Curbing the DUI Offender\u27s Self-Efficacy to Drink and Drive: A Laboratory Study

Background—People arrested for driving under the influence of alcohol (DUI) are at high risk to reoffend. One reason for this high rate of recidivism among DUI offenders is that these individuals systematically underestimate the degree to which alcohol impairs their ability to drive. This study compared perceived and objective driving ability following alcohol and performance feedback in drivers with and without a history of DUI. Method—Adult drivers with (n = 20) and without (n = 20) a history of DUI arrest attended two dose challenge sessions where they received 0.64 g/kg alcohol or placebo, completed a simulated driving task, and provided measures of subjective impairment. They attended a third retesting session where they received feedback that they were impaired by alcohol. They received 0.64 g/kg alcohol and their objective and perceived driving ability was retested. Results—Both groups showed significant impairment of driving performance following 0.64 g/kg alcohol compared to placebo. DUI offenders rated themselves as less impaired than controls. After performance feedback, self-reported impairment during the alcohol retest increased for DUI offenders but not for controls. There was no effect of performance feedback on objective driving ability. Conclusions—These results support the notion that under alcohol DUI offenders characteristically perceive themselves as better able to drive than non-offenders. These perceptions can be tempered by performance feedback. To the extent that perceived ability to drive safely after drinking contributes to DUI and its recidivism, feedback geared towards lowering this self-efficacy could reduce willingness to engage in this behavior

Measuring Heightened Attention to Alcohol in a Naturalistic Setting: A Validation Study

Attentional bias to alcohol-related stimuli is believed to be an important contributor to the development and maintenance of drug abuse. There is a considerable body of research examining attentional bias, much of which has typically utilized image-display tasks as a means to assess the phenomenon. Little, however, is known about the nature of this bias in an individual’s natural environment. The current study sought to implement a novel approach to assessing attentional bias in vivo. Participants wore portable eye-tracking glasses that recorded video from their point of view and measured fixation time to objects they observed. They entered a room that was designed to represent a recreational setting in which both alcohol- and nonalcoholic-neutral beverages were placed along with other stimuli. In two different testing sessions, participants were free to visually explore the room. Participants showed similar fixation times to alcohol and neutral beverages during Session 1. Attentional bias to alcoholic beverages was observed in Session 2 because fixation time decreased to neutral but not to alcoholic beverages. The magnitude of attentional bias was positively associated with drinking habits, with heavier drinkers demonstrating a higher degree of bias to alcohol. These findings provide an ecological model of how attentional bias can develop as the net result of attention being sustained to alcoholic stimuli while diminishing to other stimuli over time

Laboratory Analysis of Risky Driving at 0.05% and 0.08% Blood Alcohol Concentration

Background—The public health costs associated with alcohol-related traffic crashes are a continuing problem for society. One harm reduction strategy has been to employ per se limits for blood alcohol concentrations (BACs) at which drivers can legally operate motor vehicles. This limit is currently 0.08% in all 50 US states. Recently, the National Transportation Safety Board proposed lowering the legal limit to 0.05 % (NTSB, 2013). While research has well-validated the ability of alcohol to impair driving performance and heighten crash-risk at these BACs, relatively little is known about the degree to which alcohol might increase drivers’ risk-taking. Methods—Risk-taking was examined in 20 healthy adults who were each tested in a driving simulator following placebo and two doses of alcohol calculated to yield peak BACs of 0.08% and 0.05%, the respective current and proposed BAC limits. The drive test emphasized risk-taking by placing participants in a multiple-lane, high-traffic environment. The primary measure was how close drivers maneuvered relative to other vehicles on the road (i.e., time-to-collision, TTC). Results—Alcohol increased risk-taking by decreasing drivers’ TTC at the 0.08% target BAC relative to placebo. Moreover, risk-taking at the 0.05% target was less than risk-taking at 0.08% target BAC. Conclusions—These findings provide evidence that reducing the legal BAC limit in the USA to 0.05% would decrease risk-taking among drivers. A clearer understanding of the dose-response relationship between various aspects of driving behaviors, such as drivers’ accepted level of risk while driving, is an important step to improving traffic safety

Drinking to Distraction: Does Alcohol Increase Attentional Bias in Adults With ADHD?

Previous research has shown that social drinkers continue to show attentional bias toward alcohol-related stimuli even after consuming a moderate dose of alcohol. In contrast, little is known about how alcohol acutely affects attentional bias in groups at risk to develop alcohol-related problems, such as adults with attentiondeficit/ hyperactivity disorder (ADHD). Such individuals may show increased attentional bias following alcohol relative to nonclinical controls. The present study tested this hypothesis by examining acute alcohol effects on attentional bias in 20 social drinkers with ADHD and 20 social drinkers with no history of ADHD. Participants performed a visual-probe task after receiving the following doses of alcohol: 0.64g/kg, 0.32g/kg, and 0.0g/kg (placebo). Those in the ADHD group showed increased attentional bias under active alcohol doses, whereas attentional bias was similar across doses in the control group. Attentional bias predicted ad libitum alcohol consumption during a taste-rating session. This relation was observed only in the ADHD group. These findings indicate that an acute alcohol dose increases attentional bias in adults with ADHD. Further, attentional bias appears to be a predictor of ad libitum consumption in this group

Linking impulsivity and inhibitory control using manual and oculomotor response inhibition tasks

