The effects of alcohol and alcohol expectancies on subjective reports and physiological reactivity: a meta-analysis

Placebo and nocebo effects and mechanisms associated with pharmacological interventions: an umbrella review

OBJECTIVES

This review aimed to summarise the existing knowledge about placebo and nocebo effects associated with pharmacological interventions and their mechanisms.

DESIGN

Umbrella review, adopting the Assessment of Multiple Systematic Reviews 2 tool for critical appraisal.

DATA SOURCES

MEDLINE/PubMed, Scopus, Web of Science, PsycINFO, Cochrane Central Register of Controlled Trial were searched in September 2022, without any time restriction, for systematic reviews, narrative reviews, original articles. Results were summarised through narrative synthesis, tables, 95% CI.

OUTCOME MEASURES

Mechanisms underlying placebo/nocebo effects and/or their effect sizes.

RESULTS

The databases search identified 372 studies, for a total of 158 312 participants, comprising 41 systematic reviews, 312 narrative reviews and 19 original articles. Seventy-three per cent of the examined systematic reviews were of high quality.Our findings revealed that mechanisms underlying placebo and/or nocebo effects have been characterised, at least in part, for: pain, non-noxious somatic sensation, Parkinson's disease, migraine, sleep disorders, intellectual disability, depression, anxiety, dementia, addiction, gynaecological disorders, attention-deficit hyperactivity disorder, immune and endocrine systems, cardiovascular and respiratory systems, gastrointestinal disorders, skin diseases, influenza and related vaccines, oncology, obesity, physical and cognitive performance. Their magnitude ranged from 0.08 to 2.01 (95% CI 0.37 to 0.89) for placebo effects and from 0.32 to 0.90 (95% CI 0.24 to 1.00) for nocebo effects.

CONCLUSIONS

This study provides a valuable tool for clinicians and researchers, identifying both results ready for clinical practice and gaps to address in the near future.

FUNDING

Università Cattolica del Sacro Cuore, Milan, Italy with the 'Finanziamento Ponte 2022' grant.

PROSPERO REGISTRATION NUMBER

CRD42023392281.

Late positive potential as a candidate biomarker of motivational relevance in substance use: Evidence from a meta-analysis

The objective of the current meta-analysis was to assess the effect size of the Late Positive Potential (LPP) to drug and emotional cues in substance users compared to controls. The secondary objective was to test for moderation by: age, gender, years of use, use status, and substance type. Search was performed in August 2021 using PubMed. Inclusion criteria were: substance use disorder/dependence or validated self-report, LPP means, healthy control comparison, non-acute drug study, data available, peer-reviewed journal, English, and human participants. Selection bias was tested through modified Egger's regression and exploratory 3-parameter selection model tests. Results (k = 11) indicated LPP to drug cues was larger in substance use compared to control group, with a large effect size (Hedges' g=1.66, 95%CI [0.64,2.67], p = 0.005). There were no overall differences for emotional cues. Though threats of selection bias were not severe, inclusion of more studies with larger sample sizes in future meta-analyses will allow more robust tests of publication bias and more accurate measures of effect size.

Effects of alcohol and task difficulty on visual tracking and inattentional blindness

RATIONALE

Inattentional blindness (IB) describes the failure to notice salient but unexpected stimuli in one's focal visual field. It typically occurs while performing a demanding task (e.g. tracking and counting basketball passes), which consumes attentional resources. Alcohol intoxication is also known to reduce attentional resources, thereby potentially increasing IB and disrupting task performance.

OBJECTIVES

To test the extent to which acute alcohol and task difficulty disrupt counting performance and increase the rate of IB across two experimental tasks.

METHODS

To test the effects of alcohol consumption and task difficulty on IB, we used the Simons and Chabris (Percept 28:1059-1074, 1999) and Simons (2010) "gorilla in our midst" basketball clip in experiment 1 and abstract but analogous stimuli presented in a computerised alternative to that task in experiment 2.

