Testing Automatic Action-Tendency Retraining in Heavy Drinking Young Adults Using

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DESCRIPTION (provided by applicant): Young adult heavy drinking is a public health concern. Young people drink alcohol frequently, which puts them at risk for injuries, accidents and subsequent alcohol dependence. Due to strong contingencies supporting their alcohol use and limited motivation to change, young adult drinkers are a challenging population to treat. Current behavioral interventions are efficacious overall but effect sizes have been modest. Given these factors, new interventions are needed to target cognitions and behaviors that support young adult heavy drinking. Dual process models posit that addictive behaviors stem from failed attempts at inhibiting impulses and overactive automatic, appetitive, approach tendencies. Current behavioral interventions typically aim to enhance young adults' inhibitory control over excessive drinking by prompting effortful behavior change. In contrast, automatic, approach tendencies have been ignored largely in behavioral interventions. Findings of strong automatic approach tendencies among heavy drinking young adults suggest that an intervention to reduce these tendencies may be well-suited to this population. Automatic action tendency retraining (Wiers et al. 2010; 2011) is a theoretically-supported, novel intervention with promising initial empirical support. The retraining procedure entails pushing away motions with a joystick in response to alcohol images over repeated trials. In the proposed study, automatic action tendency retraining will be compared to a control condition in heavy drinking young adults (N = 72), using a novel, naturalistic alcohol self-administration model of impaired control over alcohol use (Leeman et al. 2012). Impaired control is a deviation from a conscious attempt to limit alcohol use that may occur due to strong automatic approach tendencies toward alcohol. Notably, the impaired control paradigm creates disincentives for drinking alcohol excessively, providing participants with reasons to limit alcohol use. Excessive alcohol use in this paradigm ignores a guideline for moderate use and occurs despite possible negative consequences, thus modeling key elements of problem drinking. We hypothesize young adults randomized to automatic action tendency retraining will drink to significantly lower peak estimated blood alcohol concentrations and consume fewer drinks overall than those randomized to the control condition. Exploratory comparisons will also be made between the experimental retraining and control conditions on measures of drinking topography including mean time taken to consume each drink. Findings from this study will inform future clinical trials to test the efficacy of automatic action tendency retraining for young adult heavy drinkers. Results of the proposed study will also inform subsequent research to combine the retraining procedure with an intervention to enhance inhibitory control. Theory and evidence suggest automatic/implicit and effortful/explicit interventions contribute uniquely to alcohol use reduction, making their combination promising.