BACKGROUND: Motivational conflict is central to alcohol dependence, with patients reporting motivation to limit their drinking at the same time as urges to drink alcohol. In addition, dual process models of addiction emphasise the power of automatic cognitive processes, particularly automatic approach responses elicited by alcohol-related cues, as determinants of drinking behavior. We aimed to examine the strength of automatic and self-reported alcohol approach and avoidance tendencies among alcohol-dependent inpatients relative to matched controls. METHODS: A total of 63 alcohol-dependent patients undergoing detoxification and 64 light-drinking controls completed a stimulus-response compatibility (SRC) task, which assesses the speed of categorization of alcohol-related pictures by making symbolic approach and avoidance movements. We also included modified versions of the SRC task to assess automatic motivational conflict, that is, strong approach and avoidance tendencies elicited simultaneously by alcohol-related cues. RESULTS: There were no differences between alcohol-dependent patients and controls on the SRC task, although individual differences in the quantity of alcohol consumed before entering treatment were significantly positively correlated with the strength of approach (but not avoidance) tendencies elicited by alcohol-related cues. Automatic approach tendencies were also positively correlated with self-reported "approach" inclinations and negatively correlated with self-reported "avoidance" inclinations. CONCLUSIONS: Although alcohol-dependent patients and matched controls did not differ on automatic approach and avoidance tendencies elicited by alcohol-related cues, individual differences in the quantity of alcohol consumed before entering treatment were associated with the strength of automatic approach tendencies elicited by alcohol cues.