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Addiction (1999) 94(7), 1033± 1041 RESEARCH REPORT Activation of alcohol-related associative networks by recent alcohol consumption and alcohol-related cues STEVEN GLAUTIER & KLAIR SPENCER Department of Psychology, Southampton University, UK Abstract Aims. To investigate the in¯ uence of recent alcohol consumption and alcohol-related cues on performance in a sentence generation task. Design. Two experiments were carried out. In the ® rst, the performances of light, moderate and heavy drinkers were compared. In the second, subjects were randomly assigned to one of three experimental treatments (alcohol-priming, non-alcohol priming, and control) and classi® ed as light, moderate or heavy drinkers. The effect of experimental treatment, drinking status, gender and the interaction between these factors was studied. Setting. The experiments were carried out in quiet research rooms in psychology departments. Participants. Volunteers recruited from university campuses. Measurements. Question- naires were used to ascertain recent drinking histories. Subjects generated sentences incorporating ambiguous alcohol-related words which were provided by the experimenter. The sentences were then classi® ed as alcohol-related or not, the dependent measure was the number of alcohol-related sentences produced. Findings. In both experiments heavier drinkers produced more alcohol-related sentences and males produced more alcohol-related sentences than females. In the second experiment more alcohol-related sentences were produced after subjects were exposed the alcohol priming condition. Conclusions. The alcohol-related meaning of ambiguous words is more likely to be accessed by males and by heavier drinkers and after exposure to other alcohol cues. Introduction Associative learning theories play an important role in our understanding of the basic mecha- nisms involved in motivation to use drugs in both dependent and non-dependent individuals. Perhaps the best-known example of the appli- cation of associative learning principles to addic- tion comes from cue reactivity research. This research has provided evidence that presentation of drug-related cues can trigger a variety of re- sponses including changes in physiological, be- havioural and subjective state (Niaura et al., 1988; Powell et al., 1990; Drummond, Cooper & Glautier, 1990; Drummond et al., 1995). The basic associative mechanism postulated to un- derlie these effects is classical conditioning. The drug-related cue acts as a conditioned stimulus because it has been associated previously with an unconditioned stimulus, the drug effect. Presen- tation of a conditioned stimulus is thought to elicit responding because it activates a represen- tation of the unconditioned stimulus (Dickinson, Correspondence to: Dr Steven Glautier at the Department of Psychology, Southampton University, High® eld, Southampton , SO17 1BJ, UK. E-mail: [email protected]. Submitted 17th September 1998; initial review completed 18th December 1998; ® nal version accepted 18th January 1999. 0965± 2140/99/071033± 09 Ó Society for the Study of Addiction to Alcohol and Other Drugs Carfax Publishing, Taylor & Francis Ltd

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Page 1: Activation of alcohol-related associative networks by recent alcohol consumption and alcohol-related cues

Addiction (1999) 94(7), 1033± 1041

RESEARCH REPORT

Activation of alcohol-related associativenetworks by recent alcohol consumption andalcohol-related cues

STEVEN GLAUTIER & KLAIR SPENCER

Department of Psychology, Southampton University, UK

Abstract

Aims. To investigate the in¯ uence of recent alcohol consumption and alcohol-related cues on performance in

a sentence generation task. Design. Two experiments were carried out. In the ® rst, the performances of light,moderate and heavy drinkers were compared. In the second, subjects were randomly assigned to one of three

experimental treatments (alcohol-priming, non-alcohol priming, and control) and classi® ed as light, moderate

or heavy drinkers. The effect of experimental treatment, drinking status, gender and the interaction betweenthese factors was studied. Setting. The experiments were carried out in quiet research rooms in psychology

departments. Participants. Volunteers recruited from university campuses. Measurements. Question-

naires were used to ascertain recent drinking histories. Subjects generated sentences incorporating ambiguousalcohol-related words which were provided by the experimenter. The sentences were then classi® ed as

alcohol-related or not, the dependent measure was the number of alcohol-related sentences produced.

Findings. In both experiments heavier drinkers produced more alcohol-related sentences and males producedmore alcohol-related sentences than females. In the second experiment more alcohol-related sentences were

produced after subjects were exposed the alcohol priming condition. Conclusions. The alcohol-related

meaning of ambiguous words is more likely to be accessed by males and by heavier drinkers and after exposureto other alcohol cues.

