The effect of alcohol cue exposure on working memory in individuals with alcohol use disorder.

Alcohol use disorder (AUD) represents a grave public health concern in the U.S. with high prevalence and relapse rates, and a major risk factor for relapse is inability to cope with cravings. A possible explanatory factor is the experience of working memory impairment in individuals with AUD. The present study sought to demonstrate the effect of imaginal alcohol cue exposure on distress level, alcohol craving, and working memory performance to establish a possible pathway by which coping skill use is impaired in individuals with AUD during cravings. The study utilized a repeated-measures design to test working memory performance and examine subjective report of cue reactivity and objective arousal (i.e., blood pressure and heart rate) before and after a cue exposure. The sample consisted of 91 participants with AUD in residential substance use treatment, with 46 participants randomly assigned to the neutral-cue group and 45 participants to the alcohol-cue group. A repeated-measures ANOVA revealed a statistically significant effect of time and condition on subjective distress, F(1,89) = 4.72, p = .032, partial η2 = .05, and alcohol craving as measured by a single-item rating, F(1,89) = 5.79, p = .018, partial η2 = .06; however, working memory performance improved from pre- to post-cue exposure for both groups. While results showed a statistically significant interaction between time and condition for heart rate, F(2.46,162.32) = 5.77, p = .002, partial η2 = .08, heart rate remained stable from baseline to cue exposure in the alcohol cue group. Additionally, there was no significant difference in systolic or diastolic blood pressure between groups. Results suggest that individuals with AUD subjectively experience craving during an alcohol cue reactivity paradigm, but that working memory performance is unaffected by exposure to alcohol cues. Further, results are indicative of an attenuated cardiovascular response to stress and alcohol cue exposure.