Archives of Sexual Behavior

, Volume 45, Issue 1, pp 43–51 | Cite as

Acute Effects of Intoxication and Arousal on Approach/Avoidance Biases Toward Sexual Risk Stimuli in Heterosexual Men

  • Jeffrey S. SimonsEmail author
  • Stephen A. Maisto
  • Tyler B. Wray
  • Noah N. Emery
Original Paper


This study tested the effects of alcohol intoxication and physiological arousal on cognitive biases toward erotic stimuli and condoms. Ninety-seven heterosexual men were randomized to 1 of 6 independent conditions in a 2 (high arousal or control) × 3 (alcohol target BAC = 0.08, placebo, or juice control) design and then completed a variant of the Approach–Avoidance Task (AAT). The AAT assessed reaction times toward approaching and avoiding erotic stimuli and condoms with a joystick. Consistent with hypotheses, the alcohol condition exhibited an approach bias toward erotic stimuli, whereas the control and placebo groups exhibited an approach bias toward condom stimuli. Similarly, the participants in the high arousal condition exhibited an approach bias toward erotic stimuli and the low arousal control condition exhibited an approach bias toward condoms. The results suggest that acute changes in intoxication and physiological arousal independently foster biased responding toward sexual stimuli and these biases are associated with sexual risk intentions.


Implicit associations Alcohol administration Risky sex 



This research was supported in part by National Institute on Alcohol Abuse and Alcoholism Grants R01AA017433 (JSS), 2K05 AA16928 (SAM), and F31AA020151 (TBW). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors thank Rob Dvorak and Frank Schieber for their assistance programming the AAT.


The authors have no conflicts of interest.


