Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Addiction Science & Clinical Practice
Published in: Addiction Science & Clinical Practice 1/2012

Open Access 01-12-2012 | Research

When wanting to change is not enough: automatic appetitive processes moderate the effects of a brief alcohol intervention in hazardous-drinking college students

Authors: Brian D Ostafin, Tibor P Palfai

Published in: Addiction Science & Clinical Practice | Issue 1/2012

Login to get access

Abstract

Background

Research indicates that brief motivational interventions are efficacious treatments for hazardous drinking. Little is known, however, about the psychological processes that may moderate intervention success. Based on growing evidence that drinking behavior may be influenced by automatic (nonvolitional) mental processes, the current study examined whether automatic alcohol-approach associations moderated the effect of a brief motivational intervention. Specifically, we examined whether the efficacy of a single-session intervention designed to increase motivation to reduce alcohol consumption would be moderated by the strength of participants’ automatic alcohol-approach associations.

Methods

Eighty-seven undergraduate hazardous drinkers participated for course credit. Participants completed an Implicit Association Test to measure automatic alcohol-approach associations, a baseline measure of readiness to change drinking behavior, and measures of alcohol involvement. Participants were then randomly assigned to either a brief (15-minute) motivational intervention or a control condition. Participants completed a measure of readiness to change drinking at the end of the first session and returned for a follow-up session six weeks later in which they reported on their drinking over the previous month.

Results

Compared with the control group, those in the intervention condition showed higher readiness to change drinking at the end of the baseline session but did not show decreased drinking quantity at follow-up. Automatic alcohol-approach associations moderated the effects of the intervention on change in drinking quantity. Among participants in the intervention group, those with weak automatic alcohol-approach associations showed greater reductions in the amount of alcohol consumed per occasion at follow-up compared with those with strong automatic alcohol-approach associations. Automatic appetitive associations with alcohol were not related with change in amount of alcohol consumed per occasion in control participants. Furthermore, among participants who showed higher readiness to change, those who exhibited weaker alcohol-approach associations showed greater reductions in drinking quantity compared with those who exhibited stronger alcohol-approach associations.

Conclusions

The results support the idea that automatic mental processes may moderate the influence of brief motivational interventions on quantity of alcohol consumed per drinking occasion. The findings suggest that intervention efficacy may be improved by utilizing implicit measures to identify those who may be responsive to brief interventions and by developing intervention elements to address the influence of automatic processes on drinking behavior.

