Using alcohol expectancies to predict adolescent drinking behavior after one year

Measuring adolescent alcohol outcome expectancies

The psychometric properties and construct validity of the Comprehensive Effects of Alcohol (CEOA) questionnaire were compared with those of the Alcohol Expectancy Questionnaire--Adolescent version (AEQ-A) in relation to adolescent alcohol consumption. Both measures of adolescent alcohol expectancies were found to be internally reliable and temporally stable. Alcohol use was significantly associated with subjective evaluations for Cognitive and Behavioral Impairment and Self-Perception on the CEOA and with expected effects for Cognitive and Motor Impairment and Changes in Social Behavior on the AEQ-A. Compared with the AEQ-A, the CEOA explained more variance in quantity (28%) and a similar variance in frequency (15%) for adolescent alcohol use (AEQ-A quantity = 20%, frequency = 15%). Whereas the general content and psychometric properties of the 2 measures are markedly similar, the Likert response format, shorter length, and assessment of both expected effects and subjective evaluations with the CEOA may offer measurement advantages over the AEQ-A.

The predictive utility of drinking refusal self-efficacy and alcohol expectancy: a diary-based study of tension reduction

The potential tension reduction effects of alcohol may be most appropriately tested by examining the role of alcohol related beliefs regarding alcohol's anxiolytic properties. The relationship between affective change drinking refusal self-efficacy, tension reduction alcohol expectancies, and ongoing drinking behavior was examined amongst 57 regular drinkers. Alcohol consumption, antecedent, and consequent mood states were monitored prospectively by diary, Social learning theory hypothesizes that low drinking refusal self-efficacy when experiencing a negative mood state should be associated with more frequent drinking when tense. Strong alcohol expectancies of tension reduction were hypothesized to predict subsequent tension reduction. Contrary to this hypothesis, the present study found that alcohol expectancies were more strongly related to antecedent mood states. Only a weak relationship between drinking refusal self-efficacy and predrinking tension, and between alcohol expectancy and subsequent tension reduction, was evident.

Effects of nicotine deprivation on alcohol-related information processing and drinking behavior

This study examined the influence of smoking cues and nicotine deprivation on responses to alcohol among hazardous drinkers. Fifty-six daily smoking, hazardous drinkers were exposed to either smoking cues or control cues after either 6 hr of nicotine deprivation or no deprivation. Urges to drink alcohol, alcohol-related cognitive processing, and alcohol consumption were assessed after cue exposure. Results indicated that nicotine deprivation increased urges to drink, the accessibility of alcohol outcome expectancies, and the volume of alcohol consumed. There was little influence of the smoking cue manipulation on these processes. Implications for understanding the mechanisms underlying alcohol-tobacco interactions are discussed.

The effects of familial risk, personality, and expectancies on alcohol use and abuse

This study tested a structural model of the association between familial risk, personality risk, alcohol expectancies, and alcohol abuse in a sample of 224 young adult offspring of alcoholics and 209 offspring of nonalcoholics. The results provided support for 2 personality-risk pathways, a social deviance proneness and an excitement/pleasure seeking path, that accounted for a significant portion of the association between a familial alcoholism and alcohol abuse. The path from familial alcoholism to social deviance proneness lead directly to alcohol problems. The path from familial alcoholism to excitement/pleasure seeking was associated with increased drinking, which, in turn, was associated with alcohol problems. Positive alcohol expectancies accounted for part of the association between excitement seeking and alcohol use. The results suggest 2 different biopsychosocial mechanisms that elevate risk for abuse in the offspring of alcoholics.

Expectancies for alcohol to affect tension and anxiety as a function of time

Alcohol outcome expectancies have been linked to drinking behavior on both empirical and theoretical grounds. Although typically measured as a static construct, we hypothesized that expectancies may be time-specific. Subjects rated their expectancies for a moderate amount of alcohol to increase, decrease, or not change their level of tension and anxiety. Ratings were repeated for when the intoxicating effects of the drinking would be: (1) "at their peak;" (2) "nearly worn off;" and (3) "completely worn off" (Time Epochs 1-3, respectively). As predicted, most subjects (72%) expected alcohol to reduce tension and anxiety at Time Epoch 1; however, significantly fewer subjects expected this effect at Time Epochs 2 and 3 (25% and 2%, respectively). Conversely, few subjects expected alcohol to worsen tension and anxiety at Time Epoch 1 (3.5%); however, significantly more subjects expected this effect at Time Epochs 2 and 3 (31% and 34%, respectively). Expectancies for Time Epoch 1 related most strongly to several measures of alcohol use, including drinking for the purpose of reducing tension (whole sample) and drinking frequency (men but not women). These findings show that tension-reduction expectancies are not stable over the course of a drinking episode and suggest the possibility of a treatment approach aimed at amplifying attention to expectancies for alcohol's more negative longer-term effects.

