Methodological issues attached to the alcohol Stroop paradigm: comments on a paper by Sharma, Albery & Cook (2001).
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Biomedical subjects
Publications and source records attributed to J C Laberg.
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On the basis of the restraint theory and the continuum hypothesis of eating disorders, the objective of this paper was twofold. First, subjects who, on the basis of items from the Eating Disorder Examination Questionnaire (EDE-Q) which are generated from DSM-III-R diagnostic criteria, fulfilled the diagnostic criteria for anorexia nervosa (AN) and bulimia nervosa (BN) were identified. Second, differences in scale scores between a case group and a non-case group were tested, and case group distribution of the two self-report questionnaires Eating Attitudes Test (EAT-12) and Eating Disorder Inventory (EDI) was compared as a means for investigating the sensitivity of the instruments in detecting eating disorder cases. In a classroom setting 224 8th-grade female students from 5 schools in western Norway completed the questionnaires. The responses to the questionnaires were analysed by case group and instrument/subscales by using the t test, Cohen's d-values, eta squared statistic, point biserial correlation, and two-way ANOVA. No BN cases and 10 AN cases were identified. AN cases scored significantly higher on all measures of eating problems than normal subjects and differed most from non-cases on the "dieting" dimension. Clinical implications are discussed in the light of screening.
OBJECTIVE: This study investigated alcoholics' selective attention to alcohol words in a version of the Stroop color-naming task. METHOD: Alcoholic subjects (n = 23) and nonalcoholic control subjects (n = 23) identified the color of Stroop versions of alcohol, emotional, neutral and color words. Manual reaction times (RTs), skin conductance responses (SCRs) and heart rate (HR) were recorded. RESULTS: Alcoholics showed overall longer RTs than controls while both groups were slower in responding to the incongruent color words than to the other words. Alcoholics showed longer RTs to both alcohol (1522.7 milliseconds [ms]) and emotional words (1523.7 ms) than to neutral words (1450.8 ms) which suggests that the content of these words interfered with the ability to attend to the color of the words. There was also a negative correlation (r = -.41) between RT and response accuracy to alcohol words for the alcoholics, reflecting that the longer time the alcoholics used to respond to the color of the alcohol words, the more incorrect their responses were. The alcoholics also showed significantly greater SCRs to alcohol words (0.16 microSiemens) than to any of the other words (ranging from 0.04-0.08 microSiemens), probably reflecting the emotional significance of the alcohol words. Finally, the alcoholics evidenced smaller HR acceleration to alcohol (1.9 delta bpm) compared to neutral (2.8 delta bpm), which could be related to difficulties alcoholics experience in terminating their attention to the alcohol words. CONCLUSIONS: These findings indicate that it is difficult for alcoholics to regulate their attention to alcohol stimuli, suggesting that alcoholics' processing of alcohol information is automated.
The aim of the present study was to investigate the effect of different coping styles on the development of self-reported mental health problems in a radically changing context. This was investigated, using a longitudinal design, by following soldiers from before entering service to 8 months of service. Based on their scores on the 30-item General Coping Questionnaire, soldiers were allocated to one of three groups: those whose coping styles were emotional, avoidance, or task focused. These three groups were assessed four times. The General Health Questionnaire (30-item version), Ursin's Health Inventory, and the Alcohol Use Disorders Identification Test (AUDIT) were used as dependent measures. Avoidance-focused soldiers reported an increase in General Health Questionnaire scores over time. Furthermore, the avoidance-focused copers revealed higher scores on the AUDIT questionnaire as well as an increase in AUDIT scores over time. The present study showed that there was an interaction of personality variables and contextual factors involved. More specifically, young subjects with a preference for an avoidance-focused coping strategy are at greater risk of experiencing symptoms of mental health problems compared with task-focused and emotion-focused subjects when exposed to a radically changing environment.
