Alcohol Attentional Bias Predicts Same-Day Desire to Get Drunk and Alcohol Consumption in Non-Treatment Seeking Young Adults Identified With Hazardous Alcohol Use in the Emergency Department.

BACKGROUND

Attentional bias (AB) toward alcohol cues is theorized to reflect automatic motivational processes that contribute to heavy drinking, but ecologically valid, real-time assessments of how these biases manifest in daily life remain limited. This study used ecological momentary assessment (EMA) and weekly mobile Stroop tasks to test whether daily AB predicts same-day desire to get drunk and alcohol use among non-treatment-seeking young adults with hazardous drinking.

METHODS

This secondary analysis used data from young adults (N = 579; aged 18-25) with hazardous drinking recruited from Emergency Departments enrolled in a clinical trial testing different text-message interventions. Procedures included weekly alcohol-neutral Stroop task and same-day EMA of desire to get drunk and subsequent drinking for 14 weeks. AB scores were decomposed into within-person (day-to-day fluctuations) and between-person (stable individual differences) components. Mixed-effects logistic models tested whether same-day AB predicted (1) any desire to get drunk and (2) alcohol use, adjusting for covariates. Exploratory analyses tested whether within-person associations differed on days with prior drinking and whether impulsivity traits predicted between-person AB.

RESULTS

AB showed substantial within-person fluctuation. On days when individuals showed faster-than-usual responses to alcohol cues, they had significantly greater desire to get drunk and heavier drinking. These associations were absent on days when drinking had already begun. Impulsivity traits explained < 1% of between-person AB variance.

CONCLUSIONS

Alcohol AB in this young adult sample functioned as a dynamic, state-like cognitive process. Faster response to alcohol cues was associated with same-day desire to get drunk and heavier drinking, suggesting AB may serve as a proximal indicator of motivation.