Treating Adolescents with Substance Use Disorders: An Overview of Practice Issues and Treatment Outcome

The knowledge base and research gaps of the adolescent drug abuse treatment field are discussed. In addition to summarizing several challenges faced by clinicians treating drug-abusing adolescents, traditional and emerging treatment strategies are described. The treatment outcome literature is seen as having several weaknesses, including that most studies are limited to descriptive designs. The author suggests that the most important research priority for the field is to address meaningfully the issue of which treatment approaches work best for which types of adolescent drug abusers.

Low-risk drinking guidelines: the scientific evidence

In 1997 the Addiction Research Foundation of Ontario and Canadian Centre on Substance Abuse released updated guidelines for low-risk alcohol consumption. This paper presents the scientific rationale behind this statement. Important comprehensive overviews on the consequences of alcohol use were studied. Formal meta-analyses on morbidity and mortality were examined wherever possible. Individual elements from similar guidelines were investigated for their scientific foundation. Limited original analyses defined risk levels by average weekly consumption. The evidence reviewed demonstrated that placing limits on both daily intake and cumulative intake over the typical week is justifiable for the prevention of important causes of morbidity and mortality. Gender-specific limits on weekly consumption were also indicated. In these updated guidelines intended for primary prevention, days of abstinence are not necessarily recommended. Intoxication should be avoided and abstinence is sometimes advisable. Available evidence does not strongly favour one alcoholic beverage over another for cardiovascular health benefits.

The relationship of positive and negative alcohol expectancies to patterns of consumption of alcohol in social drinkers

Negative alcohol expectancies have recently come to occupy a more important position in the expectancy literature, but recent claims that positive expectancies are unimportant in the consumption of alcohol when compared with negative expectancies are based on potentially flawed methodology. This study investigated the relative contribution of positive and negative expectancies to the consumption of alcohol using an instrument designed to measure both positive and negative expectancies. One hundred ninety-three men and women from the general community participated in the study. Findings showed while negative expectancies accounted for the greater proportion of variance of frequency of consumption, positive expectancies remained an important predictor of consumption, accounting for the greater proportion of variance of quantity consumed per session. The interesting but sometimes counterintuitive directions of these relationships can be explained in terms of social learning principles. The relatively neglected concept of negative expectancies is worthy of further use and investigation.

The contribution of treatment outcome research to the reform of children's mental health services: multisystemic therapy as an example

Service system reforms of the past decade have yielded innovations in type, accessibility, and cost of services provided for some children and families with serious problems, but few of the treatments delivered have been empirically evaluated. Rigorous tests of well-conceived treatments are needed to provide a solid foundation for continued reform. Multisystemic therapy has demonstrated efficacy in treating serious clinical problems in adolescents and their multineed families and is an example of the successful blending of rigorous treatment outcome research and service system innovation.

Possible precursors of gender drinking differences

This study explored the responses of sixth graders to a recently developed alcohol expectancy scale and a drinking attitude question. While factor analyses yielded the same "positive" and "negative" factors previously identified in scale construction, no significant gender differences were observed on scale items or factors. However, sixth grade males responded more favorably than their female counterparts to the general attitude item regarding alcohol consumption. Results also revealed that while male attitudes were related significantly to whether they reported observing adult intoxication in the home, female attitudes were not. Results are discussed in terms of their implication for the origins of initial male-female drinking behavior differences.

