Abstract

Learning to quit drinking: An impulsive and reflective route to behavioral change According to contemporary dual-process theories, alcohol misuse is the result of an imbalance between two distinct cognitive systems: An impulsive system and a reflective system. While the automatic impulsive system becomes hypersensitive to alcohol-related reward with prolonged alcohol abuse, the slower reflective system is weakened and is no longer able to inhibit automatic impulses to drink alcohol. The clinical implication of these insights is that interventions might benefit from procedures that either change the impulsive system or strengthen inhibitory control abilities. These two potential routes to behavioral change were examined in two separate studies. The first study demonstrates that the reward value assigned to alcohol can be reduced via an evaluative conditioning procedure that consistently pairs alcohol-related stimuli with negative affect. Moreover, this procedure did not only change alcohol-related affect, but also resulted in a significant decrease in alcohol intake. The second study aimed to increase response inhibition by having participants consistently stopping or inhibiting responses to alcohol-related stimuli. This inhibition training also decreased alcohol-related affective value and significantly reduced alcohol consumption. Together these two studies demonstrate that evaluative conditioning and strengthening response inhibition can be effective strategies to reduce excessive alcohol use. These two studies, therefore, provide initial data suggesting the potential utility of two novel, conceptually-derived interventions for reducing drinking.

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