RESULTS

IB was associated with increased (counting) task difficulty but not alcohol consumption. However, counting accuracy was impaired by both alcohol and increased task difficulty, with the largest detriment being for alcohol participants who noticed the salient but unexpected stimulus.

CONCLUSION

The absence of alcohol effects on IB in both experiments was unexpected and warrants further investigation in a field vs lab study comparison and in combination with baseline cognitive measures to test for alcohol expectancy and task compensation effects.

The effects of menstrual cycle stage and hormonal contraception on alcohol consumption and craving: A pilot investigation

Background and aims

Although alcohol research often comments on observed sex differences (i.e. patterns of consumption), there is a lack of investigation into the reasons for these differences. For females, the regular hormonal fluctuations across the menstrual cycle are a potential influencing factor for alcohol consumption. In this pilot we aimed to investigate the relationship between menstrual cycle phase (follicular-phase [FP] and luteal-phase [LP]) and status (naturally-cycling [NC] and hormonal-contraception [HC]) on alcohol consumption and craving of casual drinkers, and identify potential influencing factors in this relationship.

Methods

Study One: participants (n ​= ​28; 15 HC, 13 NC) were either NC or HC (between subject factor: hormonal status) and attended two lab-based sessions corresponding with their FP and LP (within factor: cycle phase [NC] or time [HC]). Participants completed a mock alcohol taste-test, in addition to pre- and post-consumption measures of craving, anxiety, stress, and mood. Study Two: participants (n ​= ​262; 144 HC, 118 NC) were either NC or HC (between subject factor) and completed an online study assessing menstrual cycle phase, alcohol use, craving, impulsivity, and stress.

Results

Study One: A significant effect of cycle phase was found on alcohol craving (p ​= ​.019): craving was higher during the FP compared to the LP for NC participants, with HC participants showing no difference across sessions. There was no effect of phase or status on alcohol consumption, stress, or mood (ps ​> ​.05). Study Two: Regression analyses showed that age, craving, impulsivity and stress were significantly associated with alcohol consumption for NC participants (ps ​< ​.05), however only age and craving were associated with consumption for the HC participants (ps ​< ​.001).

Conclusions

Alcohol craving was higher during the follicular, compared to the luteal, phase for the naturally cycling group, and different factors may be associated with drinking behaviour across women who are NC and those using HC. Future alcohol research should consider the menstrual cycle and contraceptive status for females.

No effect of moderate alcohol intake on the detection of concealed identity information in the laboratory

The Concealed Information Test (CIT) enables the detection of certain (e.g., crime-relevant or personal) information, even if participants aim to conceal their knowledge. The current preregistered study investigated whether previously observed impairing effects of alcohol intoxication on participants’ performance in a reaction time CIT (RT CIT) field study also translate to a laboratory environment. In contrast to the previous study of Suchotzki and Gamer (Sci Rep 8:7825, 2018) in which alcohol consumption was voluntary and self-administered, the current study used a randomized assignment of participants to either an alcohol group (n = 88; receiving a drink with 3 cl alcohol) or a sober control group (n = 89; receiving a drink with just some alcohol drops to hide group assignment). After drink administration, participants completed an RT CIT, in which they were instructed to hide knowledge of their own identity. Blood alcohol concentration (BAC) was estimated via breath alcohol ratio. In contrast to the previous field study, results revealed no differences in CIT-performance between intoxicated and sober participants. Aside from questioning the robustness of the result of the previous field study, our results also point to a number of interesting theoretical explanations for the discrepancy between both results, which are elaborated in the discussion.