Introduction

Associative learning theories play an importantrole in our understanding of the basic mecha-nisms involved in motivation to use drugs inboth dependent and non-dependent individuals.Perhaps the best-known example of the appli-cation of associative learning principles to addic-tion comes from cue reactivity research. Thisresearch has provided evidence that presentationof drug-related cues can trigger a variety of re-sponses including changes in physiological, be-

havioural and subjective state (Niaura et al.,1988; Powell et al., 1990; Drummond, Cooper& Glautier, 1990; Drummond et al., 1995). Thebasic associative mechanism postulated to un-derlie these effects is classical conditioning. Thedrug-related cue acts as a conditioned stimulusbecause it has been associated previously with anunconditioned stimulus, the drug effect. Presen-tation of a conditioned stimulus is thought toelicit responding because it activates a represen-tation of the unconditioned stimulus (Dickinson,

Correspondence to: Dr Steven Glautier at the Department of Psychology, Southampton University, High® eld,Southampton, SO17 1BJ, UK. E-mail: [email protected].

Submitted 17th September 1998; initial review completed 18th December 1998; ® nal version accepted 18thJanuary 1999.

0965± 2140/99/071033± 09 Ó Society for the Study of Addiction to Alcohol and Other Drugs

Carfax Publishing, Taylor & Francis Ltd

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1034 Steven Glautier & Klair Spencer

1980; Mackintosh, 1983). Recently, however,other applications of associative learning theory,particularly those derived from cognitive psy-chology, have begun to be used and they shareseveral common themes with cue reactivity re-search. In particular the key concepts are: (1)that links can be developed between cognitiverepresentations of drug-related stimuli and con-cepts (especially as a result of drug use); (2) thatactivation of one representation can spread toanother; and (3) that activation of a drug-relatedrepresentation has some relevance to drug use.

One of the ® rst alcohol experiments from thiscognitive psychology tradition was reported byHill & Paynter (1992). They presented subjectswith alcohol-related words and non-words andasked them to judge whether or not the wordwas a real word or not, i.e. a lexical decision task.Before each word was presented subjects wereª primedº by brief presentations of alcohol-re-lated words or words which were unrelated toalcohol. It was found that the alcohol-relatedprimes reduced decision times on the alcohol-re-lated words and this result was a simple replica-tion of the classic semantic priming effect(Meyer & Schvaneveldt, 1971). The explanationoffered for this result was in terms of the spread-ing activation theory of Collins & Loftus (1975).Collins & Loftus proposed that human memorycan be thought of as a network of interlinkednodes, each node representing a concept. Whenone node is activated activation spreads to otherlinked nodes and recognition of an object isfacilitated when its representation is already ac-tive. Thus, priming of all alcohol-related con-cepts through spreading activation facilitatesprocessing of all alcohol-related material. Fur-thermore, since associative links become estab-lished between concepts whenever two conceptsco-occur, Hill & Paynter (1992) hypothesizedthat alcohol-related concepts would have beenco-processed much more often in dependentthan in non-dependent individuals and that thelinks between alcohol-related concepts wouldtherefore be much more elaborate in dependentindividuals. The result would be that, in alcohol-dependent individuals, presentation of an al-cohol-related stimulus would result in greaterco-activation of other alcohol-related nodes andthus facilitate recognition of other alcohol-related stimuli more than in non-dependent sub-jects. This is exactly what Hill & Paynter found,that the priming effect was bigger in alcohol-

dependent subjects than in non-dependent sub-jects.

