Original Article Extraversion and Altered State of Awareness Predict Alcohol Cue-Reactivity Nicolas Kambouropoulos and Adam Rock Department of Psychology, Deakin University, Burwood, Australia Abstract. Studies have shown that regular drinkers respond to alcohol-related stimuli with increases in urge to drink and changes in affect. Evidence indicates that there is individual variability in responses to alcohol-related cues. The current study aimed to examine (1) the role of extraversion in understanding variability in responses to alcohol cues and (2) whether cue-elicited altered states of awareness are related to urge to drink and affective responses. Forty-one participants were exposed first to a neutral and then to an alcohol cue; urge and affective responses were then measured. Extraversion was a significant positive predictor of urge to drink, while altered state of awareness was a significant positive predictor of urge to drink and positive affect. Interestingly, altered state of awareness significantly improved prediction of both urge to drink and positive affect after controlling for levels of extraversion. These findings suggest that changes in states of awareness following presentation of alcohol cues may facilitate the observed increases in urge to drink and positive affect. Keywords: cue-reactivity, individual differences, extraversion, altered state of awareness, craving Introduction A considerable body of literature has focused on physiologi- cal and self-reported responses to alcohol-related stimuli (e.g., MacKillop, 2006; Mason, Light, Escher, & Drobes, 2008). Termed “cue-reactivity” this area of study is typically concerned with understanding the role of alcohol-related cues in triggering the urge to drink or “craving” states via the process of classical conditioning (Cooney, Gillespie, Baker, & Kaplan, 1987; Ooteman, Koeter, Vserheul, Schippers, & van den Brink, 2006). Craving is considered to be a subjective state characterized by the urge to re-experience the effect of a previously experienced substance (e.g., Ooteman et al., 2006). But there are a variety of models and accounts of crav- ing available, and the construct has been the focus of much debate (e.g., Kavanagh, Andrade, & May, 2005). More re- cently, studies have also focused on affective responses to alcohol cues (e.g., Kambouropoulos & Staiger, 2004; Mason et al., 2008), with some authors arguing that mood states are particularly important in understanding the processes under- lying cue reactivity (Mason et al., 2008). Given that both craving for alcohol and affective states are considered prox- imal motivators of drinking behavior (Armeli, Todd, Conner, & Tennen, 2008; Ooteman et al., 2006), the focus on these variables in cue-reactivity studies may have implications for our understanding of excessive alcohol use and relapse. However, of particular interest to the current study is that there are substantial individual differences in response to al- cohol-related cues (Litt, Cooney, & Morse, 2000; Rees & Heather, 1995). That is, not all individuals respond with the same intensity when confronted with stimuli associated with alcohol – and some participants fail to report heightened crav- ing altogether (Litt et al., 2000). This has prompted researchers to focus on factors that might influence the magnitude and nature of responses to alcohol cues. In particular, recent cue- reactivity studies investigated associations between personal- ity and responses to alcohol cues and reported that a high level of sensitivity to reward (i.e., the tendency to attend to and approach appetitive/rewarding stimuli, Gray, 1987) is related to increased urge and positive affective reactivity (Franken, 2002; Kambouropoulos & Staiger, 2004, 2009). Interestingly, the construct of reward sensitivity was de- veloped as an extension of Eysenck’s conceptualization of the introversion-extraversion personality dimension (Ey- senck & Eysenck, 1985; Gray, 1981). Nevertheless, few studies have specifically examined the role of extraversion in reactions to alcohol-related cues. While there consider- able attention has been given to reward sensitivity, less ev- idence is available concerning the broader and more fun- damental personality dimension of extraversion (Eysenck, 1983). According to Eysenck’s original conceptualization, introverts are more conditionable than extraverts because of chronically high levels of cortical arousal (Eysenck, 1967). Consequently, it might be expected that introverts should respond more intensely to alcohol-related stimuli because of the formation of stronger learned associations DOI: 10.1027/1614-0001/a000026 Journal of Individual Differences 2010; Vol. 31(4):178–184 © 2010 Hogrefe Publishing