Does drinking refusal self-efficacy mediate the impulsivity-problematic alcohol use relation?

Alcohol mixed energy drink usage and risk-taking among college students in Western New York State

Alcohol mixed energy drinks (AmED) may promote excessive alcohol intake and risk-taking among college students. Objective: To understand the relationship between AmED use and risky behavior as well as attitudes and motivations for AmED use. Participants: Undergraduate college students N = 422 (Study 1), N = 37 (Study 2). Methods: Using a mixed-methods approach, we first surveyed undergraduate students about their AmED and alcohol consumption and a series of risk behaviors, self-efficacy, and beliefs (Study 1). We then conducted focus groups within the same population to better understand attitudes, knowledge, and motivations for using AmED (Study 2). Results: Recent AmED use was significantly associated with an increased number of reported binge drinking occasions and self-reported driving while intoxicated events. Our qualitative data analyses revealed two major themes associated with AmED consumption: factors encouraging AmED use and decisions about driving while under the influence of alcohol. Conclusions: These findings add to the literature of beliefs and motivations for AmED use among college students.

The relationship between anxious-depressive symptoms and harmful cannabis use: Multiple mediation models via rumination, negative urgency, protective behavioral strategies and refusal self-efficacy

BACKGROUND

Distressful and negative affective states can be associated with limited self-regulation capacities, while emotion regulation processes (e.g., rumination, negative urgency) might contribute to further depletion of self-control capacities which in turn can lead to diminished control over cannabis use.

AIMS

The mediating functions of rumination (i.e., brooding and reflection), negative urgency (NU) and constructs of cannabis use regulation (i.e., cannabis protective behavioral strategies [CPBS] and cannabis refusal self-efficacy [CRSE]) were examined on the associations between anxious-depressive symptoms and cannabis use outcomes (i.e., frequency, harmful use).

METHODS

The cross-sectional study used a sample of cannabis users showing signs of harmful consumption (N = 750; Males: 70.13% [N = 526]; Age: M = 29.11 [SD = 7.45]). Standardized questionnaires measured anxious-depressive symptoms, rumination, NU, CRSE, CPBS, frequency of cannabis use and harmful cannabis use. A linear regression-based, double-mediation model was performed.

RESULTS

Five significant indirect effects were demonstrated in the mediation model. Single-mediation effects were shown between anxious-depressive symptoms and harmful cannabis use via CRSE and via CPBS. Double-mediation effects were presented between anxious-depressive symptoms and harmful cannabis use via reflection and CPBS, via reflection and CRSE, and via NU and CRSE.

CONCLUSIONS

Emotion and cannabis use regulation pathways explained the associations between anxious-depressive symptoms and harmful cannabis use. The mediation model provided new details on how anxious-depressive symptoms, rumination and NU might lead to harmful cannabis use via regulation of cannabis use. Limited self-regulation capacities and similarities between emotion and cannabis use regulation processes might explain the identified indirect effects.

Positive and negative urgency as a single coherent construct: Evidence from a large-scale network analysis in clinical and non-clinical samples

Aims

Negative and positive urgency are emotion‐related impulsivity traits that are thought to be transdiagnostic factors in psychopathology. However, it has recently been claimed that these two traits are closely related to each other and that considering them separately might have limited conceptual and methodological value. The present study aimed to examine whether positive and negative urgency constructs constitute separate impulsivity traits.

Methods

In contrast to previous studies that have used latent variable approaches, this study employed an item‐based network analysis conducted in two different samples: a large sample of non‐clinical participants (N = 18,568) and a sample of clinical participants with psychiatric disorders (N = 385).

Results

The network analysis demonstrated that items denoting both positive and negative urgency cohere as a single cluster of items termed “general urgency” in both clinical and non‐clinical samples, thereby suggesting that differentiating positive and negative urgency as separate constructs is not necessary.

Conclusion

These findings have important implications for the conceptualization and assessment of urgency and, more broadly, for future research on impulsivity, personality, and psychopathology.