Although Hill & Paynter (1992) did not ® nd afacilitation of the priming effect when heavydrinkers were compared with light drinkers (asopposed to dependent vs. non-dependentdrinkers), subsequent priming experiments haveshown that the size of priming effects can becorrelated with level of alcohol consumptioneven in non-dependent populations. Stacy, Leigh& Weingardt (1994) primed non-dependent sub-jects by having them read phrases which de-scribed behavioural outcomes which werealcohol-related (but contained no speci® c refer-ence to alcohol) or not, e.g. ª feeling relaxedº orª being thriftyº , and then asked subjects to writedown behaviours which came to mind as soon asthe priming phrase was read. The elicited re-sponses were classi® ed as alcohol-related or notand it was found that heavier drinkers were morelikely to respond with alcohol-related responseswhen given the alcohol-related primes. A furtherstudy by Weingart, Stacy & Leigh (1996) alsoused alcohol-related or non-alcohol outcomes asprimes but, as the dependent measure, subjectssimply had to name the alcohol-related wordswhich were presented after the prime. Naminglatencies were shorter, following the semanticallyrelated prime, and this facilitation was greater inheavier drinkers. In another variation on thistheme Stacy, Leigh & Weingardt (1997) pre-sented subjects with primes in the form of words,some of which were ambiguously alcohol-re-lated, e.g. ª shotº and then asked them to writedown the ® rst word thought of in response toeach prime. The probability of making an al-cohol-related response to the ambiguous wordswas higher in those who drank more heavily.This was hypothesized to be due to the greaterprobability that those ambiguous words wouldhave been co-processed previously with otheralcohol-related concepts in heavier drinkers.This would have resulted in correspondinglymore elaborate associative linkages being formedbetween those ambiguous words and other al-cohol-related concepts in the heavier drinkers,and hence more spreading activation.

The experiments reported in the current paperwere intended to extend and replicate previousresearch on associative mechanisms relevant todrug use and abuse carried out from classicalconditioning and cognitive psychology perspec-tives. Two experiments were carried out and, in

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Alcohol-related associative networks 1035

both, subjects were asked to generate a numberof sentences each incorporating ambiguous al-cohol-related words provided by the exper-imenter; the sentences generated were thenclassi® ed as alcohol-related or not. The ® rst ex-periment looked at the effect of self-reportedalcohol consumption on the number of alcohol-related sentences generated. It was hypothesizedthat the ambiguous alcohol-related words wouldactivate other alcohol-related concepts morereadily in heavier drinkers and that this wouldresult in heavier drinkers producing more al-cohol-related sentences. The second experimentalso looked at the effect of self-reported alcoholconsumption on the number of alcohol-relatedsentences generated but, in addition, the effectof exposure to alcohol-related cues before sen-tence generation was investigated. It was hypoth-esized that activation of other alcohol-relatedconcepts by the cues would result in an increasein the number of alcohol-related sentences pro-duced. We also examined whether or not priorexposure to the ambiguous alcohol-related wordsin non-alcohol contexts would affect the numberof alcohol-related sentences produced. Previousresearch has shown that priming effects can beaffected by the meaning of the context in whichthe prime occurs (Seidenberg et al., 1982). As asecondary hypothesis we tested whether heavierdrinkers would respond in the same way aslighter drinkers to a manipulation designed tofacilitate a non-alcoholic interpretation of am-biguous alcohol-related words.

Method experiment 1

Subjects

Seventy undergraduates from the University ofWales Swansea campus were recruited by postedadvertisements and by word of mouth. Dataobtained from eight subjects were excluded, asthey failed to generate the required sentenceswithin the time limit (see below), leaving a sam-ple of 62 subjects. The average age of the 62providing data was 22.3 years (standard error(SE) 0.55), their mean weekly self-reported al-cohol consumption was 38.0 units (1 unit 5 8 gethanol) and there were 31 males. In addition,three other undergraduates were recruited to actas independent raters who examined andclassi® ed as alcohol-related, or not, each of thesentences produced by the others.

