Learning to dislike alcohol: conditioning negative implicit attitudes toward alcohol and its effect on drinking behavior

Rationale: Since implicit attitudes toward alcohol play an important role in drinking behavior, a possible way to obtain a behavioral change is changing these implicit attitudes. Objectives: This study examined whether a change in implicit attitudes and in drinking behavior can be achieved via evaluative conditioning. Methods: Participants were randomly assigned to an experimental condition and a control condition. In the experimental condition, participants were subjected to an evaluative conditioning procedure that consistently pairs alcohol-related cues with negative stimuli. In the control condition, alcohol-related cues were consistently paired with neutral stimuli during the evaluative conditioning phase. Implicit attitudes, explicit attitudes, and drinking behavior were measured before and after the evaluative conditioning phase. Results: Following the evaluative conditioning procedure, participants in the experimental condition showed stronger negative implicit attitudes toward alcohol and consumed less alcohol compared to participants in the control condition. However, this effect was only found when the evaluative conditioning task paired alcohol-related cues with general negative pictures, but not when using pictures of frowning faces. Conclusions: These results demonstrate that evaluative conditioning can effectively change implicit attitudes toward alcohol and also suggest that this procedure can be used to change drinking behavior. Hence, evaluative conditioning may be a useful new intervention tool to combat alcohol misuse

Happy eating: the single target implicit association test predicts overeating after positive emotions

For many years, questionnaires have been considered the standard when examining emotional eating behavior. However, recently, some controversy has arisen about these questionnaires, and their usefulness in identifying emotional eaters has been questioned. The current study aimed to investigate the Single Target Implicit Association Test (ST-IAT) as a measure of emotional eating. Two ST-IATs (assessing food-positive and food-negative associations respectively) and the Dutch Eating Behaviour Questionnaire (DEBQ) were compared in undergraduate students. A positive, negative or neutral mood was induced by means of a film clip, and milkshake consumption was measured during and after the mood induction. It was hypothesized that participants with strong emotion-food associations on the ST-IATs (i.e., IAT-emotional eaters) would consume more food in the emotion induction condition corresponding to that emotion, as compared to those with weak emotion-food associations as well as to those in the neutral condition. Participants who scored high on both the positive and negative ST-IATs ate more during a positive mood induction than during a negative mood induction. This effect did not extend to milkshake consumption after the mood induction procedure. In addition, IAT-positive emotional eaters consumed more food than IAT-non-emotional eaters. No effects of the DEBQ on milkshake consumption were found. It is concluded that the ST-IAT has potential as a measure of emotional eating

Beer à no-go: Learning to stop responding to alcohol cues reduces alcohol intake via reduced affective associations rather than increased response inhibition

Aims Previous research has shown that consistently not responding to alcohol-related stimuli in a go/no-go training procedure reduces drinking behaviour. This study aimed to examine further the mechanisms underlying this go/no-go training effect. Design, setting and participants Fifty-seven heavy drinkers were assigned randomly to two training conditions: in the beer/no-go condition, alcohol-related stimuli were always paired with a stopping response, while in the beer/go condition participants always responded to alcohol-related stimuli. Participants were tested individually in a laboratory at Maastricht University. Measurements Weekly alcohol intake, implicit attitudes towards beer, approachavoidance action tendencies towards beer and response inhibition were measured before and after the training. Findings Results showed a significant reduction in both implicit attitudes (P = 0.03) and alcohol intake (P = 0.02) in the beer/no-go condition, but not in the beer/go condition. There were no significant training effects on action tendencies or response inhibition. Conclusions Repeatedly stopping pre-potent responses towards alcohol-related stimuli reduces excessive alcohol use via a devaluation of alcohol-related stimuli rather than via increased inhibitory control over alcohol-related responses

The Effect of Non-specific Response Inhibition Training on Alcohol Consumption: An Intervention

