The alcohol expectancy concept: Applications to assessment, prevention, and treatment of alcohol abuse

"If You Don't Eat, You Can Get Drunk Faster": A Qualitative Investigation of Food and Alcohol Disturbance (FAD) Expectancies

Background: Food and alcohol disturbance (FAD; i.e., use of any compensatory behavior within the context of a drinking episode to offset alcohol-related calories and/or enhance the effects of alcohol) is prevalent among U.S. college students and associated with negative consequences. Expectancies for anticipated outcomes of alcohol use and thinness/restriction behaviors, which comprise FAD, serve as promising targets of intervention for these behaviors individually; however, no study to date has identified or examined FAD expectancies, specifically. Objectives: The purpose of this study was to qualitatively examine the positive and negative FAD expectancies described by students experienced with FAD. Methods: Semi-structured open-ended interviews were conducted with 22 undergraduates with a lifetime history of FAD behavior (72.7% female, 77.3% white non-Hispanic, Mage=20.14). Results: Positive FAD expectancy themes included: Mood Improvement, Appearance/Weight-related Benefits, Alcohol Enhancement, and Social Approval and Connectedness. Negative FAD expectancy themes included: Reputational and Social Concerns, Negative Physical Consequences, Negative Psychological Consequences, and Cognitive and Behavioral Impairment. Conclusions: Results suggest that while there are many similarities, FAD expectancies are distinct from existing alcohol and thinness/restriction expectancies. Specifically, the Mood Improvement theme conceptualizes mood-related improvement within the context of both positive and negative reinforcement and both the Social Approval and Connectedness and Social and Reputational Consequences themes focus on the ways in which one's peers may view and interact with others. Findings lay the groundwork for identifying expectancies that underlie FAD behaviors and provide directions for future research and intervention efforts.

Development and validation of a Chinese Drinking Expectancies Questionnaire for young adults: A Hong Kong study

INTRODUCTION

Drinking expectancies, the perceived consequences of alcohol consumption, are noted to predict drinking behaviours. However, there is comparatively little research of drinking expectancies in non-Western populations. This study aimed to develop and validate a Chinese Drinking Expectancy Questionnaire (CDEQ-Adult) for Chinese young adults.

METHODS

Face and content validity were first assessed of items generated from literature review and previously conducted focus groups. Exploratory (EFA) and confirmatory factor analyses (CFA) were conducted with split-half samples from a random telephone survey that was conducted on Hong Kong Chinese adults between the ages of 18-34 (n = 675). The instrument's convergent validity and internal reliability were also examined.

RESULTS

The preliminary instrument items showed good content validity (Item Content Validity Index range: 0.8-1.0). The EFA yielded a 31-item, five-factor model consisting of five domains: Negative Consequences, Interpersonal Benefits, Increased Confidence, Health Benefits and Tension/Stress Reduction (variance explained 63.7%). The CFA revealed that the fit indices for the five-factor model using diagonal weighted least squares estimator were χ2 (256, N = 338) = 394.04, p < 0.001, comparative fit index 0.97, SRMR 0.07, RMSEA 0.06 (95% confidence interval 0.06, 0.08), suggesting a good fit of the model. The Cronbach's α coefficients were 0.94, 0.90, 0.86, 0.77 and 0.57, respectively for each of the five domains (n = 675). Significant associations with past month drinking behaviours and future drinking intentions give strong support for convergent validity.

DISCUSSION AND CONCLUSIONS

The CDEQ-Adult is a culturally relevant instrument for assessing drinking expectancies in Chinese young adults for use in future studies.

Subjective evaluations of alcohol-involved sexual experiences over time among heavy-drinking college students: Comparisons across gender

The current study described how positive sexual experiences impact hypothetical subjective evaluations at follow up relative to baseline. Eighty-eight college students who engaged in weekly heavy episodic drinking participated. At baseline, participants reported alcohol use and hypothetical evaluations of alcohol-involved sexual experiences. During a 28-day ecological momentary assessment (EMA), participants completed next morning surveys and reported whether they engaged in a sexual/romantic experience and subjective evaluation of any sexual/romantic experience. At follow-up, participants re-reported all hypothetical evaluations. Associations between baseline and follow-up evaluations for "living out a sexual fantasy" and having an "alcohol-facilitated sexual experience" were not moderated by gender or positive sexual experiences. However, associations between baseline and follow-up "alcohol-intensified sex" were moderated by gender and having a positive sexual experience during the EMA study. Among women who had a positive sexual experience, evaluations of alcohol-intensified sex remained stable over time. For men who had a positive sexual experience, evaluations at follow up became less positive relative to their evaluations at baseline. Whereas positive sexual experiences served to confirm positive evaluations over time for women, evaluations decreased for men. Women and men who did not engage in sexual experiences did not need/rely on actual lived experiences in order to maintain their positive evaluations over time. Placing such a high emphasis on alcohol on intensifying sex without actual lived experience of negotiating consent when drinking could place college students at increased risk of sexual perpetration/victimization.

Social epidemiology of early adolescent alcohol expectancies

PURPOSE

To determine the sociodemographic correlates of alcohol expectancies (i.e., beliefs regarding positive or negative effects of alcohol) in a national (U.S.) cohort of early adolescents 10-14 years old. A second aim was to determine associations between alcohol sipping and alcohol expectancies.

METHODS

We analyzed cross-sectional data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 11,868; Year 2). Linear regression analyses were conducted to estimate associations between sociodemographic factors (sex, race/ethnicity, sexual orientation, household income, parental education, parent marital status, religiosity) and positive (e.g., stress reduction) and negative (e.g., loss of motor coordination) alcohol expectancies. Additional linear regression analyses determined associations between alcohol sipping and alcohol expectancies, adjusting for sociodemographic factors.

