Working memory moderates the relation between implicit alcohol associations and heavy episodic drinking in moderate-to-heavy drinking men who have sex with men

Introduction: Heavy episodic drinking poses a risk for HIV-infection, particularly among men who have sex with men (MSM). Previous research suggests implicit associations may play a role in heavy episodic drinking and that various executive functions (EF) may moderate the relation between implicit associations and heavy episodic drinking. This study investigated the role of two EF – working memory (maintaining and updating information) and response inhibition (inhibiting prepotent responses) – as moderators of the relation between implicit alcohol approach associations and heavy episodic drinking among moderate-to-heavy drinking MSM. Methods: Two-hundred and fifty-one participants completed measures of implicit alcohol associations (the implicit alcohol approach association test - IAT), working memory, and response inhibition, as well as a self-report questionnaire assessing heavy episodic drinking. Regression analyses were conducted to examine whether the association between the IAT and heavy episodic drinking was moderated by working memory and response inhibition. Results: Results showed that working memory moderated the relation between the alcohol IAT and heavy episodic drinking such that IAT alcohol approach scores were positively associated with heavy episodic drinking among those low in working memory but not those high in working memory. Response inhibition did not moderate the association between IAT scores and heavy episodic drinking. Conclusions: Results suggest that the relation between implicit alcohol approach associations and heavy episodic drinking is stronger among moderate-to-heavy drinking MSM with lower working memory capacity compared to those with higher working memory capacity, and these individuals may particularly benefit from alcohol intervention approaches that target automatic alcohol responses.