Learning from drinking experiences in college: A test of reciprocal determinism with drinking refusal self-efficacy

Problematic drinking is common in college, with many students experiencing a range of detrimental alcohol-related consequences. An understanding of the etiological factors involved in the development and maintenance of this behavior is important, as it would inform intervention efforts. Drinking refusal self-efficacy (DRSE) plays a central role in drinking behavior. Social learning theory's principle of reciprocal determinism suggests that cognitions such as DRSE are not only learned over time from drinking experiences but also impact an individual's subsequent drinking behavior. To date, no study has tested reciprocal determinism in relation to DRSE. Accordingly, in the current study, we examined within-person reciprocal associations between DRSE and drinking experiences (alcohol use and related consequences) in college drinkers during the first year of college (n = 728). Data were drawn from a larger study of trauma, posttraumatic stress, and substance use in young adulthood. Data were analyzed using a random intercept cross-lagged panel model to disaggregate between-person and within-person effects. At the between-person level, DRSE was negatively associated with both alcohol use and alcohol-related consequences. Furthermore, DRSE exhibited significant negative prospective within-person associations with alcohol-related consequences but not with alcohol consumption. Both alcohol consumption and alcohol-related consequences exhibited significant negative prospective within-person associations with DRSE. As such, findings support reciprocal determinism between alcohol-related consequences and DRSE. These findings have several clinical implications, as they point to a risky learning process that could be targeted in treatment or in prevention programs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Negative affect-associated drug refusal self-efficacy, illicit opioid use, and medication use following short-term inpatient opioid withdrawal management

INTRODUCTION

Persons with opioid use disorder (OUD) are prone to frequent relapse following brief inpatient medically managed withdrawal. This longitudinal, naturalistic study examines associations among illicit opioid use, use of medication for opioid use disorder (MOUD), and one's confidence in the ability to resist drug use in the face of negative emotions (i.e., negative affect-associated drug refusal self-efficacy).

METHOD

Participants were 220 adults with OUD who recently completed a short-term inpatient program and the study followed for 6 months. At baseline, participants reported demographics, illicit opioid use, recent engagement with MOUD, and negative affect-associated drug refusal self-efficacy. At follow-up (1 week and 1-, 3-, and 6-months following discharge), participants reported illicit opioid use and MOUD.

RESULTS

Participants averaged 30.7 years of age, 63.2% were male, and 84.1% were white. Both illicit opioid use and rates of MOUD increased during the 6-month follow-up period, although only 34.1% received MOUD. At baseline, participants reported less than 50% self-confidence to resist using opioids during negative emotional states. Baseline negative affect-associated drug refusal self-efficacy inversely predicted illicit opioid use (p = .01) at follow-up but was not associated with follow-up MOUD.

CONCLUSION

Among persons with OUD, lower confidence to resist using opioids in negative emotional states predicts greater use of illicit opioids in the months following medically managed withdrawal, even with receipt of MOUD.

Protective behavioral strategies and alcohol-related outcomes: The moderating effects of drinking refusal self-efficacy and sex

The investigation of drinking refusal self-efficacy and alcohol protective behavioral strategies (PBSA) has revealed inconsistent results. Sex may be one factor that plays a role in these results given the demonstrable differences between the alcohol use behaviors of men and women. The current study examined the moderating effects of drinking refusal self-efficacy and sex on the relationships that PBSA subtypes have with alcohol outcomes for traditional age undergraduate students (18-25 years of age; 81% women; 60% White). Results showed negative associations between manner of drinking PBSA and alcohol consumption for individuals with high levels of drinking refusal self-efficacy but not low levels of drinking refusal self-efficacy. However, manner of drinking PBSA was positively associated with alcohol-related negative consequences for men but not for women. Results also showed negative associations between stopping and limiting drinking PBSA and alcohol related negative consequences for individuals with high levels of drinking refusal self-efficacy but not low levels of drinking refusal self-efficacy. It appears that addressing drinking refusal self-efficacy within the context of PBSA is valuable for traditional college students.

The Mediating Role of Impulsivity Between Psychological Distress and Alcohol Misuse Among College Students at a Historically Black University

Objective: Alcohol misuse is prevalent and clinically significant among college students. Psychological distress is one factor that has been found to predict alcohol misuse in this population. However, relatively few investigations examined the association of psychological distress to alcohol misuse or its underlying mechanisms among students attending historically Black colleges and universities (HBCUs). The present study examined whether impulsivity explains the relation between psychological distress and alcohol misuse in this population using structural equation modeling. Methods: Participants were 287 undergraduate students attending an HBCU in the southern United States (M_age = 22.5, 66.3% female, 93.7% Black). Results: Impulsivity was found to significantly mediate the association of psychological distress to alcohol misuse, such that higher levels of psychological distress were associated with greater impulsivity which, in turn, was related to more alcohol misuse. Further analyses indicated that attentional impulsivity significantly mediated the association of psychological distress to alcohol misuse. Conclusions: These findings suggest the utility of targeting impulsivity in interventions aimed at preventing and reducing alcohol misuse among college students attending HBCUs who experience psychological distress.