RESULTS

Overall, 48.8% of the participants were female and 47.6% racial/ethnic minorities, with a mean age of 12.02 (SD 0.67) years. Older age among the early adolescent sample, male sex, and sexual minority identification were associated with more positive and negative alcohol expectancies. Black and Latino/Hispanic adolescents reported less positive and negative alcohol expectancies compared to White non-Latino/Hispanic adolescents. Having parents with a college education or greater and a household income of $200,000 and greater were associated with higher positive and negative alcohol expectancies. Alcohol sipping was associated with higher positive alcohol expectancies.

CONCLUSIONS

Older age, White non-Latino/Hispanic race, male sex, sexual minority status, higher parental education, and higher household income were associated with higher positive and negative alcohol expectancies. Future research should examine the mechanisms linking these specific sociodemographic factors to alcohol expectancies to inform future prevention and intervention efforts.

Drug and Alcohol Use with Condomless Anal Sex among Men Who Have Sex with Men in Melbourne, Australia: A Retrospective Data Analysis from 2011 to 2017

Rises in condomless anal sex among men who have sex with men (MSM) have been reported over the last decade but there is less certainty about the role that drugs, alcohol, play in this change. We examined the changes in drug and alcohol use among 22,255 MSM reporting condomless anal sex at Melbourne Sexual Health Centre in 2011-2017. There was a 7% annual increase in using drugs before and/or during condomless anal sex but a 3% annual reduction in condomless anal sex while drunk. MSM taking PrEP were more likely to report condomless anal sex with drug use (AOR: 1.21; 95%CI: 1.07-1.37) and alcohol use (AOR: 1.29; 95%CI: 1.14-1.46) compared with MSM not taking PrEP.

Know Your Safe Drinking Skills: Adaptation Strategies for the College Effect

Objective: The current study investigates the effects of an alcohol-prevention program delivered to college students in a formal classroom setting. Participants: The sample comprised 231 first-year college students who enrolled in a multisection “First Year Experience” course at a large northeastern university in the United States. Method: A naturalistic experiment was conducted, with a baseline evaluation at the beginning of the semester and a post-experiment evaluation near the end of the semester. Results: Social drinking attitudes, proximal drinking norm and the college effect are significant predictors of pre- and post-intervention episodic drinking frequency. The intervention reduced episodic drinking frequency as well as perceived distal and proximal drinking norms. It also increased drinking attitudes and did not change perceived efficacy or drinking-outcome expectancies. Conclusions: Practitioners could consider implementing a similar intervention to allow students to learn and practice safe drinking skills in the first year of their college life.

Addiction Research Unit: Affective and cognitive mechanisms of specific Internet-use disorders

In the eleventh International Classification of Diseases (ICD-11) of the World Health Organization, gambling disorder and gaming disorder are included in the category 'disorders due to addictive behaviours', which can be specified further as occurring either predominantly offline or predominantly online. Other specific problematic behaviours may be considered for the category 'other specified disorders due to addictive behaviours'. The Research Unit FOR 2974, funded by the German Research Foundation (Deutsche Forschungsgemeinschaft, DFG), focuses on the most prominent online addictive behaviours: gaming, pornography use, buying-shopping and social-networks use. The main goal of the Research Unit is to contribute to a better understanding of the common and differential psychological as well as neurobiological mechanisms involved in these specific types of Internet-use disorders. We aim to investigate theoretically argued (bio)psychological processes with a focus on concepts coming from research of substance-use disorders, for example, cue reactivity and craving, executive functions and specific inhibitory control, coping, implicit cognitions, and decision making. One central characteristic of the Research Unit is that we will investigate all participants using a comprehensive core battery of experimental paradigms, neuropsychological tasks, questionnaires, biomarkers, ambulatory assessment, and a 6-month follow-up survey. Beyond the anticipated contributions to the scientific understanding of the mechanisms involved in the development and maintenance of respective online addictive behaviours, we also expect contributions to clinical practice by showing which affective and cognitive mechanisms may be addressed more intensively to optimize treatment.

Reinforcement-based cognitive biases as vulnerability factors in alcohol addiction: From humans to animal models

Alcohol use disorder (AUD) is one of the most common, but still poorly treated, psychiatric conditions. Developing new treatments requires a better understanding of the aetiology of symptoms and evaluation of novel therapeutic targets in preclinical studies. Recent developments in our understanding of the reinforcement-based cognitive biases (RBCBs) that contribute to the development of AUD and its treatment offer new opportunities for both clinical and preclinical research. In this review, we first briefly describe psychological and cognitive theories that involve various aspects of reinforcement sensitivity in the development, maintenance, and recurrence of alcohol addiction. Furthermore, in separate sections, we describe studies investigating RBCBs and their neural, neurochemical, and pharmacological correlates, and we discuss possible interactions between RBCBs and trajectories of AUD. Finally, we describe how recent translational studies using state-of-the-art animal models can facilitate our understanding of the role of reinforcement sensitivity and RBCBs in various aspects of AUD.

The Role of Gender, Child Maltreatment, Alcohol Expectancies, and Personality Pathology on Relationship Violence Among Undergraduates

Male (n = 1,104) and female (n = 1,337) college students' self-report surveys on childhood maltreatment, alcohol expectancies, and narcissistic personality traits are examined to determine their associations with relationship violence. Intimate partner violence was measured using the violence subscales of the revised Conflict Tactics. Because we were interested in the effects of gender and because z tests of the correlations and t tests of means indicated men and women differed significantly on several variables, ordinary least squares regression models were run separately for men and women. Results suggest there are both gender similarities and differences. Relationship violence was associated with child sexual abuse for both men and women, whereas high scores on negative alcohol expectancies and vulnerable narcissism, and low scores on grandiose narcissism, were significantly associated with violence for men only. In addition, z tests revealed the regression coefficients for child sexual abuse and negative alcohol expectancies were significantly different for men and women. Child sexual abuse and alcohol expectancies had stronger associations with men's than women's violent behavior. In addition, the models explained a greater amount of variance in men's than in women's behavior. Policy implications of the research will be discussed.