A Cross-Domain Model for Growth in Adolescent Alcohol Expectancies

Methodologists have recently shown how the methods of individual growth modeling and covariance structure analysis can be integrated, bringing the flexibility of the latter to bear on the investigation of inter-individual differences in change. The individual growth-modeling framework uses a pair of hierarchical statistical models to represent: (a) individual status as a function of time, and (b) inter-individual differences in true change. Under the covariance structure approach, these level- I and level-2 models can be reformatted as the "measurement" and "structural" components of the general LISREL model with mean structures. Consequently, a covariance structure analysis of longitudinal panel data can provide maximum-likelihood estimates for all level-2 parameters. In this article, using longitudinal data drawn from a school-based alcohol prevention trial, we demonstrate how the new approach can be used to investigate the inter-relationships among simultaneous individual changes in two domains - positive arid negative alcohol expectancies - over the course of early to mid-adolescence, for both boys and girls. We represent individual change over time in positive expectancies with a piecewise growth model, and in negative expectancies with a straight-line growth model. Then, we use multi-sample covariance structure analysis to ask whether individual changes in positive and negative expectancies are related to each other and whether the pattern of inter-relationships differs by gender. Our approach can easily be generalized to more than two domains and has a variety of other advantages that we document in the discussion.

Social skills, expectancies, and drinking in adolescents

Research in the field of teenage drinking behavior has shown relationships between both social skills and drinking and alcohol expectancies and drinking. The present research investigated the comparative power of both of these sets of variables in predicting teenage drinking behavior, as well as looking at the contribution of more global cognitive structures. It was hypothesised that adolescents with high alcohol involvement would be discriminated from those with low involvement on the basis of social skills, cognitive structures, and alcohol expectancies. Seven hundred thirty-two adolescents participated in the study. Results indicated that adolescent alcohol involvement was associated with social skills deficits, positive alcohol expectancies, and negative cognitive structures concerning parents and teachers. The results revealed that, although the bulk of the variance in drinking behavior was explained by the independent effects of social skills and expectancies, the interaction of the two constructs explained an additional and significant proportion of the variance. Implications for preventive and treatment programs are discussed.

Children's beliefs about drinking

This paper reports the results of a study in which age (grade level), racial/ethnic, and gender differences in beliefs and perceived norms about drinking were examined in a multi-ethnic urban sample of 4th through 7th grade children. Results showed that older children held beliefs and perceived norms that were more favorable toward drinking than younger children. The major difference between older and younger children lay in their differential estimates of the likelihood of certain consequences occurring and not in their evaluation of these consequences of drinking. Further, older children not only displayed less motivation to comply with their parents and greater motivation to comply with their peers, but they also perceived their parents, as well as their peers, as less disapproving of drinking than did younger children. There were few gender or race/ethnicity differences at these ages in children's beliefs and perceived norms about drinking.

Alcohol outcome expectancies and coping styles as predictors of alcohol use in young adults

This study was designed to examine the pattern and strength of relationships among coping styles and alcohol outcome expectancies with regard to drinking behavior in young adult social drinkers. Quantity and frequency of weekly consumption were used as criterion measures, and alcohol outcome expectancies/valences (CEOA: Fromme, Stroot & Kaplan, 1993) and coping styles (COPE: Carver, Scheier, & Weintraub, 1989) were used as predictor variables. For males, the expectancy of risk and aggression, and the valence of cognitive and behavioral impairment, were predictive of drinking behavior. For females, sociability valence and the expectancy of negative self-evaluation positively predicted the alcohol-use measures. With regards to coping styles, alcohol and drug disengagement and suppression of competing activities uniquely predicted alcohol use in males, whereas alcohol and drug disengagement, turning to religion, and behavioral disengagement were predictive of female alcohol use. In general, coping styles were more predictive of the alcohol-use measures than were alcohol-outcome expectancies. Practical implications of these results are highlighted.

Training school counselors in substance abuse risk reduction techniques for use with children and adolescents

A training project prepared school counselors for expanded roles in the prevention, early detection, and appropriate referral of students at high risk of substance abuse. The project trained middle and high school counselors to work as facilitators of support groups for students at greatest risk for substance abuse; the results were: 1) greater perceived self-efficacy, comfort, confidence, and competence by counselors as a result of Initial, Experiential, and Concurrent training, and 2) improved ability to use group counseling techniques as a result of training.

Reasons for drinking versus outcome expectancies in the prediction of college student drinking

This study developed a Reasons for Drinking Scale (RFD) with three factorially derived subscales, Social Camaraderie, Mood Enhancement, and Tension Reduction, among a university student sample. These scales were then compared to a measure of alcohol expectancies, the Alcohol Expectancy Questionnaire (AEQ), as predictors of several measures of alcohol use. The RFD accounted for more of the variance on all alcohol measures than the AEQ. Results are discussed in terms of reasons for drinking as a more direct assessment of cognitive motivations for drinking than outcome expectancies.