Literature
  1. Wechsler H, Dowdall GG, Davenport A, Castillo S: Correlates of college student binge drinking. Am J Public Health. 1995, 85: 921-926. 10.2105/AJPH.85.7.921.PubMed CentralView ArticlePubMed
  2. Youth Drinking Cultures: European Experiences. Edited by: Andersson B, Hibell B, Jävinen M, Room R. 2007, Aldershot, UK: Ashgate Publishing Ltd
  3. Engs RC, Diebold BA, Hanson DJ: The drinking patterns and problems of a national sample of college students. J Alcohol Drug Educ. 1994, 41: 13-33.
  4. O’Neil SE, Parra GR, Sher KJ: Clinical relevance of heavy drinking during the college years: Cross-sectional and prospective perspectives. Psychol Addict Behav. 2001, 15: 350-359.View Article
  5. Jensen CD, Cushing CC, Aylward BS, Craig JT, Sorell DM, Steele RG: Effectiveness of motivational interviewing interventions for adolescent substance use behavior change: a meta-analytic review. J Consult Clin Psych. 2011, 79: 433-440.View Article
  6. Carey KB, Scott-Sheldon LAJ, Carey MP, DeMartini KS: Individual-level interventions to reduce college student drinking: a meta-analytic review. Addict Behav. 2007, 32: 2469-2494. 10.1016/j.addbeh.2007.05.004.PubMed CentralView ArticlePubMed
  7. Dunn C, Deroo L, Rivara FP: College students’ readiness to reduce binge drinking: criterion validity of a brief measure. Addiction. 2001, 109: 236-238.
  8. Miller WR: Motivational interviewing: research, practice, and puzzles. Addict Behav. 1996, 21: 835-842. 10.1016/0306-4603(96)00044-5.View ArticlePubMed
  9. Borsari B, Carey KB: Effects of a brief motivational intervention with college student drinkers. J Consult Clin Psych. 2000, 68: 728-733.View Article
  10. Marlatt GA, Baer JS, Kivlahan DR, Dimeff LA, Larimer ME, Quigley LA, Somers JM, Williams E: Screening and brief intervention for high-risk college student drinkers: results from a 2-year follow-up assessment. J Consult Clin Psych. 1998, 66: 604-615.View Article
  11. McMahon J, Jones BT, Smith I: Paper presented at the annual conference of the British Psychological Society. Negative expectancy based intervention within a motivational interviewing context. 1996
  12. McNally AM, Palfai TP, Kahler CW: Motivational interventions for heavy drinking college students: examining the role of discrepancy-related psychological processes. Psychol Addict Behav. 2005, 19: 79-87.View ArticlePubMed
  13. Branscum P, Sharma M: A review of motivational interviewing-based interventions targeting problematic drinking among college students. Alcsm Treat Quart. 2010, 28: 63-77. 10.1080/07347320903436276.View Article
  14. Murphy JG, Benson TA, Vuchinich RE, Deskins MM, Eakin D, Flood AM, McDevitt-Murphy OT: A comparison of personalized feedback for college student drinkers delivered with and without a motivational interview. J Stud Alcohol. 2004, 65: 200-203.View ArticlePubMed
  15. Carey KB, Henson JM, Carey MP, Maisto SA: Which heavy drinking college students benefit from a brief motivational intervention?. J Consult Clin Psych. 2007, 75: 663-669.View Article
  16. Deutsch R, Strack F: Reflective and impulsive determinants of addictive behavior. Handbook of implicit cognition and addiction. Edited by: Wiers RW, Stacy AW. 2006, Thousand Oaks CA: Sage, 45-57.View Article
  17. Wiers RW, Bartholow BD, van den Wildenberg E, Thush C, Engels RCME, Sher K, Grenard J, Ames SL, Stacy AW: Automatic and controlled processes and the development of addictive behaviors in adolescents: a review and a model. Pharmacol Biochem Be. 2007, 86: 263-283. 10.1016/j.pbb.2006.09.021.View Article
  18. Bechera A, Noel X, Crone EA: Loss of willpower: abnormal neural mechanisms of impulse control and decision making in addiction. Handbook of implicit cognition and addiction. Edited by: Wiers RW, Stacy AW. 2006, Thousand Oaks CA: Sage, 215-232.View Article
  19. Fazio RH, Towles-Schwen T: The MODE model of attitude-behavior processes. Dual process theories in social psychology. Edited by: Chaiken S, Trope Y. 1999, New York: Guilford, 97-116.
  20. De Houwer J: A structural analysis of indirect measures of attitudes. The psychology of evaluation: Affective processes in cognition and emotion. Edited by: Musch J, Klauer KC. 2003, Mahwah, NJ: Lawrence Erlbaum, 219-244.
  21. Field M, Mogg K, Zetteler J, Bradley BP: Attentional biases for alcohol cues in heavy and light social drinkers: the roles of initial orienting and maintained attention. Psychopharmacology. 2004, 176: 88-93. 10.1007/s00213-004-1855-1.View ArticlePubMed
