Heart rate responses indicate locked-in attention in alcoholics immediately prior to drinking

Twenty alcohol-dependent subjects and 10 social drinkers were tested in two experimental conditions: (a) when they were informed that their drinks contained alcohol and (b) when they were informed that their drinks were soft drinks. When told "alcohol," alcoholics evidenced a heart rate (HR) acceleration, whereas control subjects were unaffected by the instruction. Moreover, severely dependent (SD) alcoholics' HR remained elevated within the evaluation period whereas moderately dependent (MD) alcoholics' HR returned to baseline levels. The sustained HR acceleration in SD alcoholics suggests that their attention became "locked in" on the alcohol information immediately prior to drinking in the "told-alcohol" condition. Such an inward focus of attention will seriously reduce the alcoholic's ability to shift attention away from alcohol information, which may explain the difficulties alcoholics experience in coping with high-risk situations for drinking. In the SD alcoholics, HR acceleration correlated with the time it took to start drinking subsequent beverages containing alcohol in the told-alcohol instruction. In the MD alcoholics, HR responses were related to the reported urge to drink, whereas it was only in the nondependent subjects that self-reported urge to drink was related to the actual alcohol-use behavior.