Daily associations between affect and alcohol use among adults: The importance of affective arousal

OBJECTIVE

Little is known about whether level of affective arousal (i.e., high vs. low) is associated with alcohol use and whether this relationship differs by valence (i.e., positive vs. negative affect) among adults.

METHODS

Participants were n = 93 self-reported current drinkers (ages 25-65) who reported positive (PA) and negative affect (NA) seven times a day and alcohol use once a day for seven consecutive days. For each individual, mean levels of high arousal PA (e.g., excited), low arousal PA (e.g., satisfied), high arousal NA (e.g., frustrated), and low arousal NA (e.g., sad) were computed for each day.

RESULTS

Alcohol use was reported on 30% of person-days, with an average of 2.3 drinks consumed on drinking days. Heavy episodic drinking (4+/5+ drinks for women/men) occurred on 4% of days. After covarying for age, gender, and weekday, days with higher-than-usual levels of high arousal PA were associated with a 52% increase in the odds of consuming any alcohol and a 105% increase in the odds of engaging in heavy episodic drinking. Individuals reporting more low arousal PA on average had a 77% increase in the odds of heavy episodic drinking. No significant associations between high or low arousal NA and alcohol use were found.

CONCLUSIONS

Greater PA, but not NA, was associated with heavy alcohol use at both the within- and between-person levels, perhaps attributable to social and enhancement drinking motives. Results differed by arousal, highlighting the importance of considering a wide range of affective states when examining alcohol use behavior.

Intrapersonal and interpersonal pathways linking 21st birthday celebration beliefs, intentions, and drinking behavior

In the United States, turning 21 often involves heavy drinking and high rates of alcohol-related consequences. Friends are an important source of social influence on young adult drinking, including during 21st birthdays. However, research is needed to investigate the specific pathways through which this interpersonal influence occurs. Data were drawn from a larger intervention study focused on reducing 21st birthday drinking. Using data from 166 celebrant and friend dyads (N = 332 individuals), we prospectively examined relations among each person's beliefs about 21st birthday celebrations, drinking intentions for the celebrant, and celebrants' estimated blood alcohol concentration (eBAC) on their 21st birthdays. Path analyses evaluated the impact of celebrant and friend beliefs on their own report of celebrant intentions, each other's report of celebrant intentions, and celebrant eBAC, as well as the mediating role of each individual's report of celebrant intentions. Results revealed significant indirect effects of each individual's beliefs on celebrant eBAC via their own report of celebrant 21st birthday drinking intentions. Friend beliefs also predicted celebrant eBAC via celebrant drinking intentions, beyond the effect of celebrant beliefs. Importantly, celebrant eBAC was as strongly predicted by friend 21st birthday celebration beliefs as they were by their own beliefs. Results highlight multiple pathways through which friends influence 21st birthday drinking and reveal that friend influence is not constrained to the celebration, but begins in advance of the event by shaping celebrants' drinking intentions. Findings highlight key directions for future work leveraging friends as intervention agents to reduce drinking related to this high-risk event.

Pain and reward circuits antagonistically modulate alcohol expectancy to regulate drinking

Expectancy of physical and social pleasure (PSP) promotes excessive drinking despite the potential aversive effects of misuse, suggesting an imbalance in the response to reward and pain in alcohol seeking. Here, we investigated the competing roles of the reward and pain circuits in PSP expectancy and problem drinking in humans. Using fMRI data during resting (n = 180) and during alcohol cue exposure (n = 71), we examined the antagonistic effects of the reward-related medial orbitofrontal cortex (mOFC) and pain-related periaqueductal gray (PAG) connectivities on PSP expectancy and drinking severity. The two regions' connectivity maps and strengths were characterized to assess their shared substrates and net relationship with PSP expectancy. We evaluated mediation and path models to further delineate how mOFC and PAG connectivities interacted through the shared substrates to differentially impact expectancy and alcohol use. During resting, whole-brain regressions showed mOFC connectivity in positive and PAG connectivity in negative association with PSP scores, with convergence in the precentral gyrus (PrCG). Notably, greater PAG-PrCG relative to mOFC-PrCG connectivity strength predicted lower PSP expectancy. During the alcohol cue exposure task, the net strength of the PAG vs. mOFC cue-elicited connectivity with the occipital cortex again negatively predicted PSP expectancy. Finally, mediation and path models revealed that the PAG and mOFC connectivities indirectly and antagonistically modulated problem drinking via their opposing influences on expectancy and craving. Thus, the pain and reward circuits exhibit functional antagonism such that the mOFC connectivity increases expectancy of drinking pleasure whereas the PAG serves to counter that effect.

Alcohol expectancies change in early to middle adolescence as a function of the exposure to parental alcohol use

INTRODUCTION

The subjective effects of alcohol, i.e., alcohol expectancies (AE), are important predictors of alcohol use. This three-year longitudinal study examined: 1) the development of enhancement, social, coping, and conformity AE from age 10-16; 2) the association between parental alcohol use exposure and positive AE among adolescents and between exposure and changes in AE over the six month period and 3) the moderating effect of gender on the association between exposure and change in AE.

METHODS

A longitudinal study followed adolescents between 10-13-years old at baseline (N = 755; 45.6 % boys) in six months intervals for three years, resulting in seven measurements.

RESULTS

Adolescents most strongly endorsed enhancement AE. Social and coping AE dimensions positively increased over time. The estimated Multilevel Model of Change revealed that exposure to either fathers 'or mothers' alcohol use predicted an increase in social AE six months later (B = .129, SE = .032). Exposure to fathers' drinking predicted an increase in enhancement AE for boys (B = .075, SE = .031) but not for girls (B=-0.045, SE = .030). No associations between parental exposure and other AE dimensions were found.

