Acute alcohol effects on inhibitory control and implicit cognition: implications for loss of control over drinking

Abstract

Alcohol impairs inhibitory control, and it alters implicit alcohol cognitions including attentional bias and implicit associations. These effects are seen after doses of alcohol which do not lead to global impairments in cognitive performance. We review studies which demonstrate that the effects of alcohol on inhibitory control are associated with the ability of alcohol to prime alcohol-seeking behavior. We also hypothesize that alcohol-induced changes in implicit alcohol cognitions may partially mediate alcohol-induced priming of the motivation to drink. Based on contemporary theoretical models and conceptualizations of executive function, impulsivity, and the motivational salience of alcohol-related cues, we speculate on other aspects of cognition that may underlie alcohol's effects on alcohol seeking. Inconsistencies in existing research and priorities for future research are highlighted, including dose effects and the potential interactions between chronic heavy drinking and the acute effects of alcohol on these cognitive processes.

Fig. 1

Schematic illustrating cognitive mechanisms that may underlie the alcohol priming effect. Administration of alcohol preloads increases the strength of automatic appetitive responses to alcohol cues, including attentional bias and the strength of associations between alcohol and concepts such as approach and positive valence. Alcohol preloads also impair response inhibition. Both of these effects may independently contribute to the alcohol priming effect (increased drinking or loss of control over alcohol-seeking behavior). In addition, the dashed line indicates a theoretically predicted interaction between these effects of alcohol preloads. Inhibitory control may normally act to reduce the influence of automatic appetitive reactions to alcohol cues on alcohol-seeking behavior; because inhibitory control is impaired by alcohol preloads, this moderating effect is diminished. As a consequence, automatic appetitive responses to alcohol cues have a greater influence on alcohol-seeking behavior after administration of an alcohol preload.