Positive expectancies and perceived impaired control mediate the influence of reward drive and rash impulsiveness on alcohol use

Health-Related Cognitions and Metacognitions Indirectly Contribute to the Relationships Between Impulsivity, Fear of COVID-19, and Cyberchondria

The aim of the study was to converge a structural equation model to unfold the compositive relationships between trait impulsivity, health cognitions, metacognitions about health, fear of COVID-19 and cyberchondria, after controlling for gender, age, marital status, having a chronic illness and chronic illness among first-degree relatives. Six hundred fifty-one participants (423 females, 65%; 228 males, 35%) participated in the study. The Short UPPS-P Impulsive Behavior Scale (S-UPPS-P), Health Cognitions Questionnaire (HCQ), The Meta-Cognitions about Health Questionnaire (MCQ-HA), Cyberchondria Severity Scale -Short Form (CSS-12), and Fear of COVID-19 Scale (FCV-19 S) were completed by volunteered participants. The structural model showed that the S-UPPS-P directly and indirectly contributed to the HCQ, MCQ-HA, CSS-12, and FCV-19 S. The multi-group structural analysis by gender showed that the structural model had a partial measurement and factorial invariance. We concluded that the significant associations between impulsivity, fear of COVID-19 and cyberchondria were indirectly contributed by health-related cognitions and metacognitions.

Reduction of symptom after a combined behavioral intervention for reward sensitivity and rash impulsiveness in internet gaming disorder: A comparative study

Impulsivity is both a core symptom and a key psychological mechanism in Internet Gaming Disorder (IGD), and therefore interventions for impulsivity in IGD have both theoretical and practical value. However, previous related interventions only tended to focus on a single factor of impulsivity and achieved inconsistent results. In this study, based on the theory of two-factor model of impulsivity (reward sensitivity and rash impulsiveness), four groups of IGD subjects were recruited to investigate whether there were different effects of single rash impulsiveness or reward sensitivity intervention versus a combined intervention. By comparing the different factors of impulsivity of the four groups before and after a 15-day intervention, the results showed that: (1) compared with the control group, subjects in the Go/No-go training group only had a significantly lower level of rash impulsiveness, subjects in the Stimulus-Response Compatibility (SRC) training group only had a significantly lower level of reward sensitivity, and subjects in the combined training group had significantly lower levels of both impulsivity; (2) among the three intervention groups, only the subjects in the combined training group had significantly lower IGD scores in the follow-up measure. This study indicated that the behavioral training of Go/No-go and SRC were effective in improving rash impulsiveness and reward sensitivity in IGD, respectively, but the intervention effect of the combined training was better than that of the single training.

Pathways of personality and learning risk for addictive behaviors: A systematic review of mediational research on the Acquired Preparedness model

OBJECTIVE

The Acquired Preparedness (AP) model proposes that impulsive personality traits predispose some individuals to learn certain behavior-outcome associations (expectancies), and that these expectancies in turn influence the escalation of risky behaviors. This theory has been applied to the development of behaviors such as drinking, drug use, gambling, and disordered eating. In the current study, we aimed to summarize empirical tests of this model over the 20 years since it was proposed.

METHOD

We used a descriptive approach to summarize tests of mediation across 50 studies involving n=21,715 total participants.

RESULTS

We observed a consistent effect of personality on expectancies (median effect size = .22), of expectancies on behavior (.24), and a small mediated effect (.05) of personality on behavior via expectancies. Impulsive traits that involve positive or negative affect showed the most consistent support for AP, as did positive expectancies. Most studies testing AP focused on alcohol, but research on other behaviors also showed support for AP.

CONCLUSIONS

The literature appears to support a small mediated effect consistent with the AP model. Future research should continue to clarify which AP pathways are most influential in explaining risky behaviors, and supplement correlational research with experimental and quasi-experimental designs.

Precision Mental Health Care for Cannabis Use Disorder: Utility of a bioSocial Cognitive Theory to Inform Treatment

Globally, cannabis is the most frequently used controlled substance after alcohol and tobacco. Rates of cannabis use are steadily increasing in many countries and there is emerging evidence that there is likely to be greater risk due to increased concentrations of delta-9-tetrahydrocannabinol (THC). Cannabis use and Cannabis Use Disorder (CUD) has been linked to a wide range of adverse health outcomes. Several biological, psychological, and social risk factors are potential targets for effective evidence-based treatments for CUD. There are no effective medications for CUD and psychological interventions are the main form of treatment. Psychological treatments based on Social Cognitive Theory (SCT) emphasize the importance of targeting 2 keys psychological mechanisms: drug outcome expectancies and low drug refusal self-efficacy. This mini-review summarizes the evidence on the role of these mechanisms in the initiation, maintenance, and cessation of cannabis use. It also reviews recent evidence showing how these psychological mechanisms are affected by social and biologically-based risk factors. A new bioSocial Cognitive Theory (bSCT) is outlined that integrates these findings and implications for psychological cannabis interventions are discussed. Preliminary evidence supports the application of bSCT to improve intervention outcomes through better targeted treatment.

