Drug-related stimuli impair inhibitory control in cocaine abusers

Background

Cocaine users show impaired inhibitory control on cued go/no-go tasks and attention bias to drug-related stimuli in the emotional Stroop task. The results of a previous study suggested that there is a relationship between inhibitory control and attention bias in alcohol drinkers such that the presentation of alcohol-related images as a go cue in a cued go/no-go task significantly impaired inhibitory control compared to neutral images as a go cue. The present study determined the generality of these previous findings by assessing inhibitory control in cocaine users utilizing a modified cued go/no-go task with cocaine or neutral images as the cues.

Methods

Non-treatment seeking cocaine users (N = 30) completed the modified task after completing detailed measures of demographics and drug use. Participants were matched on basic demographic factors and were assigned to groups in which they saw either a cocaine or neutral image as the go cue.

Results

Participants assigned to the cocaine image go cue condition had a significantly higher proportion of inhibitory failures to the no-go target than their counterparts assigned to the neutral cue condition, but there were no group differences on reaction time (i.e., accuracy was not traded for speed).

Conclusions

Cocaine users were less able to inhibit pre-potent responses when a cocaine-related image served as the go cue than when a neutral image served as the go cue, consistent with previous research in alcohol users. The outcomes suggest that cocaine-related cues produce disinhibition, perhaps contributing to the high incidence of relapse or continued cocaine use.     

Alcohol-related attentional bias in a gaze contingency task: Comparing appetitive and non-appetitive cues

BackgroundNon-problem drinkers attend automatically to alcohol-related cues compared to non-alcohol related cues on tests of inhibitory control. Moreover, attentional bias for alcohol-related cues varies between problem and non-problem drinkers.AimTo examine attentional bias towards alcoholic and non-alcoholic appetitive cues between problem and non-problem drinkers.MethodForty-one university students (9 male, 32 female; Mage = 21.50) completed an eye-tracking gaze contingency paradigm, measuring the number of times participants looked at peripherally and centrally located stimuli (break frequency) when instructed to maintain focus on a target object. Stimuli consisted of appetitive alcohol-related (e.g., wine), appetitive non-alcohol-related (e.g., cola) and non-appetitive (e.g., fabric softener) stimuli. Participants were split using the Alcohol Use Disorders Identification Test (AUDIT) into non-problem (M AUDIT = 3.86) and problematic drinkers (M AUDIT = 11.59).ResultsProblematic drinkers had higher break frequencies towards peripheral appetitive stimuli than towards non-appetitive stimuli, while break frequency was equivalent between appetitive cues presented centrally (alcohol and non-alcohol-related). In contrast, there were no differences in break frequency across stimuli type or cue presentation location (central or peripheral) for non-problem drinkers.ConclusionIn contrast to non-problem drinkers, people displaying more problematic consumption practices may find it more difficult to inhibit eye movements towards appetitive stimuli, particularly when in peripheral vision. This may suggest that attentional biases, as measured in terms of overt eye movements, in problem drinkers may be most powerful when the alcoholic and appetitive stimuli are not directly in field of view. An uncertainty reduction process in the allocation of attention to appetitive cues may help explain the patterns of results observed.     

Relationship between alcohol dependence,escape drinking,and early neural attention to alcohol-related cues

Rationale

Previous work has indicated that implicit attentional biases to alcohol-related cues are indicative of susceptibility to alcohol dependence and escape drinking, or drinking to avoid dysphoric mood or emotions.

Objective

The goal of the current study was to examine whether alcohol dependence and escape drinking were associated with early neural attentional biases to alcohol cues.

Methods

Electroencephalography data were recorded from 54 college students who reported that they regularly drank alcohol, while they viewed alcohol and control pictures that contained human content (active) or no human content (inactive).

Results

Those who were alcohol dependent showed more neural attentional bias to the active alcohol-related stimuli than to the matched control stimuli early in processing, as indicated by N1 amplitude. Escape drinkers showed greater neural attention to the active alcohol cues than non-escape drinkers, as measured by larger N2 amplitudes.

Conclusions

While alcohol dependence is associated with enhanced automatic attentional biases early in processing, escape drinking is associated with more controlled attentional biases to active alcohol cues during a relatively later stage in processing. These findings reveal important information about the time-course of attentional processing in problem drinkers and have important implications for addiction models and treatment.     