OBJECTIVE: This article examines the relationship between intention to drink alcohol, alcohol outcome expectancies and alcohol-related self-efficacy among Norwegian adolescents. The relationship of expectancies, intention and self-efficacy was assessed for respondents of different ages and different drinking experience. METHOD: Data were collected from all seventh and ninth graders in 12 randomly selected schools in Norway. The self-administered questionnaire contained a short version of the Alcohol Expectancy Questionnaire for Adolescents and measures of intentions to drink in the next 12 months, current alcohol use and alcohol-related self-efficacy (e.g., ability to refuse alcohol). RESULTS: Results showed that both alcohol outcome expectancies and previous experience with alcohol were related to intentions to drink alcohol in the near future. Drinking experience had a larger impact than a 2-year age difference on the associations between alcohol outcome expectancies, alcohol-related self-efficacy and intention to drink. A significantly higher proportion of adolescents with drinking experience reported positive alcohol expectancies, poor alcohol-related self-efficacy and strong intention to drink alcohol than did those adolescents without drinking experience. CONCLUSIONS: Personal drinking experience was a stronger predictor of drinking intentions than was age. Still, both alcohol outcome expectancies and alcohol-related self-efficacy are significant predictors of intention to drink among both seventh and ninth graders, independent of previous drinking experience. This study indicates that postponing the onset of alcohol experimentation could be a major goal in primary alcohol prevention among adolescents, although longitudinal confirmation of these results is needed.
Two versions of a school-based alcohol prevention programme for 7th grade students were evaluated against a non-treated comparison condition. Both programme versions were based on a social-cognitive theory approach to alcohol prevention, and differed in the level of role-specifications for participating teachers and peer leaders. Twelve schools with 955 students in Bergen, Norway, participated in the study. Four schools were randomly assigned to each of the three conditions, and the programme was implemented during 10 class periods over 2 months in Spring, 1992. Pre- and post-test surveys were conducted, assessing alcohol use, as well as cognitive variables related to alcohol use in a specific context (intentions, attitudes, norms and self-efficacy expectations). Results showed that the highly role-specified (HRS) version had a higher degree of student involvement than the less role-specified (LRS) version, indicating that the HRS programme was more successful in engaging students in alcohol prevention activities. A significant difference in programme effectiveness was found, as measured by an overall programme effect across all dependent variables. This effect was explained by significantly more positive outcomes in the HRS version compared to both the LRS and the non-treated conditions, while the LRS version did not differ significantly from the non-treated condition.
17 right-handed males volunteered for an experiment that compared task-related patterns of electromyographic (EMG) activation with data from muscle biopsy on proportion of slow-twitch ((ST) aerobic) to fast-twitch ((FT) anaerobic) muscle fibers. The biopsy was taken from the right-leg gastrocnemius muscle after EMG measurement from that area of the leg muscle. EMG was also recorded from the left forearm flexor carpi radialis area. Recordings were obtained from pre- and post-task resting periods and during 150 s of video-task performance when the right hand operated a joy-stick. The results showed a highly significant tonic EMG activation in the leg muscle of subjects with predominance of ST fibers, and this relationship generalized to the EMG from the 'passive' forearm. The proportion of ST to FT fibers is genetically defined and not altered by exercise. Therefore, our results lend support to a genetic differentiation between individuals with high vs. low probability of unintended build-up of muscle tension during perceptual-motor task performance.
The following questions, pertaining to cue reactivity in alcoholics, are discussed: (a) What cues are relevant to alcoholics' drinking? Previous research has been concerned with the obvious: bottles, glasses, pub/bar environments, and other visual cues. Presumably more potent cues, that is, smell, taste and internal effects, subtle stimuli like social climate, shifts in conversations, also influence drinking. The effects of mood states on alcoholics' urges and behavior are rarely integrated into experimental studies. (b) What is the CR? Given that drinking is a very complex social behavior, "the drug effect" becomes problematic to disentangle from the effects of other factors, such as bio-medical states, social setting and learning history. This is further complicated by the fact that drugs affect physiological and cognitive systems differently at different dose levels and with rising and falling Blood Alcohol Levels. Moreover, it has been found that alcohol cues may elicit responses that are in the same and in the opposite direction to the drug response. (c) If such responses are reliably tied to alcohol cues (as opposed to novelty of the experimental situation), the impact of the conditioned responses on craving for alcohol and relapse becomes an issue. (d) Another question relates to the analogy between fear in phobias and craving in substance abuse since, unlike phobics, substance abusers do not fear the substance they are responding to. (e) A further issue is the effectiveness of extinction procedures, as opposed to changes in efficacy expectations, as a therapeutic mechanism for the cue exposure paradigm. Examples of recent research at the Hjellestad Clinic are presented.
This article gives a brief historical introduction to the field of eating disorders. Anorexia Nervosa (AN) and Bulimia Nervosa (BN) are seen from a sociocultural point of view, and the current emphasis on slimness is regarded as an important factor in the etiology of eating disorders. A short description of the central features of BN is given, and some important explanatory psychological models are described with the emphasis on the cognitive-behavioral model. Recent controlled treatment studies are cited.