Female drinkers are more sensitive than male drinkers to alcohol-induced heart rate increase

The present study examined the acute effect of alcohol and its cues on autonomic and cardiovascular physiology, as indexed by changes in heart rate (HR), in a relatively large sample of healthy young adult men and women. Participants (27-31 years old, final N = 145) were administered an alcoholic beverage (n = 88; 52 women) or a placebo beverage (n = 57; 35 women) in a simulated bar. Target breath alcohol concentration (BrAC) was .08 g%. HR was recorded while participants were seated alone during an initial baseline assessment in a lab room; seated with others during preparation and administration of 2 beverages in a simulated bar; and seated alone in the lab room at ascending, peak, and descending BrAC. HR increased over time for participants in both beverage groups during beverage preparation. During beverage consumption, HR decreased over time in those who drank placebo whereas HR increased over time in those who drank alcohol, increasing at a faster rate in women compared to men. HR remained elevated at the ascending, peak, and descending limb assessments only in participants who drank alcohol with HR increasing over time at ascending BrAC in the women but not men. Sex differences in HR under alcohol were not explained by sex differences in body mass index, BrAC, recent alcohol use, or subjective stimulation. Our findings suggest that women may be more sensitive to alcohol-induced increases in HR, especially in environments where alcohol cues are abundant. This may have implications for cardiovascular risks associated with alcohol. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Concurrent Alcohol Use and Waterpipe Tobacco Smoking: Smoking Topography, Toxicant Exposure, and Abuse Liability

INTRODUCTION

Relative to non-waterpipe (WP) smokers, WP smokers are more than twice as likely to use alcohol and frequently consume alcohol before or during smoking sessions. Co-use of alcohol and WP may result in greater toxicant exposure compared to WP smoking alone. To date, no study systematically has investigated the impact of acute alcohol intoxication on WP smoking topography, exposure to tobacco-related toxicants, or abuse liability.

METHODS

Dyads of current WP smokers and drinkers (N = 42; age = 21-32 years) completed two in-laboratory ad libitum smoking sessions (≤2 hours) following 12-hour nicotine abstinence in a double-blind, randomized crossover design in which they consumed a placebo versus active drink (sustained breath alcohol concentration = .08). Exhaled carbon monoxide (eCO) and plasma nicotine concentration were assessed. Questionnaires assessed smoking experience and smoking urge. Smoking topography was measured continuously throughout each smoking session.

RESULTS

The alcohol session was associated with increased inhaled volume, flow rate, and WP session duration compared to placebo. Compared to placebo, participants reported a more positive overall smoking experience following the alcohol session and greater smoking urges pre- and post-smoking session. Although both sessions resulted in significant increases in eCO and plasma nicotine, no significant differences emerged in eCO or nicotine exposure between the active and placebo sessions.

CONCLUSIONS

Co-use of alcohol and WP may contribute to the maintenance of WP smoking through enhanced smoking experiences, increased urge to smoke, and significant exposure to addictive nicotine. Regulations may be necessary to limit the sale of alcohol in WP smoking lounges and reduce exposure to secondhand smoke.

IMPLICATIONS

The findings suggest co-use of alcohol and WP tobacco likely maintain WP use and dependence by enhancing the smoking experience and increasing urges to smoke. These findings have implications for regulations aimed at limiting co-use of alcohol and WP tobacco in WP lounges and limiting exposure to secondhand smoke.

CLINICAL TRIALS REGISTRATION

NCT03096860.

Environmental Context Influences Visual Attention to Responsible Drinking Messages

Aims

Responsible drinking messages (RDMs) are used as a key tool to reduce alcohol-related harms. A common form of RDM is in a poster format displayed in places such as bars, bus stops and toilet cubicles. However, evidence for the effectiveness of RDMs remains limited. Moreover, it is not known how environmental contexts (e.g. the number of alcohol-related cues in the environment) impact how such RDMs are interacted with, nor how this in turn affects their efficacy.

Methods

One hundred participants completed a pseudo taste preference task in either in a bar laboratory (alcohol cue rich environmental context) or a traditional laboratory. The walls of the laboratory displayed either RDM or control posters during this task and eye tracking was used to assess participant attention to the posters.

Results

Participants looked at the RDM posters less in the bar laboratory where the environmental context is rich in alcohol cues compared to a traditional laboratory where alcohol cues are sparse. Neither poster type or environmental context affected the amount of 'alcohol' consumed and the amount of visual attention given to RDMs was unrelated to the amount of 'alcohol' consumed.