Resisting temptation: decreasing alcohol-related affect and drinking behavior by training response inhibition

According to dual-process models, excessive alcohol use emerges when response inhibition ability is insufficient to inhibit automatic impulses to drink alcohol. This study examined whether strengthening response inhibition for alcohol-related cues decreases alcohol intake. Fifty-two heavy drinking students were randomly assigned to one of two conditions: In the beer/no-go condition, participants performed a go/no-go task that consistently paired alcohol-related stimuli with a stopping response, to increase response inhibition for alcohol-related stimuli. In the beer/go condition, in contrast, participants were always required to respond to alcohol-related stimuli during the go/no-go task. Before and after the go/no-go manipulation, we measured weekly alcohol intake and implicit attitudes toward alcohol. In addition, we measured alcohol consumption during a taste test immediately after the go/no-go manipulation. Following the manipulation, participants in the beer/no-go condition demonstrated significantly increased negative implicit attitudes toward alcohol, and a significant reduction in weekly alcohol intake, while participants in the beer/go condition showed a non-significant increase in implicit positive attitudes toward alcohol and a significant increase in weekly alcohol intake. This study demonstrates that repeatedly stopping prepotent responses toward alcohol-related stimuli can be an effective strategy to reduce excessive alcohol use.     

Stereotypic information about drinkers and students' observed alcohol intake: An experimental study on prototype-behavior relations in males and females in a naturalistic drinking context

Background

Cross-sectional and longitudinal research has shown that favorable drinker prototypes (i.e., perceptions about the typical drinker) are related to higher levels of alcohol consumption in adolescents and college students. So far, few studies have experimentally tested the causality of this relationship and it is not clear what type of manipulation affects drinker prototypes and drinking levels.

Methods

In an experimental 1-factor design with two levels, we tested the short-term effects of exposing students to either positive or negative stereotypic information about drinkers on their drinker prototypes and actual drinking behaviors. We exposed 192 male and female college students to positive drinker prototype information (drinkers in general were presented as being attractive, sociable and successful), or to negative information (unattractive, unsociable and unsuccessful). Subsequently, participants’ levels of alcohol consumption were observed unobtrusively while they were interacting with peers in a naturalistic drinking context, namely a bar lab.

Results

Participants exposed to positive stereotypic information about drinkers reported more favorable drinker prototypes than participants exposed to negative stereotypic information. Multilevel analyses revealed that men's subsequent alcohol consumption in the bar lab was higher in the positive prototype condition than in the negative prototype condition. For women, no prototype effects on alcohol use were found.

Conclusions

These findings underline that drinker prototypes affect actual alcohol use in men and suggest that changing perceptions of drinkers may be a useful tool in alcohol prevention programs.     

Effects of alcohol on inhibitory processes

Earlier work has shown that alcohol may have disinhibiting effects on behaviour. Two studies tested the effects of a moderate dose of alcohol (0.6 g/kg) versus placebo on tasks that evaluate inhibitory processes related to alcohol stimuli, in moderate-to-heavy social drinkers (student population). An inhibition of interference task, the Stroop task (ST; study 1), and an inhibition of a prepotent response task, the go/no-go task (GNG; study 2), were used. The effects of alcohol on working memory function were also examined. Participants preloaded with alcohol made more errors on the colour and alcohol ST than those preloaded with placebo. In the GNG task, responding to alcohol-related pictures was slower than responding to neutral pictures. When participants were required to switch responding from neutral to alcohol-related go stimuli, responding became slower; however, responding to alcohol go stimuli became faster as time progressed; no effect of alcohol was found. Alcohol had no effect, compared with placebo, on the working memory tasks. Therefore, a moderate dose of alcohol had restricted effects on inhibitory processes: only interference inhibition measured in the ST was affected. Although the data obtained with the GNG task did not show an effect of alcohol on response inhibition, increased latency of response in the presence of alcohol-related stimuli compared with neutral stimuli indicates that alcohol stimuli are more salient to social drinkers, attracting a greater amount of attention.     

Alcohol use and negative consequences among active duty military personnel

Aims

An examination of alcohol use patterns in the active duty military to determine the relations of drinking levels and self-reported negative outcomes.

Design

A population-based cross-sectional study design using two-stage complex sampling methodology.

Setting

Paper and pencil surveys were administered anonymously in groups at 64 U.S. military installations worldwide.

Participants

Randomly selected active duty members (28,546) at major military installations representing the total active force, with the exception of recruits, cadets, and incarcerated personnel.