Objective: Excessive alcohol consumption increases the risk of alcohol-related disease and injury. Poor response inhibition; the inability to intentionally override a pre-potent response, has been associated with greater alcohol consumption. The aim of the present study was to clarify if non-specific response inhibition training could improve response inhibition, and reduce alcohol consumption. Method: One hundred and sixty-eight undergraduates were randomly assigned to either an inhibition or active control condition, and completed a stop-signal task once a day for four consecutive days. The inhibition condition comprised a stop-signal task with a high target density (50% stop-signals), while the active control comprised a stop-signal task with a lower target density (25% stop-signals) and the instruction to ignore the signal. Before and after the intervention, participants completed measures of response inhibition, and alcohol consumption. Alcohol consumption was measured again at one month post-training. All parts of the study were completed online. Results: Contrary to the hypotheses, participants in the inhibition condition did not have lower levels of alcohol consumption, nor improved response inhibition after the intervention, compared to participants in the active control condition. Conclusion: It is suggested that response inhibition training needs to be specific to the target behaviour in order to be effective; however, that training did not improve response inhibition itself, calls into question the efficacy of this particular training paradigm. It is recommended that future response inhibition training paradigms consider how training intensity, and the format of administration, influences behavioural outcomes

Does neurocognitive training have the potential to improve dietary self-care in type 2 diabetes? Study protocol of a double blind randomised controlled trial

Dietary self-care is a key element of self-management in type 2 diabetes. It is also the most difficult aspect of diabetes self-management. Adhering to long-term dietary goals and resisting immediate food desires requires top-down inhibitory control over subcortical impulsive and emotional responses to food. Practising simple neurocognitive tasks can improve inhibitory control and health behaviours that depend on inhibitory control, such as resisting alcohol consumption. It is yet to be investigated, however, whether neurocognitive training can improve dietary self-care in people with type 2 diabetes. The aim of this randomised controlled trial is to investigate whether web-based neurocognitive training can improve the ability of people with type 2 diabetes to resist tempting foods and better adhere to a healthy dietary regime

Specificity of the failure to inhibit responses in overweight children

Poor response inhibition has been associated with obesity, excessive food intake, and other consumptive behaviours, including alcohol use. However, the correlation between obesity and addictive behaviours like alcoholism is low: people who are obese appear to have a specific problem in restraining food intake. This would imply that obese people have more difficulties in inhibiting responses towards food, compared to other rewarding stimuli. In the present study eighty-nine children (ages 7-9) were tested with the stop signal task, in which responses towards food pictures or toy pictures had to be inhibited. Results showed that children were less effective in inhibiting responses towards food and percentage overweight predicted a lower ability to inhibit responses in general. When dichotomizing the sample in overweight and lean children, it appeared that overweight children were specifically less effective in inhibition towards food cues, compared to lean children. In conclusion: The results confirm weight related inhibitory problems and might explain the increased overeating to food cues in overweight children, as reported in the literature

Does working memory training improve dietary self-care in type 2 diabetes mellitus? Results of a double blind randomised controlled trial

Aims: Controlling food intake despite adequate knowledge remains a struggle for many people with type 2 diabetes. The present study investigated whether working memory training can reduce food intake and improve glycaemic control. It also examined training effects on cognition, food cravings, and dietary self-efficacy and self-care. Methods: In a double-blind multicentre parallel-group randomised controlled trial, adults with type 2 diabetes mellitus were randomly allocated to receive 25 sessions of either active (n = 45) or control (n = 36) working memory training. Assessments at baseline, post-training and 3-month follow-up measured cognition, food intake (primary outcomes), glycaemic control (HbA1c) and cholesterol (secondary outcomes). Semi-structured interviews assessed participants’ experiences of the training. Results: Intention-to-treat ANOVAs (N = 81) showed improved non-trained updating ability in active compared to control training from pre-test (active M = 34.37, control M = 32.79) to post-test (active M = 31.35, control M = 33.53) and follow-up (active M = 31.81, control M = 32.65; g2 = 0.05). There were no overall effects of training on other measures of cognition, food intake, HbA1c, cholesterol, food cravings and dietary self-efficacy and self-care. In post-hoc analyses, those high in dietary restraint in the active training group showed a greater reduction in fat intake pre to post-test compared to controls. Interviews revealed issues around acceptability and performance of the training. Conclusions: Transfer of working memory training effects to non-trained behaviour were limited, but do suggest that training may reduce fat intake in those who are already motivated to do so. Trial registration: Current Controlled Trials ISRCTN22806944