Conclusions

These findings provide experimental evidence that RDMs do not influence drinking behaviour in the direction intended (reduced consumption in situ). In addition, locating RDMs in alcohol-cue rich environments may result in sub-optimal behavioural responses to the RDM materials (e.g. visual attention to content). To maximize the potential impact of RDMs, the optimal location for RDMs is in environments where pre-existing alcohol cues are sparse to non-existent.

Short Summary

Responsible drinking messages (RDMs) aim to reduce alcohol consumption, however, the findings of this study show that they may not influence in situ consumption. These findings also suggest that the optimal location for RDMs is in environments with few or no other alcohol-related cues.

Social Anxiety and the Quality of Everyday Social Interactions: The Moderating Influence of Alcohol Consumption

Most research on the link between social anxiety and alcohol consumption has examined problematic outcomes without consideration of potential adaptive functions. Alcohol is an anxiolytic that has the short-term benefit of reducing anxiety; consumption may act as a social lubricant that facilitates higher quality social interactions. Using experience-sampling methodology, we examined how consuming alcohol attenuates the adverse effects of social anxiety in naturally occurring social interactions. Participants (N = 160) completed demographic and trait measures, then completed daily assessments for 14 consecutive days. Results from multilevel model analyses revealed that during face-to-face social interactions, state social anxiety was inversely related to 10 indicators of healthy social interactions (e.g., enjoyment, laughter, feelings of acceptance). Alcohol consumption moderated seven of these associations, such that when participants consumed alcohol in social situations, state social anxiety was no longer associated with social interaction quality. The quantity of alcoholic drinks consumed moderated two of these associations. Furthermore, we found evidence for directionality, such that social anxiety in a given social interaction predicted alcohol consumption in a subsequent social interaction, but not the reverse (i.e., alcohol consumption did not prospectively predict state social anxiety). In social situations that involved alcohol, experiences of social anxiety no longer thwarted one's ability to derive social benefits. These results should be interpreted in the context of a participant sample with relatively low levels of trait social anxiety and frequency of alcohol use. Nonetheless, obtaining social rewards may be a reinforcement mechanism that maintains the link between social anxiety and alcohol consumption.

Bibi ergo sum: the effects of a placebo and contextual alcohol cues on motivation to drink alcohol

RATIONALE

Acute 'priming' doses of alcohol reliably increase alcohol-seeking behaviour in social drinkers. However, the effects of the anticipated (rather than pharmacological) effects of alcohol, and their interaction with contextual alcohol cues, are not well understood.

OBJECTIVES

This study aims to determine the extent to which an alcohol-placebo drink increases craving, subjective intoxication and beer consumption, while conjointly investigating the impact of contextual alcohol cues.

METHODS

On a within-subject basis, 64 undergraduate social drinkers consumed both a placebo (which they believed to contain alcohol) and a control drink (which they knew did not contain alcohol) in different sessions. Participants completed the study procedures in a bar laboratory designed to look like a 'pub' or a standard psychology lab containing no alcohol-related cues. Craving (Desires for Alcohol Questionnaire) and subjective intoxication were measured pre- and post-drink, and a bogus taste test to measure ad-lib alcohol consumption was completed at the end of each session.

RESULTS

Compared to the control drink, placebo significantly increased craving, ad-lib consumption and subjective intoxication, regardless of environmental context.

CONCLUSIONS

Increased craving and ad-lib alcohol consumption after consuming a priming dose of alcohol is at least partly attributable to the anticipated rather than the pharmacological effects of the priming dose.

Overcoming Resistance to Surveillance: A Genealogy of the EAP Discourse

Through an examination of employee assistance programs we address Foucault’s contention that the pervasive surveillance characteristic of disciplinary control is facilitated by a discourse claiming therapeutic rather than punitive aims. By characterizing poor job performance as evidence of substance abuse or other ‘behavioral-medical’ illness, the EAP discourse endeavors to overcome the reluctance of supervisors to identify poor performers, for whom job loss is the frequent consequence of failure to improve. Following Foucault’s view that power effects occur without express intention to exercise power, we analyze the web of institutional and professional disciplinary mechanisms that effect heightened supervisory surveillance.

