Supplementary Material s8

SUPPLEMENTARY MATERIAL

Alcohol dependent patients have weak negative rather than strong positive implicit alcohol

associations

Joanne M. Dickson

Claire Gately

Matt Field

School of Psychology, University of Liverpool, United Kingdom

1 Approach and Avoidance Motivation

As discussed in the manuscript, several prominent models of motivation and goal regulation propose that two separate approach and avoidance motivational systems underlie human behaviour, action, and decision-making. To assess approach and avoidance inclinations for alcohol, McEvoy and colleagues (McEvoy et al. 2004) designed the approach and avoidance alcohol questionnaire (AAAQ). Past research, using the AAAQ, has revealed motivational ambivalence (i.e., high approach accompanied by high avoidance) among individuals with alcohol dependence, relative to light social drinkers (Barkby et al. 2012;

Klien et al. 2007; Stritzke et al. 2007). A secondary aim of our study was to investigate whether we could replicate these findings in our sample.

Materials

Approach and Avoidance of Alcohol Questionnaire

(AAAQ;(McEvoy et al. 2004). This 20-item questionnaire yields scores on two indices of alcohol approach motivation, mild (‘inclined / indulgent’) and strong (‘obsessed / compelled’), and one index of alcohol avoidance motivation

(‘resolved/regulated’). In the present study, internal consistency was acceptable for the alcohol dependent group

(inclined/indulgent α = .88; obsessed/compelled α = .82; resolved/ regulated α = .77) and for the control group SUPPLEMENTARY MATERIAL

(inclined/ indulgent α = .75; obsessed/ compelled α = .84; resolved/ regulated α = .65). We used the ‘Right now’ version of the AAAQ in the present study.

Results Non-parametric tests were conducted as several AAAQ variables were extremely skewed. As predicted, Mann-

Whitney tests showed that alcohol dependent participants reported significantly higher scores on the AAAQ obsessed / compelled, U = 313.50, p < .001, and AAAQ resolved / regulated subscales, U = 194.00, p < .001, but groups did not differ significantly on the inclined / indulgent subscale U =

766.00, p = .14. See Table S1.

Discussion

These supplementary analyses using the AAAQ revealed findings consistent with previous studies (Barkby et al. 2012;

Klien et al. 2007; Stritzke et al. 2007) and lend further support

3 to the view that motivational ambivalence (high approach and high avoidance) is a crucial feature of alcohol dependence.

Consistent with motivational theory, our findings attest to the value of studying approach and avoidance motivational inclinations independently of each other. The results also lend support to recent research (Schlauch et al. 2012) which highlights the critical role that both approach and avoidance motivational tendencies play in alcohol dependence and in treatment outcomes.

References

Barkby H, Dickson JM, Roper L, Field M (2012) To approach or avoid alcohol? Automatic and self-reported motivational tendencies in alcohol-dependence. Alcohol Clin Exp Res 36: 361-368. Klien AA, Stasiewicz PR, Koutsky JR, Bradizza CM, Coffey SE (2007) A psychometric evaluation of the approach and avoidance alcohol questionnaire (AAAQ) in alcohol dependent outpatients. J Psychopathol Behav Assess 29: 231-240. McEvoy PM, Stritzke WG, French DJ, Lang AR, Ketterman R ( 2004) Comparison of three models of alcohol craving SUPPLEMENTARY MATERIAL

in young adults: A cross validation. Addiction 99: 482- 497. Schlauch RC, Stasiewicz PR, Bradizza CM, Coffey SF, Gulliver SB, Gudleski GD (2012) Relationship between approach and avoidance inclinations to use alcohol and treatment outcomes. Addict Behav 37: 824-830. Stritzke WG, McEvoy PM, Wheat LR, Dyer KR, French DJ (2007) The yin and yang of indulgence and restraint: The ambivalence model of craving. In: O'Neal PW (ed) Motivation of Health Behaviour. Nova Science, Huntingdon, New York

Table S1:

Group Means (SDs) on the AAAQ subscales

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Alcohol dependent patients Controls

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AAAQ inclined / indulgent 2.62 (1.92) 2.91 (1.40)

AAAQ obsessed / compelled 3.12 (2.07) 1.14 (0.41)

AAAQ resolved / regulated 5.16 (1.81) 2.00 (0.79)

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