Background: Contemporary dual-process models of alcohol abuse propose that alcohol abuse develops because of dysfunctions in the impulsive system, which generates automatic impulses to drink alcohol, and disruptions in the reflective system, which becomes unable to inhibit the influence of these automatic impulses. Based on these insights, this study investigated whether individual differences in the ability of the reflective system to exert response inhibition moderate the relationship between automatic cognitive processes and drinking behavior. Specifically, it was examined whether the interaction between implicit alcohol-related associations and response inhibition predicted drinking behavior.

Methods: Seventy-one university students completed the study online via the Internet. Implicit alcohol associations with positive affect and with arousal were assessed with variants of the Implicit Association Test. Response inhibition was measured using the original Stroop task. Participants also reported their weekly alcohol use and alcohol-related problems.

Results: As predicted, implicit associations were unrelated to drinking behavior when response inhibition was high. In contrast, when response inhibition was low, stronger implicit associations between alcohol and positive affect predicted increased alcohol use and alcohol-related problems.

Conclusions: These findings indicate that the relationship between automatic cognitive processes, originating in the impulsive system, and drinking behavior depends on individual differences in response inhibition exerted by the reflective system. As prolonged alcohol abuse is known to impair response inhibition, alcohol abusers may benefit from interventions that increase response inhibition, thereby restoring inhibitory control over automatic impulses.