Alcohol-related outcome expectancies: construct overview and implications for primary and secondary prevention

Tracking COVID-19 vaccination expectancies and vaccination refusal in the United States

To identify factors that predict COVID-19 vaccination refusal and show how expectancies affect vaccination acceptance for non-vaccinated adults, we used a monthly repeated cross-sectional sample from June/2021 to October/2021 to collect data on vaccination behaviors and predictor variables for 2,116 US adults over 50 years of age. Selection bias modeling - which is required when data availability is a result of behavioral choice - predicts two outcomes: (1) no vaccination vs. vaccination for the entire sample and (2) the effects of expectancy indices predicting vaccination Refuser vs. vaccination Accepters for the unvaccinated group. Vaccine refusers were younger and less educated, endorsed common misconceptions about the COVID-19 epidemic, and were Black. Vaccination expectancies were related to vaccination refusal in the unvaccinated eligible group: negative expectancies increased vaccine refusal, while positive expectancies decreased it. We conclude that behavior-related expectancies (as opposed to more stable psychological traits) are important to identify because they are often modifiable and provide a point of intervention, not just for COVID-19 vaccination acceptance but also for other positive health behaviors.

Alcohol Expectancy and Cerebral Responses to Cue-Elicited Craving in Adult Nondependent Drinkers

BACKGROUND

Positive alcohol expectancy (AE) contributes to excessive drinking. Many imaging studies have examined cerebral responses to alcohol cues and how these regional processes related to problem drinking. However, it remains unclear how AE relates to cue response and whether AE mediates the relationship between cue response and problem drinking.

METHODS

A total of 61 nondependent drinkers were assessed with the Alcohol Expectancy Questionnaire and Alcohol Use Disorder Identification Test and underwent functional magnetic resonance imaging while exposed to alcohol and neutral cues. Imaging data were processed and analyzed with published routines, and mediation analyses were conducted to examine the interrelationships among global positive score of the Alcohol Expectancy Questionnaire, Alcohol Use Disorder Identification Test score, and regional responses to alcohol versus neutral cues.

RESULTS

Alcohol as compared with neutral cues engaged the occipital, retrosplenial, and medial orbitofrontal cortex as well as the left caudate head and red nucleus. The bilateral thalamus showed a significant correlation in cue response and in left superior frontal cortical connectivity with global positive score in a linear regression. Mediation analyses showed that global positive score completely mediated the relationship between thalamic cue activity as well as superior frontal cortical connectivity and Alcohol Use Disorder Identification Test score. The alternative models that AE contributed to problem drinking and, in turn, thalamic cue activity and connectivity were not supported.

CONCLUSIONS

The findings suggest an important role of the thalamic responses to alcohol cues in contributing to AE and at-risk drinking in nondependent drinkers. AEs may reflect a top-down modulation of the thalamic processing of alcohol cues, influencing the pattern of alcohol use.

Outcome Expectancy and Sexual Compulsivity Among Men Who Have Sex with Men Living with HIV

Sexual compulsivity is operationalized by engaging in repetitive sexual acts, having multiple sexual partners and/or the excessive use of pornography. Outcome expectancy refers to the beliefs about the consequences of engaging in a given behavior. Research examining the relationship between outcome expectancy and sexual compulsivity is limited. The aim of this study was to assess the association between outcome expectancy and sexual compulsivity among men who have sex with men (MSM) living with HIV. Data were obtained from 338 MSM. Simple and multiple linear regression models were used to assess the association between outcome expectancy and sexual compulsivity. After adjusting for age, race/ethnicity, income, education, and employment status, for every one point increase in outcome expectancies for condom use, HIV disclosure and negotiation of safer sex practices, there was, on average, an approximate one point decrease in sexual compulsivity score. Prevention and intervention programs geared towards reducing sexual compulsivity among MSM should focus on increasing outcome expectancies for condom use, HIV disclosure and negotiation of safer sex practices.

Understanding the relationship between religiousness, spirituality, and underage drinking: the role of positive alcohol expectancies

Research has consistently found that religiousness and spirituality are negatively associated with underage drinking. However, there is a paucity of research exploring the mechanisms by which these variables influence this important outcome. With 344 underage young adults (ages 18-20; 61 % women), we investigated positive alcohol expectancies as a mediator between religiousness and spirituality (measured separately) and underage alcohol use. Participants completed the Religious Commitment Inventory-10, Daily Spiritual Experiences Scale, Alcohol Expectancies Questionnaire, and Drinking Styles Questionnaire. Results indicate less positive alcohol expectancies partially mediate the relationship between both religiousness and spirituality and underage alcohol use. This suggests religiousness and spirituality's protective influence on underage drinking is partly due to their influence on expectations about alcohol's positive effects. Since underage drinking predicts problem drinking later in life and places one at risk for serious physical and mental health problems, it is important to identify specific points of intervention, including expectations about alcohol that rise from religious and spiritual factors.

The comprehensive alcohol expectancy questionnaire: confirmatory factor analysis, scale refinement, and further validation

The Comprehensive Alcohol Expectancy Questionnaire (CAEQ; Demmel & Hagen, 2003a, 2003b) is a self-report measure designed to assess an individual's alcohol expectancies. In this study, we examined the CAEQ in a student sample (N= 932) and in a clinical sample of alcohol-dependent inpatients (N= 744). The Five-factor structure was confirmed by means of confirmatory factor analysis. Convergent validity of the revised CAEQ was supported by showing significant relationships to quantity and frequency of drinking. The results of this study suggest that the revised CAEQ appears to be a psychometrically sound tool for the assessment of alcohol expectancies among both students and alcohol-dependent inpatients.