  1. Abbey, A. (2011). Alcohol’s role in sexual violence perpetration: Theoretical explanations, existing evidence and future directions. Drug and Alcohol Review, 30, 481–489. doi: 10.1111/j.1465-3362.2011.00296.x.PubMedPubMedCentralCrossRefGoogle Scholar
  2. Ames, S. L., Grenard, J. L., & Stacy, A. W. (2013). Dual process interaction model of HIV-risk behaviors among drug offenders. AIDS and Behavior, 17, 914–925.PubMedPubMedCentralCrossRefGoogle Scholar
  3. Ariely, D., & Loewenstein, G. (2006). The heat of the moment: The effect of sexual arousal on sexual decision making. Journal of Behavioral Decision Making, 19, 87–98. doi: 10.1002/bdm.501.CrossRefGoogle Scholar
  4. Bargh, J. A., & Morsella, E. (2008). The unconscious mind. Perspectives on Psychological Science, 3, 73–79. doi: 10.1111/j.1745-6916.2008.00064.x.PubMedPubMedCentralCrossRefGoogle Scholar
  5. Cahalan, D., Cisin, I., & Crossley, H. (1969). American drinking practices. New Brunswick, NJ: Rutgers Center for Alcohol Studies.Google Scholar
  6. Carey, M. P., Maisto, S. A., Kalichman, S. C., Forsyth, A. D., Wright, E. M., & Johnson, B. T. (1997). Enhancing motivation to reduce the risk of HIV infection for economically disadvantaged urban women. Journal of Consulting and Clinical Psychology, 65, 531–541.PubMedPubMedCentralCrossRefGoogle Scholar
  7. Centers for Disease Control and Prevention. (2013). HIV surveillance report, 2011. Retrieved from
  8. Centers for Disease Control and Prevention. (2014). STDs in adolescents and young adults. Centers for Disease Control and Prevention. Retrieved from
  9. Chen, M., & Bargh, J. A. (1999). Consequences of automatic evaluation: Immediate behavioral predispositions to approach or avoid the stimulus. Personality and Social Psychology Bulletin, 25, 215–224. doi: 10.1177/0146167299025002007.CrossRefGoogle Scholar
  10. Curtin, J. J. (2000). BAC calculator: Unpublished computer program.Google Scholar
  11. Czopp, A. M., Monteith, M. J., Zimmerman, R. S., & Lynam, D. R. (2004). Implicit attitudes as potential protection from risky sex: Predicting condom use with the IAT. Basic and Applied Social Psychology, 26, 227–236.CrossRefGoogle Scholar
  12. Del Boca, F. K., Darkes, J., Goldman, M. S., & Smith, G. T. (2002). Advancing the expectancy concept via the interplay between theory and research. Alcoholism, Clinical and Experimental Research, 26, 926–935. doi: 10.1097/00000374-200206000-00024.PubMedCrossRefGoogle Scholar
  13. Dogan, S. J., Stockdale, G. D., Widaman, K. F., & Conger, R. D. (2010). Developmental relations and patterns of change between alcohol use and number of sexual partners from adolescence through adulthood. Developmental Psychology, 46, 1747–1759. doi: 10.1037/a0019655.PubMedPubMedCentralCrossRefGoogle Scholar
  14. Farris, S. R., & Ostafin, B. D. (2008). Alcohol consumption primes automatic alcohol-approach associations. American Journal of Drug and Alcohol Abuse, 34, 703–711.PubMedCrossRefGoogle Scholar
  15. Finer, L. B., & Zolna, M. R. (2011). Unintended pregnancy in the United States: Incidence and disparities, 2006. Contraception, 84, 478–485. doi: 10.1016/j.contraception.2011.07.013.PubMedPubMedCentralCrossRefGoogle Scholar
  16. Friese, M., & Hofmann, W. (2009). Control me or I will control you: Impulses, trait self-control, and the guidance of behavior. Journal of Research in Personality, 43, 795–805.CrossRefGoogle Scholar
  17. Fromme, K., D’Amico, E. J., & Katz, E. C. (1999). Intoxicated sexual risk taking: An expectancy or cognitive impairment explanation? Journal of Studies on Alcohol, 60, 54–63. Alcohol Research Documentation.PubMedCrossRefGoogle Scholar
  18. George, W. H., Davis, K. C., Norris, J., Heiman, J. R., Stoner, S. A., Schacht, R. L., … Kajumulo, K. F. (2009). Indirect effects of acute alcohol intoxication on sexual risk-taking: The roles of subjective and physiological sexual arousal. Archives of Sexual Behavior, 38, 498–513. doi: 10.1007/s10508-008-9346-9.
  19. Gladwin, T. E., Figner, B., Crone, E. A., & Wiers, R. W. (2011). Addiction, adolescence, and the integration of control and motivation. Developmental Cognitive Neuroscience, 1, 364–376. doi: 10.1016/j.dcn.2011.06.008.PubMedCrossRefGoogle Scholar
  20. Goldman, M. S., & Darkes, J. (2004). Alcohol expectancy multiaxial assessment: A memory network-based approach. Psychological Assessment, 16, 4–15.PubMedCrossRefGoogle Scholar
  21. Gordon, C. M., Carey, M. P., & Carey, K. B. (1997). Effects of a drinking event on behavioral skills and condom attitudes in men: Implications for HIV risk from a controlled experiment. Health Psychology, 16, 490–495.PubMedCrossRefGoogle Scholar