Design, materials, procedure and analysis

Local ethical committee approval was obtainedfor the procedures and subjects signed a consentform containing a brief description of the proce-dures before they took part. Subjects were testedindividually or in small groups ( , 6) in a smallresearch room where no alcohol-related cueswere present. The experimenter read from one ofthree lists of 20 ambiguous alcohol-related wordsat the rate of one word every 30 seconds andsubjects were asked to write down a sentenceincorporating each word immediately it had beenread out. Each list contained the same words ina different order and the order was changed aftereach subject. Each word could be used in al-cohol-related sentences or not. For example, theword ª barº could be used in ª we went to thebarº (alcohol-related) or in ª a bar of chocolateº .The complete list of words is included as anappendix. Subjects who did not complete a fullset of sentences were excluded from the analysis,i.e. if a subject had not completed a sentencewithin the 30-second time limit (inter-word in-terval) they would not have a complete set. Oncompletion of the sentence generation task sub-jects completed a short questionnaire to ascer-tain their alcohol consumption. Each subject wasclassi® ed as a light, moderate or heavy drinkeron the basis of cut points at the 33.3rd and66.7th percentile for the drinking score distribu-tions. The cut-points were calculated separatelyfor males and females to ensure that gender wasnot confounded with drinking level (males drankmore than females (t(60 df) 5 5.59, p , 0.001),with means of 56.4 (SE 6.0) and 19.6 (SE 2.8)units per week, respectively). Table 1 shows themean drinking levels for males and females onthe basis of these cut-points. The number ofalcohol-related sentences generated was analysedas a function of drinking level and post hoc analy-ses were carried out to determine whether or notany effects of gender were present given thatmales and females were different in terms ofdrinking level. The three independent ratersclassi® ed each sentence as alcohol-related or notand, in the case of disagreement, between ratersthe ® nal classi® cation of a sentence was made ona majority rule basis.

Results experiment 1

Figure 1 illustrates the effect of drinking statusupon the number of alcohol-related sentences

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1036 Steven Glautier & Klair Spencer

Table 1. Mean alcohol consumption among males and females in the light, moderate and heavydrinking categories used in experiments 1 and 2

Drinking status (8 g ethanol units)

Gender Light Moderate Heavy

Experiment 1 Male 22.8 (4.4) 53.6 (2.1) 93.1 (8.2)Female 5.3 (1.3) 15.6 (1.1) 38.5 (3.4)

Experiment 2 All subjects 7.2 (0.8) 18.1 (0.7) 37.9 (1.8)

generated. It can be seen that there was a posi-tive correlation between alcohol consumptionand production of alcohol-related sentences andone-way analysis of variance showed this effectwas statistically signi® cant (F(2,59 df) 5 8.61,p , 0.001). Pairwise comparisons between thegroups showed that moderate drinkers producedmore alcohol-related words than light drinkers(t(40 df) 5 1.92, one-tail p , 0.05), as did heavydrinkers (t(38 df) 5 4.49, p , 0.001) and thatheavy drinkers produced more alcohol-relatedwords than moderate drinkers (t(40 df) 5 2.22,p , 0.05). Post hoc analysis with a two-way analy-sis of variance incorporating gender and drinkingstatus as independent variables showed an effectof drinking status (F(2,56 df) 5 19.16,p , 0.001), an effect of gender (F(1,56df) 5 71.61, p , 0.001), but no interaction be-tween gender and drinking status (F(2,56df) 5 1.24). The gender effect consisted of malesproducing more alcohol-related sentences thanfemales (means of 13.6 (SE 0.5) and 8.29 (0.6),respectively) and may re¯ ect the fact that malesdrank more heavily than females.

Method experiment 2

SubjectsSeventy-eight undergraduates from the Univer-sity of Southampton were recruited by postedadvertisement and word of mouth. Data ob-tained from one subject were excluded becauseof an extreme score on self-reported alcohol con-sumption (more than four standard deviationunits above the mean) leaving a sample of 77subjects. The average age of these subjects was21.4 years (0.45 SE), the mean weekly self-re-ported alcohol consumption was 20.2 units, andthere were 24 males. In addition, three otherundergraduates were recruited to act as indepen-dent raters who examined and classi® ed as al-

cohol-related, or not, each of the sentencesproduced by the others.

Design, materials, procedure and analysis

Local ethical committee approval was obtainedfor the procedures and subjects signed a consentform containing a brief description of the proce-dures before they took part. Subjects were testedin small groups (5± 10) and each group wasassigned randomly to participate in one of threeexperimental conditions. In the alcohol-primingcondition subjects carried out the sentence gen-eration task after sampling an alcoholic and anon-alcoholic lager and deciding which was thealcoholic one. In a second, non-alcoholic, prim-ing condition subjects carried out the sentencegeneration task after checking a prose passage forspelling mistakes. The prose passage containedeach of the ambiguous alcohol-related words inthe context of a non-alcohol related story and isincluded in the appendix. In the no-primingcondition subjects carried out the sentence gen-eration task after completing their consent form.The words used in the sentence generation taskwere read out at the rate of one every 20 secondsand subjects were asked to write down as quicklyas possible a sentence incorporating each word.The word list was made up of ® ve ambiguousalcohol-related words and 15 neutral ® llers, e.g.bar (ambiguous alcohol-related) and smile (neu-tral); the complete list of words is included inAppendix 1. On completion of the sentence gen-eration task subjects completed a short question-naire to ascertain their alcohol consumption.Each subject was classi® ed as a light, moderateor heavy drinker on the basis of cut-pointsat the 33.3rd and 66.7th percentile for thedrinking scores distribution. The cut-points werecalculated for males and females togetheras, although males again drank more than fe-males, this difference was not signi® cant as in

