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Background and Objectives: Response inhibition is usually considered a hallmark of executive control. However, recent work indicates that stop performance can become associatively mediated ('automatic') over practice. This study investigated automatic response inhibition in sober and recently detoxified individuals with alcoholism.., Methods: We administered to forty recently detoxified alcoholics and forty healthy participants a modified stop-signal task that consisted of a training phase in which a subset of the stimuli was consistently associated with stopping or going, and a test phase in which this mapping was reversed., Results: In the training phase, stop performance improved for the consistent stop stimuli, compared with control stimuli that were not associated with going or stopping. In the test phase, go performance tended to be impaired for old stop stimuli. Combined, these findings support the automatic inhibition hypothesis. Importantly, performance was similar in both groups, which indicates that automatic inhibitory control develops normally in individuals with alcoholism.., Limitations: This finding is specific to individuals with alcoholism without other psychiatric disorders, which is rather atypical and prevents generalization. Personalized stimuli with a stronger affective content should be used in future studies., Conclusions: These results advance our understanding of behavioral inhibition in individuals with alcoholism. Furthermore, intact automatic inhibitory control may be an important element of successful cognitive remediation of addictive behaviors.., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background and Objectives: Automatic hedonic ("liking") and incentive ("wanting") processes are assumed to play an important role in addiction. Whereas some neurobiological theories suggest that these processes become dissociated when drug use develops into an addiction (i.e., "liking" becomes weaker, whereas "wanting" becomes exaggerated; e.g., Robinson & Berridge, 1993), other theories suggest that there is a linear relationship between these two processes (i.e., both "liking" and "wanting" increase equally; e.g., Koob & Le Moal, 1997). Our aim was to examine "wanting" and "liking" in three groups of participants: alcohol-dependent patients, heavy social drinkers, and light social drinkers., Methods: Participants performed two different single target implicit association tests (ST-IATs; e.g., Bluemke & Friese, 2007) and explicit ratings that were designed to measure "liking" and "wanting" for alcohol., Results: Our results are in sharp contrast with the theories of both Robinson and Berridge and Koob and Le Moal: heavy drinkers had higher scores than light drinkers and alcohol-dependent patients on both the wanting ST-IAT and the liking ST-IAT. There were no differences between alcohol-dependent patients and light drinkers. Explicit ratings mirrored these results., Limitations: These findings suggest that our ST-IATs are not valid measures of "wanting" and "liking". Instead, they might assess more complex knowledge regarding participants' experiences and goals., Conclusions: These findings suggest that the relationship between drug consumption and appetitive drug associations is not linear, highlighting the importance of testing both sub-clinical and clinical samples in future research., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Background: Alcohol dependence is associated with poor decision-making under ambiguity, that is, when decisions are to be made in the absence of known probabilities of reward and loss. However, little is known regarding decisions made by individuals with alcohol dependence in the context of known probabilities (decision under risk). In this study, we investigated the relative contribution of these distinct aspects of decision-making to alcohol dependence., Methods: Thirty recently detoxified and sober asymptomatic alcohol-dependent individuals and 30 healthy control participants were tested for decision-making under ambiguity (using the Iowa Gambling Task[IGT]) and decision-making under risk (using the Cups Task and Coin Flipping Task). We also tested their capacities for working memory storage (digit span forward) and dual tasking (operation span task)., Results: Compared to healthy control participants, alcohol-dependent individuals made disadvantageous decisions on the IGT, reflecting poor decisions under ambiguity. They also made more risky choices on the Cups and Coin Flipping Tasks reflecting poor decision-making under risk. In addition, alcohol-dependent participants showed some working memory impairments, as measured by the dual tasking, and the degree of this impairment correlated with high-risk decision-making, thus suggesting a relationship between processes subserving working memory and risky decisions., Conclusions: These results suggest that alcohol-dependent individuals are impaired in their ability to decide optimally in multiple facets of uncertainty (i.e., both risk and ambiguity) and that at least some aspects of these deficits are linked to poor working memory processes., (Copyright © 2014 by the Research Society on Alcoholism.)