Cannabis intoxication inhibits avoidance action tendencies: a field study in the Amsterdam coffee shops

RATIONALE

Experimental laboratory studies suggest that the approach bias (relatively fast approach responses) toward substance-related materials plays an important role in problematic substance use. How this bias is moderated by intention to use versus recent use remains unknown. Moreover, the relationship between approach bias and other motivational processes (satiation and craving) and executive functioning remains unclear.

OBJECTIVES

The aim of this study was to investigate the cannabis approach bias before and after cannabis use in real-life setting (Amsterdam coffee shops) and to assess the relationship between approach bias, craving, satiation, cannabis use, and response inhibition.

METHODS

Cannabis, tobacco, and neutral approach and avoidance action tendencies were measured with the Approach Avoidance Task and compared between 42 heavy cannabis users with the intention to use and 45 heavy cannabis users shortly after cannabis use. The classical Stroop was used to measure response inhibition. Multiple regression analyses were conducted to investigate relationships between approach bias, satiation, craving, cannabis use, and response inhibition.

RESULTS

In contrast to the hypotheses, heavy cannabis users with the intention to use did not show a cannabis approach bias, whereas intoxicated cannabis users did show an approach bias regardless of image category. This could be attributed to a general slowing of avoidance action tendencies. Moreover, craving was negatively associated with the approach bias, and no relationships were observed between the cannabis approach bias, satiation, prior cannabis use, and response inhibition.

CONCLUSION

Cannabis intoxication in a real-life setting inhibited general avoidance. Expression of the cannabis approach bias appeared not to be modulated by satiation or response inhibition.

A critical systematic review of alcohol-related outcome expectancies

To assess the validity of the research into alcohol-related outcome expectancies a systematic review of 80 articles published between 1970 and 2013 was conducted. Participant gender, age, and contextual influences are highlighted as possible causes of the observed variations in research findings. There is a need for fuller consideration of the influences of demographics and environmental and social contexts on research findings. It is recommended that alcohol intake measures should be standardized to a greater degree in future research. Contextual influences on expectancies also require extensive future investigation to increase the validity of research and improve alcohol-related interventions.

Alternative substance paradigm: effectiveness of beverage blinding and effects on acute alcohol responses

A fundamental goal of double-blind alcohol challenge studies is to reduce alcohol expectancies, though there is little research on the effectiveness of blinding procedures and their relationship to acute alcohol responses. This study examined social drinkers' perception of beverage content and related alcohol response during 3 separate double-blind experimental sessions with placebo, low-dose alcohol (0.4 g/kg), and high-dose alcohol (0.8 g/kg). Using the alternative substance paradigm, participants (N = 182) were informed that the beverage they consumed might contain alcohol, a stimulant, a sedative, or a placebo. At several time points, subjective and objective measures were obtained, and participants were asked to identify which substance they received. During both placebo and low-dose alcohol sessions, 33% and 50% of participants, respectively, did not correctly identify the beverage content; during the high-dose alcohol session, 20% did not correctly identify the beverage. Although correct and incorrect identifiers at any dose level did not differ on major background variables, drinking characteristics, or psychomotor performance during these sessions, they did differ on self-reported subjective responses, with greater sedation reported by incorrect identifiers in the placebo and high-dose conditions. In summary, results suggest that the alternative substance paradigm may be a viable option for alcohol laboratory studies, particularly for repeated sessions in within-subject designs and in cases in which the experimenter wants to reduce expectancy by not revealing a priori that alcohol is being administered.

Implicit and explicit alcohol cognitions and observed alcohol consumption: three studies in (semi)naturalistic drinking settings

AIMS

  Dual-process models imply that alcohol use is related to implicit as well as explicit cognitive processes. Few studies have tested whether both types of processes are related to ad libitum drinking. In a series of three studies, we tested whether both implicit and explicit alcohol-related cognitions predicted the amount of alcohol consumed in an ad libitum (semi)naturalistic drinking situation.