Relationships among alcohol availability, drinking location, alcohol consumption, and drinking problems in adolescents

We examined relationships among perceived alcohol availability, drinking location, alcohol consumption, and drinking problems. Subjects were 3,372 adolescent drinkers, ages 16-18, who participated in the Communities Mobilizing for Change on Alcohol Project baseline survey. Mixed-model regression was employed to identify predictors of alcohol consumption and drinking consequences. Perceived alcohol availability was significantly associated with higher levels of alcohol consumption for males. Drinking in a public location with higher levels of alcohol consumption for females. Results underscore the importance of youth alcohol assessibility.

The Inventory of Drinking Situations (IDS) in current drinkers with different degrees of alcohol problems

The Inventory of Drinking Situations (IDS) is a questionnaire developed to characterize the situations where alcoholics in treatment drank excessively. The purpose of the present study was to extend the understanding of this instrument as a research and diagnostic tool by applying it to drinking situations in individuals who have never been diagnosed as alcoholics, but who may have problems due to alcohol. Seventy-three current drinkers (32.1 +/- 9.98 years) were examined with a version of the IDS suitable for nonalcoholic individuals. Using the CAGE test we categorized the subjects in five groups according to their score. Correlational analysis revealed that the IDS subscale scores increased significantly with the severity of drinking problems. The CAGE score, the factor-derived scale Negative Situations, being male, and a preference for drinking alone were also correlated with the amount of alcohol consumed, while age was correlated with none of the variables of interest. To facilitate the analysis of the profiles of drinking situations, the IDS subscales underwent a factor analysis that rendered two factor-derived scales, suggesting that drinking occurs both in positive and in negative situations. In persons with more alcohol problems, according to their high CAGE scores, there was more drinking in negative situations that in positive ones. Accordingly, we confirmed that the profiles of drinking situations seen in problem drinkers indicated that situations related to negative emotions are more important determinants to drink. Implications of a shift from drinking in positive to drinking in negative emotional situations are discussed. We further substantiated the value of this test instrument for studies on drinking situations and for studies in nonalcoholic individuals.

Alcohol expectancies: effects of gender, age, and family history of alcoholism

To explore the effects of gender, age, and positive (FH+) and negative (FH-) family history of alcoholism on alcohol-related expectancies, the Alcohol Expectancy Questionnaire (AEQ) was administered to 627 college students (female n = 430). In an attempt to control for consumption effects, only individuals who described themselves as heavy drinkers were included in the study. A 2 (Family History) x 2 (Gender) x 2 (Age Range) multivariate analysis of variance (MANOVA) was conducted on the six scales of the AEQ. Results indicated that FH+ females under the age of 20 years reported stronger expectancies of social and physical pleasure than did FH- females. Results also suggested that females over the age of 20 reported significantly lower expectancies of global, positive effects compared to all other subjects, regardless of family history of alcoholism. Finally, both male and female subjects under the age of 20 reported greater expectancies of global, positive effects, sexual enhancement, feelings of increased power and aggression, and social assertion compared to individuals over the age of 20. These results indicate that alcohol-related expectancies vary as a function of age, gender, and family history of alcoholism.

Salience of alcohol expectancies and drinking outcomes

There is a body of research which indicates that endorsement of positive alcohol expectancies predicts alcohol drinking patterns; however, there is inconsistency in the literature regarding which particular alcohol expectancies predict drinking. Although an individual may endorse a variety of alcohol expectancy beliefs, these beliefs may not be of equal importance to drinking decisions. This study investigated whether the prediction of drinking might be enhanced by considering salience of alcohol expectancies rather than mere endorsement. Hierarchical regression analyses demonstrated that expectancy salience significantly improved the prediction of total alcohol consumption above and beyond the effects of expectancy endorsement. Expectancy salience was less effective as a predictor of heavy drinking.

Effects of suppressing the urge to drink on the accessibility of alcohol outcome expectancies

Previous work has shown that attempts to deliberately suppress a given thought is associated with heightened accessibility of thought-related information both during and following suppression (Wegner, 1994, Psychological Review, 101, 34-52). This study examined whether attempts to suppress the urge for alcohol would similarly be associated with heightened accessibility of alcohol-related information. Heavy social drinkers were exposed to the sight and smell of their usual alcoholic beverage either under the instructions to suppress their urge to drink alcohol or without such instruction. Following this task, participants were asked to make timed judgements about the applicability of a series of alcohol outcome expectancies. Results supported the view that suppression increases the accessibility of information in memory. Those in the Suppression condition were faster to endorse alcohol outcome expectancies following the exposure to alcohol cues than those in the Control condition. Findings are discussed in terms of cognitive strategies for regulating alcohol use and patterns of restrained drinking.

