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To mislead people as to whether they have or have not consumed alcohol, two conditions must be met:
Firstly, the taste must not disclose the alcohol content.
Alcohol's impact upon the taste of beverages is much less than most people believe (chapter 8). Experiments have established that the alcohol content is scarcely discernible in ordinary drinks (6-8 % alcohol) and common beer (4-5 %).1 Hence, these beverages have been used in several blind tests.
Stronger beverages have also been used. Research groups in New Jersey and Montreal have used drinks with 13-15 % alcohol, and some others have used 20-30% alcohol (!).2 ,3 This makes the conclusions less reliable. Secondly, internal cues must not disclose the presence of alcohol in the blood.
The concentrations of blood alcohol that human beings can detect, varies between individuals and between situations.
One blind test aimed at finding which internal cues most reliably informs an individual of having alcohol in the blood.4
The participants drank various beverages and were asked to fill in a questionnaire where several internal cues were mentioned. For some internal cues, even an alcohol content corresponding to a little more than one ordinary drink made a small difference - a modest, but statistically significant tendency that answers were more often correct than false. But uncertainty was the rule at this level of blood alcohol.This shows that even a little more than one ordinary drink, has effects which may be detected under optimal circumstances. But the participants knew that some did not get alcohol, they had been instructed to use their senses well and were even told which internal cues they should look out for. They were concentrating on a questionnaire instead of participating in the social activities of a normal drinking situation.
Most of the blind tests with alcohol have used quantities of alcohol corresponding to 2-3 drinks or glasses of wine. Such amounts of alcohol are most commonly consumed, and the most enjoyable psychological effects are also attributed to these quantities.5 But as these amounts produce internal cues which may be detected, there may still be a danger that in "blind" experiments, effects are attributed to alcohol which in reality are caused by the identification of cues associated with alcohol.
Because the experimenters' deception may be revealed, this method can perhaps not prove behavior effects of alcohol, but may possibly indicate cases where expectancy effects may be sufficient to produce behavioral changes which are commonly attributed to alcohol.6, 7, 8
The best procedure has been developed by a group of researchers led by Alan Marlatt, who is a professor of psychology at Washington State University in Seattle. The group published their first experiments in 1973-749, 10 and since then, they have further developed their technique.11, 12 The participants are divided into 4 groups:
|One half is told
|One half is told
|One half gets
|Told alcohol and
does drink it
but drinks alcohol
|One half gets
|Told alcohol but
|Told tonic and
does drink it
The mixing of drinks is observed by the prospective drinker. Smirnoff vodka and tonic is poured into the glasses from correct bottles. For those who only receive tonic, but are told they will receive alcohol, the vodka bottle contains de-carbonated tonic.
When vodka and tonic is mixed in the ratio 1 to 5, there is little risk that the participants will recognize alcohol by the taste. But to make sure, the participants receive a dose of mouth-spray prior to drinking.
The blood alcohol level is apparently measured by breathing into an electronic alcometer. But the alcometer is rigged and only confirms the instructions given on the beverage content.
Because alcohol is served in quantities which may be noticeable on the basis of internal cues, Marlatt and his co-workers want to avoid the artificial situation that participants stop their normal activities in order to concentrate upon internal cues. Avoiding questionnaires, the participants are encouraged to take part in social activities while research assistants discreetly observe behavior and measure reactions.
Concluding the experiment, the success of the beverage manipulation is checked by asking how much alcohol each participant believes he has been drinking.
To make the drinking situation as realistic as possible, Marlatt and his group have even made a "simulated bar-room", which is situated in the basement of Guthrie House on the campus in Seattle. At least for a visitor, it is hard to notice any difference between the simulated bar-room and a real bar-room.
This is the most convincing method for blind tests with alcohol. But in spite of the sophisticated technique, sources of error still exist, as the participants have experience with the substance being tested. The participants may recognize taste or effects of alcohol and reason that "I know I didn't receive alcohol, but my feeling is the very same ..." Learned effects may also operate at the unconscious level: Internal cues which through learning have become associated with, as an example, joy or loss of inhibitions, may be interpreted as these feelings. This is why blind tests with participants experienced with alcohol, cannot totally exclude all learned effects.
Most of the blind tests which have been published, have used far less convincing techniques than the one which was described here.
Many blind tests have used the "Stop, sit down and concentrate upon internal cues"-method (questionnaires). This does not resemble an actual drinking situation and reduces the validity.
