Alcohol cue-induced heart rate variability and drinking behavior: The role of impulsivity

Research has demonstrated that exposure to alcohol-related cues (e.g., sight or smell of a preferred beverage) elicits heightened self-reported craving and psychophysiological responses, including changes in heart rate (HR) and heart rate variability (HRV), particularly among individuals high in trait impulsivity. While cue-induced psychophysiological reactivity is well documented, its predictive value for drinking behavior, particularly in individuals with elevated impulsivity, has received more limited empirical attention. The present study examined whether trait impulsivity predicts cardiovascular reactivity to alcohol cues and whether these physiological responses mediate the relationship between impulsivity and drinking behavior. We hypothesized that individuals higher in trait impulsivity would exhibit greater HR and HRV reactivity to alcohol cues, and that these responses would, in turn, predict greater alcohol consumption. Seventy-three young adult drinkers from a major urban university completed self-report measures of trait impulsivity (UPPS-P) and past 90-day drinking behavior (timeline follow back). Participants were then exposed to counterbalanced presentations of a glass of alcohol and a glass of water while HR and HRV were continuously recorded. HRV was analyzed via power spectral density, focusing on low-frequency oscillations in the 0.04-0.15 Hz range. Mediation analyses partially supported these hypotheses: impulsivity was directly associated with greater alcohol use, but indirectly associated via HRV responses to alcohol cues to lower alcohol use. No significant effects were observed for HR. These findings identify HRV as a potential biomarker linking impulsivity to alcohol consumption and raise the possibility that cue-induced autonomic reactivity may play a role in modulating drinking behavior.