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Num

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Light Moderate Heavy

5

10

15

Alcohol-related associative networks 1037

Figure 1. Number of alcohol-related sentences produced by light, moderate and heavy drinkers in experiment 1 ( 1 1 SE).

experiment 1 (t(75 df) 5 1.04, with means of22.8 (SE 3.3) and 19.2 (SE 1.8) units per week,respectively). Table 1 shows the mean drinkinglevels on the basis of these cut-points. The num-ber of alcohol-related sentences generated wasanalysed as a function of drinking level, as afunction of priming condition and as a functionof gender. Gender was included to follow-up the® nding of a gender effect in experiment 1. It wasincluded in the analysis even though males andfemales did not differ in terms of alcohol con-sumption, in order to examine the possibilitythat the gender effect reported in experiment 1might have re¯ ected differences between malesand females other than alcohol consumption.Three independent raters classi® ed each sen-tence as alcohol-related or not and, in the case ofdisagreement between raters, the ® nalclassi® cation of a sentence was made on a ma-jority rule basis.

Results experiment 2

Figure 2 illustrates the effect of drinking statuson the number of alcohol-related sentences gen-erated and Fig. 3 illustrates the effect of primingcondition on the number of alcohol-related sen-tences generated. It can be seen that there was a

positive correlation between number of alcohol-related sentences and alcohol consumption andthat subjects in the alcohol-related priming con-dition produced more alcohol-related sentencesthan the other two groups. The non-alcoholpriming subjects produced an intermediate num-ber of alcohol-related sentences. A three-wayanalysis of variance with drinking status (threelevels), priming condition (three levels) and gen-der as factors was carried out and showed asigni® cant effect of drinking status(F(2,59) 5 5.67, p , 0.007), of priming con-dition (F(2,59) 5 7.41, p , 0.002) and of gender(F(1,59) 5 4.57, p , 0.04).

Pairwise comparisons between the groupsshowed that moderate drinkers did not producemore alcohol-related sentences than lightdrinkers (t(51 df) 5 1.06), but heavy drinkers did(t(50 df) 5 3.28, p , 0.003), and that heavydrinkers produced more alcohol-related wordsthan moderate drinkers (t(47 df) 5 2.09,p , 0.05). With respect to priming condition,pairwise comparisons showed that alcohol-re-lated priming produced marginally more alcohol-related words than non-alcohol priming (t(49df) 5 1.69, p , 0.10, one-tail p , 0.05) and morealcohol-related words than no priming (t(50df) 5 3.00, p , 0.005), and that there was no

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2

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1038 Steven Glautier & Klair Spencer

Figure 2. Number of alcohol-related sentences produced by light, moderate and heavy drinkers in experiment 2 ( 1 1 SE).

difference between the no priming and non-al-cohol priming conditions (t(49 df) 5 1.47).

In addition to these main effects there werenear signi® cant two-way interactions betweenpriming condition and drinking status(F(4,59) 5 2.30, p 5 0.07) and between primingcondition and gender (F(2,59) 5 2.76, p 5 0.07),and a near signi® cant three-way interaction(F(4,59) 5 2.21, p 5 0.08). The three-way inter-action suggested that the effect of drinking statusby priming condition interaction was largeramong males. However, given the marginal ef-fect size and the small numbers in some of thecells involved in the three-way interaction it isdif® cult to place con® dence in the interpretationof these interactions. As far as the two-way inter-actions are concerned the pattern of means onthe number of alcohol-related sentences is asfollows. For the priming condition and drinkingstatus interaction the difference between lightand heavy drinkers is larger in the alcohol prim-ing condition than in the other two conditions(2.2 (light drinkers) and 3.6 (heavy drinkers),2.3 (light drinkers) and 2.6 (heavy drinkers), and1.4 (light drinkers) and 2.4 (heavy drinkers) forthe alcohol priming, non-alcohol priming, andno priming conditions, respectively). For thepriming condition and gender interaction the

