Cognitive biases toward alcohol-related words and executive deficits in polysubstance abusers with alcoholism

AIM: To study cognitive biases for alcohol-related cues on executive function tasks involving mental flexibility and response inhibition in polysubstance abusers with alcoholism. DESIGN: The responses to alcohol-related cues of detoxified polysubstance abusers with alcoholism and of non-addicts were compared. SETTING: The University of Iowa City, Iowa, USA. PARTICIPANTS: Thirty detoxified polysubstance abusers with alcoholism (PSA) and 30 healthy non-substance abusers (CONT). MEASUREMENTS: Using the 'Alcohol Shifting Task', a variant of the go/no-go paradigm, we measured the response times and the accuracy of responses to targets and distracters. Sometimes the alcohol-related words were the targets for the 'go' response, with neutral words as distracters, sometimes the reverse. Several shifts in the type of the target occurred during the task. FINDINGS: Relative to CONT, PSA were generally slower to respond to targets, but the group difference was smaller when alcohol-related words were the targets. A signal detection analysis also indicated that relative to CONT, the PSA had more difficulties discriminating between targets and distracters (low d'), and they showed more signs of decision bias (low C), reflecting increased readiness to respond to both targets and distracters. However, these discrimination and inhibition deficits were more pronounced when alcohol-related words were the targets. Furthermore, the weaknesses in RT and C were more pronounced in PSA after shifting the targets from alcohol-related to neutral words, or vice versa. CONCLUSIONS: These results suggest that PSA have cognitive biases towards information related to alcohol, and that these biases, as well as the poor executive functions (lower mental flexibility and response inhibition) revealed in PSA might be responsible for their failure to maintain abstinence.