CONCLUSION

The results add to previous studies in showing that the association between parental drinking behavior and offspring AE develops within short periods. Prevention should, therefore, include explicit guidelines for parents with respect to how their drinking behavior affect their offspring.

Pathways from Positive, Negative, and Specific Alcohol Expectancies to Weekday and Weekend Drinking to Alcohol Problems

The current study tested and identified risk and protective pathways from alcohol expectancies to weekday and weekend consumption to problematic consequences. Adult alcohol users (N = 395) completed measures of alcohol expectancies, daily consumption habits during a typical week, and alcohol-related problems. Confirmatory factor analysis supported the five-factor structure of positive expectancy, negative expectancy, weekday drinking, weekend drinking, and alcohol problems. The structural equation model specifying general positive and negative expectancy to weekday and weekend use to alcohol problems exhibited satisfactory fit indices. Specifically, positive expectancy contributed to greater weekend drinking, but negative expectancy prompted greater weekday drinking. Furthermore, lower positive expectancy, higher negative expectancy, higher weekday drinking, and higher weekend drinking each uniquely explained greater alcohol problems. The structural equation model involving the seven specific expectancies to weekday and weekend use to alcohol problems produced high fit indices. Specifically, higher risk and aggression, higher self-perception, and lower cognitive and behavioral impairment expectancies uniquely predicted weekday drinking. In contrast, higher sociability, higher liquid courage, higher risk and aggression, and lower cognitive impairment expectancies explained weekend drinking. The predictive model premised on specific alcohol expectancies as distinct constructs exhibited higher fit indices and more nuanced insights regarding risk and protective pathways for prevention than the model involving general positive versus negative expectancy constructs. Findings underscore that different types of self-fulfilling alcohol expectancy beliefs distinctively explain weekday versus weekend intake and problems.

(Don't Fear) the Reefer: Cannabis Worldview Beliefs and the Management of Death-Related Existential Concerns Among High Frequency Cannabis Users

Introduction: The current research employed a terror management framework to understand the cognitive effects of frequent drug use. The study focused specifically on cannabis users and tested the hypothesis that frequent cannabis use is associated with the development of cannabis-related worldview beliefs that take on an existential function for frequent users.

Method: Participants (N = 226) answered questions about their cannabis use and completed a measure of cannabis worldview investment. Thereafter, they were randomly assigned to a cannabis worldview threat (vs. no threat) condition and completed measures of death-thought accessibility (DTA) and cannabis worldview defense.

Results: A positive association between frequency of cannabis use and cannabis worldview investment was observed. Moreover, among high frequency cannabis users, those highly invested in the cannabis worldview evinced significantly more DTA following exposure to the worldview threat than no threat condition. Participants with high investment in the cannabis worldview also showed more derogation of the cannabis worldview threat (vs. no threat) essay-author. However, this relationship was not influenced by DTA or frequency of cannabis use.

Discussion: A terror management perspective on drug use is discussed, including implications for understanding drug abuse, addiction, and treatment.

Selfie Expectancies Among Adolescents: Construction and Validation of an Instrument to Assess Expectancies Toward Selfies Among Boys and Girls

Selfie-taking and posting is one of the most popular activities among teenagers, an important part of online self-presentation that is related to identity issues and peer relations. The scholarly literature emphasizes different yet conflicting motivations for selfie-behavior, stressing deeper analysis of psychological factors and the influence of gender and age. Expectancies are "explanatory device[s]" that can help us study adolescent behavior. However, no instruments have been devised that specifically explore the expectations teenagers have about selfies and their influence on selfie-frequency. The current study proposes a short and reliable instrument to identify teen expectancies about selfie-behavior. This instrument was validated using a sample of 646 Italian adolescents (14 to 19 years old) by means of Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). We also explore the relationship between selfie expectancies and selfie-frequency, as well as the role of gender in shaping selfies. Our results point toward a 7-factor model that characterizes expectations toward selfies as a multi-dimensional construct linked to both positive and negative perceptions of the nature and consequences of selfies. The overall model fitted the data sufficiently (χ2 = 5067.051, p 0.0000; CFI = 0.962; TLI = 0.954; RMSEA ≤ 0.05: 0.035; SRMR = 0.046), showing an adequate reliability of the scale (α = 0.830). Bivariate correlations between selfie expectancies and selfie-frequency (r = 0.338, p < 0.001) confirmed the convergent validity of the tool. Selfie-sharing is a common practice that is widespread among the participants in this study. Self-promotion represents a positive function of selfies. Selfies promote self-presentation and self-confidence, both in boys and girls. Moreover, selfie expectancies address sexual self-attractiveness, especially among boys. Despite the positive aspects of selfies, our results stress adolescent awareness of the negative consequences of this type of web-exposure. This is especially true among girls, whose selfie-behavior is, paradoxically, more frequent than boys. Self-management through selfie-posting is a positive outcome of selfie-behavior that plays a key role among adolescents, even though the dangers of manipulating selfies in order to garner approval from one's peers need to be considered. The positive psychometric properties of the measure point toward the need for further research on both generalized and specific selfie-behaviors.

Traumatic Brain Injuries during Development: Implications for Alcohol Abuse

Traumatic brain injuries are strongly related to alcohol intoxication as by some estimates half or more of all brain injuries involve at least one intoxicated individual. Additionally, there is mounting evidence that traumatic brain injuries can themselves serve as independent risk factors for the development of alcohol use disorders, particularly when injury occurs during juvenile or adolescent development. Here, we will review the epidemiological and experimental evidence for this phenomenon and discuss potential psychosocial mediators including attenuation of negative affect and impaired decision making as well as neurochemical mediators including disruption in the glutamatergic, GABAergic, and dopaminergic signaling pathways and increases in inflammation.