difference between males and females is alsolarger in the alcohol priming condition than inthe other two conditions (2.2 (females) and 3.4(males), 2.2 (females) and 2.7 (males), and 2.0(females and males) for the alcohol priming,non-alcohol priming, and no priming conditions,respectively).

Discussion

The results of these experiments replicate andextend previous work, which has shown how theassociative organization of memory differs be-tween heavier and lighter drinkers and betweendependent and non-dependent individuals (Hill& Paynter, 1992; Stacy et al., 1994, 1997; Wein-gardt et al., 1996). Heavier drinkers and maleswere more likely to respond to ambiguous al-cohol-related material with alcohol-related re-sponses than lighter drinkers. It seems likely thatthis was due to the fact that, on previous occa-sions, heavier drinkers would have co-processedambiguous and unambiguous alcohol-relatedmaterials more often than lighter drinkers. Thisco-processing of material is argued to have re-sulted in the formation of associative linkagesbetween the items in memory and these linksallowed activation to spread between representa-

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4

Alcohol-related associative networks 1039

Figure 3. Number of alcohol-related sentences produced by subjects in the no-priming, non-alcoholic and alcoholic primingconditions in experiment 2 ( 1 1 SE).

tions of ambiguous and unambiguous alcohol-re-lated material. In turn, this led to an increasedlikelihood of subjects responding to ambiguousitems with an alcohol-related sentence. The cur-rent experiments also link cue-reactivity researchand the cognitive research traditions. Alcohol-re-lated cues in the form the visual, olfactory andgustatory stimulation arising from tasting al-coholic and non-alcoholic beers also appeared toincrease the likelihood of subjects responding toambiguous alcohol-related material with alcohol-related sentences and it is hypothesized that thiswas because these cues activated representationsof other alcohol-related materials in memory.Although the foregoing aspects of the resultsappear to be straightforward, a number of ques-tions were raised by the data and these arediscussed below.

First, the alcohol cue-reactivity research litera-ture suggests that heavier drinkers would re-spond differentially to alcohol-related cues (e.g.Kaplan, Meyer & Stroebel, 1983; Monti et al.,1987; McCusker & Brown, 1991; Glautier &Drummond, 1994) and on the basis of this re-search an interaction between level of alcoholconsumption and the priming condition was pre-dicted. However, although only a weak interac-

tion was found it was nevertheless in thepredicted direction, with heavier drinkers re-sponding more strongly to the priming manipu-lations. One possible explanation for theweakness of the effect may be that ceiling effectswere present such that alcohol priming alreadyproduced a high level of alcohol-related sen-tences that it was not possible to detect thehypothesized interaction. An alternative is thatthe chances of observing such an interactionwere reduced, because there also appeared to begender effects, including interactions (againweak) with the main experimental variables. Themarginal three-way interaction suggests that thepriming by drinking status interaction may belarger in males than in females. At present it isnot clear why there should be gender effects inthese experiments, since the gender effect ob-served in experiment 1 may not have been due tothe fact that males drank more than females. Inexperiment 2, where the mean level of alcoholconsumption was not signi® cantly different formales and females, males still produced morealcohol-related sentences than females.

Secondly, the alcohol priming condition hasuntil now been assumed to have exerted its effectbecause of visual, olfactory and gustatory stimu-

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1040 Steven Glautier & Klair Spencer

lation provided by the priming drinks. However,an alternative explanation is that the observedeffects may have been due to the verbal cuesprovide by the instruction to determine which ofthe two drinks contained alcohol. One solutionto this problem would be to carry out an addi-tional experiment in which control subjects wereasked to make a judgement about some non-al-cohol-related attribute of the drinks, e.g. sweet-ness. An experiment of this sort would re® ne ourunderstanding of which kinds of cue were moreor less salient to subjects.

