The present study investigated the nature of physiological cue reactivity and craving in response to alcohol cues among alcohol-dependent patients (N = 80) who were enrolled in detoxification treatment. Further, the predictive value with regard to future drinking of both the magnitude of the physiological and craving response to alcohol cues while in treatment and the degree of alcohol-cue exposure in patients’ natural environment was assessed. Physiological reactivity and craving in response to experimental exposure to alcohol and soft drink advertisements were measured during detoxification treatment using heart rate variability and subjective rating of craving. Following discharge, patients monitored exposure to alcohol advertisements for five consecutive weeks with a diary and were followed up with an assessment of relapse at 5 weeks and 3 months post-discharge. The results indicated that the presence of alcohol cues such as the portrayal of the drug and drinking behaviour induced physiological cue reactivity and craving. Additionally, cue reactivity and craving were positively correlated, and cue reactivity was larger for patients with shorter histories of alcohol dependence. Further, patients reported a substantial daily exposure to alcohol cues. The magnitude of cue reactivity and the craving response to alcohol cues at baseline and degree of exposure to alcohol cues in patients’ natural environment did not predict relapse. It is concluded that the presence of alcohol cues such as portrayal of alcoholic beverages and drinking behaviour induces cue reactivity and craving in alcohol dependence through a conditioned appetitive response.

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BackgroundAlexithymia, a condition characterized by deficits in interpreting and regulating feelings, is a risk factor for a variety of psychiatric conditions. Little is known about how alexithymia influences the processing of emotions in music and speech. Appreciation of such emotional qualities in auditory material is fundamental to human experience and has profound consequences for functioning in daily life. We investigated the neural signature of such emotional processing in alexithymia by means of event-related potentials.MethodologyAffective music and speech prosody were presented as targets following affectively congruent or incongruent visual word primes in two conditions. In two further conditions, affective music and speech prosody served as primes and visually presented words with affective connotations were presented as targets. Thirty-two participants (16 male) judged the affective valence of the targets. We tested the influence of alexithymia on cross-modal affective priming and on N400 amplitudes, indicative of individual sensitivity to an affective mismatch between words, prosody, and music. Our results indicate that the affective priming effect for prosody targets tended to be reduced with increasing scores on alexithymia, while no behavioral differences were observed for music and word targets. At the electrophysiological level, alexithymia was associated with significantly smaller N400 amplitudes in response to affectively incongruent music and speech targets, but not to incongruent word targets.ConclusionsOur results suggest a reduced sensitivity for the emotional qualities of speech and music in alexithymia during affective categorization. This deficit becomes evident primarily in situations in which a verbalization of emotional information is required.

The phenomenon of affective priming has caught scientific interest for over 30 years, yet the nature of the affective priming effect remains elusive. This study investigated the underlying mechanism of cross-modal affective priming and the influence of affective incongruence in music and speech on negativities in the N400 time-window. In Experiment 1, participants judged the valence of affective targets (affective categorization). We found that music and speech targets were evaluated faster when preceded by affectively congruent visual word primes, and vice versa. This affective priming effect was accompanied by a significantly larger N400-like effect following incongruent targets. In this experiment, both spreading of activation and response competition could underlie the affective priming effect. In Experiment 2, participants categorized the same affective targets based on nonaffective characteristics. However, as prime valence was irrelevant to the response dimension, affective priming effects could no longer be attributable to response competition. In Experiment 2, affective priming effects were observed neither at the behavioral nor electrophysiological level. The results of this study indicate that both affective music and speech prosody can prime the processing of visual words with emotional connotations, and vice versa. Affective incongruence seems to be associated with N400-like effects during evaluative categorization. The present data further suggest a role of response competition during the affective categorization of music, prosody, and words with emotional connotations.