The effects of cognitive reappraisal following retrieval-procedures designed to destabilize alcohol memories in high-risk drinkers

RATIONALE

Addiction is a disorder of motivational learning and memory. Maladaptive motivational memories linking drug-associated stimuli to drug seeking are formed over hundreds of reinforcement trials and accompanied by aberrant neuroadaptation in the mesocorticolimbic reward system. Such memories are resistant to extinction. However, the discovery of retrieval-dependent memory plasticity has opened up the possibility of permanent modification of established (long-term) memories during 'reconsolidation'.

OBJECTIVES

Here, we investigate whether reappraisal of maladaptive alcohol cognitions performed after procedures designed to destabilize alcohol memory networks affected subsequent alcohol memory, craving, drinking and attentional bias.

METHODS

Forty-seven at-risk drinkers attended two sessions. On the first lab session, participants underwent one of two prediction error-generating procedures in which outcome expectancies were violated while retrieving alcohol memories (omission and value prediction error groups). Participants in a control group retrieved non-alcohol memories. Participants then reappraised personally relevant maladaptive alcohol memories and completed measures of reappraisal recall, alcohol verbal fluency and craving. Seven days later, they repeated these measures along with attentional bias assessment.

RESULTS

Omission prediction error (being unexpectedly prevented from drinking beer), but not a value prediction error (drinking unexpectedly bitter-tasting beer) or control procedure (drinking unexpectedly bitter orange juice), was associated with significant reductions in verbal fluency for positive alcohol-related words. No other statistically robust outcomes were detected.

CONCLUSIONS

This study provides partial preliminary support for the idea that a common psychotherapeutic strategy used in the context of putative memory retrieval-destabilization can alter accessibility of alcohol semantic networks. Further research delineating the necessary and sufficient requirements for producing alterations in alcohol memory performance based on memory destabilization is still required.

Alcohol Expectancies Mediate the Relationship Between Age of First Intoxication and Drinking Outcomes in College Binge Drinkers

BACKGROUND

While prior research has shown that age of first intoxication (AI) is associated with negative alcohol outcomes, limited research has examined factors accounting for this relationship. Alcohol expectancies, or beliefs about the effects of alcohol, may explain such associations as both positive and negative expectancies have been shown to be key predictors of drinking outcomes.

OBJECTIVE

The present study examined expectancies as mediators between early AI and alcohol-related outcomes.

METHOD

Data collection occurred in 2012 and 2013. Participants were college students (N = 562, 65.8% women) who completed an online survey including measures of alcohol use history, alcohol expectancies, typical alcohol consumption, and alcohol-related problems. Structural equation modeling was used to test the hypothesized model.

RESULTS

Our findings support a model whereby AI is associated with drinking through its influence on both positive and negative expectancies. Specifically, an earlier AI was associated with stronger alcohol expectancies, which in turn, was associated with heavier alcohol use and alcohol-related problems.

CONCLUSIONS/IMPORTANCE

These findings are consistent with expectancy theory and previous research suggesting that more experienced drinkers hold stronger drinking-related beliefs, be it positive or negative, and these expectancies ultimately explain variability in alcohol use and problems. Our findings further support that expectancies play an important role in the initiation of drinking behavior.

The effects of mental health symptoms and marijuana expectancies on marijuana use and consequences among at-risk adolescents

Based on expectancy theory, adolescents at risk for mental health symptoms, such as those involved in the juvenile court system, may use marijuana due to the belief that use will attenuate anxiety and depressive symptoms. In a diverse sample of youth involved in the Santa Barbara Teen Court system (N = 193), we examined the association between mental health symptoms and marijuana expectancies on marijuana use and consequences. In general, stronger positive expectancies and weaker negative expectancies were both associated with increased marijuana use. Youth that reported more symptoms of both anxiety and depression and stronger positive expectancies for marijuana also reported more consequences. We found that youth experiencing the greatest level of consequences from marijuana were those that reported more depressive symptoms and stronger positive expectancies for marijuana. Findings suggest that these symptoms, combined with strong positive expectancies about marijuana's effects, have implications for consequences among at-risk youth.

The role of alcohol expectancies in drinking behavior among women with alcohol use disorder and comorbid posttraumatic stress disorder

Understanding how alcohol expectancies relate to alcohol use among individuals with concurrent alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) is important to understanding and treating this comorbidity. This study examined the role of positive and negative alcohol expectancies and PTSD symptoms in drinking behavior in a comorbid female sample. Participants were women (n = 33; 56% Caucasian) seeking AUD and PTSD treatment in an outpatient community co-occurring disorders program. Hypotheses related to drinking days and alcohol problems outcomes were evaluated using negative binomial hierarchical regression. PTSD symptoms were associated with fewer reported days of alcohol-related problems. Negative expectancies related to negative changes in social behavior associated with drinking days and cognitive and motor impairment associated with problems. Both the general positive expectancies score and specific global positive change subscale were uniquely associated with drinking and alcohol-related problems days after controlling for PTSD symptom severity and negative expectancies scores. Results suggest that both negative and positive expectancies about alcohol's effects are important correlates of drinking behavior among women with AUD and PTSD, with positive expectancies playing a potentially more salient role on use and consequences than symptom severity and negative expectancies.

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.

Predicting overt and cyber stalking perpetration by male and female college students

In this study, self-report student surveys on early childhood maltreatment, attachment styles, alcohol expectancies, and narcissistic personality traits are examined to determine their influence on stalking behavior. Two subtypes of stalking were measured using Spitzberg and Cupach's (2008) Obsessive Relational Intrusion: cyber stalking (one scale) and overt stalking (comprised of all remaining scales). As t tests indicated that men and women differed significantly on several variables, OLS regression models were run separately for men (N = 807) and women (N = 934). Results indicated that childhood sexual maltreatment predicted both forms of stalking for men and women. For men, narcissistic vulnerability and its interaction with sexual abuse predicted stalking behavior (overt stalking R² = 16% and cyber stalking R² = 11%). For women, insecure attachment (for both types of stalking) and alcohol expectancies (for cyber stalking) predicted stalking behavior (overt stalking R² = 4% and cyber stalking R² = 9%). We discuss the methodological and policy implications of these findings.