Measures

Personnel were classified into five drinking levels ranging from abstainer to heavy drinker based on quantity and frequency of alcohol intake. Negative outcomes were measured as self-reported serious consequences of alcohol use and alcohol-related productivity loss. Risk for other alcohol related problems was assessed by the Alcohol Use Disorders Identification Test (AUDIT).

Findings

Alcohol negative outcomes showed a curvilinear dose–response relationship with drinking levels. Higher levels of drinking were associated with higher rates of alcohol problems, but problem rates were notably higher for heavy drinkers. Heavy alcohol users showed nearly three times the rate of self-reported serious consequences and over twice the rate of self-reported productivity loss than moderate/heavy drinkers. Heavy drinkers also had the highest risk for alcohol problems on the AUDIT. One fifth of military personnel were heavy drinkers and were most likely aged 18 to 35.

Conclusions

Prevention and clinical interventions should include a major focus on heavy drinkers. Commanders and peers should be trained in recognizing signs of heavy alcohol use and in approaching heavy alcohol users in a way that will foster positive attitudes as opposed to defensiveness and stigma.     

Alcohol-related stimuli reduce inhibitory control of behavior in drinkers

Rationale

Poor behavioral control and heightened attentional bias toward alcohol-related stimuli have independently received considerable attention in regard to their roles in alcohol abuse. Theoretical accounts have begun to speculate as to potential reciprocal interactions between these two mechanisms that might promote excessive alcohol consumption, yet experimental evidence is lacking.

Objectives

The objective of the study was to integrate these two lines of research through the development of a novel laboratory task that examines the degree to which alcohol cues serve to disrupt mechanisms of behavioral control.

Methods

Fifty adult drinkers were recruited to perform the attentional bias?Cbehavioral activation (ABBA) task. The ABBA task, an adaptation of traditional cued go/no-go tasks, is a reaction time model that measures the degree to which alcohol-related stimuli can increase behavioral activation of a drinker and reduce the ability to inhibit inappropriate responses. Participants also completed a novel measure of attentional bias, the scene inspection paradigm (SIP), that measures fixation time on alcohol content imbedded in complex scenes.

Results

As hypothesized, the proportion of inhibitory failures on the ABBA task was significantly higher following alcohol images compared to neutral images. Correlational analyses showed that heightened attentional bias on the SIP was associated with greater response activation following alcohol images on the ABBA task.

Conclusions

These findings suggest that alcohol stimuli serve to disrupt mechanisms of behavioral control, and that heightened attentional bias is associated with greater disruption of control mechanisms following alcohol images.     

Alcohol cue reactivity task development

Background

The physiological and cognitive reactions provoked by alcohol cues, as compared to non-alcohol cues, can predict future drinking. Alcohol cue reactivity tasks have been developed; however, most were created for use with alcohol use disordered individuals and utilize limited or only partially standardized stimuli. This project systematically created an alcohol cue reactivity task for studies with non-drinkers, using well-characterized stimuli.

Objectives

We comprehensively standardized 60 alcohol and 60 non-alcohol beverage pictures using ratings from young non-drinkers (N = 82) on affective and perceptual features.

Results

A statistical matching approach yielded 26 matched alcohol–non-alcohol picture pairs matched on valence, arousal, image complexity, brightness, and hue. The task was piloted and further refined to 22 picture pairs. An 8-minute, 32-second event-related task was created using a random stimulus function for optimized condition timing and systematic presentation of the images.

Conclusions

The long-term objectives of this project are to utilize this task with non-drinking youth to investigate how reactivity to alcohol stimuli may predict alcohol use initiation and escalation, to help identify the role of exposure to alcohol stimuli on the subsequent development of alcohol-related problems.     

Attentional biases for alcohol cues in heavy and light social drinkers: the roles of initial orienting and maintained attention

Rationale There has been considerable theoretical interest in attentional biases for drug-related cues. However, there is little research on the component processes of such attentional biases.Objectives We examined initial orienting to, and the maintenance of attention on, alcohol-related cues in heavy and light social drinkers.Methods The present study used a visual probe task to investigate biases in visual orienting to alcohol-related cues. We varied the presentation duration of alcohol-related pictures (200, 500 or 2000 ms) to investigate whether attentional biases operated in initial orienting or the maintenance of attention.Results In comparison with light social drinkers, heavy social drinkers had an attentional bias for alcohol pictures which were presented at the longer exposure durations (500 and 2000 ms), but not at the shorter duration of 200 ms. Subjective alcohol craving was correlated with the attentional bias index for alcohol pictures presented for 2000 ms.Conclusions These results suggest that biases in visual orienting to alcohol-related cues in heavy social drinkers operate mainly in the processes involved in the maintenance of attention.     