Thirdly, the data from the non-alcohol prim-ing condition require consideration. It was hy-pothesized that the non-alcohol primingcondition would reduce the number of alcohol-related words produced but that the heavierdrinkers would be less affected by this manipu-lation. However, there was no evidence for theseeffects; in fact, the non-alcohol priming con-dition appears to have had the opposite effect,with the number of alcohol-related sentencesincreasing after subjects were exposed to theambiguous words in the non-alcohol context.Although there was no signi® cant difference be-tween the no priming and non-alcohol primingcondition the results suggest that the passage wasnot effective in its intended role. Without thiscondition producing a reduction in the numberof alcohol-related sentences (in at least onegroup of subjects) the test of the hypothesis, thatheavier drinkers are more dif® cult to bias to-wards making a non-alcoholic interpretation ofambiguous alcohol-related words, must remaininconclusive.

Finally, although these results are of interest intheir own right, it is their relevance to drug usewhich is of particular interest. On one hand thedata may simply re¯ ect the operation of basiclearning processes and index the behavioural his-tory of heavier drinking individuals. In this casea subject’ s response to a drug-related cue or theirscore in a cognitive version of a cue-reactivitytest, such as the one used in the current experi-ments, could simply be taken as a measure ofdependence or dependence liability. Heavierdrinkers are more likely to become dependentupon alcohol and this study and others suggestheavier drinkers can be distinguished fromlighter drinkers on the basis of their scores onsimilar tests (Stacy et al., 1994, 1997; Weingardtet al., 1996). In addition, at least one study ofthis sort (Hill & Paynter, 1992) has shown that

dependent and non-dependent drinkers can bedistinguished using this kind of cognitive mea-sure. However, a systematic programme to es-tablish the basic reliability and validity of such anapproach to the measurement of dependence hasnot yet been undertaken and a fair comparisonwith more traditional approaches cannot there-fore be made. On the other hand, the assump-tions motivating much cue-reactivity research arethat basic learning processes are actually in-volved with the development and maintenance ofaddictive behaviour. While the basic mechanismshave not been elucidated fully, classically con-ditioned responses to drug-related cues arethought to develop with repeated drug use and,when they occur, are thought to increase thelikelihood of drug taking (e.g. Glautier & Rem-ington, 1995; Tiffany, 1995). It does not seemunreasonable to suggest that activation of drug-related representations by stimuli other thanthose directly associated with drug use (e.g. sightand smell of a cigarette vs. a verbal stimulus suchas the word ª smokeº printed on a page) wouldhave similar behavioural consequences, i.e. in-crease the likelihood of drug taking. An extensivehistory of drug use may imbue a wide range ofstimuli with the capacity to activate representa-tions of drug-related material and elicit a varietyof responses both of which may impact upon anindividual’ s motivation for the drug.

Acknowledgements

We would like to thank Phillip Shaw and IndiaDevoe, who collected the data for experiment 1.We would also like to thank an anonymousreviewer who suggested the exploration of thegender effects reported in this revision of themanuscript.

ReferencesCOLLINS, A. M. & LOFTUS, E. F. (1975) A spreading

activation theory of semantic processing, Psychologi-cal Review, 82, 407± 428.

DICKINSON, A. (1980) Contemporary Animal LearningTheory (Cambridge, Cambridge University Press).

DRUMMOND, D. C., COOPER, T. & GLAUTIER, S. P.(1990) Conditioned learning in alcohol dependence:implications for cue exposure treatment, British Jour-nal of Addiction, 85, 725± 743.

DRUMMOND, D. C., TIFFANY, S. T., GLAUTIER, S. &REMINGTON, R. (1995) Addictive Behaviour: cue ex-posure theory and practice (Chichester, John Wiley &Sons).

Page 9: Activation of alcohol-related associative networks by recent alcohol consumption and alcohol-related cues

Alcohol-related associative networks 1041

GLAUTIER, S. & DRUMMOND, D. C. (1994) Alcoholdependence and cue reactivity, Journal of Studies onAlcohol, 55, 224± 229.

GLAUTIER, S. & REMINGTON, R. (1995) The form ofconditioned responses to drug cues, in: DRUMMOND,D. C., TIFFANY, S. T., GLAUTIER, S. & REMINGTON,R. (Eds) Addiction: cue exposure theory and practise,pp. 21± 46 (Chichester, Wiley).

