The dosing procedure that “makes the poison”: Comparing the effects of single versus cumulative alcohol administration methods on emotion recognition

Abstract

Background: Most people often consume alcohol cumulatively and gradually. Yet almost scientific knowledge about alcohol’s acute effects on cognition, behavior, and affect stems from laboratory studies that employ a single beverage administration procedure. Objective: This study tests the hypothesis that alcohol’s acute effects depend on both methods of administration and alcohol blood level. We introduce a new laboratory procedure for studying cumulative alcohol drinking and examine alcohol’s effects on emotion recognition as a function of both alcohol administration method and alcohol blood level. Methods: Participants were recruited for one of two studies. One study employed a between-subject design using a single alcoholic dose. Participants were randomly assigned to drink either placebo (0.00%), low (0.03%), moderate (0.06%), or high (0.09%) alcohol levels. The second study employed a within-subject design using a cumulative alcoholic administration method, in which each participant drank four drinks (placebo, followed by three alcoholic drinks). Both groups reached similar breath alcohol concentrations. In both studies, participants attended a single study session, in which emotion recognition was examined following alcohol administration. Results: Single alcoholic beverage administration method caused greater impairment in emotion recognition ability, specifically for anger, happiness, and fear, as compared with cumulative administration method, even though breath alcohol levels were similar in both conditions. Conclusions: This paper presents questions concerning the internal validity of previous laboratory studies that use a single beverage administration procedure. Insights into the effects of alcohol on behavior, as well as regarding our knowledge about models of addiction are presented.

A systematic review of the acute effects of alcohol on emotion recognition of facial expressions

“…Two studies found the opposite effect, such that happiness recognition significantly worsened following a moderate 57 and a high 53 (Study 1) dosage of alcohol compared to placebo. One article 53 (Study 2) reported on a second study that used a cumulative drinking design. When comparing results across studies (i.e., single dosage procedure vs. cumulative dosage procedure), they found that participants who consumed a single high dosage of alcohol were significantly less accurate on happiness recognition than participants assigned to the cumulative drinking procedure who eventually drank to a high dosage of alcohol 53 .…”

“…Although both studies found impairments to negative emotion recognition, one of these two studies found a high dosage of alcohol‐impaired recognition of anger and disgust/contempt (and not sadness or fear), 40 whereas the second study found a high dosage of alcohol‐impaired recognition of fear (and not sadness or anger) 53 (Study 1) (see Supplemental Tables 1 and 2). Finally, five of the 16 studies that examined negative emotion recognition included low dosages of alcohol, with all five studies finding no effects of a low dosage of alcohol on negative emotion recognition 16,29,30,36 , 53 . (Study 1) Taken together, there do not appear to be consistent dose–response effects of alcohol on emotion recognition for positive or negative emotion recognition.…”

“…The first type, used by 18 (94.74%) studies, captured an individual's ability to identify a specific emotion (e.g., happy) from facial expressions 15,16,28–30,33,36,37,40 , 52 . (Studies 1 and 2), 53–58 (Studies 1 and 2) Of these 18 studies, one varied the presentation of facial expressions by time, such that following a static neutral expression, a static micro‐expression (i.e., 200 ms presentation) or a static longer expression (i.e., 400 ms presentation) of an emotion (e.g., sadness) was shown 30 . The outcomes measured by this study included accuracy (i.e., score for correct emotion identifications) and reaction times (i.e., amount of time between when the stimulus was first presented and when an emotion was identified).…”

“… b Results reported comparing emotion recognition abilities between those who consumed alcohol by a cumulative drinking design 53 (Study 2) versus a single‐dose drinking design 53 (Study 1) ; results comparing an alcoholic dose versus placebo or another alcohol dose are not reported in this paper–see Supplemental Table 1 for more detailed results. …”

“…The majority of studies using tasks that measured the ability to identify a specific emotion (e.g., happiness) from facial expressions found no effect of any dosage of alcohol on the recognition of any emotion tested. Specifically, no effects of alcohol were found for 68.75% of studies examining happiness recognition, 15,28–30,33,37,40 , 52 (Study 2), 54–57 87.5% of studies examining anger recognition 15,16,28–30,33,36,37,52 (Study 1), 53 , (Study 1), 54,56,57 , 66.7% of studies examining sadness recognition, 16,29,30,36,40 , 52 (Studies 1 and 2 ), 53 (Study 1) 77.78% of studies examining disgust recognition, 16,28,37 , 52 (Studies 1 and 2), 57 75% of studies examining fear recognition 16,30,44 , 52 (Studies 1 and 2), 54,56,57 and 100% of studies examining surprise recognition. Further, in the few ( k = 5) studies that found effects of alcohol on happiness recognition, the results were mixed, with three studies finding an improvement 16,36 , 52 (Study 1) and two studies finding an impairment 53,57 of alcohol on happiness recognition.…”