Environmental predictors of drinking and drinking-related problems in young adults

We examined relationships among drinking norms, peer alcohol use, alcohol availability, drinking location, alcohol consumption, and drinking-related problems among young adult drinkers. The specific objectives of our study were to assess the relative contribution of normative and physical environmental factors to drinking and drinking consequences. Subjects were 3,095 young adults, aged eighteen to twenty years old who participated in the Communities Mobilizing for Change on Alcohol Project baseline survey. Alcohol consumption (i.e., number of drinks on the last occasion) and drinking consequences served as dependent variables. Multiple linear regression was used to identify predictors of alcohol consumption, and logistic regression was employed to identify predictors of drinking consequences. Drinking norms and peer alcohol use were positively related to alcohol consumption and to drinking consequences. Drinking in a public setting was positively related to alcohol consumption, but not to drinking-related problems. Findings suggest that policies and programs that alter the normative and physical environment surrounding drinking may reduce alcohol consumption and subsequent problems in young adults.

The utility of novelty seeking, harm avoidance, and expectancy in the prediction of drinking

To test the hypothesis that two temperament scales (Novelty Seeking and Harm Avoidance) are differentially related to alcohol expectancies and drinking patterns, 140 adolescents from an inpatient psychiatric facility completed several self-report questionnaires measuring temperament, alcohol expectancies, and alcohol consumption. Moderated multiple regression analyses indicated that Novelty Seeking was significantly related to frequency of drinking and problem drinking, but that Harm Avoidance was not related to these variables. Results of the MANOVA indicated that high novelty seeking and low harm avoidant (Type 2) individuals had a significantly higher frequency of drinking than did individuals who were high on Harm Avoidance and low on Novelty Seeking (Type 1). Results also showed that expectancy and Novelty Seeking contributed significant independent and overlapping variance in the prediction of amount of drinking. Although Novelty Seeking was related to expectations of social functioning, other hypothesized relationships between temperament and expectancy were not supported.

The self-generated alcohol expectancies of Puerto Rican drinkers and abstainers

Using data from an epidemiological study of mainland Puerto Rican drinking, this work compares the self-generated alcohol expectancies of Puerto Rican drinkers and abstainers. While positive expectancies are more characteristic of drinkers, especially "heavy drinkers," negative expectancies are more characteristic of abstainers, especially lifetime abstainers. Results are discussed in terms of the cultural influences on alcohol expectancies and the positivity bias in alcohol expectancy research.

Predicting onset of drinking in a community sample of adolescents: the role of expectancy and temperament

We report results of a prospective examination of the influence of outcome expectancy variables and inherited temperaments on the onset of drinking over a 12-month period in a sample of 1,164 high school students. While univariate prospective analysis indicated that drinkers and nondrinkers were different both on measures of outcome expectancy and temperament, multivariate analysis supported, most strongly, a social learning account of the processes influencing the onset and maintenance of drinking behavior in this sample. The multivariate analysis revealed that only expectancies for enhanced social behavior were consistently associated with the onset of drinking from baseline to 12-month follow-up (p < .001). Among all nondrinkers at baseline, those entertaining higher expectancies about the positive effects of alcohol on social interaction were more likely to begin drinking between baseline and follow-up. At present, few, if any, alcohol abuse prevention studies with adolescents have explicitly attempted to alter alcohol expectancies or to establish a link between expectancy and behavior change. Our results suggest that it may be useful to do so.

A comparison of factor structures of adolescent and adult alcohol effect expectancies

A comparison of the factor structures of alcohol effect expectancies of adults (aged 18 and older) and adolescents (aged 12-17) was conducted. Data were from a nationally representative sample of United States residents. Two factors were extracted for the adults, and three for the adolescents. General positive and negative factors were common to each solution. In addition, the adolescent solution contained a factor related to alcohol-induced sexual enhancement. The pattern and magnitude of the loadings for the adult and adolescent negative factor were nearly identical, and the positive factors were very similar. Results are consistent with a two-factor model of alcohol expectancies among adults, with slightly more differentiated expectancies among adolescents.

