Taking back control: fractioning the homunculus to improve our understanding of the role of 'inhibitory control' in heavy drinking

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Alcohol abuse imposes a substantial burden on society, yet our understanding of the psychological processes that influence drinking behaviours is inadequate. This is partly because psychological theories of substance use disorders (addictions) rely on a simplistic conceptualization of 'inhibitory control', defined as the ability to stop, change or delay inappropriate behaviour. These theories are founded on the assumption that behaviour is controlled by an unspecified 'inhibitory homunculus' or central control system, and that impairments to the functioning of this homunculus result in addiction. There is good reason to believe that this assumption is incorrect. In this project I aim to apply predictions from a recent theoretical framework of inhibitory control to the study of inhibitory deficits in heavy drinkers. Specifically, I will break down the inhibitory 'homunculus' into its component processes in order to more precisely specify the nature of inhibitory deficits in alcohol use disorders. In an initial study, I will investigate the extent to which different inhibitory sub-processes are influenced by alcohol-related cues in a naturalistic 'bar lab', and measure the association between these inhibitory sub-processes and individual differences in drinking behaviour. In a second study I will use ecological momentary assessment to investigate the effect of situational variables (including alcohol cues) on inhibitory sub-processes in participants' natural environments, and I will investigate which inhibitory sub-processes are associated with increased alcohol consumption. Finally, a third study will investigate whether alcohol-cues can be paired with the engagement of inhibitory control, and if this 'inhibitory control training' (ICT) can prompt a reduction in alcohol consumption that survives a change in context. The results from these studies will form the basis of a new theoretical understanding of inhibitory control in addiction. Findings will also impact the future development of behavioral treatments.