Background: Altruistic punishment is an evolutionary-based mechanism aimed at maximizing the probability of reciprocity in cooperative exchanges, through the deterrence of non-cooperators. In economic games, humans will often punish others for non-cooperation, even if this punishment is costly to the self. For instance, in the Ultimatum Game paradigm, people refuse offers considered as unfair even though they are disadvantaged financially by doing so. Here, we hypothesize that, due to an impulsive decision making style, individuals with alcoholism will display an heightened unfairness sensitivity that leads them to reject advantageous offers more frequently on the Ultimatum Game., Methods: Thirty recently detoxified alcohol-dependent individuals and 30 matched healthy control participants performed the Ultimatum Game task, in which participants had to respond to take-it-or-leave-it offers ranging from fair to unfair and made by a fictive proposer., Results: Alcohol-dependent participants decided to reject unfair offers more frequently during the Ultimatum Game, as compared to controls., Conclusions: In situations of social frustration or irritation, such as unfair Ultimatum Game offers, alcohol-dependent individuals may have more difficulty than controls regulating their emotional impulses, and respond aggressively or retributively (i.e., by rejecting the unfair offer)., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Background: Impulsivity is a hallmark of addictive behaviors. Addicts' weakened inhibition of irrelevant prepotent responses is commonly thought to explain this association. However, inhibition is not a unitary mechanism. This study investigated the efficiency of overcoming competition due to irrelevant responses (i.e., inhibition of a prepotent response) and overcoming competition in memory (i.e., resistance to proactive interference) in sober and recently detoxified alcohol-dependent individuals., Methods: Three cognitive tasks assessing the inhibition of a prepotent response (Hayling task, anti-saccade task and Stroop task) and two tasks tapping into the capacity to resist proactive interference (cued recall, Brown-Peterson variant) were administered to 30 non-amnesic recently detoxified alcohol-dependent individuals and 30 matched healthy participants without alcohol dependency. In addition, possible confounds such as verbal updating in working memory was assessed., Results: Alcohol-dependent subjects performed worse than healthy participants on the three cognitive tasks assessing the inhibition of irrelevant prepotent responses but group performance was similar in the tasks assessing overcoming proactive interference in memory, updating of working memory and abstract reasoning., Conclusions: These findings suggest that alcohol-dependence is mainly associated with impaired capacity to intentionally suppress irrelevant prepotent response information. Control of proactive interference from memory is preserved. Theoretical and clinical implications are discussed., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Aim: To test the generalized emotional decoding impairment hypothesis in alcoholism., Design: Cross-sectional behavioural study comparing emotion recognition conveyed by faces, voices and musical excerpts., Setting: Alcohol detoxification unit of Brugmann University Hospital., Participants: Twenty-five recently detoxified alcohol-dependent patients were compared to 25 normal controls matched for sex, age and educational level., Measurements: From faces, voices and musical excerpts, participants were instructed to rate the intensity of several emotions on a scale from 0 for 'absent' to 9 for 'highly present'. Depression, anxiety and sustained/selective attention capacities were controlled for., Findings: Alcohol-dependent patients were less accurate than controls in identifying the target emotion in faces (P < 0.001), voices (P < 0.001) and musical excerpts (P < 0.001)., Conclusions: Alcohol-dependent patients who are completing detoxification are impaired in recognizing emotions conveyed by faces, voices and music; these results suggest a generalized emotional decoding impairment. Hypothetically, deficits in the fronto-parietal mirror neurone system could link all these disturbances together., (© 2012 The Authors, Addiction © 2012 Society for the Study of Addiction.)

Background: Prominent addiction models posit that automatically activated approach/avoidance tendencies play a critical role in addiction. Nevertheless, only a limited number of studies have actually documented the relationship between relapse and automatically activated approach/avoidance tendencies. We compared automatically activated approach/avoidance tendencies towards alcohol in 40 abstaining alcohol-dependent patients and 40 controls. We also examined whether individual differences in automatically activated approach/avoidance tendencies towards alcohol are predictive of relapse in patients., Methods: A Relevant Stimulus Response Compatibility task was used to measure relative approach/avoidance tendencies. In one block of trials, participants were asked to approach alcohol-related pictures and to avoid alcohol-unrelated pictures (i.e., compatible block). In a second block of trials, participants were asked to approach alcohol-unrelated pictures and to move away from alcohol-related pictures (i.e., incompatible block). Patients were tested between 18 and 21 days after they quit drinking. Relapse was assessed 3 months after patients were discharged from the hospital., Results: Whereas abstaining alcohol-dependent patients were faster to respond to incompatible trials as compared to compatible trials, participants in the control group showed the exact opposite pattern. Within the patient group, the likelihood of relapse increased as participants were faster to respond to incompatible trials relative to compatible trials., Conclusions: Unlike controls, abstaining alcohol-dependent patients revealed a relative avoidance bias rather than relative approach bias. Moreover, relapse rates were found to increase as the relative tendency to avoid alcohol increased. This finding suggests that an avoidance orientation towards alcohol can potentially be harmful in clinical samples., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Individuals with alcoholism commonly exhibit impaired performance on episodic memory tasks. However, the contribution of their impaired executive functioning to poor episodic memory remains to be clarified. Thirty-six recently detoxified and sober asymptomatic alcoholic men and 36 matched non-alcoholic participants were tested for processing speed, prepotent response inhibition, mental flexibility, coordination of dual-task and a verbal episodic memory task. Compared with non-alcoholic individuals, the alcoholic patients showed impaired executive functions combined with below normal performance on both free and delayed recall. In contrast, processing speed, cued recall and recognition were preserved. Regression analyses revealed that 47% of alcoholics' episodic memory's free recall performance was predicted by mental flexibility and that 49% of their delayed recall performance was predicted by mental flexibility, manipulation of dual-task and prepotent response inhibition. Regarding participants' executive predictors of episodic memory performance, the slopes of β coefficients were significantly different between the two groups, with alcoholics requiring more their executive system than non-alcoholics. Once detoxified, alcoholic patients showed episodic memory deficits mainly characterized by impaired effortful (executive) processes. Compared with controls, patients used effortful learning strategies, which are nonetheless less efficient., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Aim: Sober alcoholic abusers exhibit personality traits such as novelty-seeking (NS) and sensation-seeking, which overlap to a limited extent. In parallel, they also show impaired executive and decision-making processes. However, little is known about the specific and common cognitive processes associated with NS and sensation-seeking personality traits in detoxified sober alcoholic abusers., Methods: In these present studies, we have investigated the relationships between executive functioning/central executive of working memory (pre-potent response inhibition, manipulation stored in working memory), and decision-making under uncertainty and NS/sensation-seeking traits in such alcoholics., Results: Compared with healthy controls (n = 30, mean age = 40.2), and in agreement with previous studies, alcoholics (n = 30, mean age = 40.4) showed higher levels of both NS and sensation-seeking traits. Alcoholics were also disadvantaged with respect to (a) gambling tasks, as reported previously, and (b) a poor ability to manipulate information stored in working memory and inhibit pre-potent responses. Most importantly, regression analyses and mediation analyses measures showed that poor response inhibition and decision-making were associated with high NS behaviour. In addition, impaired decision-making and manipulation of stored information in working memory were associated with a high sensation-seeking trait., Conclusions: Overall, these results support the existence of specific links between cognitive executive functioning, decision-making under uncertainty and NS/sensation-seeking personality traits in individuals with alcoholism.