Examination of an Experimental Paradigm of Impaired Control over Alcohol Use

Alcohol use disorders peak during young adulthood with nearly 27% of individuals aged 18 to 30 meeting diagnostic criteria. Impaired control, or difficulty limiting alcohol use, has been identified as one of the earliest symptoms of an alcohol use disorder and is predictive of alcohol use severity. Despite the relevance of impaired control for identifying and preventing hazardous drinking behaviors, there is a dearth of research that exists on this critical risk factor. The current study tested an experimental paradigm of impaired control whereby participants self-administered alcohol following guidelines to limit consumption to a low level. It was hypothesized that participants would be more likely to violate drinking guidelines following alcohol cue exposure and when inhibitory control was diminished. Potential moderators of the association between alcohol cue exposure and guideline violations were tested (i.e., drinking-induced disinhibition expectancies and trait impaired control) along with a mediational model whereby alcohol cue exposure leads to guideline violations through diminishing effects on inhibitory control. Participants (N = 20, Mage = 23.20, 60% female, 40% White, 35% Black) completed an in-person session including initial assessments, computerized performance tasks, and alcohol self-administration. Contrary to hypotheses, individuals in the control condition experienced greater reductions in inhibitory control (p = .056), though likelihood of violating drinking guidelines did not differ by condition. Although moderation models were nonsignificant, the mediational model was trending in significance such that individuals in the neutral context were more likely to violate drinking guidelines due to diminished inhibitory control. These findings are discussed in the context of boredom and under stimulation, which may have influenced the attentional capacity and inhibitory control of individuals in the neutral context condition. Follow-up supplemental analyses suggested that alcohol cue exposure may have reduced inhibitory control but only once drinking had been initiated. Although the experimental paradigm appeared successful, the small sample size limits implications and generalizability. Nonetheless, results, contextualized by several large effect sizes, shed light on critical paths for future experimental research on impaired control including the need for more generalizable control conditions and the relevance of priming doses when examining the effects of alcohol cue exposure.