Single-session expectancy challenge with young heavy drinkers on holiday

The association between drinking motives and alcohol-related consequences - room for biases and measurement issues?

AIMS

To investigate whether the predominant finding of generalized positive associations between self-rated motives for drinking alcohol and negative consequences of drinking alcohol are influenced by (i) using raw scores of motives that may weight inter-individual response behaviours too strongly, and (ii) predictor-criterion contamination by using consequence items where respondents attribute alcohol use as the cause.

DESIGN

Cross-sectional study within the European School Survey Project on Alcohol and other Drugs (ESPAD).

SETTING

School classes.

PARTICIPANTS

Students, aged 13-16 (n = 5633).

MEASUREMENTS

Raw, rank and mean-variance standardized scores of the Drinking Motives Questionnaire--Revised (DMQ-R); four consequences: serious problems with friends, sexual intercourse regretted the next day, physical fights and troubles with the police, each itemized with attribution ('because of your alcohol use') and without.

FINDINGS

As found previously in the literature, raw scores for all drinking motives had positive associations with negative consequences of drinking, while transformed (rank or Z) scores showed a more specific pattern: external reinforcing motives (social, conformity) had negative and internal reinforcing motives (enhancement, coping) had non-significant or positive associations with negative consequences. Attributed consequences showed stronger associations with motives than non-attributed ones.

CONCLUSION

Standard scoring of the Drinking Motives Questionnaire (Revised) fails to capture motives in a way that permits specific associations with different negative consequences to be identified, whereas use of rank or Z-scores does permit this. Use of attributed consequences overestimates the association with drinking motives.

Using the Drinking Expectancy Questionnaire (revised scoring method) in clinical practice

The Drinking Expectancy Questionnaire (Young & Knight, 1989; Young & Oei, 1996) has been widely used in clinical and research settings over the past 20 years. A revised scoring method with a five-factor structure has been proposed but no norms for this method are available (Lee, Oei, Greeley, & Baglioni, 2003). The aim of this study is to establish sample means for the five expectancy subscales (Social Confidence; Sexual Interest; Cognitive Enhancement; Tension Reduction; and Negative Consequences) in a sample of adults entering hospital treatment for alcohol dependence (N=163) and a sample of university undergraduate students (N=110). Clinical sample means on the expectancy subscales tended to be substantially higher than the means for the student sample, with the exception of Sexual Interest (which was higher in the students). Interestingly, the Negative Consequences subscale mean was more than two standard deviations higher in the clinical sample, and was strongly correlated with measures of depression, anxiety and stress. The Negative Consequences scores were strongly associated with drinking risk in the student sample but were not related to drinking measures in the clinical sample. A ROC analysis established a cut-off on the DEQ total of 107 that distinguished dependent drinkers from student drinkers with high sensitivity and specificity. The clinical utility of the DEQ in general will be discussed.

An integrated theoretical approach to substance use and risky sexual behavior among men who have sex with men

Research demonstrates a consistent association between substance use and sexual risk, particularly among men who have sex with men (MSM). The present study builds upon two existing theories (Cognitive Escape Theory and Expectancy Theory) to examine the synergistic role of sexual conflict (surrounding unsafe sex) and expectancies in sexual behavior among 135 MSM. Two conflicts were examined: (1) The conflict between motivation to practice safer sex and temptation for unprotected sex; and (2) The conflict between motivation to practice safer sex and perceived benefits of unprotected sex. Factorial ANOVAs (2 × 2; high versus low expectancies and conflict versus no conflict) revealed a significant interaction between conflict and expectancies-individuals who reported high levels of conflict were more sensitive to the effect of expectancies than were those experiencing low levels of sexual conflict. Results demonstrate the synergistic effects of conflict and expectancies and highlight the importance of integrating existing theories to more fully consider the intrapsychic operation and experience of sexual conflicts.

Patterns of alcohol consumption and sexual behavior among young adults in nightclubs

BACKGROUND

Alcohol consumption has been linked to a variety of sexual risk behaviors. However, much research addresses this connection among college students, ignoring other social contexts in which this association may be prevalent, such as club settings.

OBJECTIVES

As such, this study assessed patterns of drinking and sexual activity among young adults who frequent nightclubs.

METHODS

Using time-space sampling, we surveyed 308 young adults (ages 18-29) in New York City clubs.