Testing the biosocial cognitive model of substance use in cannabis users referred to treatment

BACKGROUND

The bioSocial Cognitive Theory (bSCT) hypothesizes two pathways linking dimensions of impulsivity to substance use. The first predicts that the association between reward sensitivity and substance use is mediated by positive outcome expectancies. The second predicts that the relationship between rash impulsiveness and substance use is mediated by refusal self-efficacy. This model has received empirical support in studies of alcohol use. The present research provides the first application of bSCT to a cannabis treatment population and aims to extend its utility to understanding cannabis use and severity of dependence.

DESIGN

273 patients referred for cannabis treatment completed a clinical assessment that contained measures of interest.

SETTING

A public hospital alcohol and drug clinic.

MEASUREMENTS

The Sensitivity to Reward Scale, Dysfunctional Impulsivity Scale, Cannabis Expectancy Questionnaire, Cannabis Refusal Self-Efficacy Questionnaire and Severity of Dependence Scale-Cannabis were completed, along with measures of cannabis consumption.

FINDINGS

The bSCT model provided a good fit to the data for cannabis use and severity of dependence outcomes. The association between reward sensitivity and each cannabis outcome was fully mediated by positive cannabis expectancies and cannabis refusal self-efficacy. The relationship between rash impulsiveness and each cannabis outcome was fully mediated by cannabis refusal self-efficacy.

CONCLUSIONS

Findings support the application of the bSCT model to cannabis use and dependence severity and highlight the important role of social cognitive mechanisms in understanding the association between impulsivity traits and these outcomes. The differential association of impulsivity traits to social cognition may assist targeted treatment efforts.

Relationships between eating disorder-specific and transdiagnostic risk factors for binge eating: An integrative moderated mediation model of emotion regulation, anticipatory reward, and expectancy

Although relationships between negative affect, emotion dysregulation, and binge eating have been well-established, the mechanisms and individual risk factors that account for this relationship have yet to be elucidated. In addition to emotion dysregulation, altered reward functioning and negative affect eating expectancies (i.e., the expectancy that eating will relieve negative affect) are factors that have been previously linked to binge eating, though theoretical frameworks have not provided an integrated conceptualization of relationships between these domains. Therefore, the present study examined an integrative moderated mediation model among a sample of 101 adults with self-reported eating disorder (ED) symptoms who completed a battery of online questionnaires. Results supported the hypothesized model, which demonstrated that eating expectancies mediated the relationship between emotion dysregulation and binge eating frequency, and there was a positive association between emotion dysregulation and eating expectancies among individuals high in anticipatory reward. These findings provide preliminary support for an integrated approach to understanding transdiagnostic and ED-specific risk factors that potentiate binge eating.

A biosocial cognitive model of cannabis use in emerging adulthood

OBJECTIVES

The aim of this study was to test a new theoretical model of cannabis use incorporating biologically-based personality traits and social cognition. This biosocial cognitive theory (bSCT) has robust support in alcohol studies, but has not been applied to cannabis. The model proposes two pathways linking dimensions of impulsivity to cannabis use. The first predicts that the association between Reward Sensitivity (SR) and cannabis use is mediated by positive outcome expectancies. The second predicts that the relationship between Rash Impulsiveness (RI) and cannabis use is mediated by cannabis refusal self-efficacy. An extended version of this model was also tested and included a third pathway linking Punishment Sensitivity (SP) to cannabis use via higher negative outcome expectancies.

METHOD

Participants were 252 18-to-21-year-olds who completed questionnaires assessing cannabis use, personality and social cognition. Theoretical models were tested using structural equation modeling.

RESULTS

The bSCT model provided a good fit to the data (CFI=0.95; RMSEA=0.07; SRMR=0.06). Positive cannabis expectancies and refusal self-efficacy partially mediated the association between SR and cannabis use (p<0.05). Cannabis refusal self-efficacy fully mediated the relationship between RI and cannabis use (p<0.05). The addition of a third SP pathway did not improve model fit.

CONCLUSIONS

Consistent with alcohol studies, the association between impulsivity and cannabis use is largely mediated by social cognition. The bSCT may provide novel insights to inform prevention and treatment of problematic cannabis use.

