Examining these questions will mean exchanging a diagnostic framework for screening, in which health need is indicated by the presence of a psychological disorder, for a public health framework, in which health need is identified from multiple perspectives.

Objective: We conducted a randomized controlled trial to compare the effects of three types of Internet-delivered Inhibitory Control Training (ICT) with each other and with an active control intervention on alcohol consumption in a community sample of problem drinkers. Method: Two hundred and 46 heavy drinkers, who were motivated to reduce their alcohol consumption (mean age 41.32, 130 female) self-monitored their alcohol consumption for 1 week before being randomized to receive 1 of 3 variants of ICT (Associative No-Go, Associative Stop Signal, General Inhibition) or an active control. Participants then completed up to 14 ICT/control sessions on the Internet over a 4-week period, while regularly recording their alcohol consumption. Results: There were significant reductions in alcohol consumption across all groups over the 4-week training period (main effect of time, F(2, 402) = 77.12, p < .01, ηp2 = .28, BF10 > 99), however there were no differences between ICT groups, or between ICT groups and the active control group (Group × Time interaction, F(6, 402) = 1.10, p = .36, ηp2 = .02, BF10 = 0.03). Contrary to hypotheses, there were no changes in general inhibitory control, the disinhibiting effects of alcohol cues, or alcohol affective associations after ICT. Conclusions: In this study, which attempted to translate findings from proof-of-concept laboratory studies into a viable behavior change intervention, we found that multiple sessions of ICT delivered over the Internet did not help heavy drinkers to reduce their alcohol consumption beyond nonspecific effects associated with taking part in a trial.

RationaleStress increases alcohol consumption and the risk of relapse, but little is known about the psychological mechanisms that underlie these effects. One candidate mechanism is inhibitory control, which may be impaired by acute stress and is believed to exert a causal influence on alcohol consumption.ObjectivesWe investigated if acute stress would impair inhibitory control and if impaired inhibitory control would be associated with subsequent ad-libitum alcohol consumption in a naturalistic laboratory setting.Materials and methodsOne hundred heavy drinkers took part in an experimental study in a naturalistic ‘bar laboratory’. Participants were randomly assigned to an acute stress (n = 50) or control (n = 50) group. In the stress group, participants were exposed to the social evaluative threat of giving a self-critical presentation, whereas the control group completed simple anagrams. Prior to and following the manipulation, participants completed the stop signal task as a measure of inhibitory control. Finally, participants completed a bogus taste test, as a measure of ad-libitum alcohol consumption.ResultsThe stress manipulation had no effect on performance on the stop signal task. However, there was a small but significant increase in ad-libitum alcohol consumption in the acute stress group compared to that in the control group.ConclusionsAcute stress increased alcohol consumption in heavy drinkers, in a semi-naturalistic setting. However, this was not through the hypothesised mechanism of a transient impairment in inhibitory control.Electronic supplementary materialThe online version of this article (doi:10.1007/s00213-016-4205-1) contains supplementary material, which is available to authorized users.

Treatment of acne improves QoL, particularly in those with more depressive symptoms at the outset. Mood deterioration was not detected, but the possibility of subtle or rare mood effects of isotretinoin cannot be ruled out.