  22. Greenwald, A. G., Nosek, B. A., & Banaji, M. R. (2003). Understanding and using the Implicit Association Test: I. An improved scoring algorithm. Journal of Personality and Social Psychology, 85, 197–216. doi: 10.1037/0022-3514.85.2.197.PubMedCrossRefGoogle Scholar
  23. Grenard, J. L., Ames, S. L., & Stacy, A. W. (2013). Deliberative and spontaneous cognitive processes associated with HIV risk behavior. Journal of Behavioral Medicine, 36, 95–107.PubMedPubMedCentralCrossRefGoogle Scholar
  24. Hepler, J., Albarracin, D., McCulloch, K. C., & Noguchi, K. (2012). Being active and impulsive: The role of goals for action and inaction in self-control. Motivation and Emotion, 36, 416–424. doi: 10.1007/s11031-011-9263-4.PubMedPubMedCentralCrossRefGoogle Scholar
  25. Hicks, J. A., Friedman, R. S., Gable, P. A., & Davis, W. E. (2012). Interactive effects of approach motivational intensity and alcohol cues on the scope of perceptual attention. Addiction, 107, 1074–1080. doi: 10.1111/j.1360-0443.2012.03781.x.PubMedCrossRefGoogle Scholar
  26. Hofmann, W., & Friese, M. (2008). Impulses got the better of me: Alcohol moderates the influence of implicit attitudes toward food cues on eating behavior. Journal of Abnormal Psychology, 117, 420–427. doi: 10.1037/0021-843X.117.2.420.PubMedCrossRefGoogle Scholar
  27. Hofmann, W., Friese, M., & Gschwendner, T. (2009a). Men on the “pull”: Automatic approach-avoidance tendencies and sexual interest behavior. Social Psychology, 40, 73–78. doi: 10.1027/1864-9335.40.2.73.CrossRefGoogle Scholar
  28. Hofmann, W., Friese, M., & Roefs, A. (2009b). Three ways to resist temptation: The independent contributions of executive attention, inhibitory control, and affect regulation to the impulse control of eating behavior. Journal of Experimental Social Psychology, 45, 431–435. doi: 10.1016/j.jesp.2008.09.013.CrossRefGoogle Scholar
  29. Hofmann, W., Friese, M., & Strack, F. (2009c). Impulse and self-control from a dual-systems perspective. Perspectives on Psychological Science, 4, 162–176. doi: 10.1111/j.1745-6924.2009.01116.x.PubMedCrossRefGoogle Scholar
  30. Hofmann, W., Gschwendner, T., Friese, M., Wiers, R. W., & Schmitt, M. (2008). Working memory capacity and self-regulatory behavior: Toward an individual differences perspective on behavior determination by automatic versus controlled processes. Journal of Personality and Social Psychology, 95, 962–977. doi: 10.1037/a0012705.PubMedCrossRefGoogle Scholar
  31. Krebs, C. P., Lindquist, C. H., Warner, T. D., Fisher, B. S., & Martin, S. L. (2009). College women’s experiences with physically forced, alcohol- or other drug-enabled, and drug-facilitated sexual assault before and since entering college. Journal of American College Health, 57, 639–647. doi: 10.3200/JACH.57.6.639-649.PubMedCrossRefGoogle Scholar
  32. Lieberman, M. D. (2007). Social cognitive neuroscience: A review of core processes. Annual Review of Psychology, 58, 259–289. doi: 10.1146/annurev.psych.58.110405.085654.PubMedCrossRefGoogle Scholar
  33. Maisto, S. A., Carey, M. P., Carey, K. B., Gordon, C. M., Schum, J. L., & Lynch, K. G. (2004). The relationship between alcohol and individual differences variables on attitudes and behavioral skills relevant to sexual health among heterosexual young adult men. Archives of Sexual Behavior, 33, 571–584. doi: 10.1023/B:ASEB.0000044741.09127.e6.PubMedPubMedCentralCrossRefGoogle Scholar
  34. Maisto, S. A., Palfai, T., Vanable, P. A., Heath, J., & Woolf-King, S. E. (2012). The effects of alcohol and sexual arousal on determinants of sexual risk in men who have sex with men. Archives of Sexual Behavior, 41, 971–986. doi: 10.1007/s10508-011-9846-x.PubMedPubMedCentralCrossRefGoogle Scholar
  35. Meston, C. M., & Frohlich, P. F. (2003). Love at first fright: Partner salience moderates roller-coaster-induced excitation transfer. Archives of Sexual Behavior, 32, 537–544.PubMedCrossRefGoogle Scholar
  36. Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., & Howerter, A. (2000). The unity and diversity of executive functions and their contributions to complex ‘frontal lobe’ tasks: A latent variable analysis. Cognitive Psychology, 41, 49–100. doi: 10.1006/cogp.1999.0734.PubMedCrossRefGoogle Scholar
  37. Ostafin, B. D., & Palfai, T. P. (2006). Compelled to consume: the Implicit Association Test and automatic alcohol motivation. Psychology of Addictive Behaviors, 20, 322–327. doi: 10.1037/0893-164X.20.3.322.PubMedCrossRefGoogle Scholar
  38. Palfai, T. P., & Ostafin, B. D. (2003). Alcohol-related motivational tendencies in hazardous drinkers: Assessing implicit response tendencies using the modified-IAT. Behaviour Research and Therapy, 41, 1149–1162. doi: 10.1016/S0005-7967(03)00018-4.PubMedCrossRefGoogle Scholar