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.

Positive and negative alcohol-related consequences: associations with past drinking

While recent attention suggests that positive and negative alcohol-related expectancies are important determinants of alcohol use, less is known about what types of consequences young people report actually experiencing when drinking alcohol. The present study (N = 742, 54% women) examined positive (Fun/Social, Relaxation/Coping, Positive Image) and negative (Physical, Behavioral, Driving) consequences of alcohol use among individuals with prior drinking histories who completed surveys the summer before their first year at university. Fun/Social consequences were reported more frequently than any negative consequences. Alcohol consequences were associated with drinking behaviors. In particular, positive Fun/Social consequences and negative Physical and Driving-related consequences were related to alcohol frequency, alcohol quantity, and frequency of heavy episodic drinking. Positive consequences were at least as strongly associated with drinking as were negative consequences. The possible role of Fun/Social consequences in the escalation and maintenance of high-risk drinking is discussed.

The Positive Drinking Consequences Questionnaire (PDCQ): validation of a new assessment tool

Expected and experienced negative consequences and expected positive consequences of alcohol use have been widely studied, while little attention has been given to experienced positive drinking consequences. Although existing studies suggest that positive consequences may be important [Park, C.L. (2004). Positive and negative consequences of alcohol consumption in college students. Addictive Behaviors, 29, 311-321.; Park, C.L. & Grant, C. (2005). Determinants of positive and negative consequences of alcohol consumption in college students: Alcohol use, gender, and psychological characteristics. Addictive Behaviors, 30, 755-765.], it is not clear if they are distinct from expected positive outcomes or uniquely associated with drinking behavior. The primary goal of the current study was to develop a measure that directly assessed specific, real life drinking consequences rather than relying on general past tense derivations ("I forgot my worries") of expectancy items. Such a measure is necessary to determine whether or not positive consequences are distinct from positive expectancies and to assess the unique contribution of positive drinking consequences to drinking behavior. Participants were 423 undergraduate students who completed an online survey; 277 drinkers (56.5% women) completed all data necessary for analyses. Principal components analysis of the Positive Drinking Consequences Questionnaire (PDCQ) identified a single-factor structure with good internal and split-half reliability. The PDCQ also demonstrated discriminant validity relative to a positive expectancy measure and incremental validity in relation to drinking behavior. Although additional studies with heavier drinking populations are needed, the PDCQ may ultimately serve as a valuable research and clinical assessment tool.

[Alcohol consumption and positive alcohol expectancies in young adults: a typological approach using TwoStep cluster]

AIMS

The present study investigates the heterogeneity of the population of young adult drinkers with respect to alcohol consumption and Positive Alcohol Expectancies (PAEs). Based on the positive relationship between both kinds of variables, PAE is commonly viewed as a potential motivational factor of alcoholic addiction. Empirical analyses based on the regression of alcohol consumption on PAEs suppose that the observations are statistically homogeneous with respect to the level of alcohol consumption, however. We explored the existence of moderate drinkers with a high PAE profile, and abusive drinkers with a low PAE profile.

METHOD

1,017 young adult drinkers, mean age=23 +/- 2.84, with various educational levels, comprising 506 males and 511 females, were recruited as voluntary participants in a survey by undergraduate psychology students from the University of Toulouse Le Mirail. They completed a French version of the Alcohol Use Disorders Identifiction Test (AUDIT) and a French adaptation of the Alcohol Expectancy Questionnaire (AEQ). Three levels of alcohol consumption were defined using the AUDIT score, and six composite scores were obtained by averaging the relevant item-scores from the AEQ. The AEQ scores were interpreted as measurement of six kinds of PAEs, namely Global positive change, Sexual enhancement, Social and physical pleasure, Social assertiveness, Relaxation, and Arousal/Power. The TwoStep cluster methodology was used to explore the data. This methodology is convenient to deal with a mix of quantitative and qualitative variables, and it provides a classification model which is optimized through the use of an information criterion as Schwarz's Bayesian Information Criterion (BIC).

RESULTS

The automatic clustering suggested five clusters, whose stability was ascertained until 75% of the sample size. Low drinkers (n=527) were split into one cluster of low PAEs (I1) and, interestingly, one cluster of high PAEs (I3, 46%). High drinkers (n=344) were split into one cluster of intermediate PAEs (II4) and one cluster of high PAEs (II5, 52%). Interestingly again, abusive drinkers (n=146) remained a single group (III2), exhibiting high PAEs. Clusters I3 and III3 comprised a significant proportion of males. Constraining the algorithm to find 6 clusters did not affect class III2, but split low drinkers into three clusters.

DISCUSSION

Although the present results should be considered cautiously because of the novelty of TwoStep cluster methodology, they suggest a group of moderate drinkers with high PAEs. Also, abusive drinkers express high PAEs (except for 2 cases). Statistical homogeneity of moderate drinkers with respect to PAE variables appears as a dubious assumption.

Short-term changes in plans to drink and importance of positive and negative alcohol consequences

Experienced consequences predicted short-term changes in alcohol use plans and perceptions of the importance of alcohol-related consequences. Participants were 176 traditionally aged first-year university students who completed a 10-week telephone diary study (total weeks=1735). In multi-level models, men and students who experienced more positive and negative consequences on average planned to drink more and rated avoiding negative consequences as less important. Students who experienced more positive consequences rated them as more important (between-person analyses). Following weeks of experiencing relatively more positive drinking consequences, students planned to drink more and rated experiencing positive consequences as more important for the subsequent week (within-person analyses). Challenges for intervening in the ongoing formation of anticipatory cognitions regarding alcohol use are discussed.