Alcohol misuse in emerging adulthood: Association of dopamine and serotonin receptor genes with impulsivity-related cognition

Impulsivity predicts alcohol misuse and risk for alcohol use disorder. Cognition mediates much of this association. Genes also account for a large amount of variance in alcohol misuse, with dopamine and serotonin receptor genes of particular interest, because of their role in motivated behavior. The precise psychological mechanisms through which such genes confer risk is unclear. Trait impulsivity conveys risk for alcohol misuse by influencing two distinct domains of cognition: beliefs about the reinforcing effects of alcohol consumption (positive alcohol expectancy) and the perceived ability to resist it (drinking refusal self-efficacy). This study investigated the effect of the dopamine-related polymorphism in the DRD2/ANKK1 gene (rs1800497) and a serotonin-related polymorphism in the HTR2A gene (rs6313) on associations between impulsivity, cognition, and alcohol misuse in 120 emerging adults (18-21years). HTR2A predicted lower positive alcohol expectancy, higher refusal self-efficacy, and lower alcohol misuse. However, neither polymorphism moderated the linkages between impulsivity, cognition, and alcohol misuse. This is the first report of an association between HTR2A and alcohol-related cognition. Theoretically-driven biopsychosocial models have potential to elucidate the specific cognitive mechanisms through which distal risk factors like genes and temperament affect alcohol misuse in emerging adulthood.

Testing the Acquired Preparedness Model: Predicting College Student Gambling Frequency and Symptomatology

The acquired preparedness model posits that impulsivity influences the development of outcome expectancies that then influence the engagement in a specific risk taking behavior. The purpose of this study was to test the acquired preparedness model for gambling behavior of college students using a multidimensional approach to impulsivity. Employing a structural equation approach, it was predicted that a full mediational model that includes multiple dimensions of impulsivity and multiple outcome expectancies would predict gambling frequency and gambling symptomatology. Support was found for the acquired preparedness model in understanding why some college students gamble more frequently or problematically. Specifically, better model fit was found for the full mediational model that included outcome expectancies to predict both frequency and gambling symptomatology than the model that included the direct relation between impulsivity and gambling.

Impulsivity: four ways five factors are not basic to addiction

Several impulsivity-related models have been applied to understanding the vulnerability to addiction. While there is a growing consensus that impulsivity is multifaceted, debate continues as to the precise number of facets and, more critically, which are most relevant to explaining the addiction-risk profile. In many ways, the current debate mirrors that which took place in the personality literature in the early 1990s (e.g., Eysenck's 'Big Three' versus Costa and McCrae's 'Big Five'). Indeed, many elements of this debate are relevant to the current discussion of the role of impulsivity in addictive behavior. Specifically, 1) the use of factor analysis as an atheoretical 'truth-grinding machine'; 2) whether additional facets add explanatory power over fewer; 3) the delineation of specific neurocognitive pathways from each facet to addictive behaviors, and; 4) the relative merit of 'top-down' versus 'bottom-up' approaches to the understanding of impulsivity. Ultimately, the utility of any model of impulsivity and addiction lies in its heuristic value and ability to integrate evidence from different levels of analysis. Here, we make the case that theoretically-driven, bottom-up models proposing two factors deliver the optimal balance of explanatory power, parsimony, and integration of evidence.

Impulsivity-related cognition in alcohol dependence: Is it moderated by DRD2/ANKK1 gene status and executive dysfunction?

Perceived impaired control over alcohol use is a key cognitive construct in alcohol dependence that has been related prospectively to treatment outcome and may mediate the risk for problem drinking conveyed by impulsivity in non-dependent drinkers. The aim of the current study was to investigate whether perceived impaired control may mediate the association between impulsivity-related measures (derived from the Short-form Eysenck Personality Questionnaire-Revised) and alcohol-dependence severity in alcohol-dependent drinkers. Furthermore, the extent to which this hypothesized relationship was moderated by genetic risk (Taq1A polymorphism in the DRD2/ANKK1 gene cluster) and verbal fluency as an indicator of executive cognitive ability (Controlled Oral Word Association Test) was also examined. A sample of 143 alcohol-dependent inpatients provided an extensive clinical history of their alcohol use, gave 10ml of blood for DNA analysis, and completed self-report measures relating to impulsivity, impaired control and severity of dependence. As hypothesized, perceived impaired control (partially) mediated the association between impulsivity-related measures and alcohol-dependence severity. This relationship was not moderated by the DRD2/ANKK1 polymorphism or verbal fluency. These results suggest that, in alcohol dependence, perceived impaired control is a cognitive mediator of impulsivity-related constructs that may be unaffected by DRD2/ANKK1 and neurocognitive processes underlying the retrieval of verbal information.