Accounting for Variation in the Perceived Effects of Adolescent Substance Use: Steps towards a Variable Reinforcement Model

Prior research indicates that many young people associate substance use with immediate pleasures and rewards, including kicks, thrills, excitement, or relief from psychic pain. Moreover, the anticipation of such rewards appears to represent a significant motivating force behind adolescent substance use. Yet, while substance use is rewarding and reinforcing for many young people, the reward potential of drugs/alcohol appears to be highly variable across individuals. For instance, some youths do not associate substance use with pleasurable effects and this fact requires explanation. In this paper, the writer proposes an integrated theoretical model that attempts to account for individual variation in the reward potential of drugs and alcohol. It is argued that this model may also help to predict the future behavior of adolescent substance users. Data from a large survey of adolescents are used to conduct an initial test of the proposed model. The implications of the findings for theory and research are discussed.

Young men's ambivalence toward alcohol

There is widespread concern about the health and social consequences of excessive alcohol consumption among young men. Interventions to reduce alcohol-related harm will be affected by ambivalence toward alcohol, because ambivalent attitudes are worse predictors of behaviour than are homogeneous attitudes. It is therefore important to identify aspects of alcohol consumption about which young men are not ambivalent. In-depth interviews were conducted with a socioeconomically diverse sample of 31 men, aged 18-21 living in London, UK. Ambivalence toward alcohol was widespread. None of the drinkers who were interviewed had uncomplicated positive evaluations of drinking: all mentioned compelling reasons not to drink. Most motives for drinking were also identified as reasons for not drinking if consumption became excessive. However, three motives for not drinking were not also motives for drinking: violence, alcoholism, and cost. These findings should be considered during the design of interventions to reduce the health and social consequences of excessive alcohol consumption amongst young men.

Adolescent alcohol misuse: methodological issues for enhancing treatment research

AIMS

The objective of this article is to present an overview of the current state of the field of adolescent alcohol treatment research and to discuss several priorities for future research directions.

METHOD

The authors identified trends in adolescent alcohol treatment research from multiple sources, including searches of the National Institutes of Health grantee listings, proceedings from annual meetings of the Research Society on Alcoholism and relevant English-language journal articles available in MEDLINE and PSYCHLIT databases over the past decade.

RESEARCH RECOMMENDATIONS

This field must build on its major strength, which has been its success in appreciating the unique developmental characteristics of adolescence and meaningfully incorporating them into adolescent alcohol treatment approaches. Priorities for future research include: empirically investigating the potential value of harm reduction approaches for promoting public health and reducing total harm for adolescents; developing efficacious interventions across a wide range of intensities and settings; increasing the reach and relevance of randomized treatment efficacy trials and their products, with a particular focus on enhancing the recruitment and retention of diverse treatment samples; increasing a focus on key individual difference variables such as co-occurring diagnoses, that may serve as the basis for treatment tailoring; and exploration of the potential benefits of transdisciplinary research.

Combating substance abuse with ibogaine: pre- and posttreatment recommendations and an example of successive model fitting analyses

Ibogaine is an indole alkaloid derived from the root bark of the African shrub Tabernan the iboga and it has been used for many years as a medicinal and ceremonial agent in West Central Africa. Furthermore, both anecdotal observations and recent studies suggest that ibogaine alleviates withdrawal symptoms and reduces drug cravings. Although ibogaine articles typically include information bearing on the duration of drug abstinence following treatment, little if any attention is given to the psychological and environmental factors that might facilitate a positive treatment outcome. Hence, a major purpose of the present review is to suggest a number of theory-driven, pretreatment and posttreatment recommendations that have good potential for enhancing ibogaine's effectiveness. The second major purpose of this review is to demonstrate, through a reanalysis of previously published results, the utility of conducting successive model fitting analyses on ibogaine treatment data. Such analyses are useful for determining both the strength and form of the association between pre-ibogaine treatment variables and post-ibogaine treatment outcomes. Finally, in order to facilitate future quantitative reviews, the authors recommend that a minimum set of patient- and treatment-related variables be included in all ibogaine publications involving human participants.

Rational decision perspectives on alcohol consumption by youth. Revising the theory of planned behavior

Cognitive and developmental approaches have made great strides in describing and predicting alcohol consumption by youth. The present review examines several theories of decision making with regard to alcohol consumption, including subjective expected utility (SEU) theory, the theories of reasoned action and planned behavior, and alcohol-related outcome expectancy theory. In addition, the developmental literature on the contribution of parents and peers to adolescent alcohol consumption is reviewed. A model is proposed, which integrates the theory of planned behavior and alcohol-related outcome expectancy theory with modifications based on findings from the developmental literature. Implications for further research are discussed.

Smoking Consequences Questionnaire--Spanish

A total of 212 Spanish smokers completed a Spanish version of a smoking questionnaire based on the Smoking Consequences Questionnaire--Adult (A. L. Copeland, T. H. Brandon, & E. P. Quinn, 1995) and a nicotine dependence (ND) measure. Confirmatory factor analysis results supported an a priori defined 8-factor structure. The results also indicated good internal consistency for the instrument and the scales derived from each factor. Positive outcome smoking expectancies scales were significantly and substantially associated with ND scores. Also, after controlling for the influence of ND, the authors found higher smoking expectancies in women than in men in (a) weight control, (b) craving reduction and addictiveness, and (c) negative-affect reduction. The results support the instrument's construct validity.