incentive Salience of Alcohol Cues

We tested whether affiliating beer brands with universities enhances the incentive salience of those brands for underage drinkers. In Study 1, 128 undergraduates viewed beer cues while event-related potentials (ERPs) were recorded. Results showed that beer cues paired with in-group backgrounds (logos for students’ universities) evoked an enhanced P3 ERP component, a neural index of incentive salience. This effect varied according to students’ levels of identification with their university, and the amplitude of the P3 response prospectively predicted alcohol use over 1 month. In Study 2 (N = 104), we used a naturalistic advertisement exposure to experimentally create in-group brand associations and found that this manipulation caused an increase in the incentive salience of the beer brand. These data provide the first evidence that marketing beer via affiliating it with students’ universities enhances the incentive salience of the brand for underage students and that this effect has implications for their alcohol involvement.

Alcohol effects on response inhibition: Variability across tasks and individuals.

Considerable research has investigated the acute effects of alcohol on response inhibition, but a number of issues remain unresolved. Given that most studies use only a single laboratory task to assess inhibition, it is often difficult to determine whether alcohol’s effects are task specific or generalize across measures of the same construct. Moreover, relatively few studies have directly compared effects of alcohol under ascending and descending blood alcohol concentrations (BACs), and those that have often failed to disentangle BAC limb effects from the effects of repeated testing. This study was intended to provide a test of alcohol’s effects on behavioral inhibition using multiple laboratory measures in a relatively large sample and comparing effects under ascending and descending BAC. Young adults (N = 216) completed three commonly used inhibition tasks (Stroop, antisaccade, and stop-signal) at baseline and again 1–3 weeks later under one of three beverage conditions (alcohol, placebo or control) and one of two BAC limb conditions (ascending/descending or descending only). Findings indicated considerable specificity in alcohol’s effects. Relative to control and placebo conditions, antisaccade performance suffered under both ascending and descending BAC and stop-signal reaction time (RT) suffered only under descending BAC. The Stroop RT interference effect was not affected by alcohol, though alcohol did impair response accuracy on incongruent Stroop trials. Baseline performance moderated effects of alcohol on both antisaccade accuracy and Stroop interference, suggesting the importance of individual differences. The current findings suggest that more specificity is required in characterizing acute effects of alcohol on inhibitory control.