Numerous studies have not included a check on the beverage manipulation. In other studies, the check shows that manipulation has been deficient. In addition, recent studies indicate that even if certain manipulation checks may give erroneous evidence of apparently successful beverage manipulation.13, 14
In the following pages, an outline is given of most of the blind tests that have been published. Only experiments with major errors in methodology have been omitted from the review.
Numerous blind tests have been performed, especially at Rutgers University in New Jersey.
In most of the studies, the sexual arousal has been assessed by objective measurement. The methods are commonly used in sexual research. Small devices measuring the reactions are located on the participants, while they are watching films or listening to tapes with sexually stimulating content. Males have a little rubber ring measuring the penis diameter, while females have small device in the vagina, measuring blood pressure and vein volume.
The experiments have shown conclusively that alcohol reduces sexual arousal.
The two experiments with females have demonstrated a decrease in arousal following alcohol consumption.15, 16
In studies with males, the given dose of alcohol has weakened arousal in 4 experiments17, 18, 19, 20 and produced no change in 5.21, 22, 23, 24,25
In one study, the male participants were instructed to suppress their sexual reaction. The conclusion was that alcohol reduces the ability to control the reaction.26
The conclusion of the research is obvious: Alcohol reduces sexual arousal, and most of the doses served in these experiments (approximately 2-3 drinks) are sufficient to demonstrate the reduction.
When objective measures are not employed, and the participants are instead instructed to concentrate upon their internal cues, the response could be based on interpretation of the internal cues. As might be expected, this method produces more varying outcomes:
In two studies, the participants declared they had increased arousal when actually drinking alcohol, while objective measures taken at the same time showed that the opposite was the case.27, 28
In two other studies, the participants also declared that they had more arousal when they actually had alcoholic beverages. It is not clear, however, whether this reflected the obviously deficient manipulation of beverages.29, 30
Studies of chemical substances' effects upon human sexual functions have become difficult to finance in the United States, as federal funding is no longer granted. Congressman Michel from Illinois proposed and got support for a law banning federal support, claiming that the studies "offended the feelings of most Americans". His assertions were widely publicized and happened to coincide with his bid for reelection, which ended with the voters' granting him renewed confidence.31
Male sexual reactions, alcohol and expectancy
Research groups have shown that men's increased sexual arousal when they believe they have been drinking alcohol, is strongest if the erotic stimulation has the character of a taboo, indicating that consideration for self respect normally dampens arousal.
In one study, the stimulant material was homosexual practices32 and in the other cases rape33 or other violence related to sex.34 The mean penile diameter increased significantly when the participants believed they had consumed alcohol, while the actual consumption of alcohol had no effect.
The report concludes that this finding throws light on the frequency of alcohol intoxication at the time of rape and other sex crimes - when men think they have been drinking (and in most cases, they do have been drinking!), they let out more of their forbidden impulses. The report also concludes that alcohol itself does not seem to remove inhibitions.
A group at the University of Wisconsin used other techniques to study the effects of alcohol on sexual interest:35
Seventy-two young males were divided into groups which were convincingly manipulated into believing that they either did or did not receive alcoholic beverages (the "Marlatt method").Two additional experiments have concluded that the participants displayed most sexual interest when they believed that they had been drinking alcohol, irrespective of the actual content of the glasses.36, 37
Pornographic pictures were passed around, and the participants were instructed to record to what degree they judged the pictures as sexually stimulating.
Those who believed they had received alcohol, found the pictures clearly more stimulating than those who believed their drinks did not contain alcohol. Alcohol itself made no difference.
Observers discreetly recorded the time they kept the pictures before passing them on. Those who believed they had been drinking alcohol, kept each pornographic picture 2.4 seconds more than the others. Alcohol itself made no significant difference.
One study, based on personal reports, concluded that level of disinhibition varied with expectancies and social setting, not with the actual beverage content.38
The studies which have used other methods for measuring the effects of alcohol on inhibitions have used less reliable techniques, especially for beverage manipulation. Three studies showed no significant effects, either of alcohol or of expectation.39, 40, 41
One single study indicates that alcohol does weaken inhibitions:42
The frequency of drawing graffiti was measured in a blind test with small amounts of alcohol (corresponding to less than one ordinary drink). Among the 29 participants, 8 drew graffiti, 7 of whom had been drinking alcohol.This experiment has some obvious weak points - low alcohol doses and few participants, of which only a minority showed the behavior which was used as the measure of inhibitions. Nevertheless, the outcome is statistically significant.
