Automatic and controlled processes in the pathway from drug abuse to addiction

Abstract

Heavy drinking is associated with a cluster of cognitive processes, which we have termed controlled processes (rational decision-making and alcohol outcome expectancies), automatic processes (implicit memory associations and attentional bias) and executive dysfunction (which includes working memory and impulsivity). In this chapter, we review evidence which suggests that these different types of cognitions have a causal influence on future alcohol consumption and the development of alcohol problems. We highlight gaps in the evidence base which we hope will be tackled in future research. We also discuss recent research which suggests that it is important to consider interactions between these different types of cognitive processes when attempting to predict future alcohol problems, and we speculate on the relative importance of different types of cognitive processes at different stages of the alcohol addiction cycle, from controlled social drinking through to alcohol abuse and alcohol dependence.