The potential cost-effectiveness of general practitioner delivered brief intervention for alcohol misuse: evidence from rural Australia

Objective

This paper aims to model General Practitioner (GP) delivered screening and brief intervention (BI), and to identify the costs per additional risky drinker who reduces alcohol consumption to low-risk levels, relative to current practice.

Method

A decision model and nine different scenarios were developed to assess outcomes and costs of GP-delivered screening and BI on the potential number of risky drinkers who reduce their alcohol consumption to low-risk levels in 10 rural communities in New South Wales, Australia.

Findings

Based on evidence from current practice, approximately 19% of all risky drinkers visiting GPs annually would reduce alcohol consumption to low-risk levels, of which 0.7% would do so because of GP-delivered screening and BI. If rates of screening and BI are increased to 100%, 36% of these risky drinkers would reduce their drinking to low risk-levels. Alternatively, increments of 10% and 20% in GP-delivered screening and BI would reduce the proportion of risky drinkers by 2.1% and 4.2% respectively. The most cost-effective outcome per additional risky drinker reducing their drinking relative to current practice would be if all of these risky drinkers are screened alone with an ICER of AUD$197.

Conclusion

These findings indicate that increments in rates of screening and BI delivered by GPs can result in cost-effective reductions per additional risky drinkers reducing their drinking to low-risk levels, relative to current practice. They also imply that achieving substantial reductions in the prevalence of risky drinking in a community will require strategies other than opportunistic screening and BIs by GPs.     

Brief alcohol intervention for college drinkers: How brief is?

Objective

Brief interventions for college student drinkers have been shown to be effective in reducing the amount of alcohol consumed as well as the number of alcohol-related problems. However, the duration of brief interventions varies substantially across studies.

Method

In the present study 114 undergraduate students who drank alcohol heavily were randomly assigned to a 10-minute brief intervention, a 50-minute brief intervention, or assessment-only control. The content of the active interventions was based on the same concept, and both interventions incorporated motivational interviewing components. Participants were assessed at baseline and 4-week post intervention on quantity of alcohol use, alcohol-related problems, and protective behavioral strategies.

Results

As hypothesized, there was a significant difference between participants in the 10-minute intervention and control condition regarding their alcohol consumption at 4-week follow up. However, there was no significant difference between the 50-minute intervention and the control condition on alcohol consumption. There were also no significant differences between active intervention conditions, and neither intervention showed advantages for reducing problems or increasing protective behaviors relative to the control condition.

Conclusions

Results suggest a very brief intervention can impact short-term alcohol use outcomes, with potentially no advantage of longer interventions for this population.     

The influence of depressed mood on action tendencies toward alcohol: The moderational role of drinking motives

Background

Research suggests that depressed mood is associated with alcohol-related problems, though its relation with drinking behavior has been inconsistent across studies. Efforts to better understand the link between depressed mood and alcohol use have examined drinking motives as a potentially important moderating variable. The current study sought to examine whether drinking motives moderate the influence of depressed mood on alcohol-related action tendencies. Based on Baker, Morse, and Sherman's (1986) positive and negative reinforcement schema model, two competing moderational hypotheses regarding the influence of depressed mood on appetitive responses for alcohol were tested.

Methods

One hundred and sixty-nine college student drinkers completed assessments of drinking motives and alcohol use. Subjects were exposed to a neutral or depressed mood induction followed by a computerized measure of action tendencies toward alcohol stimuli.

Results

Hierarchical regression analyses were conducted to examine whether the influence of depressed mood on action tendencies toward alcohol was moderated by drinking motives. Results showed that there was a significant interaction between mood induction condition and enhancement motives, such that depressed mood appeared to suppress appetitive responding toward alcohol among those with higher enhancement motives. In contrast, there was no evidence that coping motives moderated the association between mood and appetitive response to alcohol.

Conclusions

These results suggest that inhibiting affect states associated with one's motivational disposition for drinking may result in the devaluation of alcohol. Limitations and implications are discussed.     

Alcohol mixed with energy drinks: Are there associated negative consequences beyond hazardous drinking in college students?

Objective

The consumption of alcohol mixed with energy drinks (AmED) is prevalent among college students as is hazardous drinking, a drinking pattern that places one at risk for alcohol-related harm. The present study, therefore, examined associations between AmED use, hazardous drinking, and alcohol-related consequences in college students.

