Personalizing the alcohol-IAT with individualized stimuli: relationship with drinking behavior and drinking-related problems

Research aimed at uncovering implicit cognitive processes involved in alcohol use and abuse has demonstrated that implicit attitudes toward alcohol are negative and unrelated to drinking behavior. Here, it was examined whether these findings could be due to contamination of the IAT by extrapersonal associations that are irrelevant to behavior. Participants performed a traditional alcohol-IAT as well as a personalized IAT, which has been demonstrated to reduce extrapersonal contamination. Additionally, the personalized IAT presented individualized stimuli, which should further reduce extrapersonal contamination. Consistent with this hypothesis, significantly weaker IAT effects emerged in the personalized IAT compared to the traditional IAT. However, both the traditional and personalized IAT still indicated negative implicit attitudes toward alcohol. Incremental predictive validity was demonstrated for both tasks. Importantly, these findings underscore the importance of implicit attitudes toward alcohol as determinants of alcohol use and abuse.     

Polymorphisms in the mu-opioid receptor gene (OPRM1) and the implications for alcohol dependence in humans

Twin and adoption studies have shown that alcohol dependence contains a substantial genetic component. In attempts to identify the genetic factors involved, association studies have linked the opioid system to alcohol dependence, with a main focus on the OPRM1 gene encoding the mu-opioid receptor. Our aim was to conduct a systematic review of the literature on the associations between polymorphisms in OPRM1 and alcohol dependence. We addressed findings of 12 studies that met our inclusion criteria. All studies employed a case-control design and included alcohol dependence as a dependent outcome measure. Our review showed that clinical studies do not unequivocally support an association between polymorphisms in OPRM1 and alcohol dependence. Factors that complicate genetic research on alcohol dependence, such as gene-environment interaction, and genetic and clinical heterogeneity, are discussed.     

Treatment of knee prosthesis infections: evaluation of 15 patients over a 5-year period

Our objective was to evaluate different treatment alternatives for total knee arthroplasty (TKA) infection and to compare outcomes depending on adherence to a current treatment algorithm. All patients treated for a first episode of TKA infection between January 2000 and July 2005 were included. Patient records were reviewed and data were extracted retrospectively. Fifteen patients were followed up for a median of 25 months. The cure rate in patients with two-stage exchange of knee prosthesis was higher than in patients who had débridement without implant removal (100 vs 37%, p = 0.03). Cure rates were not different between these two surgical approaches in ten patients who were treated according to a current treatment algorithm. Success rates for treatment of TKA infections varied considerably with the treatment strategy chosen. Our results support the use of existing algorithms to select patients who are eligible for débridement with retention of the prosthesis or need two-stage exchange of knee implants.     

The search for new ways to change implicit alcohol-related cognitions in heavy drinkers

This article summarizes a symposium on new ways to change implicit alcohol-related cognitions, presented at the 2005 Annual Meeting of the Research Society on Alcoholism in Santa Barbara, California, organized by Wiers and Cox. During the past few years, research has demonstrated that implicit cognitions predict unique variance in prospective alcohol use and preliminary results indicate that they also predict treatment outcomes. The central question in this symposium was how implicit cognitions can be changed and how the changes will influence behavior. Field presented data showing that an attentional bias for alcohol can be altered by attentional training: heavy drinkers who were trained not to attend to alcohol stimuli reported less craving and drank less beer than those trained to attend to alcohol stimuli. Schoenmakers used a similar, clinically relevant attentional retraining (AR) procedure, heavy drinkers were trained not to attend to alcohol pictures or received no training. After the training, the AR group attended less to the alcohol pictures than the control group. Fadardi described the Alcohol Attentional Control Training Program (AACTP), which makes alcohol drinkers aware of the automatic, cognitive determinants of their drinking and aims to help them to gain control over these processes. Data were presented to support the effectiveness of the AACTP. Palfai presented data showing that alcohol drinkers can be taught to use implementation intentions to gain control over their drinking, which may be used to automatically activate self-control skills in the presence of alcohol cues. In his discussion, Stacy pointed out the importance of recent cognitive theories that integrate attention and memory processes-theories that can help us better understand the mechanisms involved in AR. Together, the studies presented demonstrate that there are promising new ways in which implicit alcohol-related cognitions and their effects on drinking can be changed. After further refinement, these procedures might be used in clinical interventions that have not previously addressed implicit cognitive processes.