Impulsivity facets and substance use initiation: A comparison of two models of impulsivity

Several types of impulsivity have been linked to various substance use outcomes. The UPPS-P framework has received major focus within the field of substance use research. However, this framework is not without limitation. An alternative framework is the Two-Factor Model of impulsivity, which posits that rash impulsivity and reward drive are the central, if not sufficient, domains of impulsivity. Unfortunately, the extant literature is quite limited in terms of work that have directly compared the UPPS-P framework to the Two-Factor Model of impulsivity, particularly in prospective designs focused on the initiation of common, problematic forms of substance use among adolescents (i.e., alcohol and marijuana use). In the current study, the UPPS-P measures were compared to dedicated measures of the Two-Factor Model of impulsivity in a sample of Chilean adolescents who were lifetime abstainers of alcohol or marijuana use at baseline (N = 541) to predict the initiation of use for these substances at a one-year follow-up. Results showed that the Two-Factor Model had superior predictive utility compared to the UPPS-P measures, and only rash impulsivity and reward drive were significant predictors in a multivariate model that simultaneously considered UPPS-P and Two-Factor Model assessments. Overall, the current findings indicate that the Two-Factor Model should be considered to index risk of substance use initiation to guide prevention efforts and highlight the importance of direct comparisons of alternative measurement and theoretical frameworks of impulsivity within the field of substance use research.

Psychometric evaluation of the drinking refusal self-efficacy scale - revised with college students in the United States

Drinking refusal self-efficacy has recently emerged as a potential factor related to reduced alcohol consumption and alcohol-related negative consequences in college students. The Drinking Refusal Self-Efficacy Questionnaire-Revised (DRSEQ-R) has been commonly used to assess for drinking refusal self-efficacy. However, psychometric evaluation of the measure with college students from the United States is needed to enhance its research and clinical utility. The goal of the present study was to confirm the factor structure of the DRSEQ-R with a sample of traditional aged college students from the United States as well as assess the measurement invariance of the factor structure across sex and race and the measure's convergent validity with other common alcohol use measures. Traditional age college students (n = 1683, 73% women; 63% White, non-Hispanic) completed measures of drink refusal self-efficacy, protective behavioral strategies, weekly alcohol use, hazardous drinking, and alcohol-related negative consequences. Using exploratory factor analysis and multi-group confirmatory factor analyses, a three-factor structure was identified, but, unlike the DRSEQ-R, one item loaded onto the opportunistic relief factor instead of the social pressure factor. The proposed model registered more reliable internal consistencies across the subscales, was invariant across sex and race, and demonstrated acceptable convergent validity with other commonly used alcohol measures. The proposed model for the DRSE-R may be a more psychometrically sound way to assess for drinking refusal self-efficacy among college students in the United States. Implications, limitations, and future research directions are discussed.

Assessment tools for the measurement of the self-efficacy of drug users: protocol for a systematic review

INTRODUCTION

The abuse of alcohol and other drugs is a worldwide problem, the treatment of which poses a challenge to healthcare workers.

OBJECTIVE

This study presents a proposal for a systematic review to analyse the psychometric properties of assessment tools developed to measure the self-efficacy of drug users with regard to resisting the urge to take drugs in high-risk situations.

METHODS AND ANALYSIS

The guiding question was based on PICOS (Population Intervention Comparator Outcome Setting), and the report of the methods of review protocol was written in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Searches will be performed in the PsycINFO, Cochrane, Pubmed, Web of Science, SCOPUS and CINAHL databases, followed by the use of the 'snowball' strategy. The inclusion criteria for the articles will be (1) assessment tool validation studies; (2) assessment tools developed to measure self-efficacy; (3) quantitative measures; (4) measures designed for use on adults; (5) data from self-reports of the participants; (6) studies involving a description of psychometric properties of the measures; and (7) studies that explain how the level of self-efficacy is scored. The search, selection and analysis will be performed by two independent reviewers. In cases of a divergence of opinion, a third reviewer will be consulted. The COSMIN checklist will be used for the appraisal of the methodological quality of the assessment tools and the certainty of the evidence in the articles (risk of bias) will be analysed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach.

ETHICS AND DISSEMINATION

This protocol does not require ethical approval. However, this protocol is part of the thesis entitled Drug-Taking Confidence Questionnaire for use in Brazil, presented for obtaining a doctorate in neuropsychiatry and behavioural sciences from the Federal University of Pernambuco, and has received approval from the human research ethics committee of the Federal University of Pernambuco (reference number: 1.179.162).The results will be disseminated to clinicians and researchers through peer-reviewed publications and conferences.

PROSPERO REGISTRATION NUMBER

CRD42017068555.