Methods

Based on a probability sample conducted in 2010, participants were 606 undergraduate students aged 18–25. AmED consumption included lifetime and past year use. Hazardous drinking and alcohol-related consequences were measured during the past year. Point prevalence was used to estimate rates of AmED use, and chi-square, ANOVA, and logistic regression were used to examine associations between AmED use, hazardous drinking, and alcohol-related consequences.

Results

Lifetime and past year AmED use prevalence rates were 75.2% and 64.7%, respectively. Hazardous drinkers who engaged in AmED use were significantly more likely than past year hazardous drinkers who did not engage in AmED use to have had unprotected sex (OR = 2.35, CI 1.27–4.32).

Conclusions

AmED use appears to be highly prevalent among college students, and AmED use may confer additional risk for unprotected sex beyond hazardous drinking. Unprotected sex has implications for public health, and students who drink hazardously and consume AmED may be at greater risk.     

Attentional bias to alcohol stimuli predicts elevated cue-induced craving in young adult social drinkers

Considerable evidence has identified biased cognitive processing of alcohol-related stimuli as an important factor in the maintenance of alcohol-seeking and relapse among individuals suffering from alcohol use-disorders (AUDs). In addition, a large body of research has demonstrated that exposure to alcohol cues can elicit powerful alcohol cravings. Little is known, however, about the possible relationship between attentional bias and cue-induced cravings, and even less is known about these processes in social drinkers without a personal history of AUDs. The goal of this study was to examine the possibility that attentional biases toward alcohol-related stimuli would predict elevated cue-induced alcohol craving in this population. Young adult social drinkers (N = 30, Mean age = 22.8 ± 1.9, 61% female) recruited from an urban university population completed a visual dot probe task in which they were presented with alcohol and neutral stimulus pictures that were immediately followed by a visual probe replacing one of the pictures. Attentional bias was measured by calculating reaction times to probes that replaced alcohol stimuli vs. neutral stimuli. Participants then completed a classic alcohol cue-exposure task and reported cravings immediately before and after alcohol and neutral cue-exposures. Not surprisingly, exposure to alcohol cues elicited significant cravings. Consistent with the study hypothesis, larger attentional biases toward alcohol stimuli predicted higher levels of alcohol craving. Findings demonstrate that heightened attention to alcohol stimuli can significantly impact motivation to consume in healthy young adults, and suggest a possible pathway linking cognitive processes early in the drinking trajectory to the later development of AUDs.     

Variations by age and sex in alcohol-related problematic behaviour per drinking volume and heavier drinking occasion

Aims

This study aims to assess the relationships between age, sex, drinking behaviour and self-reported alcohol-related problem behaviour.

Design

Cross-sectional population survey.

Setting and participants

Interviews were undertaken in 2004, with a representative sample of Australian residents aged 12 and over (N = 29,445).

Measurements

Alcohol use was measured using graduated frequency questions and, using these questions, estimates of total annual intake and frequency of heavy drinking occasions were derived. Alcohol-related problems were measured using a 10-item scale, relating to behaviour in the 12 months prior to the survey.

Findings

Alcohol-related problem behaviours clustered into two groups: hazardous behaviour and delinquent behaviour. Rates of problem behaviours and drinking followed similar patterns for males and females, with peaks in early adulthood and a subsequent decline with age. Males drank at higher levels than females and behaved more problematically. Once alcohol consumption and drinking pattern were controlled for, male and female rates of problem behaviours were not markedly different. However, there were substantial differences by age, with young people behaving significantly more problematically than older people with the drinking variables controlled for.

Conclusions

The results of this study provide strong evidence that young drinkers behave more problematically than older drinkers with drinking behaviour controlled for. The study also provides further evidence that women and men do not report substantially different rates of alcohol-related problems for similar amounts or patterns of drinking. The study has implications for public health messages that focus on the risk of harm from drinking, clearly demonstrating that young drinkers are more likely to report problems for a given amount of drinking.     