Separate cognitive processes govern the inhibitory control of manual and oculomotor movements. Despite this fundamental distinction, little is known about how these inhibitory control processes relate to more complex domains of behavioral functioning. This study sought to determine how these inhibitory control mechanisms relate to broadly defined domains of impulsive behavior. Thirty adults with attention-deficit/ hyperactivity disorder (ADHD) and 28 comparison adults performed behavioral measures of inhibitory control and completed impulsivity inventories. Results suggest that oculomotor inhibitory control, but not manual inhibitory control, is related to specific domains of self-reported impulsivity. This finding was limited to the ADHD group; no significant relations between inhibitory control and impulsivity were found in comparison adults. These results highlight the heterogeneity of inhibitory control processes and their differential relations to different facets of impulsivity

Examining Manual and Visual Response Inhibition Among ADHD Subtypes

This study compared inhibitory functioning among ADHD subtype groups on manual and visual versions of the stop task. Seventy-six children, identified as ADHD/I (n = 16), ADHD/C (n =42), and comparison (n = 18) completed both tasks. Results indicated that both ADHD groups were slower to inhibit responses than the comparison group on both tasks. Comparison children were faster to inhibit than activate responses on both versions of the task. Children in the ADHD groups also demonstrated this robust pattern on the manual task. However, on the visual task, children in the ADHD groups evidenced slowed inhibition comparable to the time required to activate responding. This implies that the visual task is more sensitive to inhibitory impairment in ADHD than the manual task. The ADHD/I group did not differ from children with ADHD/C on most measures, suggesting that the stop task is not effective in differentiating the subtypes. These findings extend work highlighting the role of disinhibition in ADHD, and contrast recent work suggesting divergence between ADHD subtypes

Inhibitory deficits in children with attention-deficit/hyperactivity disorder: Intentional versus automatic mechanisms of attention

Application of theoretically based tasks to the study of the development of selective attention has led to intriguing new findings concerning the role of inhibitory mechanisms. This study examined inhibitory mechanisms using a countermanding task and an inhibition of return task to compare deficits in intentionally, versus reflexively, controlled inhibition of attention in children with attention deficit hyperactivity disorder. Fifty children with attention-deficit/hyperactivity disorder (ADHD) were classified into one of three subtypes: predominantly inattentive (ADHD/PI), combined (ADHD/C), and those children with ADHD/C who also met criteria for comorbid oppositional defiant disorder (ADHD/C + ODD). The groups were compared to a comparison group of children (n = 21). The countermanding task showed that the ADHD groups required more time to inhibit responses and this impairment did not differ among subtypes. With respect to reflexively controlled inhibition, compared with controls ADHD/C and ADHD/C + ODD groups showed impaired reflexive inhibition, whereas the ADHD/PI group was considerably less impaired. The findings highlight a dissociation between the two forms of inhibitory deficits among children with the inattentive subtype, and raise the possibility that the efficient operation of reflexive inhibitory mechanisms might be necessary for the development of effective intentional control of inhibition

Faster Self-Paced Rate of Drinking for Alcohol Mixed with Energy Drinks Versus Alcohol Alone

The consumption of alcohol mixed with energy drinks (AmED) has been associated with higher rates of binge drinking and impaired driving when compared with alcohol alone. However, it remains unclear why the risks of use of AmED are heightened compared with alcohol alone even when the doses of alcohol consumed are similar. Therefore, the purpose of this laboratory study was to investigate if the rate of self-paced beverage consumption was faster for a dose of AmED versus alcohol alone using a double-blind, within-subjects, placebo-controlled study design. Participants (n = 16) of equal gender who were social drinkers attended 4 separate test sessions that involved consumption of alcohol (1.97 ml/kg vodka) and energy drinks, alone and in combination. On each test day, the dose assigned was divided into 10 cups. Participants were informed that they would have a 2-h period to consume the 10 drinks. After the self-paced drinking period, participants completed a cued go/no-go reaction time (RT) task and subjective ratings of stimulation and sedation. The results indicated that participants consumed the AmED dose significantly faster (by approximately 16 minutes) than the alcohol dose. For the performance task, participants\u27 mean RTs were slower in the alcohol conditions and faster in the energy-drink conditions. In conclusion, alcohol consumers should be made aware that rapid drinking might occur for AmED beverages, thus heightening alcohol-related safety risks. The fast rate of drinking may be related to the generalized speeding of responses after energy-drink consumption

Neurophysiological Capacity in a Working Memory Task Differentiates Dependent from Nondependent Heavy Drinkers and Controls

Background—Determining the brain-behavior profiles that differentiate heavy drinkers who are and are not alcohol dependent will inform treatment efforts. Working memory is linked to substance use disorders and can serve as a representation of the demand placed on the neurophysiology associated with cognitive control. Methods—Behavior and brain activity (via fMRI) were recorded during an N-Back working memory task in controls (CTRL), nondependent heavy drinkers (A-ND) and dependent heavy drinkers (A-D). Typical and novel step-wise analyses examined profiles of working memory load and increasing task demand, respectively. Results—Performance was significantly decreased in A-D during high working memory load (2-Back), compared to CTRL and A-ND. Analysis of brain activity during high load (0-Back vs. 2-Back) showed greater responses in the dorsal lateral and medial prefrontal cortices of A-D than CTRL, suggesting increased but failed compensation. The step-wise analysis revealed that the transition to Low Demand (0-Back to 1-Back) was associated with robust increases and decreases in cognitive control and default-mode brain regions, respectively, in A-D and A-ND but not CTRL. The transition to High Demand (1-Back to 2-Back) resulted in additional engagement of these networks in A-ND and CTRL, but not A-D. Conclusion—Heavy drinkers engaged working memory neural networks at lower demand than controls. As demand increased, nondependent heavy drinkers maintained control performance but relied on additional neurophysiological resources, and dependent heavy drinkers did not display further resource engagement and had poorer performance. These results support targeting these brain areas for treatment interventions