A recent experiment studied the tendency to risk-taking behavior in people inclined to risk-taking ("high sensations-seekers") and a group of more careful people. They reacted differently to the expectation of having taken alcohol, while alcohol itself did not influence risk-taking.43
The participants took part in simulated driving. High sensation seekers took more risks when they believed they had consumed alcohol. Low sensation seekers became more cautious in driving when they believed they had consumed alcohol. Alcohol consumption did not produce a significant effect.While blind tests may give us a hint on the relationship between alcohol and inhibitions, we have much material in studies of drinking in different cultures.
Around 1970, American researchers made systematic observations of "alcoholics" during drinking. They found that symptoms of anxiety, tension and restlessness increased, although on sobering up, the alcoholics often argued that the opposite had been the case.44 They had to watch video films of themselves to be convinced of what actually had taken place.
In 1972, leading Canadian researchers published a review of the research.45 They concluded that the findings were contradictory at best, and largely weighed against TRT.
In the last decade, numerous blind tests have been published. The results are highly contradictory. Alcohol has
- increased anxiety in 4 experiments46, 47, 48, 49
- had no effect in 7 experiments50, 51, 52, 53, 54, 55, 56
- decreased anxiety in 4 experiments57, 58, 59, 60
Among the four experiments in which alcohol decreased anxiety, only one had successful manipulation of the beverage content.61
The varying outcomes reflect, among other things, that different methods of study have been employed. But the conclusion must be that alcohol (as a pharmacological agent) largely does not relieve anxiety. Most reviews including other types of research than blind tests, also conclude that alcohol largely does not reduce anxiety.62, 63, 64, 65
Comparing this research with the research on commonly used sedatives (Valium etc.), we must definitely conclude that alcohol is hopelessly ineffective as an anxiety-reducing drug. The commonly used sedatives have demonstrated their anxiety-reducing effects in almost every study which has been conducted. For alcohol, the number of studies indicating anxiety-reducing effect only equals the number of studies with the opposite conclusion. If drug-producers had considered marketing alcohol as a sedative, existing research would have made the company stop further testing immediately.
But as mentioned earlier (chapter 2), the sociopsychological role of being intoxicated may, together with expectancy effects, fully explain the subjective feeling that intoxicants reduce anxiety.
Alan Marlatt and his co-workers conducted a study in which beverage manipulation was performed according to the convincing method which has been described earlier.66
Ninety-six individuals took part and the quantity of alcohol was rather large (corresponding to approximately 4 drinks). One half of the participants were provoked by insulting remarks from the persons to whom they were about to render electrical shocks.The levels of aggression were significantly influenced by the beverage which the participants believed they had consumed, while the actual beverage content (alcohol versus no alcohol) had no significant impact upon aggression. The interpretation of the researchers was that alcohol as such hardly influences the level of aggression, but people let out more of their forbidden impulses when they think, "Now, I have been drinking alcohol".
A group of psychologists in Montreal has challenged this conclusion in a series of experiments concluding that alcohol as such increases the level of aggression.67, 68, 69, 70, 71 But this series of experiments seem to have less effective beverage manipulation. For example, the alcoholic drinks contain approximately 15 % (!) alcohol in orange juice, although another study has demonstrated that alcohol in this concentration is apt to be discovered by taste.72 Two other experiments with similar unsuccessful beverage manipulation had the same conclusion.73, 74
There are also some other studies with varying techniques which have not given clear conclusions.75, 76, 77
We may conclude that blind tests on alcohol and aggression have rendered mixed results. As will be shown later, there are several "natural experiments" throwing light upon the issue.
Mirth was measured by discretely recording the duration of laughter in response to jokes made by the experimenters.Two South African psychologists concluded a study by stating that the expectancy of alcohol did not influence mood, while alcohol tended to make the participants more depressed.81
Alcohol itself had no effect upon mirth. But the participants who believed they were drinking alcohol, laughed substantially more than the others.
Another blind test tried to test the commonly held idea that alcohol increases self-confidence.82 The report concluded that "the experience of getting high is rooted in the expectancies of the individual".
Reaction time, coordination, simulated driving and intellectual performances have been studied. All experiments conclude that alcohol impairs skills and performances.