Attentional blink to alcohol cues in binge drinkers versus non-binge drinkers

Previous studies have shown alcohol-related attentional biases in social drinkers; however, the temporal dynamics of these biases are not well understood. The current study examined this issue in 94 participants (27 male) categorized as binge drinkers (BD) or non-binge drinkers (NBD). Two versions of an alcohol-related attentional blink (AB) paradigm were used: one with words and one with images. It was predicted that BDs (versus NBDs) would exhibit reduced AB for alcohol cues, which would be enhanced for the pictorial version of the task (versus words). The relationships between AB and alcohol craving, quantity and frequency of alcohol consumption, symptoms of alcohol use disorder, and family history of alcohol use disorder (AUD) were also examined. While an AB was observed for both alcohol and non-alcohol targets in the NBD group, no AB was found for alcohol targets in the BD group. Furthermore, the magnitude of the AB was related to drinking, such that higher self-reported hazardous drinking was associated with smaller ABs to alcohol-related targets. However, AB was not related to craving or family history of AUD. These results suggest that alcohol-related stimuli are processed more efficiently by BDs, especially those with hazardous alcohol consumption patterns. These results may inform treatment and prevention efforts targeting binge drinkers.     

Cognitive predictors of problem drinking and AUDIT scores among college students

Evidence from a number of substance abuse populations suggests that substance abuse is associated with a cluster of differences in cognitive processes. However, investigations of this kind in non-clinical samples are relatively few. The present study examined the ability of alcohol-attentional bias (an alcohol Stroop task), impulsive decision-making (a delay discounting task), and impaired inhibitory control (a GO-NOGO task) to: (a) discriminate problem from non-problem drinkers among a sample of college students; (b) predict scores on the Alcohol Use Disorders Identification Test (AUDIT; a measure of alcohol consumption, drinking behaviour, and alcohol-related problems) across all of the student drinkers; (c) predict AUDIT scores within the subgroups of problem and non-problem student drinkers. In logistic regression controlling for gender and age, student drinkers with elevated alcohol-attentional bias and impulsive decision-making were over twice as likely to be a problem than a non-problem drinker. Multiple regression analysis of the entire sample revealed that all three cognitive measures were significant predictors of AUDIT scores after gender and age had been controlled; the cognitive variables together accounted for 48% of the variance. Moreover, subsequent multiple regressions revealed that impaired inhibitory control was the only significant predictor of AUDIT scores for the group of non-problem drinkers, and alcohol-attentional bias and impulsive decision-making were the only significant predictors of AUDIT scores for the group of problem drinkers. Finally, both impulsive decision-making and impaired inhibitory control were significantly correlated with alcohol-attentional bias across the whole sample. Implications are discussed relating to the development of problematic drinking.     

Phone-delivered brief motivational interventions for mandated college students delivered during the summer months

Objective

Across the United States, tens of thousands of college students are mandated to receive an alcohol intervention following an alcohol policy violation. Telephone interventions may be an efficient method to provide mandated students with an intervention, especially when they are away from campus during summer vacation. However, little is known about the utility of telephone-delivered brief motivational interventions.

Method

Participants in the study (N = 57) were college students mandated to attend an alcohol program following a campus-based alcohol citation. Participants were randomized to a brief motivational phone intervention (pBMI) (n = 36) or assessment only (n = 21). Ten participants (27.8%) randomized to the pBMI did not complete the intervention. Follow-up assessments were conducted 3, 6, and 9 months post-intervention.

Results

Results indicated the pBMI significantly reduced the number of alcohol-related problems compared to the assessment-only group. Participants who did not complete the pBMI appeared to be lighter drinkers at baseline and randomization, suggesting the presence of alternate influences on alcohol-related problems.

Conclusion

Phone BMIs may be an efficient and cost-effective method to reduce harms associated with alcohol use by heavy-drinking mandated students during the summer months.     

Anxiety and explicit alcohol-related memory in problem drinkers

Anxiety is associated with increased craving following in vivo cue exposure in alcoholics. Theoretical accounts [Psychol. Rev. 97 (1990) 147.] have proposed that conscious, deliberate cognitive processes underlie increased craving in drinkers who are trying to abstain. The present study tested the hypothesis that anxiety is associated with biases in explicit (i.e., conscious, deliberate) memory that promote recall of alcohol-related concepts in response to negative affective cues. Fifty-two (seven females) outpatient problem drinkers performed a cued recall task that assessed memory for alcohol-related (ALC), negative affective (NEG), and neutral (NEU) target concepts that had been paired with NEG, ALC, and NEU cues during an incidental study phase. Higher anxiety was associated with increased recall of ALC targets paired with NEG cues. State and trait anxiety were intercorrelated, with higher levels coinciding with a higher frequency of drinking in negative mood states. These findings demonstrate a correspondence between anxiety and alcohol-related memory, and suggest that explicit memory biases may contribute to increased subjective responses (e.g., craving, expectancies) to alcohol stimuli in anxious problem drinkers.