Neurocognitive mechanisms underlying alcohol-related emotional association bias among alcohol use disorder: Evidence...

This study aimed to investigate behavioral pattern of emotional association bias toward alcohol-related cues in alcohol use disorder (AUD) and its neurophysiological mechanisms.

47 individuals with AUD and 32 healthy Control (HC) were recruited in this cross-sectional study. All participants completed an emotional association bias task with electroencephalography recording. A hierarchical drift-diffusion model (HDDM) was used to characterize the behavioral patterns. Event-related potentials (ERP) analysis were conducted to explore the specific ERP component associated with alcohol cue-related emotional processing.

Compared to HCs, individuals with AUD exhibited heightened automaticity in processing alcohol-related positive cues, as indicated by a significantly lower decision threshold (P < 0.001). They also showed a stronger implicit emotional bias toward alcohol-related cues, reflected by enhanced EPN amplitudes (P = 0.043). Furthermore, individuals with AUD demonstrated difficulties disengaging from alcohol-related positive cues, as evidenced by slower drift rates (P < 0.001) and longer non-decision times (P < 0.001) than HCs. Importantly, mediation analysis revealed that LPP amplitude significantly mediated the relationship between group and non-decision time, with an inconsistent mediation pattern, suggesting that enhanced late-stage neural processing partially compensates for behavioral deficits.

These findings suggest that individuals with AUD exhibit specific emotional association biases toward alcohol and distinct neurophysiological mechanisms, providing insights into the underlying cognitive and neural processes and offering potential support for interventions targeting emotion regulation and emotional association bias modification in AUD.