The blind tests teach us that suggestion and expectancy play a crucial role in establishing the perceived effects of alcohol.89, 90
In one study, the participants were instructed to "stay sober" during drinking. The study demonstrated the ability to "sober up" for behaviors such as loud talking and disinhibited behavior. This finding confirms the common experience that judgment returns if the need arises ("Suddenly, I got sober!").For centuries, human beings have taught each other what alcohol does - for example that it loosens inhibitions, enhances mood and relieves anxiety. Nevertheless, the only effect on behavior which is convincingly demonstrated by the research, is the reduction of skills and performances.
In another study, all participants did receive alcohol, but were told they had received either a large or a small quantity. The behavior of the two groups differed in many ways. The difference was largest for mirth, the feeling of being drunk, and the amount of "drunk behavior" as measured by observers.
The main trend in blind tests is that the individual's belief about alcohol consumption is the most important factor, provided that reactions are assessed by objective measures and the beverage manipulation is successful. In blind tests with less convincing manipulation and/or with effects reported in questionnaires, the alcohol content often determines behavior.
In addition, there are large numbers of "natural experiments", demonstrating the effects of alcohol in other cultures.
People discovered that when beverages were made and kept in certain ways, after a while, they contained a substance whose effects might be felt in the body. In many different societies, alcoholic beverages were known before the white Europeans arrived. This does not necessarily mean that the use of alcoholic beverages was motivated by their alcohol content.
Some societies chose not to use beverages containing alcohol. In others, it seems to have been unknown. In arctic areas (the Eskimos), in most of North America and the Pacific Islands, alcohol was unknown when white Europeans turned up.
Until the seventies, no anthropologists went out primarily to study alcohol use in other societies. However, their reports often contained amazing reports on the effects of alcohol in other cultures. Only the bodily effects (impairment of skills, nausea etc.) are observable in all drinking societies. The effects of alcohol upon behavior are surprisingly varied.
The classical survey and analysis of anthropological research on alcohol is the book "Drunken Comportment", published in 1969 by Edgerton and MacAndrew at the University of California in Berkeley.91 The survey presented here is, to a large extent, built upon this excellent analysis. Later on, anthropologists have given us many new reports on different effects of alcohol in different cultures.92, 93, 94
The Yuruna Indians in South America drank large amounts of alcohol without ever demonstrating any kind of disinhibited behavior, just like the Vicos Indians in the Andes mountains. An anthropologist reported that among the Vicos Indians, criminality, extra-marital sex and similar activities related to drunkenness in the white man's culture, did not at all take place on drinking occasions. On the contrary - such activities mostly occured when individuals were quite sober.
The Camba people in Bolivia drink a distillate of sugar cane. With good reason, they call it alcohol. Chemical analysis has shown an alcohol content of 89 %, and the Cambas drink this beverage undiluted. The majority drinks to intoxication at least twice each month. The impaired skills due to alcohol could hardly be more evident. But "... drinking does not lead to expressions of aggression in verbal or physical form ... Neither is there a heightening of sexual activity".
The report from a British officer of his experiences with the Kikuyu people in East Africa early in this century, showed that the people maintained complete control of themselves when they were drunk, but were capable of the most bestial acts under conditions of sobriety.
The people of Aritama in Colombia are characterized by subtle aggressiveness hidden behind their formal politeness and over-controlled behavior. According to our ideas, this should be an ideal place for observing the effect of alcohol upon inhibitions. Nevertheless, the Aritamans are even more silent and reserved when they are "under the influence".
The Japanese fishing community of Takashima is also a community where aggressive feelings are obviously strongly repressed, and the sexual norms may be labelled puritan. Nevertheless, this is a society where alcohol lacks its magic power to remove inhibitions.
There are numerous examples. In an anthropological survey of 46 societies, a link between alcohol and violence was only found in one fifth.
Even in the industrialized parts of the world, we can observe fundamental differences in drunken comportment. This is often noticed when people from different drinking cultures meet, for example when Nordic tourists spend their holidays in the Mediterranean countries.
At one restaurant table, a Scandinavian drinks a bottle of wine. Simultaneously, a Spaniard or an Italian drinks an identical bottle of wine at the next table. In most cases, the difference between the effects is strikingly evident. The same bottle which makes one man show disinhibited behavior, has no visible impact upon the other man's behavior.In some societies, alcohol apparently turns people into helpless victims of whims and impulses which they are unable to control. In other societies, this is obviously not the case. One possible explanation is that the difference might be due to genetic differences. Let us now examine the evidence for this theory.
Over the course of time, an increasing number of Basutos moved to the cities to work in the factories of the Europeans. Having moved to the cities, they continued to brew their beer. In the cities - exposed to the influence of the white man's culture - the same beer, consumed by the same people, had markedly different effects.
