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Aims: Drinking behaviours are regulated by motivational tendencies – fast and automatic responses to alcohol related cues - and by a reflective system which can inhibit impulsive actions. While heavy drinkers tend to display an approach tendency, an avoidance tendency has been promoted by the Cognitive Bias Modification, a training that has reduced relapse rate in individuals treated for alcohol dependence. This study investigates motivational tendencies in a group of young heavy drinkers and matched controls. Methods: Participants were selected on the basis of their scores on the Alcohol Use Disorders Identification Test (AUDIT) and 23 heavy drinkers were compared with 20 social drinkers on a Relevant-Stimulus Response Compatibility (R-SRC) task. The R-SRC is a measure of automatic motivational tendencies and it requires to move a manikin away or towards alcohol related and neutral pictures on a computer screen. Neuropsychological tests and the Attentional Control Scale (ACS) were also administered. Results: Heavy drinkers and controls differed in their responses on the R-SRC task, with heavy drinkers being faster in approaching alcohol related images. There were minimal differences in working memory and attention between the two groups, while heavy drinkers reported lower scores than social drinkers on the ACS. Conclusions: Heavy drinkers showed an approach tendency towards alcohol-related cues. This might reflect motivational tendencies towards alcohol although these could have also been influenced by social desirability effects. Group differences in ACS scores might reflect heavy drinkers’ awareness of alcohol-related cognitive decline. Motivational tendencies and drinking patterns might increase the risk of alcohol dependence.

This thesis investigates the capacity to identify Emotional Facial Expressions (EFE) in people who have a history of using illicit substances. Part one is a systematic literature review that critically appraises the available research in this area. The studies reviewed investigate the acute, sub-acute and/or chronic effects of different levels of use of opiates, cannabis, MDMA, cocaine, methamphetamine, and multiple substances. Methodological constraints in this area of research make synthesis and interpretation of findings problematic. Despite this, the review highlights evidence of deficits in EFE recognition associated with substance use. These appear more marked for negative emotions, particularly fear and disgust. Part two is an empirical study that aims to investigate EFE recognition in opiate users. Substitute prescribed opiate users are compared with controls on performance on a dynamic EFE recognition task. The findings of this study suggest that there is a general deficit in sensitivity to EFEs in opiate uses and specific deficits in the recognition of neutral disgust and fear expressions. Part three is a critical appraisal focusing on the process of carrying out research with clinical populations and within substance use in particular. This considers the difficulties and benefits of integrating clinical practice and empirical research in the role of clinical psychologists.