HILL, A. B. & PAYNTER, S. (1992) Alcohol dependenceand semantic priming of alcohol related words, Per-sonality and Individual Differences, 13, 745± 750.

KAPLAN, R. F., MEYER, R. E. & STROEBEL, E. F. (1983)Alcohol dependence and responsivity to an ethanolstimulus as predictors of alcohol consumption,British Journal of Addiction, 78, 259± 267.

MACKINTOSH, N. J. (1983) Conditioning and AssociativeLearning (Oxford, Clarendon Press).

MCCUSKER, C. G. & BROWN, K. (1991) The cue-re-sponsivity phenomenon in dependent drinkers:ª personalityº , vulnerability, and anxiety as interven-ing variables, British Journal of Addiction, 86, 905±912.

MEYER, D. E. & SCHVANEVELDT , R. W. (1971) Facili-tation in recognising pairs of words: evidence of adependence between retrieval operations, Journal ofExperimental Psychology, 90, 227± 234.

MONTI, P. M., BINKOFF, J. A., ABRAMS, D. B., ZWICK,W. R., NIRENBERG, T. D. & LIEPMAN, M. R. (1987)Reactivity of alcoholics and non-alcoholics to drink-ing cues, Journal of Abnormal Psychology, 96, 122±126.

NIAURA, R. S., ROSENHOW, D. J., BINKOFF, J. A.,MONTI, P. M., PEDRAZA, M. & ABRAMS, D. B.(1988) Relevance of cue reactivity to understandingalcohol and smoking relapse, Journal of AbnormalPsychology, 97, 133± 152.

POWELL, J., GRAY, J. A., BRADLEY, B. P. et al. (1990)The effects of exposure to drug-related cues indetoxi® ed opiate addicts: a theoretical review andsome new data, Addictive Behaviours, 15, 339± 345.

SEIDENBERG, M. S., TANENHAUS, M. K., LEIMAN, J. M.& BIENKOWSKI, M. (1982) Automatic access of themeaning of ambiguous words in context: some limi-tations of knowledge based processing, Cognitive Psy-chology, 14, 489± 573.

STACY, A. W. S., LEIGH, B. C. & WEINGARDT, K. R.(1994) Memory accessibility and association of al-cohol use and its positive outcomes, Experimentaland Clinical Psychopharmacology, 2, 269± 282.

STACY, A. W., LEIGH, B. C. & WEINGARDT, K. (1997)An individual-difference perspective applied to wordassociation, Personality and Social Psychology Bulletin,23, 229± 237.

TIFFANY, S. T. (1995) Potential functions of classicalconditioning in drug addiction, in: DRUMMOND, D.C., TIFFANY, S. T., GLAUTIER, S. & REMINGTON, R.(Eds) Addiction: cue exposure theory and practise,pp. 21± 46 (Chichester, Wiley).

WEINGARDT, K. R., STACY, A. W. & LEIGH, B. C.(1996) Automatic activation of alcohol concepts inresponse to positive outcomes of alcohol use, Alco-holism: Clinical and Experimental Research, 20, 25± 30.

AppendixWords used in experiment 1:

bar pint spirits shot pool glass club double short bottle

drink round crawl yard stool house lime barrel mug measure

Words used in experiment 2:

smile wind spirits* hard town pint* found read shot* end

sun door bar* plan car mind bank light arm round*

Note, all the words used in experiment 1 were ambiguous alcohol-related words. In experiment 2 only thosemarked* were ambiguous alcohol-related words.

Non-alcohol-related prose passage used in the spell-check task:Katy was about to pop round to the local shop to buy a pint of milk and a bar of chocolate, when she heard

a strange noise coming from the attic. She stopped in her tracks, her heart pounding. She had heard soundsbefore, but never as loud as these. This time. It certainly couldn’ t be mice. What on earth was it?

Katy tried to calm her nerves by thinking rationally. She didn’t believe all that hocus pocus about ghosty spirits.Nevertheless she couldn’ t account for what she had just heard. Having composed herself and decided to call herbrother Jack to help her check out the loft, Katy was in for another shock. A shot echoed around the houses,which seemed to emanate from her own back garden.