Is beer the drink of choice for women with alcohol use problems? --Positive alcohol outcome expectancies as a function of beverage type

The primary goal of this study was to evaluate whether women with alcohol problems report differences in their strength of endorsement of specific positive outcome expectancies as a function of alcoholic beverage type. Fifty-four participants completed the Beverage Expectancy Questionnaire (BEQ) that assessed five specific positive outcome expectancies across three different beverage types (i.e., wine, beer, hard liquor). Participants endorsed the strongest expectancies of Social/Sexual Enhancement, Global Positive Affect and Relaxation in the beer-specific context as compared to the wine-specific context. Levels of consumption were significantly higher overall for hard liquor than for wine in the sample as a whole. Quantity of wine drinking was predicted by wine-specific Arousal and Personality Transformation expectancies; quantity of beer drinking was predicted by beer-specific Arousal expectancies; quantity of hard liquor consumption was predicted by hard liquor-specific Personality Transformation, Relaxation, and Arousal expectancies. Clinical implications of the findings and future research directions are discussed.

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

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

Alcohol expectancy multiaxial assessment: a memory network-based approach

Despite several decades of activity, alcohol expectancy research has yet to merge measurement approaches with developing memory theory. This article offers an expectancy assessment approach built on a conceptualization of expectancy as an information processing network. The authors began with multidimensional scaling models of expectancy space, which served as heuristics to suggest confirmatory factor analytic dimensional models for entry into covariance structure predictive models. It is argued that this approach permits a relatively thorough assessment of the broad range of potential expectancy dimensions in a format that is very flexible in terms of instrument length and specificity versus breadth of focus.

An investigation of the cognitive organization of body comparison sites in relation to physical appearance related anxiety and drive for thinness

Modeling cognitive processes that link variables associated with maladaptive behavior has led to successful interventions, particularly for alcohol use. In the present study, Individual Differences Scaling (INDSCAL) was used to model the cognitive structure of appearance-related comparisons in relation to physical appearance related anxiety and drive for thinness (DT) among 635 college students. Results were consistent with previous work in finding two primary comparison dimensions. A weight/nonweight dimension was primarily emphasized by females and a muscle/nonmuscle dimension was primarily emphasized by males. These gender differences continued to be evident when females and males were matched on levels of appearance-related anxiety and DT. Gender-specific analyses indicated that females with higher levels of appearance-related anxiety and DT primarily emphasized the weight dimension while females with lower levels of these characteristics tended to emphasize a physical attractiveness dimension. Males with higher levels of appearance-related anxiety and DT also primarily emphasized the weight dimension while males with lower levels of these characteristics tended to emphasize a muscle-related dimension. Findings are discussed in terms of risk factors for disturbance, and as a means of improving assessment, treatment, and prevention strategies.

Prospective association of peer influence, school engagement, drinking expectancies, and parent expectations with drinking initiation among sixth graders

Early initiation of drinking increases the lifetime risk for substance abuse and other serious health and social problems. An understanding of the predictors of early initiation is needed if successful preventive interventions are to be developed. Surveys were completed by 1009 sixth grade students at the beginning (Time 1) and end (Time 2) of the school year in four schools in one suburban school district. At Time 1, 55/1009 (5.5%) reported drinking in the past 30 days. From Time 1 to Time 2, the percentage of drinkers increase to 127/1009 (10.9%) of whom 101 were new drinkers. In multiple logistic regression analyses, school engagement was negatively associated and peer influence and drinking expectancies were positively associated with drinking initiation. A significant interaction was found between drinking expectancies and parental expectations. Among sixth graders with high drinking expectancies, those with low parental expectations for their behavior were 2.6 times more likely to start drinking than those with parents with high expectations for their behavior. Positive drinking expectancies were significantly associated with drinking initiation only among teens who believed their parents did not hold strong expectations for them not to drink. This finding held for boys and girls, Blacks and Whites and was particularly strong for Black youth. This finding provides new information about the moderating effect of parental expectations on drinking expectancies among early adolescents.

Alcohol expectancies and drinking in different age groups

AIMS

Because expectancies about the effects of alcohol change as drinking experience is accumulated, it is likely that the relationship of expectancy to drinking will differ with age. In this study, we examine the prediction of drinking behavior from positive and negative outcome expectancy at different ages.

DESIGN

Data were collected as part of the National Alcohol Survey, using a multi-stage area probability sample of the household population of the 48 contiguous United States.

PARTICIPANTS

US residents aged 12 and older (n = 2875).

MEASUREMENTS

Survey questions included drinking habits (frequency, quantity, frequency of drunkenness, maximum quantity) and beliefs about the effects of alcohol (alcohol expectancies).

FINDINGS

Structural equation models tested the relationship of positive and negative expectancy to drinking behavior in six age groups. Outcome expectancy accounted for a larger portion of the variance in drinking among younger respondents than among older respondents. However, suppression effects were common. When suppression effects were considered, positive expectancy predicted drinking better than negative expectancy only among respondents under 35, while negative expectancy was a better predictor of drinking status in most respondents over 35 years. Among drinkers, positive expectancy predominated over negative expectancy when suppression effects were considered.

CONCLUSIONS

These results suggest that negative expectancy predicts abstention, while positive expectancy predicts level of drinking among drinkers. In expectancy research, differences between drinkers and abstainers, age of participants and the presence of suppression effects should be taken into account.

Alcohol expectancies: integrating cognitive science and psychometric approaches

AIMS

To demonstrate an integrative methodology to explore psychological constructs, we used multiple methods in the examination of alcohol expectancies-a psychological construct that is generally measured using survey methodology. We then used the methodology in order to assess the relationship of alcohol expectancy dimensions to drinking-related outcomes.

DESIGN

We developed alcohol expectancy models using a cognitive paradigm designed to maximize cognitive activation of expectancies, in order to delineate dimensions of alcohol expectancies. Next, using multidimensional scaling (MDS), we defined heuristic models representing domains for arousing, sedating, positive, and negative alcohol expectancies. We then assessed these models in a separate sample using confirmatory factor analysis (CFA) and covariance structure modeling.