  22. Noël X, Colmant M, Van Der Linden M, Bechara A, Bullens Q, Hanak C, Verbanck P: Time course of attention for alcohol cues in abstinent alcoholic patients: the role of initial orienting. Alcohol Clin Exp Res. 2006, 30: 1871-1877. 10.1111/j.1530-0277.2006.00224.x.View ArticlePubMed
  23. Stormark KL, Laberg JC, Nordby H, Hugdahl K: Alcoholics’ selective attention to alcohol stimuli: automated processing?. J Stud Alcohol. 2000, 61: 18-23.View ArticlePubMed
  24. Cox W, Hogan LM, Kristian MR, Race JH: Alcohol attentional bias as a predictor of alcohol abusers’ treatment outcome. Drug Alcohol Depen. 2002, 68: 237-243. 10.1016/S0376-8716(02)00219-3.View Article
  25. Carpenter KM, Schreiber E, Church S, McDowell D: Drug Stroop performance: relationships with primary substance use and treatment outcome in a drug-dependent outpatient sample. Addict Behav. 2006, 31: 174-181. 10.1016/j.addbeh.2005.04.012.View ArticlePubMed
  26. Waters AJ, Shiffman S, Sayette MA, Paty JA, Gwaltney CH, Balabanis MH: Attentional bias predicts outcome in smoking cessation. Health Psychol. 2003, 22: 678-387.View Article
  27. Greenwald AG, McGhee DE, Schwartz JLK: Measuring individual differences in implicit cognition: the Implicit Association Test. J Pers Soc Psychol. 1998, 74: 1464-1480.View ArticlePubMed
  28. Wiers RW, van Woerden N, Smulders FTY, de Jong PJ: Implicit and explicit alcohol-related cognitions in heavy and light drinkers. J Abnormal Psychol. 2002, 111: 648-658.View Article
  29. Ostafin BD, Palfai TP: Compelled to consume: the Implicit Association Test and automatic alcohol motivation. Psychol Addict Behav. 2006, 20: 322-327.View ArticlePubMed
  30. Ostafin BD, Brooks JJ: Drinking for relief: negative affect increases automatic alcohol motivation in coping-motivated drinkers. Motiv Emotion. 2011, 35: 285-295. 10.1007/s11031-010-9194-5.View Article
  31. Palfai TP, Ostafin BD: Alcohol-related motivational schema among hazardous drinkers: assessing implicit response tendencies using the modified-IAT. Behav Res Ther. 2003, 41: 1149-1162. 10.1016/S0005-7967(03)00018-4.View ArticlePubMed
  32. Ostafin BD, Marlatt GA, Greenwald AG: Drinking without thinking: an implicit measure of alcohol motivation predicts failure to control alcohol use. Behav Res Ther. 2008, 46: 1210-1219. 10.1016/j.brat.2008.08.003.View ArticlePubMed
  33. Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M: Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction. 1993, 88: 791-804. 10.1111/j.1360-0443.1993.tb02093.x.View ArticlePubMed
  34. National Institute on Alcohol Abuse and Alcoholism Task Force: Recommended alcohol questions. 2003, http://​www.​niaaa.​nih.​gov/​research/​guidelines-andresources/​recommended-alcohol-questions.
  35. Biener L, Abrams DB: The Contemplation Ladder: Validation of a measure of readiness to consider smoking cessation. Health Psychol. 1991, 10: 360-365.View ArticlePubMed
  36. Clair M, Stein LA, Martin R, Barnett NP, Colby SM, Monti PM, Golembeske C, Lebeau R: Motivation to change alcohol use and treatment engagement in incarcerated youth. Addict Behav. 2011, 36: 674-680. 10.1016/j.addbeh.2011.01.007.PubMed CentralView ArticlePubMed
  37. McGee R, Williams S, Kypri K: College students’ readiness to reduce binge drinking: criterion validity of a brief measure. Drug Alcohol Depen. 2010, 109: 236-238. 10.1016/j.drugalcdep.2009.12.009.View Article
  38. Schneider W, Eschman A, Zuccolotto A: E-Prime user’s guide. 2002, Pittsburgh, PA: Psychology Software Tools
  39. Greenwald AG, Nosek BA, Banaji MR: Understanding and using the Implicit Association Test: I. An improved scoring algorithm. J Pers Soc Psychol. 2003, 85: 197-216.View ArticlePubMed
  40. Wood MD, Read JP, Palfai TP, Stevenson JF: Social influence processes and college student drinking: the mediational role of alcohol outcome expectancies. J Stud Alcohol. 2001, 62: 32-43.View ArticlePubMed
  41. Hurlbut BT, Sher KJ: Assessing alcohol problems in college students. J Am Coll Health. 1992, 41: 49-58. 10.1080/07448481.1992.10392818.View ArticlePubMed
  42. Miller WR, Tonigan JS, Longabaugh R: Project MATCH Monograph Series, vol 4. The drinker inventory of consequences (DrInc): An instrument for assessing adverse consequences of alcohol abuse. Test manual. 1995, Bethesda, MD: National Institute on Alcohol Abuse and AlcoholismView Article
  43. Miller WR, Rollnick S: Motivational interviewing: Preparing people to change addictive behavior. 1991, New York: Guilford Press
  44. Aiken LS, West SG: Multiple regression: Testing and interpreting interactions. 1991, Thousand Oaks, CA: Sage
