Anticipated Effects of Alcohol Stimulate Craving and Impair Inhibitory Control

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A considerable evidence base has demonstrated that priming doses of alcohol impair inhibitory control and activate motivation to consume alcohol. There is, however, a lack of studies investigating the effect of placebo-alcohol on these processes and their association with alcohol outcome expectancies (AOE). We investigated the effect of placebo-alcohol on craving and inhibitory control, and the extent to which placebo effects correlated with AOE in 32 nondependent drinkers. Participants completed questionnaires assessing typical alcohol use (fortnightly alcohol consumption, AUDIT) and AOE (measured using the Alcohol Outcome Expectancy Scale). On a within-subjects basis participants consumed a placebo-alcohol drink and control drink. Measures of craving were taken pre- and postdrink, and participants completed a go/no-go task following the drink. Craving was increased by the placebo-alcohol and, importantly, placebo-alcohol impaired inhibitory control. Furthermore expectancies of cognitive and behavioral impairment were correlated with go/no-go task performance following a placebo. Increases in craving were associated with a range of elevated outcome expectancies. This suggests that the anticipated effects of alcohol can impair inhibitory control and increase craving; therefore studies using placebo versus alcohol comparisons relative to studies using a pure no-alcohol control are underestimating the real-world effect of alcohol on these processes, which is a combination of pharmacological and anticipated effects of alcohol. Furthermore, individual differences in AOE may influence reactivity to the anticipated effects of alcohol.

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