Arguments and violence became so common that the white rulers tried to forbid the native beer. While the beer was brewed illegally, the problems accompanying the drinking were labelled "a threat to the nation".
As long as the Basutos live in their traditional societies, the same quantities of beer could be consumed without apparent problems. People can learn the magic effect on inhibitions.
The Papago Indians live in the border area between Arizona and Mexico. Between 1912 and 1938, three different anthropologists published reports describing the drinking of the Papagos. Their own wine was often consumed in large quantities and caused vomiting and unsteadyness, but never generated disputes or brutality.
In the 1930s, the white man's whiskey came into use in the Papago community, producing the effects the "firewater" used to have when introduced (and taught) by the white man. For many years, the two kinds of drinking existed side by side - the whiskey alcohol producing effects entirely different from the wine alcohol. In the end, the Papagos were drawn into the white man's culture as employees, and all alcohol beverages finally acquired the same effects.
The Iroquois Indians populated an area in northeastern USA and southeastern Canada. They started using alcohol from contact with the whites, but for a long time, they only used it to attain religious visions. Towards the end of the 18th century the area was more often visited by white trappers and traders. At that time, alcohol started to remove inhibitions among the Iroquois.
Alcohol is also used without the disinhibiting effect in large populations like the Jews and the Chinese. The Japanese, who used to drink with great dignity, had a gradual change in drunk behavior during the American occupation after World War II.
A report says that at "drinking sessions", "the men will sit in the sun - talking, sleeping, listening to the radio ...". They behaved peacefully and the athmosphere was anything but euphoric, rather "drowsy, relaxed, and possibly a little depressive".
But the Maori people also had "drinking parties", during which they were "gay and noisy". During the night, quarreling, violence, and a sexual undertone were common phenomena.
The Tecospa Indians are peaceful when they drink their wine together with people from their own tribe. If they drink with members of other tribes, the wine removes their inhibitions.
There are examples of this "only-now-and-then" phenomenon from many societies. If we take a look at the Western culture, the difference in the effects that alcohol produces at cocktail parties and at boozing sessions is remarkable.
In some societies, aggression is only within the group, while in others, it is only directed towards outsiders. In some cultures, aggression is only expressed in words, whereas in others, it is also expressed by extreme physical violence. Similarly, violating the sexual norms may only be allowed with special kinds of partners, and so on.
The content and extent of the disinhibited behavior in different societies is extremely diverse. This fact may hardly fit in with the theory that alcohol has a direct effect upon the brain which turns people into helpless victims of their instincts and impulses. On the contrary, the "uncontrolled" impulses appear to be controlled by the social conventions of the individual's society, that is, by the society's instructions about the effects of alcohol upon behavior.
In the societies where alcohol "loosens up" behavior, it still complies with distinct rules - "thus far, but no further".
"Over the course of socialization, people learn about drunkenness what their society "knows" about drunkenness; and, accepting and acting upon the understandings thus imparted to them, they become the living confirmation of their society's teachings."Subsequent anthropological reports have given additional support to this conclusion.
Alcohol's removal of inhibition is the most prominent aspect of its effect in the Western culture. It is a very old phenomenon. The effect is substantially stronger in Northern Europe than in Southern Europe. Nevertheless, the difference is one of degree. To some extent, disinhibited drunk behavior also exist in the Mediterranean countries. In several other societies, this effect of alcohol is entirely absent. Some anthropologists have concluded that disinhibited drunk behavior has been spread by the white man to other cultures, just like the neck tie and Coca Cola.
The blind tests with alcohol have some limitations in their methodology. For two reasons, the trans-cultural studies of alcohol effects are the most conclusive:
The decisive importance of learning for the subjective experience of "getting high" and "disinhibited", refutes some biological theories which have been put forward. Through the years, biological researchers have considered different theories as very promising:
It has also been claimed that these biochemical events may explain the phenomenon of addiction. However, epidemiological research has demonstrated that most users of all intoxicants do not become addicted. The selection of users into addicts is obviously determined by social and psychological factors.
These theories are seeking pharmacological explanations and justifications
for socially derived experiences. There is an increasing need for scrutinizing
our ideas about intoxicants, intoxicated behavior and the psychological
effects of intoxicants. In the next chapter, we
will look at the relationship between the chemical effects of intoxicants,
the bodily reactions, the subjective experience and the intoxicated behavior.
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