Concurrent and prospective screening for problem drinking among college students

PURPOSE

Previous studies suggest that combining the CAGE questionnaire with the Perceived Benefit of Drinking Scale (PBDS), information about an adolescent's use of tobacco, and best friend's drinking pattern is a useful composite screening measure for problem drinking. The present study was undertaken to evaluate this composite screening measure prospectively as a predictor of subsequent problem drinking among late adolescents across 3 years of college.

METHODS

A random sample of 452 college freshmen entered a longitudinal study of alcohol use at the beginning of their freshman year. A total of 184 (58%) completed follow-up measures of alcohol use 32 months later. Outcome measures included the quantity and frequency of alcohol use and a composite measure of specific alcohol-related problems.

RESULTS

CAGE scores, PBDS scores, tobacco use, and best friend's drinking patterns as reported at college entry together explained 33% of the variance in the quantity/frequency measure and 37% of the variance in the alcohol-related problems measure from the end of the junior year. These same variables as reported at the end of the junior year explained 50% of the variance in the quantity/frequency measure and 61% of the variance in the alcohol-related problems measure. The composite screening measure as reported at college entry had a sensitivity of 73%, specificity of 70%, positive predictive value (PPV) of 63%, and negative predictive value (NPV) of 78% for students at high risk for problem drinking at the end of the junior year. A similar concurrent composite screening measure consisting of the same variables reported at the end of the junior year had a sensitivity of 88%, specificity of 56%, PPV of 60%, and NPV of 83% for high-risk drinkers. A total of 70-73% of students could be correctly categorized by each composite screening measure. These composite screening tests had significantly better test characteristics than the CAGE or PBDS alone.

CONCLUSIONS

College students' responses to the CAGE, PBDS, tobacco use, and their friends' drinking remain consistent over 3 years and correlate with concurrent and future risk for problem drinking. These variables explain significant variance in drinking and alcohol-related problems and may constitute a useful screening measure for current and future problem drinking.

Age-dependent inhibition of long-term potentiation by ethanol in immature versus mature hippocampus

The goal of this study was to assess the effects of ethanol on the induction of long-term potentiation (LTP) in hippocampal slices from immature versus mature rats. Population excitatory postsynaptic potentials (pEPSPs) were recorded from stratum radiatum of area CA1 of hippocampal slices using electrical stimulation of the Schaffer collateral/commissural fiber pathway. The slices were prepared from rats aged 15 to 25 or from 70 to 100 days. Long-term potentiation (LTP) of the pEPSP slope was induced using a single, theta-burst stimulus train in the presence or absence of 60 mM ethanol. Under control conditions, the stimulus train induced LTP in slices from both immature and mature animals. However, the magnitude of LTP was greater in slices from immature rats. When ethanol was present during the stimulus train, the magnitude of LTP in slices from mature animals did not differ significantly from the magnitude of LTP in control slices. However, ethanol virtually blocked the induction of LTP in slices from immature animals. These results indicate that memory-related synaptic plasticity in the hippocampus is attenuated by ethanol to a greater degree in immature versus mature animals.

Adolescent health-threatening and health-enhancing behaviors: a study of word association and imagery

PURPOSE

To examine the ways in which perceived risks and benefits relate to health-threatening and health-enhancing behaviors by adolescents.

METHOD

The study used a word association methodology to explore adolescents' thoughts and affective feelings associated with five health-threatening behaviors (e.g., drinking beer, smoking cigarettes) and three health-enhancing behaviors (e.g., exercising, using a seat belt).

RESULTS

Each behavior elicited a mix of positive and negative associations. Health-threatening behaviors had many positive associations in common, such as having fun, social facilitation, and physiological arousal. Health-enhancing behaviors had much less commonality in their positive associations. Patterns of negative associations were not highly similar across behaviors. The content and affective tone of the associations were closely linked to participation in health-threatening behaviors and health-enhancing behaviors. Participants in an activity were far more likely than nonparticipants to associate that activity with positive outcomes, concepts, and affect and less likely to produce outcomes, concepts, and affect and less likely to produce negative associations.

CONCLUSIONS

The word association methodology provides a useful technique for exploring adolescents' cognitions and affective reactions with regard to health-related behaviors. The data provided by this method have implications for prevention and intervention programs, as well as for future research.