  39. Peeters, M., Wiers, R. W., Monshouwer, K., van de Schoot, R., Janssen, T., & Vollebergh, W. A. M. (2012). Automatic processes in at-risk adolescents: The role of alcohol-approach tendencies and response inhibition in drinking behavior. Addiction, 107, 1939–1946. doi: 10.1111/j.1360-0443.2012.03948.x.PubMedCrossRefGoogle Scholar
  40. Phaf, R. H., Mohr, S. E., Rotteveel, M., & Wicherts, J. M. (2014). Approach, avoidance, and affect: A meta-analysis of approach-avoidance tendencies in manual reaction time tasks. Frontires in Psychology, 5, 378. doi: 10.3389/fpsyg.2014.00378.Google Scholar
  41. Schoenmakers, T., Wiers, R. W., & Field, M. (2008). Effects of a low dose of alcohol on cognitive biases and craving in heavy drinkers. Psychopharmacology, 197, 169–178. doi: 10.1007/s00213-007-1023-5.PubMedPubMedCentralCrossRefGoogle Scholar
  42. Simons, J. S., Dvorak, R. D., & Lau-Barraco, C. (2009). Behavioral inhibition and activation systems: Differences in substance use expectancy organization and activation in memory. Psychology of Addictive Behaviors, 23, 315–328.PubMedPubMedCentralCrossRefGoogle Scholar
  43. Stacy, A. W., Ames, S. L., Ullman, J. B., Zogg, J. B., & Leigh, B. C. (2006). Spontaneous cognition and HIV risk behavior. Psychology of Addictive Behaviors, 20, 196–206.PubMedCrossRefGoogle Scholar
  44. Stacy, A. W., Newcomb, M. D., & Ames, S. L. (2000). Implicit cognition and HIV risk behavior. Journal of Behavioral Medicine, 23, 475–499.PubMedCrossRefGoogle Scholar
  45. Stacy, A. W., & Wiers, R. W. (2010). Implicit cognition and addiction: A tool for explaining paradoxical behavior. Annual Review of Clinical Psychology, 6, 551–575. doi: 10.1146/annurev.clinpsy.121208.131444.PubMedPubMedCentralCrossRefGoogle Scholar
  46. StataCorp. (2013). Stata Statistical Software: Release 13. College Staion, TX: Stata Corporation.Google Scholar
  47. Steele, C. M., & Josephs, R. A. (1990). Alcohol myopia: Its prized and dangerous effects. American Psychologist, 45, 921–933. doi: 10.1037/0003-066X.45.8.921.PubMedCrossRefGoogle Scholar
  48. Ward, A., Mann, T., Westling, E. H., Creswell, J. D., Ebert, J. P., & Wallaert, M. (2008). Stepping up the pressure: Arousal can be associated with a reduction in male aggression. Aggressive Behavior, 34, 584–592. doi: 10.1002/ab.20270.PubMedPubMedCentralCrossRefGoogle Scholar
  49. Weafer, J., & Fillmore, M. T. (2008). Individual differences in acute alcohol impairment of inhibitory control predict ad libitum alcohol consumption. Psychopharmacology, 201, 315–324. doi: 10.1007/s00213-008-1284-7.PubMedPubMedCentralCrossRefGoogle Scholar
  50. Wiers, R. W., Bartholow, B. D., van den Wildenberg, E., Thush, C., Engels, R. C. M. E., Sher, K. J., … Stacy, A. W. (2007). Automatic and controlled processes and the development of addictive behaviors in adolescents: A review and a model. Pharmacology, Biochemistry and Behavior, 86, 263–283. doi: 10.1016/j.pbb.2006.09.021.
  51. Wiers, R. W., Beckers, L., Houben, K., & Hofmann, W. (2009). A short fuse after alcohol: Implicit power associations predict aggressiveness after alcohol consumption in young heavy drinkers with limited executive control. Pharmacology, Biochemistry and Behavior, 93, 300–305. doi: 10.1016/j.pbb.2009.02.003.PubMedCrossRefGoogle Scholar
  52. Wiers, R. W., Gladwin, T. E., Hofmann, W., Salemink, E., & Ridderinkhof, K. R. (2013). Cognitive bias modification and cognitive control training in addiction and related psychopathology: Mechanisms, clinical perspectives, and ways forward. Clinical Psychological Science, 1, 192–212. doi: 10.1177/2167702612466547.CrossRefGoogle Scholar
  53. Wiers, R. W., Rinck, M., Kordts, R., Houben, K., & Strack, F. (2010). Retraining automatic action-tendencies to approach alcohol in hazardous drinkers. Addiction, 105, 279–287. doi: 10.1111/j.1360-0443.2009.02775.x.PubMedCrossRefGoogle Scholar
  54. Wray, T. B., Simons, J. S., & Maisto, S. A. (2014). Effects of alcohol intoxication and autonomic arousal on delay discounting and risky sex in young adult heterosexual men. Addictive Behaviors, 42C, 9–13. doi: 10.1016/j.addbeh.2014.10.037.Google Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Jeffrey S. Simons
    • 1
    Email author
  • Stephen A. Maisto
    • 2
  • Tyler B. Wray
    • 1
    • 3
  • Noah N. Emery
    • 1
  1. 1.Department of PsychologyUniversity of South DakotaVermillionUSA
  2. 2.Psychology DepartmentSyracuse UniversitySyracuseUSA
  3. 3.Brown UniversityProvidenceUSA

Personalised recommendations