Reward and punishment sensitivity and alcohol use: the moderating role of executive control

Reward sensitivity and to a lesser extent punishment sensitivity have been found to explain individual differences in alcohol use. Furthermore, many studies showed that addictive behaviors are characterized by impaired self-regulatory processes, and that individual differences related to alcohol use are moderated by executive control. This is the first study that explores the potential moderating role of executive control in the relation between reward and punishment sensitivity and alcohol use. Participants were 76 university students, selected on earlier given information about their alcohol use. Half of the participants indicated to drink little alcohol and half indicated to drink substantial amounts of alcohol. As expected, correlational analyses showed a positive relationship between reward sensitivity and alcohol use and a negative relation between punishment sensitivity and alcohol use. Regression analysis confirmed that reward sensitivity was a significant independent predictor of alcohol use. Executive control moderated the relation between punishment sensitivity and alcohol use, but not the relation between reward sensitivity and alcohol use. Only in individuals with weak executive control punishment sensitivity and alcohol use were negatively related. The results suggest that for individuals with weak executive control, punishment sensitivity might be a protective factor working against substantial alcohol use.

Risky cognitions associated with adolescent alcohol misuse: moral disengagement, alcohol expectancies and perceived self-regulatory efficacy

AIM

To examine the longitudinal associations between moral disengagement, alcohol related expectancies, perceived self-regulatory efficacy and alcohol use amongst adolescents.

DESIGN AND PARTICIPANTS

A total of 367 students (mean age=13.1, SD=0.51; 65% male) from five schools across Sydney, Australia took part in this longitudinal study. Participants completed a self-report questionnaire at four time points across an 18 month period which assessed their alcohol use, levels of moral disengagement, alcohol related expectancies and perceived self-regulatory efficacy to resist peer pressure to engage in transgressive behaviours.

RESULTS

Over time, rates of binge drinking in the past three months significantly increased, but rates of drinking any alcohol in the past three months remained stable. As hypothesised, all three cognitions were independently and consistently associated with adolescent alcohol use and binge drinking over time, with the exception of perceived self-regulatory efficacy which was not associated with an increased risk of drinking any alcohol in the past three months when controlling for moral disengagement, alcohol expectancies, gender and age.

CONCLUSIONS

The current study is the first study to longitudinally map three distinct cognitive factors associated with adolescent alcohol use. Considering the alarming number of adolescents drinking at levels that place them at risk of significant harm, this study has provided important implications about cognitive factors that can be targeted to increase the accuracy of assessment and efficacy of prevention for alcohol misuse amongst adolescents.

Personality, cognition and hazardous drinking: Support for the 2-Component Approach to Reinforcing Substances Model

Personality and cognitive processes are both related to alcohol use and misuse. A recent model of hazardous drinking referred, the 2-CARS model, postulates two major pathways to hazardous drinking. One pathway primarily involves the association between Reward Drive and Positive Outcome Expectancies, the second involves the association between Rash Impulsiveness and Drinking Refusal Self-Efficacy. In previous tests of the model, Drinking Refusal Self-Efficacy was found to have the most proximal impact on drinking, being directly influenced by Rash Impulsiveness, and indirectly influenced by Reward Drive through Positive Outcome Expectancies. The aim of the current study was to test the 2-CARS model in a larger independent sample. Results found that individuals with a strong Reward Drive showed higher Positive Outcome Expectancies, while individuals high in Rash Impulsiveness were more likely to report reduced Drinking Refusal Self-Efficacy. The present results also showed a theoretically unexpected pathway with a direct association between Rash Impulsiveness and Positive Outcome Expectancies. However, overall the results support the view that a greater understanding of hazardous drinking can be achieved by investigating the relationship between these personality and cognitive variables.

Great expectations. Eating expectancies as mediators of reinforcement sensitivity and eating

Eating expectancies are proposed as cognitive pathways linking reinforcement (reward and punishment) sensitivities and the tendency to over-eat in response to appetitive and emotional cues. In Study One (N=243 university women) explicit eating expectancies were tested as potential mediators of reinforcement sensitivities and eating styles. Broadly, expectancies that eating alleviates negative affect/boredom mediated both reward and punishment sensitivity and emotional eating. The expectancy that eating is pleasurable and rewarding mediated reward sensitivity and external eating. In Study Two (N=109), using an implicit eating expectancy task, reward sensitivity and external eating was mediated via positive expectancy statements, notably, that eating is pleasurable and rewarding. Reward sensitivity and emotional eating was mediated specifically by expectancies that eating manages boredom. Punishment sensitivity was not associated with any implicit expectancies. Findings support the role of expectancies as cognitive mediators in the relationship between reinforcement sensitivities and emotionally-driven versus externally-driven eating styles. However, the largely appetitive implicit expectancies task only supported an association with reward sensitivity.