Alcohol schema acquisition in preschoolers: differences between children of alcoholics and children of nonalcoholics

Cognitive schemas provide the structure within which children organize their knowledge and beliefs about the use of alcohol. The development of schemas about alcohol should be affected both by age and parental patterns of alcohol use. We examined differences in alcohol schema development among 139 male children of alcoholics (COAs) and 82 controls [children of nonalcoholics (NCOAs)] utilizing the Appropriate Beverage Task as an indicator of these processes. Overall, the vast majority of the sample identified at least one alcoholic beverage from photographs, even at age 3. COAs were more likely to identify at least one alcoholic beverage. With age controlled, COAs were better able to identify specific alcoholic beverages and correctly identified a larger number of alcoholic beverages. There was a trend for these children of alcoholic men to attribute more alcoholic beverage use to male adults than NCOAs. Moreover, differences in these children's attributions of alcoholic consummatory behavior were predicted by their parents' current consumption levels. Results provide evidence that alcohol schemas are detectable in early childhood and are more common in children from alcoholic homes. Discussion focuses on the potential relevance of these risk attributes to the development of more fully formed alcohol expectancies and to the later emergence of alcohol-related difficulty.

Cognitive and situational factors predict alcoholic beverage selection

It has been clearly established that individuals' alcohol consumption tends to covary with the rate and absolute quantity of a drinking partner. Sixty men and 73 women participated in a two-part study designed to examine the role of modeling and alcohol-related expectancies in predicting whether individuals would model the type of beverage selected by a confederate. A stepwise logistic regression designed to predict whether an individual would select an alcoholic or nonalcoholic drink indicated that confederate beverage choice and personal alcohol expectancy (social/physical pleasure) predicted beverage selection. Nonsignificant predictors included gender of the participant, whether participant and confederate were of the same gender, fear of negative evaluation, and typical drinking. The results indicate the importance of evaluating both individual and situational variables in predicting behavior.

Alcohol expectancies among adolescents with conduct disorder: prediction and mediation of drinking

Among adolescents with conduct disorder, alcohol expectancies were examined for both predictive utility and mediation of other predictors of alcohol use (i.e., delinquency, family history, demographic and psychopathology variables). Data were collected from 260 adolescents with conduct disorder 11-18 years of age, who had been in either mental health residential facilities or community-based special education programs for adolescents with serious emotional disturbances. Zero-order correlations and structural path models assessed relationships between expectancies, alcohol use, and other predictors of alcohol use. Results indicated: (a) expectancies of enhanced social and cognitive behavior were significant (p < .05) univariate predictors of drinking, (b) among all of the selected predictors, expectancies of enhanced social behavior (i.e., Subscale 2 of the Alcohol Expectancy Questionnaire--Adolescent Form; AEQ-A) had the strongest association with alcohol use (r = .54) and mediated between 31% to 44% of the drinking variance associated with other significant predictors (p < .01). Results were discussed as supporting similar expectancy-drinking relationships among CD and nonclinical youth.

Principles of brief intervention for adolescent alcohol, tobacco, and other drug use

Early intervention within a primary health-care setting for problems with ATOD use includes screening, assessment, and referral services, and cognitive and behavioral brief interventions. All health-care providers who care for adolescents should possess the basic skills to communicate effectively with young patients and with parents about their concerns about ATOD use problems, should be able to identify appropriate substance-abuse services in their communities, and should be able to determine the appropriate referral options for a given adolescent patients. Some difficulties will be encountered with the introduction of behavioral technologies into medical practice. As such, more research is needed to determine the most effective approach to incorporate brief interventions into the health-care setting. Health-care providers should incorporate the principles of effective patient-provider communication and the concepts of behavior-changing strategies into their daily practices.

Evaluation of a preventive intervention for a self-selected subpopulation of children

Evaluated an experimental preventive intervention developed for children who perceived their parents as problem drinkers. The 8-session program was designed to improve children's coping, self-esteem, and social competence, and modify alcohol expectancies which were specified as mediators of the effects of parental alcohol abuse on child mental health. Participants were 271 self-selected 4th-, 5th-, and 6th-grade students in 13 schools. The children were randomly assigned to treatment or delayed treatment conditions and the program was given to three successive cohorts of students. A meta-analysis across three different cohorts indicated significant program effects to improve knowledge of the program content and the use of support- and emotion-focused coping behaviors for the full sample. A slightly stronger range of effects was found for a high-risk subsample.

Relationship of alcohol expectancies to problem drinking among college women

PURPOSE

To evaluate the stability of expectancies about alcohol and their ability to prospectively explain drinking patterns and the occurrence of alcohol-related problems among college freshman women.