RESULTS

Participants reported binge drinking on 52% of drinking days. Roughly, 62% reported recent sex under the influence, and 29% of them reported being less safe in sexual situations as a result of their drinking. Men reported more days of drinking and binge drinking than women, and were more likely to report recent sex under the influence. Younger participants were more likely to report being less safe sexually while intoxicated. Recent binge drinking was associated with sex after drinking.

CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE

These data suggest the need for targeted intervention and prevention efforts at nightclubs.

Adolescents binge drinking when on holiday: an evaluation of a community intervention based on self-regulation

This paper presents a case study of a community intervention aimed at reducing excessive drinking in young men on holiday in seaside camping resorts in the Netherlands. The self-regulated voluntary covenant of parties concerned was evaluated on the basis of several types of data (all collected in 2004 ): questionnaires administered to young men (N = 191), observations carried out by trained "peers," nuisance questionnaires among city center residents (N = 121), and interviews with local actors. Compliance with measures as well as the effects of measures are discussed. Limitations are noted and recommendations for optimizing the potential of community interventions are made.

Reasons for abstaining or limiting drinking: a developmental perspective

The cross-sectional and longitudinal relations between reasons for abstaining or limiting drinking (RALD) and abstention were examined in a 16-year longitudinal study (N = 489) of college students with and without a family history of alcohol problems. Results indicated that RALD based upon upbringing or religiosity were associated with increased rates of abstention, whereas RALD based upon perceived or experienced negative consequences of drinking were associated with lower rates of abstention and increased alcohol consumption among drinkers. In addition, changes in RALD over time coincided with alcohol consumption transitions. Abstainers who began drinking after turning 21 reported a decrease in the importance of RALD associated with loss of control and upbringing or religiosity compared to abstainers who continued to abstain after turning 21. Conversely, drinkers who began abstaining after leaving college reported an increase in the importance of RALD associated with loss of control and upbringing or religiosity compared to drinkers who continued to drink after leaving college. Examining the reciprocal influences of RALD on drinking outcomes extends previous research and may inform prevention and intervention programs among college drinkers.

Varying cluster sizes in trials with clusters in one treatment arm: sample size adjustments when testing treatment effects with linear mixed models

Trials in which treatments induce clustering of observations in one of two treatment arms, such as when comparing group therapy with pharmacological treatment or with a waiting-list group, are examined with respect to the efficiency loss caused by varying cluster sizes. When observations are (approximately) normally distributed, treatment effects can be estimated and tested through linear mixed model analysis. For maximum likelihood estimation, the asymptotic relative efficiency of unequal versus equal cluster sizes is derived. In an extensive Monte Carlo simulation for small sample sizes, the asymptotic relative efficiency turns out to be accurate for the treatment effect, but less accurate for the random intercept variance. For the treatment effect, the efficiency loss due to varying cluster sizes rarely exceeds 10 per cent, which can be regained by recruiting 11 per cent more clusters for one arm and 11 per cent more persons for the other. For the intercept variance the loss can be 16 per cent, which requires recruiting 19 per cent more clusters for one arm, with no additional recruitment of subjects for the other arm.

Cognitive processes in alcohol binges: a review and research agenda

Alcohol abuse is associated with a cluster of long-term changes in cognitive processes, as predicted by contemporary models of addiction. In this paper we review evidence which suggests that similar changes may occur during an alcohol binge, and as such they may play an important role in explaining the loss of control over alcohol consumption that occurs during alcohol binges. As a consequence of both acute alcohol intoxication (alcohol 'priming' effects) and exposure to environmental alcohol-related cues, we suggest that a number of changes in cognitive processes are likely. These include increased subjective craving for alcohol, increased positive and arousing outcome expectancies and implicit associations for alcohol use, increased attentional bias for alcohol-related cues, increased action tendencies to approach alcohol, increased impulsive decision-making, and impaired inhibitory control over drives and behaviour. Potential reciprocal relationships between these different aspects of cognition during an alcohol binge are discussed. Finally, we discuss the relationship between the current model and existing models of cognitive processes in substance abuse, and we speculate on the implications of the model for the reduction binge drinking and its consequences.

Prevention of alcohol problems in Dutch youth: missed opportunities and new developments

Binge drinking among young people is a problem in the Netherlands. This article outlines the current Dutch approach to alcohol prevention in this target group. It is argued that well-enforced evidence-based control measures are lacking despite renewed political interest in them. Politicians often favor alcohol education, but to increase the effectiveness of alcohol prevention, a combined approach of policy measures, enforcement, and education is needed. Translation of education and policy-based measures is discussed.