On the predictive validity of automatically activated approach/avoidance tendencies in abstaining alcohol-dependent patients

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.