DESIGN

  Two experimental studies used trained confederates (same-sex peers) who consumed either alcoholic or non-alcoholic beverages, while observing participants' drinking behaviour in a 30-minute session. The third study involved observations of participants' alcohol use during a 45-minute session in which participants spent time with five to seven friends.

SETTING

  A (semi)naturalistic drinking setting, a laboratory bar.

PARTICIPANTS

  Participants were undergraduates recruited at Radboud University (study 1: n = 115; study 2: n = 121; study 3: n = 200).

MEASUREMENTS

  We used coding of drinking behaviour from observations, questionnaire data on positive alcohol expectancies and alcohol use patterns and implicit association tests to assess alcohol associations.

FINDINGS

  Implicit associations were not related to observed alcohol use, whereas explicit positive expectancies were related positively to observed alcohol use in study 1 and study 2.

CONCLUSIONS

  Among undergraduate students in (semi)naturalistic drinking settings with peers, implicit alcohol-related cognitions do not predict the amount of alcohol consumed.

Revisiting Truth or Triviality: The External Validity of Research in the Psychological Laboratory

Anderson, Lindsay, and Bushman (1999) compared effect sizes from laboratory and field studies of 38 research topics compiled in 21 meta-analyses and concluded that psychological laboratories produced externally valid results. A replication and extension of Anderson et al. (1999) using 217 lab-field comparisons from 82 meta-analyses found that the external validity of laboratory research differed considerably by psychological subfield, research topic, and effect size. Laboratory results from industrial-organizational psychology most reliably predicted field results, effects found in social psychology laboratories most frequently changed signs in the field (from positive to negative or vice versa), and large laboratory effects were more reliably replicated in the field than medium and small laboratory effects.

Memory associations between negative emotions and alcohol on the lexical decision task predict alcohol use in women

Implicit alcohol expectancies, or beliefs about alcohol which exist in the form of automatic memory associations, are thought to uniquely affect drinking behavior. Research also has indicated that there may be a distinctive relationship between negative reinforcement and alcohol use in women. However, the most common measures used to examine implicit alcohol cognitions may be insufficient to examine associations involving negative reinforcement. The current study utilized the Lexical Decision Task (LDT) to examine the relationship between implicit alcohol cognitions and reported drinking in a sample of college women. Seventy-eight female participants completed a LDT including alcohol- and emotion-words, questionnaire measures of explicit alcohol expectancies, and a measure of drinking behavior at baseline and after two months. Strong associations between negative emotion-words and alcohol-words (as measured by the LDT) were found to predict drinking at follow up, and to account for unique variance in drinking beyond the contribution of explicit measures. In addition, women who reported heavier drinking in response to social conflict on an explicit measure showed stronger priming of alcohol words by negative emotion words, thus implying that the LDT may tap into implicit cognitions related to alcohol use as a method of coping. These findings suggest that the LDT is sensitive to negative-reinforcement associations in a way that other measures are not.

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.

Alcohol expectancy increases positive responses to cigarettes in young, escalating smokers

RATIONALE

A large proportion of smokers consolidate their smoking patterns during young adulthood, and it is possible that the high rates of drinking found in this age group may facilitate the transition from nondaily to daily cigarette use.

OBJECTIVE

The primary aim of this study was to examine how alcohol alters the subjective effects of smoking in heavy-drinking young adults (age 21-25) who are still at an experimental stage of smoking but show recent increases in their smoking behavior.

METHODS

Using a within-subject design, we examined whether alcohol or the expectation of receiving alcohol increased either subjective responses to smoking or the amount smoked. Subjects participated in three sessions, in which they received alcohol (0.08 g/dL targeted blood alcohol level), a taste-masked placebo presented as alcohol, or a mixer beverage not presented as alcohol. Measures included positive and negative subjective reactivity (e.g., satisfaction, nausea, craving relief, and enjoyment of airway sensations) associated with smoking a single cigarette and subsequent ad lib smoking behavior.

