Thought suppression, impaired regulation of urges, and Addiction-Stroop predict affect-modulated cue-reactivity among alcohol dependent adults
Open accessAbstract
Abstinent alcohol dependent individuals commonly employ thought suppression to cope with stress and intrusive cognitions about alcohol. This strategy may inadvertently bias attention towards alcohol-related stimuli while depleting neurocognitive resources needed to regulate urges, manifested as decreased heart rate variability (HRV) responsivity to alcohol cues. The present study tested the hypothesis that trait and state thought suppression, impaired regulation of urges, and alcohol attentional bias as measured by the Addiction-Stroop would have significant effects on the HRV responsivity of 58 adults in residential treatment for alcohol dependence (mean age=39.6 ± 9.4, 81% female) who participated in an affect-modulated cue-reactivity protocol. Regression analyses controlling for age, level of pre-treatment alcohol consumption, and baseline HRV indicated that higher levels of trait thought suppression, impaired regulation of alcohol urges, and attentional fixation on alcohol cues were associated with lower HRV responsivity during stress-primed alcohol cue-exposure. Moreover, there was a significant state × trait suppression interaction on HRV cue-responsivity, such that alcohol dependent persons reporting high levels of state and trait suppression exhibited less HRV during cue-exposure than persons reporting low levels of state and trait suppression. Results suggest that chronic thought suppression taxes regulatory resources reflected in reduced HRV responsivity, an effect that is particularly evident when high trait suppressors engage in intensive suppression of drinking-related thoughts under conditions of stress. Treatment approaches that offer effective alternatives to the maladaptive strategy of suppressing alcohol urges may be crucial for relapse prevention.
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Given that suppression of addictive urges exhausts autonomic resources for self-control and paradoxically amplifies craving, MBIs may reduce addictive behavior by providing an effective alternative to thought suppression.
“given that suppression of addictive urges exhausts autonomic resources for self-control [58] and paradoxically amplifies craving [59], MBIs may reduce addictive behavior by providing an effective alternative to thought suppression.”
From Mindfulness-based treatment of addiction: current state of the field and envisioning the next wave of research (2018) · cites this paper as [58]
Cue reactivity paradigms have been useful for predicting substance use behaviors, including self-initiated abstinence, latency to use, and relapse, in various substance-dependent populations.
“Further, these paradigms have demonstrated utility in predicting substance use behaviors – including self-initiated abstinence, latency to use, and relapse – among a variety of substance dependent populations (Conklin, Parzynski, Salkeld, Perkins, & Fonte, 2012; Fatseas et al., 2011; Garland, Carter, Ropes, & Howard, 2012; Shiffman et al., 2013).”
From Laboratory-induced cue reactivity among individuals with prescription opioid dependence (2014) · cites this paper as Garland, Carter, Ropes, & Howard, 2012
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Garland, E. L., & Howard, M. O. (2018) · Addiction Science & Clinical Practice · doi:10.1186/s13722-018-0115-3 · Cited by 300 · see citing works
Self-citationGarland, E. L., Froeliger, B., & Howard, M. O. (2014) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2013.00173 · Cited by 268 · see citing works
“When addictive urges are chronically suppressed over time, the neurocognitive resources for self-regulation are depleted, resulting in an inability to inhibit substance-related cognitions and an attentional bias toward drug-related cues (54).”
BackgroundSelf-citationGarland, E. L., & Roberts-Lewis, A. (2013) · Addictive Behaviors · doi:10.1016/j.addbeh.2012.02.004 · Cited by 88 · see citing works
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Trait mindfulness predicts attentional and autonomic regulation of alcohol cue-reactivity
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Garland, E. L., Hanley, A. W., Thomas, E. A., Knoll, P., & Ferraro, J. (2015) · Journal of Addiction Medicine · doi:10.1097/adm.0000000000000090 · Cited by 52 · see citing works
“…experience more severe substance craving (Garland & Roberts-Lewis, 2013; Garland et al., 2014a), consume larger quantities of substances (Garland et al., 2012a, 2012b), and exhibit greater attentional fixation on substance-related cues (ie, attentional bias, see Garland et al., 2012a,…”
BackgroundSelf-citationMindfulness:<i>A Transtherapeutic Approach for Transdiagnostic Mental Processes</i>
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Self-citationBaker, A. K., & Garland, E. L. (2019) · Experimental and Clinical Psychopharmacology · doi:10.1037/pha0000225 · Cited by 21 · see citing works
- Authors
- Garland, E. L., Carter, K., Ropes, K., & Howard, M. O.
- Affiliations
- Florida State University (US)
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Garland, Eric L.
- Venue
- Biological Psychology
- Publisher
- Elsevier BV
- Published
- 2012-01
- Volume
- 89
- Issue
- 1
- Pages
- 87-93
- ISSN
- 0301-0511 (ISSN-L)
- PMC
- PMC3245812
- OpenAlex
- W2042505321
- Cited by
- 62
- References
- 64
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 4 · 2022: 6 · 2021: 5 · 2020: 3 · 2019: 4 · 2018: 6 · 2017: 3 · 2016: 1 · 2015: 9 · 2014: 7 · 2013: 4 · 2012: 6
- FWCI
- 4.34
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Biological Psychology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Complementary and Alternative Medicine (T32AT003378)
- Francisco J. Varela Research Grant
- Armfield-Reeves Innovation Grant
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- thought suppression, alcoholism, alcohol cue reactivity, heart rate variability, attentional bias, stress, relapse prevention
- MeSH terms
- Adaptation, Psychological, Adult, Alcoholism, Attention, Cognition Disorders, Cues, Electrocardiography, Female, Heart Rate, Humans, Male, Middle Aged, Models, Psychological, Neuropsychological Tests, Pain Measurement, Regression Analysis, Repression, Psychology, Statistics as Topic, Bias
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