Treatment and research efforts at the Hjellestad Clinic are based on a biobehavioural model of the addictions. The treatment program encompasses life-style changes and relapse prevention, and extensive assessment for the purpose of the treatment choices. The clinic is treating nearly 1500 patients a year. Psychological and medical research projects have included experimental drinking studies, psychopharmacological and biomedical studies, treatment evaluations, studies of neuropsychological assessment, studies of personality subtypes, studies of violence related to alcohol and drugs, and investigations of women alcoholics. A new research laboratory houses an experimental bar, and state-of-the-art facilities for psychophysiological and neuropsychological testing. The Hjellestad Clinic is the only Norwegian centre for clinical and experimental research on the addictions from a psycho-physiological as well as behavioral and cognitive perspective. In addition, a national educational program offers theoretical and practical training for professionals and paraprofessionals in the addictions in co-operation with the University of Bergen. Training in the addictions and internships for psychology students at the University of Bergen is provided at the Clinic. The centre has established connections with centres in Scandinavia, England, Canada and the U.S., through visiting scholars and study trips. (The centre has an especially strong liaison with the Rutgers Center of Alcohol Studies.)
Interactive effects of expectancy and alcohol dose on CNS functioning were examined in subjects differing in degree of dependence on alcohol, using the balanced placebo design. Male subjects (N = 30), 10 severely-, 10 moderately- and 10 nondependent on alcohol, were tested with the Klove-Matthews Motor Steadiness Battery before and after drinking. The administered alcohol dose yielded .07 mg/dl mean blood alcohol level. Expectations about alcohol resulted in impaired sensorimotor coordination in severely dependent alcoholics, as compared to expectations of soft drinks. Moderately dependent subjects showed an opposite response pattern. Such expectancy factors may counteract neuropharmacological tolerance effects, neutralizing real tolerance effects on moderate doses of alcohol for severely dependent alcoholics. High tolerance also makes larger quantities necessary, leading to increased consumption to obtain the same effect.
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This study address the question of cued reactivity in alcoholics. Twenty alcoholic in-patients and 20 control subjects were presented with repeated exposures to a alcohol-related (A) and a neutral (B) slide, in either an ABA or BAB sequence. Skin Conductance Level (SCL) and Skin Conductance Responses (SCR) were recorded. Alcohol-dependent subjects showed increased SCR compared to the control subjects. This was, however, independent of whether the presented stimuli were alcohol-related or neutral. Thus, the results did not support the hypothesis of cued reactivity, but point to a nonspecific hyper-reactivity in alcohol-dependent subjects. The results are discussed in relation to risk-factors for alcoholism and relapse.
The present study was designed to investigate autonomic cued reactivity to olfactory alcohol stimuli in alcoholics. Twenty outpatient alcoholics and 20 social drinkers were exposed to high- and low-potency alcohol and neutral odors. The alcoholics showed greater skin conductance responses and increased heart rate acceleration responses to the high-potency alcohol odor than social drinkers, while there was no difference between the groups' responses to the low-potency alcohol odor. Alcoholics also reported greater difficulties in resisting a potential offer for a drink after relative to before the experiment, while there was no change in the desire to drink. The results indicate that alcohol cues are perceived as emotionally aversive and elicit a defensive response to avoid further processing of these stimuli. The increased autonomic reactivity may thus reflect a shift of focus from the environmental alcohol cues to internal thoughts and feelings. A rigid internal focus may constrain the ability to resist alcohol consumption and thus be a critical determinant in promoting craving and relapse in alcoholics.
Attentional bias was studied with a modified version of the Stroop test in active smokers, abstinent smokers, and nonsmokers. The task was color-naming of incongruent color-words, smoking-related words, and neutral words. The results showed that the active smokers used longer verbal reaction time (VRT) to smoking-related words compared to abstinent smokers, i.e., indicating stronger attentional bias in the active smokers. Furthermore, longer VRTs to the Stroop words compared to the smoking words and the neutral words were found only in nonsmokers and abstinent smokers. Finally, a significant negative correlation was found between attitudes against smoking and VRTs to the smoking-related words. Taken together the main finding was that the active smokers showed no differential response to the stimuli. This could be caused by a lack of ability to modulate attentional processes in active smokers.