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Title: Getting a Grip on Drinking Behavior Training Working Memory to Reduce Alcohol Abuse
Authors: Houben K, Wiers RW, Jansen A
Journal: Psychol Sci. 2011 Jul 1;22(7):968-75. Epub 2011 Jun 17.
DOI: 10.1177/0956797611412392
Research Ideas:

• conflicts between automatic impulses and directed goals (e.g. cake vs. diet) envisioned as a competition between information processing systems (reflective-impulsive model, Strack & Deutsch, 2004)
• executive control refers to those systems that allow ind. to engage in goal-directed behavior and/or override automatic impulses; may include planning, attention, memory, action initiation/inhibition
• chronic alcohol abusers show deficits in executive control as measured by response inhibition, working memory (WM); these ind. cannot adequately regulate impulse to drink alcohol when executive functioning is low
• one aspect of executive control - working memory - has been shown to correspond with level of executive control, to improve with training, and to improve other areas of executive contol
• can WM be strengthened in chronic alcohol abusers via training? will this training be associated with less alcohol consumption (presumably due to better impulse regulation through executive control)? [Yes, and yes]

Participants:

• 48 adult heavy drinkers

Measures:

• AUDIT; Alcohol Use Disorders Identification Test - used to screen for problem drinkers (those scoring 8 or higher)
• 3 WM tasks: visuospatial WM task, backward digit task, letter span task
• IAT; Implicit Association Test - alcohol vs. soft drink, pleasant vs. unpleasant
• WM capacity - measured as length of longest sequence correctly reproduced for each WM task
• Alcohol use - TLFB; Time-Line Follow-Back questionnaire - asks how many alcoholic beverages consumed each day of the previous week

Procedure:

• Ps randomly assigned to training or control condition
• In training condition, difficulty of WM tasks adjusted according to performance, trial-by-trial, starting with three items and adding/subtracting items every two trials depending on if both trials were performed correctly or not
• In control condition, WM tasks did not change
• Ps completed study online; 1 pre-test consisting of WM capacity test, IAT, TLFB; 25 training sessions of all three WM tasks; 1 post-test of WM capacity test, TLFB; 1 follow-up (same as post-test, conducted 1 month after post-test)

Results:

• Training effect on WM: comparing Ps in training condition to controls, WM capacity increased more from pre to post and from pre to follow-up
• Training effect on alcohol use (TLFB): comparing Ps in training condition to controls shows greater reduction in alcohol consumption from pre to post and from pre to follow-up (marginal; p = .06)
• Results appear to be mediated by level of automatic impulses (as measured by IAT score), specifically, moderated mediation; increasing WM capacity appears to be especially effective at reducing alcohol consumption for Ps w/ high automatic preferences for alcohol

Limitations:

• Internet-based: lack of experimenter control, lack of proper-screening for alcohol dependence
• Unclear if WM changes and alcohol consumption changes persist beyond 1 month follow-up

Conclusions:

• WM training may be a useful intervention for impulse-control disorders; shown here to benefit alcohol-users, shown previously to benefit ind. w/ ADHD; effects on binge-eating, over-eating, drug-abuse remain to be seen (as well as on clinical samples)

Further Reading:

• 1. On reflective-impulsive model of information processing: Strack F., 
  2. Deutsch R.
   (2004). Reflective and impulsive determinants of social behavior. Personality and Social Psychology Review, 8, 220–247. doi: 10.1207/s15327957pspr0803_1
• 1. On WM training (in ADHD children): Klingberg T., 
  2. Forssberg H., 
  3. Westerberg H.

   (2002). Training of working memory in children with ADHD. Journal of Clinical and Experimental Neuropsychology, 24,781–791.
   doi: 10.1076/jcen.24.6.781.8395