RESULTS

Both conditions in which the subjects expected to receive alcohol increased positive effects of smoking (satisfaction, calm, and taste), compared to the mixer beverage. Alcohol, compared to the placebo and mixer beverages, decreased negative effects (nausea) associated with smoking a cigarette and increased subsequent smoking.

CONCLUSIONS

This initial study has implications for understanding how alcohol and the expectation of alcohol improves the experience of smoking in nondaily smokers who are still at an experimental stage of smoking.

Expectancy and treatment interactions: a dissociation between acupuncture analgesia and expectancy evoked placebo analgesia

Recent advances in placebo research have demonstrated the mind's power to alter physiology. In this study, we combined an expectancy manipulation model with both verum and sham acupuncture treatments to address: 1) how and to what extent treatment and expectancy effects - including both subjective pain intensity levels (pain sensory ratings) and objective physiological activations (fMRI) - interact; and 2) if the underlying mechanism of expectancy remains the same whether placebo treatment is given alone or in conjunction with active treatment. The results indicate that although verum acupuncture+high expectation and sham acupuncture+high expectation induced subjective reports of analgesia of equal magnitude, fMRI analysis showed that verum acupuncture produced greater fMRI signal decrease in pain related brain regions during application of calibrated heat pain stimuli on the right arm. We believe our study provides brain imaging evidence for the existence of different mechanisms underlying acupuncture analgesia and expectancy evoked placebo analgesia. Our results also suggest that the brain network involved in expectancy may vary under different treatment situations (verum and sham acupuncture treatment).

ALCOHOL HANGOVER EFFECTS ON MEASURES OF AFFECT THE MORNING AFTER A NORMAL NIGHT'S DRINKING

AIM

To investigate the effects of students' usual levels of alcohol consumption on aspects of mood and anxiety the following morning.

METHODS

Students were recruited who consumed their usual quantity of any type of alcoholic beverage in their chosen company and then completed assessments of the effects the following day. The timing of drinking was restricted to the period between 22:00 and 02:00 h the night before testing as these are the most popular hours for consuming alcohol in the population under investigation. The testing included an assessment of mood and anxiety; testing was also performed after an evening of abstinence (no hangover condition), following a counterbalanced repeated measure design, with time of testing and order of testing as 'between participant' factors. Forty-eight student social drinkers (33 women, 15 men) aged between 18 and 43 years were tested, with a 1 week interval between test sessions.

RESULTS

Males reported consuming on average 14.7 units and females 10.5 units the night before testing. On the morning after alcohol consumption, ratings of alertness and tranquility were lower than the ratings the morning following an evening of abstinence at both 11:00 and 13:00 h and the post intoxication physical symptoms, emotional symptoms and symptoms of fatigue persisted throughout the morning.

CONCLUSION

Heavy alcohol consumption lowers mood, disrupts sleep, increases anxiety and produces physical symptoms, emotional symptoms and symptoms of fatigue throughout the next morning.

Deception in research on the placebo effect

A common feature of research investigating the placebo effect is deception of research participants about the nature of the research. Miller and colleagues examine the ethical issues surrounding such deception.

The effects of alcohol expectancies on drinking behaviour in peer groups: observations in a naturalistic setting

AIMS

To study the functionality of alcohol expectancies in predicting drinking behaviour in existing peer groups of young adults in a 'naturalistic' setting.

DESIGN AND SETTING

Young adults were invited to join an experiment with their peer group in a bar annex laboratory. During a 'break' of 50 minutes in this experiment, their activities, social behaviour and drinking behaviour were observed with digital video and audio equipment.

PARTICIPANTS

Twenty-eight peer groups were involved in this study. A peer group consisted of seven to nine people, with relationships ranging from intimate relations and close friendships to being acquaintances. A total of 238 participants were involved. Measurements Information of the drinking behaviour from observations and questionnaire data on alcohol expectancies provide the opportunity to look at how and which expectancies are related to actual drinking patterns. Multiple regression and multi-level analyses were applied.

FINDINGS

Expectancies on the positive and arousing effects of alcohol consumption were related to alcohol consumption in a naturalistic, social drinking situation, in addition to group effects of drinking. Expectancies on the negative and sedative effects of drinking, however, were not related to drinking.

