Instructed versus pharmacological effects of alcohol in alcoholics and social drinkers

Twelve alcoholics and 12 social drinkers were studied in an experiment where instructions about alcohol or placebo were orthogonally crossed with administration of alcohol or placebo in a Balanced Placebo Design. Three subjects were simultaneously observed while watching soccer games on the TV together and having free access to a mixed drink, which in the alcohol conditions contained 150ml of 80% proof vodka. The assessment procedure included several aspects of drinking behavior, behavioral observations during the session, psychiatric ratings and nurse observations before and after each session, ratings for craving, self-reported state anxiety and physiological changes (heart rate and blood pressure). In general, the results showed the alcoholic's behavior to be controlled by instruction-induced expectancies rather than by the actual beverage given, whereas the social drinkers showed tendencies in the opposite direction. The implications of these results for the traditional disease conception of alcoholism and for learning theory approaches are discussed.