METHODS

College women (n = 120) completed a standardized measure of expectations and subjective evaluations of positive and negative outcomes associated with drinking and a questionnaire assessing drinking patterns and common alcohol-related problems at both the beginning and end of the school year. Ninety percent of the students were Caucasian with a mean age of 17.9 years (SD = 0.5).

RESULTS

Students' positive and negative outcome expectations and their subjective evaluations at the beginning of the year were significantly correlated with drinking patterns at the end of the year (p's < .05). During the year, students at low risk for problem drinking developed stronger positive attitudes toward the effects of alcohol upon courage, became less concerned about potential behavioral impairment, and perceived less negative effects upon self-perception. High risk students showed a significant decline in their positive attitudes toward the effects of alcohol upon their sociability. Expectancies about alcohol at the beginning of the school year explained 33% of variance in subsequent drinking (F = 6.17; p < .0004) and 20% of the variance in alcohol-related problems occurring during the year (F = 3.26; p < .02). Outcome evaluation scales at the beginning of the year explained more variance in subsequent drinking and alcohol-related problems than did outcome expectation scales.

CONCLUSIONS

Alcohol outcome expectations and their subjective evaluations were relatively stable across the freshman year for these college women. Alcohol expectancies on entry into college explained significant amounts of variability in drinking behavior and the occurrence of alcohol-related problems during the subsequent freshman year. Students' attitudes toward perceived outcomes may be more important than the perceived likelihood of the outcomes themselves.

Alcohol expectancies and changes in beer consumption of first-year college students

The present study used a prospective design to evaluate the relationship between alcohol expectancies and the progression of beer consumption of first-year college students over a 2-month period. One hundred and fifty-four first-year undergraduate students completed the Alcohol Expectancy Questionnaire (AEQ; Brown, Goldman, Inn, & Anderson, 1980) and a measure of precollege drinking during their first week of college, and completed a retrospective diary account of alcohol consumption also during the first week and at 1-month and 2-month follow-up. Beer was consumed considerably more frequently than other alcoholic beverages and was used as the dependent measure. The results showed that each AEQ subscale was positively correlated with beer consumption at almost all time points, and the magnitude of these correlations was generally higher for male subjects. Furthermore, the expectancies that alcohol increases social assertiveness and that alcohol is associated with global, positive changes were positively correlated with increases in beer consumption from Session 1 to Session 2 and from Session 1 to Session 3 for male, but not female, subjects. The findings extend previous research by demonstrating that certain alcohol expectancies are related to progressive increases over time in the amount of beer consumed.

Criterion variability in problem-drinking research on college students

A persistent issue confronting research on problem drinking (PD) and heavy drinking (HD) among college-age adults is the lack of a consistent, valid definition and criteria for either of the two conditions. This article presents a review and analysis of the criteria used in a selected group of studies on college students' PD and HD from 1974 to 1993. All studies within the time period that employed a random sample of students were analyzed for variations in criteria used to define either PD or HD. Sample characteristics, the specific criteria used, and data on prevalence rates found with those criteria are described. Areas of uniformity and inconsistency were identified and effects of criterion variations were described for the 23 studies reviewed. Of particular note was the lack of differential criteria for gender.

Adolescent drinking and driving: etiology and interpretation

In the adolescent population, drinking and driving is an important cause of injury, disability and premature death. A literature review of the demographics and etiology of drinking and drinking/driving reveals: 1) which subgroups of the adolescent population are more likely to drink and drink/drive; 2) where and why adolescents drink and drink/drive; 3) peer and family issues associated with adolescent drinking and drinking/driving; and 4) adolescent expectancies and perceived efficacies associated with drinking and drinking/driving. A discussion of the role of theory and the use of etiologic data in intervention research precedes an overview of several types of school-based alcohol-prevention programs and recommendations for more theory based interventions.

Alcohol-related expectations among Mexican-American women

The article explores alcohol expectations among Mexican-American women utilizing the Alcohol Expectancy Questionnaire and a series of quantity/frequency alcohol use measures. The results indicate that Mexican-American women generally have similar expectations about the benefits of alcohol use as women in the larger population. Within the sample of Mexican-American women however, there were differences in alcohol expectations based on occupational status and acculturation level: those Mexican-American women who are more acculturated and hold higher professional status occupations have higher expectations of the benefits of alcohol use than less acculturated Mexican-American women in blue-collar or service occupations.