Standard measures for sickle cell disease research: the PhenX Toolkit sickle cell disease collections

Standard measures and common data elements for sickle cell disease (SCD) will improve the data quality and comparability necessary for cross-study analyses and the development of guidelines that support effective treatments and interventions. In 2014, the National Institutes of Health, National Heart, Lung, and Blood Institute (NHLBI) funded an Administrative Supplement to the PhenX Toolkit (consensus measures for Phenotypes and eXposures; https://www.phenxtoolkit.org/) to identify common measures to promote data comparability across SCD research. An 11-member Sickle Cell Disease Research and Scientific Panel provided guidance to the project, establishing a core collection of SCD-related measures and defining the scope of 2 specialty collections: (1) cardiovascular, pulmonary, and renal complications, and (2) neurology, quality-of-life, and health services. For each specialty collection, a working group of SCD experts selected high-priority measures using a consensus process that included scientific community input. The SCD measures were released into the Toolkit in August 2015. The 25 measures included in the core collection are recommended for use by all NHLBI-funded investigators performing human-subject SCD research. The 10 neurology, quality-of-life, and health services measures and 14 cardiovascular, pulmonary, and renal measures are recommended for use within these specialized research areas. For SCD and other researchers, PhenX measures will promote collaborations with clinicians and patients, facilitate cross-study analysis, accelerate translational research, and lead to greater understanding of SCD phenotypes and epigenetics. For clinicians, using PhenX measures will help elucidate the etiology, progression, and treatment of SCD, leading to improved patient care and quality of life.

The development and initial evaluation of the Pornography-Use Avoidance Self-Efficacy Scale

Background and aims This study employed a newly developed questionnaire to evaluate whether men's self-efficacy to avoid using pornography in each of 18 emotional, social, or sexually arousing situations was associated with either their typical frequency of pornography use or their hypersexuality. Methods Using an Internet-based data collection procedure, 229 male pornography users (M_age = 33.3 years, SD = 12.2) who had sought or considered seeking professional help for their use of pornography completed questionnaires assessing their situationally specific self-efficacy, history of pornography use, self-efficacy to employ specific pornography-reduction strategies, hypersexuality, and demographic characteristics. Results Frequency of pornography use was significantly negatively associated with level of confidence in 12 of the 18 situations. In addition, lower hypersexuality and higher confidence to employ pornography-use-reduction strategies were associated with higher confidence to avoid using pornography in each of the 18 situations. A principal axis factor analysis yielded three clusters of situations: (a) sexual arousal/boredom/opportunity, (b) intoxication/locations/easy access, and (c) negative emotions. Discussion and conclusions This questionnaire could be employed to identify specific high-risk situations for lapse or relapse and as a measure of treatment outcome among therapy clients, but we recommend further examination of the psychometric properties and clinical utility of the questionnaire in treatment samples. Because only one of the three clusters reflected a consistent theme, we do not recommend averaging self-efficacy within factors to create subscales.

The relationship between the UPPS-P impulsive personality traits and substance use psychotherapy outcomes: A meta-analysis

BACKGROUND

Although impulsive personality traits have been well implicated in substance use disorder (SUD) risk, little work has established how specific impulsive personality traits influence and are influenced by SUD psychotherapy outcomes. The purpose of this meta-analysis was to quantitatively review existing work to examine 1) how impulsive personality traits affect SUD psychotherapy outcomes and 2) reductions in impulsive personality traits during SUD psychotherapy.

METHODS

Studies were identified by conducting a comprehensive review of the literature.

RESULTS

For aim one (k=6), significant effects were found for lack of premeditation (g=0.60, SE=0.30, 95% CI 0.01-1.20; z=1.99, p=0.05) and negative urgency (g=0.55, SE=0.17, 95% CI 0.22-0.88, z=3.30, p=0.001), with trait scores related to poorer SUD psychotherapy outcomes. For aim two (k=10), decreases in sensation seeking (g=-0.10, SE=0.05, 95% CI -0.20 to 0.004; z=-1.88, p=0.02) and negative urgency (g=-0.25, SE=0.14, 95% CI -0.53 to 0.03; z=-1.75, p=0.03) during SUD psychotherapy were significant.

CONCLUSIONS

Overall, our quantitative synthesis suggests that lack of premeditation and negative urgency are related to poorer SUD psychotherapy outcomes. Although negative urgency and sensation seeking are decreasing during SUD psychotherapy, the magnitude of the change is quite small. Overall, we suggest that the measurement and targeting of impulsive personality traits in psychotherapy has strong potential to improve clinical outcomes across SUDs and a wide range of clinical problems and disorders.