SETTING

The research was conducted at a large public university in the southeastern US.

PARTICIPANTS

A total of 927 male and female college students ranging in age from 17 to 35 years participated.

MEASUREMENTS

Measures included the Alcohol Expectancy Inventory, the Quantity Frequency Index (QFI), and the Drinking Styles Questionnaire.

FINDINGS

Single indicator models representing expectancies for arousing and positive effects of alcohol did not differ significantly in the prediction of drinking, and both accounted for significantly more variance in self-reported drinking than expectancies for sedating and negative effects of alcohol consumption. Expectations for the sedating effects of alcohol accounted for significantly more variance than those for negative effects. Expectations for sedating effects added unique variance in the prediction of drinking when all predictors were simultaneously modeled.

CONCLUSIONS

The multiple methods integrated here can be used in the development and testing of alcohol expectancy models. This integrative methodology warrants further development and validation.

Expectancies specific to condom use mediate the alcohol and sexual risk relationship

The present study tested the role of alcohol expectancies for condom use in mediating the alcohol and risky sex relationship. Expectancies for condom use are specific anticipations for alcohol's effect on one's ability to use a condom. College students (N = 563) reported on beliefs, intentions and actual sexual and drinking behavior. Among the sexually active, alcohol was directly related to future intention to use a condom in drinking situations for men, but not for women. In the men, alcohol expectancies for condom use mediated the relationship between drinking and condom intention. Beliefs that alcohol negatively impacts one's ability to use condoms were associated with more drinking and lower intentions to use a condom. These expectancies may help explain how alcohol affects risky sex in men. Gender differences and implications are discussed.

Contributions of imagery ability to stress and relaxation

This study examined the contribution of imagery ability to psychological and physiological responses to stress and relaxation. Individuals (N = 176) participated in two study sessions. In the first session, participants completed the Creative Imagination Scale and were block-randomized to a stress or relaxation condition based on imaging scores. During the second session, stress and mood were assessed before and after participants watched a stressful movie or listened to a relaxation tape. Finger temperature was monitored during the interventions. Changes in temperature and in self-reports of stress and mood indicated that the manipulations were effective. In comparison to low imagers, high imagers reported greater stress after the movie and less stress and negative affect after the relaxation tape. Imagery ability predicted neither levels of negative affect following the stress condition nor changes in positive affect or temperature during the interventions. In the stress condition, expectations of stress partially mediated the relation between imagery ability andpsychological stress. In contrast, expectations of relaxation did not significantly predict responses to the relaxation intervention. These findings suggest that imagery ability is related to greater subjective responses to both stress and relaxation and that, in stressful situations, expectancies may account for some of the effects of imagery ability on perceived stress.

Activation of alcohol expectancies in memory in relation to limb of the blood alcohol curve

Attempts to understand the mechanism by which alcohol expectancies might influence drinking have related activation of expectancies in memory to alcohol use. Limb of the blood alcohol curve, however, has not been considered. In the present study, 527 undergraduates completed the Anticipated Biphasic Alcohol Effects Scale and a drinking measure. Multidimensional scaling was used to map expectancies into memory network format, and likely activation of expectancies was empirically modeled. Heavier drinkers were most likely to activate positive and arousing expectancies associated with the ascending limb, whereas lighter drinkers were most likely to activate negative and sedating expectancies associated with the descending limb. These findings add to the literature suggesting that activation of expectancies in memory may be an important determinant of drinking behavior and a promising target for intervention strategies.

Psychometric evaluation of the marijuana and stimulant effect expectancy questionnaires for adolescents

Alcohol expectancies are important in the mediation and prediction of alcohol use. Expectancies for the effects of other drugs, although less well delineated, appear equally important. Therefore, development and validation of expectancy measures for drugs other than alcohol is necessary for evaluating the importance of these constructs. We examined the factor structure, reliability, and validity of the Marijuana Effect Expectancy Questionnaire (MEEQ) and the Stimulant Effect Expectancy Questionnaire (SEEQ) in clinical and community samples of adolescents as they moved into young adulthood (N=279). Confirmatory factor analyses (CFAs) supported the a priori factors, and we found good reliability for most individual scales. Temporal stability and convergent and discriminant validity of drug effect expectancies were supported in this sample of adolescents and young adults. Drug effect expectancies were associated with drug preference and drug use patterns over 2 years. Use of these measures may aid our understanding of the etiology and course of marijuana and stimulant involvement during adolescence and young adulthood.

Alcohol expectancies in convicted rapists and child molesters

BACKGROUND: Previous findings suggest that cognitive factors and expectancies related to drinking can mediate subjective sexual arousal as well as aggression in men. Our aim was to investigate the drinking habits and alcohol-related expectancies that might predispose men to sexually aggress in two groups of sexual offenders. METHOD: Men convicted of rape (n = 10) were compared with men convicted of child molesting (n = 10) and with control subjects (n = 31). Current drinking habits (while not in prison) were assessed by self-report, and the extent of alcohol abuse was mapped by the Michigan Alcoholism Screening Test (MAST; Selzer, 1971). Cognitive expectancies related to alcohol use were explored by the standard Alcohol Expectancy Questionnaire (AEQ; Brown et al., 1980). RESULTS: The majority of the men who committed rape (70%) but only a third of the men convicted of child molesting were diagnosed with antisocial personality disorder. Alcohol abuse was common in men convicted of both rape and child molesting and the men convicted of rape expected significantly more positive effects from drinking than the control group. Both sex offender groups were the only groups to express significant alcohol-related cognitive expectancies linked to arousal and aggression. Expectancy patterns were directly linked to the antisocial personality characteristics. CONCLUSION: Alcohol abuse is common in men who commit both rape and child molesting. Heavy drinking and the anticipation of alcohol effects such as sexual enhancement, arousal and aggression may facilitate sexual aggression in offenders with antisocial personality disorder.