  45. Widiger TA, Smith GT: Substance use disorder: Abuse, dependence and dyscontrol. Addiction. 1994, 89: 267-282. 10.1111/j.1360-0443.1994.tb00889.x.View ArticlePubMed
  46. Friese M, Hofmann W, Wänke M: When impulses take over: moderated predictive validity of explicit and implicit attitude measures in predicting food choice and consumption behavior. Brit J Soc Psychol. 2008, 47: 397-419. 10.1348/014466607X241540.View Article
  47. McClelland DC, Koestner R, Weinberger J: How do self-attributed and implicit motives differ?. Psychol Rev. 1989, 96: 690-702.View Article
  48. Perugini M: Predictive models of implicit and explicit attitudes. Brit J Soc Psychol. 2005, 44: 29-45. 10.1348/014466604X23491.View Article
  49. Daeppen JB, Gaueme J, Bady P, Yersin B, Calmes JM, Gmel G: Brief alcohol intervention and alcohol assessment do not influence alcohol use in injured patients treated in the emergency department: a randomized controlled clinical trial. Addiction. 2007, 102: 1224-1233. 10.1111/j.1360-0443.2007.01869.x.View ArticlePubMed
  50. Karpinski A, Steinman RB: The single category implicit association test as a measure of implicit social cognition. J Pers Soc Psychol. 2006, 91: 16-32.View ArticlePubMed
  51. Wiers RW, van de Luitgaarden J, van den Wildenberg E, Smulders FTY: Challenging implicit and explicit alcohol-related cognitions in young heavy drinkers. Addiction. 2005, 100: 806-819. 10.1111/j.1360-0443.2005.01064.x.View ArticlePubMed
  52. Gawronski B, Strack F: On the propositional nature of cognitive consistency: dissonance changes explicit, but not implicit, attitudes. J Exp Soc Psychol. 2004, 40: 535-542. 10.1016/j.jesp.2003.10.005.View Article
  53. Houben K, Havermans RC, Wiers RW: Learning to dislike alcohol: conditioning negative implicit attitudes toward alcohol and its effect on drinking behavior. Psychopharmacology. 2010, 211: 79-86. 10.1007/s00213-010-1872-1.PubMed CentralView ArticlePubMed
  54. Schoenmakers TM, de Bruin M, Lux IRM, Goertz AG, Van Kerkhof DHAT, Wiers RW: Clinical effectiveness of attentional bias modification training in abstinent alcoholic patients. Drug Alcohol Depend. 2010, 109: 30-36. 10.1016/j.drugalcdep.2009.11.022.View ArticlePubMed
  55. Palfai TP: Automatic Processes in the Self-Regulation of Addictive Behaviors. Handbook of implicit cognition and addiction. Edited by: Wiers RW, Stacy AW. 2006, Thousand Oaks CA: Sage, 411-424.View Article
  56. Ostafin BD, Bauer C, Myxter P: Mindfulness decouples the relation between automatic alcohol motivation and drinking behavior. J Soc Clin Psychol. 2012, 31: 729-745. 10.1521/jscp.2012.31.7.729.View Article
  57. Ostafin BD, Marlatt GA: Surfing the urge: Experiential acceptance moderates the relation between automatic alcohol motivation and hazardous drinking. J Soc Clin Psychol. 2008, 27: 426-440.View Article
  58. Mastroleo NR, Murphy JG, Colby SM, Monti PM, Barnett NP: Incident-specific and individual-level moderators of brief intervention effects with mandated college students. Psychol Addict Behav. 2011, 25: 616-624.PubMed CentralView ArticlePubMed
  59. Hunt WA, Barnett LW, Branch LG: Relapse rates in addiction programs. J Clin Psych. 1971, 27: 455-456. 10.1002/1097-4679(197110)27:4<455::AID-JCLP2270270412>3.0.CO;2-R.View Article
Metadata
Title
When wanting to change is not enough: automatic appetitive processes moderate the effects of a brief alcohol intervention in hazardous-drinking college students
Authors
Brian D Ostafin
Tibor P Palfai
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Addiction Science & Clinical Practice / Issue 1/2012
Electronic ISSN: 1940-0640
DOI
https://doi.org/10.1186/1940-0640-7-25

Other articles of this Issue 1/2012

Addiction Science & Clinical Practice 1/2012 Go to the issue

Letter to the Editor

Comment on the case for considering quality of life in addiction research and clinical practice

Research

Screening for adolescent alcohol and drug use in pediatric health-care settings: predictors and implications for practice and policy

Review

Building the first step: a review of low-intensity interventions for stepped care

Research

Feedback from recently returned veterans on an anonymous web-based brief alcohol intervention

Review

Can screening and brief intervention lead to population-level reductions in alcohol-related harm?

Research

Early data from project engage: a program to identify and transition medically hospitalized patients into addictions treatment