CONCLUSIONS

The findings indicate that among young adults observed in a peer group and naturalistic drinking setting, positive expectancies about the effects of alcohol and expectancies about the effects of alcohol on arousal are related positively to drinking level.

Alcohol consumption increases attractiveness ratings of opposite-sex faces: a possible third route to risky sex

AIMS

To measure the effect of moderate alcohol consumption on males' and females' attractiveness ratings of unfamiliar male and female faces.

PARTICIPANTS

Eighty undergraduate volunteers were used in each of three experiments.

DESIGN

Participants' ratings on a 1-7 scale was the dependent variable. A three-factor mixed design was used. For experiments 1 and 2: one within-factor, sex-of-face to be rated (male/female); two between-factors, sex-of-rater (male/female) and alcohol status of rater (0 UK units/1-6 UK units). For experiment 3, the two levels of sex-of-face were replaced by two levels of a non-face object. In experiment 1, the faces were rated for attractiveness; in experiment 2, the faces were rated for distinctiveness and in experiment 3, the non-face objects were rated for attractiveness.

SETTING

Quiet, prepared corners of bars and licensed eating areas on a civic university campus.

METHOD

For each experiment, 118 full-colour photographic images were presented randomly on a laptop computer screen, each remaining until a rating response was made.

FINDINGS

There was a significant alcohol consumption enhancement effect only for attractiveness ratings of opposite-sex faces in experiment 1. This indicates that the opposite-sex enhancement effect is not due simply to alcohol consumption causing the use of higher points of ratings scales, in general.

CONCLUSION

Since Agocha & Cooper have shown that the likelihood of intentions to engage in risky sex increases as the facial attractiveness of the potential sexual partner increases, through the opposite-sex enhancement effect we identify a new possible link between risky sex and alcohol consumption.

Faktorenstruktur und psychometrische Eigenschaften einer gekürzten deutschsprachigen Version des Alcohol Expectancy Questionnaire (Brief AEQ-G)

Zusammenfassung: Gegenstand der vorliegenden Arbeit ist die Entwicklung eines ökonomischen Verfahrens zur Erfassung von Alkoholwirkungserwartungen. An einer Stichprobe von insgesamt 714 Erwachsenen - bzw. verschiedenen Teilstichproben - wurden erstmals Faktorenstruktur, psychometrische Eigenschaften und Validität einer deutschsprachigen Version des Alcohol Expectancy Questionnaire (AEQ) überprüft. Die Faktorenstruktur der deutschsprachigen Version entspricht nicht der des amerikanischen Originalinstruments. Eine zweifaktorielle Lösung lässt sich in Übereinstimmung mit den Annahmen psychologischer Modelle der Genese von Alkoholabhängigkeit und -missbrauch interpretieren: Faktor 1 (Erleichterung des Sozialkontakts) beschreibt eine Zunahme sozialer Kompetenz, Faktor 2 (Spannungsreduktion und Affektregulation) die Erwartung intrapsychischer Effekte. Zusammenhänge zwischen Konsummaßen und den AEQ-Summenwerten lassen sich als erste Hinweise auf die Validität des Verfahrens interpretieren.

Dimensions of alcohol-related social and health consequences in survey research

Dimensions of alcohol-related social and health consequences are approached from two different perspectives. First, classical approaches with factor analytic techniques are used to empirically determine the dimensionality of item batteries intended to measure harm. Second, a closer look is taken at theoretically underlying dimensions of social and health consequences and their association with alcohol consumption. Using as empirical material data from the US national survey of males aged 21-59 (N3) conducted in 1969, the following specific questions are discussed: (1) What are the underlying dimensions of alcohol-related social and health consequences? (2) How should the relation between alcohol consumption and consequences best be assessed (in terms of epidemiological traditions or social constructivist traditions)? (3) How can we best incorporate the time perspective into modeling the relationship between alcohol consumption and consequences? A first attempt is made to develop practical guidelines for future research on handling these problems.