Increased Awareness and Self-Challenge of Alcohol Expectancies

Insight into Selecting Adolescents for Drinking Intervention Programs: a Simulation Based on Stochastic Actor-Oriented Models

Adolescent drinking remains a prominent public health and socioeconomic issue in the USA with costly consequences. While numerous drinking intervention programs have been developed, there is little guidance whether certain strategies of participant recruitment are more effective than others. The current study aims at addressing this gap in the literature using a computer simulation approach, a more cost-effective method than employing actual interventions. We first estimate stochastic actor-oriented models for two schools from the National Longitudinal Study of Adolescent to Adult Health (Add Health). We then employ different strategies for selecting adolescents for the intervention (either based on their drinking levels or their positions in the school network) and simulate the estimated model forward in time to assess the aggregated level of drinking in the school at a later time point. The results suggest that selecting moderate or heavy drinkers for the intervention produces better results compared to selecting casual or light drinkers. The intervention results are improved further if network position information is taken into account, as selecting drinking adolescents with higher in-degree or higher eigenvector centrality values for intervention yields the best results. Results from this study help elucidate participant selection criteria and targeted network intervention strategies for drinking intervention programs in the USA.

Single-session expectancy challenge with young heavy drinkers on holiday

Expectancy challenges (ECs) were used to change alcohol expectancies and alcohol consumption in young heavy drinking men (age 16-24) on holiday. The intervention took place in community centers and bars. Alcohol expectancies and consumption were assessed with paper and pencil measures prior to the intervention (N=301) and 2 days afterwards (EC: n=178; controls: n=86). Six weeks after the EC, participants were interviewed by telephone (EC: n=163; controls: n=71). The intervention resulted in an increase in sedation expectancies in the EC group. Furthermore, the EC led to a differential reduction in alcohol consumption on a night out at the six-week posttest in the heaviest drinkers only. The reduction in alcohol consumption on a night out was not mediated by the change in sedation expectancies. These findings suggest that further research on the mechanisms of change is necessary before a single-session EC may be used in a real-life prevention setting.

Identification, prevention, and treatment revisited: individual-focused college drinking prevention strategies 1999-2006

This paper serves to update a prior review of the literature on individual-focused prevention and treatment approaches for college drinking [Larimer, M.E. & Cronce, J.M. (2002). Identification, prevention and treatment: A review of individual-focused strategies to reduce problematic alcohol consumption by college students. Journal of Studies on Alcohol Suppl. 14, 148-163.], and covers the period from late 1999 through 2006. No support was found for information/knowledge approaches alone, or for brief values clarification approaches alone or with other informational content. Evidence was found in support of skills-based interventions and motivational interventions that incorporated personalized feedback, with or without an in-person intervention. Normative re-education interventions received mixed support, though personalized normative feedback was associated with positive outcomes. Significant advances have been made over the past seven years with respect to mailed and computerized feedback interventions, and interventions with mandated students. Much of the research reviewed suffered from significant limitations, particularly small sample sizes, attrition, and lack of appropriate control groups. More research is needed to determine the best methods for disseminating such interventions on college campuses, as well as additional research on interventions with high-risk groups of students.

Individual-level interventions to reduce college student drinking: a meta-analytic review

In light of increasing numbers of controlled studies evaluating alcohol abuse prevention interventions for college drinkers, we conducted a meta-analysis to summarize the current status of the literature. The meta-analysis includes 62 studies, published between 1985 to early 2007, with 13750 participants and 98 intervention conditions. All studies were content coded for study descriptors, participant characteristics, and intervention components. We derived weighted mean effect sizes for alcohol interventions versus comparison conditions for consumption variables and alcohol-related problems, over four measurement intervals. Over follow-up intervals lasting up to 6 months, participants in risk reduction interventions drank significantly less relative to controls. Students receiving interventions also reported fewer alcohol-related problems over longer intervals. Moderator analyses suggest that individual, face-to-face interventions using motivational interviewing and personalized normative feedback predict greater reductions in alcohol-related problems. Implications for future research include attention to maintenance of effects, and developing more efficacious interventions for at-risk college drinkers.

From the laboratory to real life: a pilot study of an expectancy challenge with "heavy drinking" young people on holiday

The Alcohol Expectancy Challenge (EC) is a promising program for changing alcohol expectancies and reducing alcohol consumption in "heavy drinking" young men in a bar-lab setting. In this study the EC was adapted for use in mixed-gender groups in a holiday setting and its feasibility tested in camping resorts in the Netherlands where a lot of binge drinking takes place (summer 2002). Male and female participants (N = 170; mean age, 18.8 years) were randomly assigned to an EC or to an assessment-only control group. One day before the intervention, alcohol expectancies were measured by a Visual Analogue Scale of arousal-sedation expectancies (VAS expectancies questionnaire). At the same time, alcohol use in everyday life and on holiday was assessed by a General Drinking Questionnaire and a 24-hour drinking diary, respectively. Twenty-four hours after the intervention, the VAS expectancies questionnaire was administered again and alcohol use over the previous 24 hours was reported in the drinking diary. Six weeks after the intervention, participants were telephoned and administered oral versions of the VAS expectancies questionnaire and General Drinking Questionnaire. Data were analyzed using mixed ANOVAs. Although the study was hampered by recruitment difficulties, the EC proved feasible in this setting, was well received by youngsters, and effects on their alcohol expectancies may have been present. No effect was found on alcohol use. In conclusion, implementation must be improved and more studies are needed to come to more definite conclusions about the value of the EC in a real-life targeted intervention.

Changing expectancies: cognitive mechanisms and context effects

This article presents the proceedings of a symposium at the 2002 RSA Meeting in San Francisco, organized by Reinout W. Wiers and Mark D. Wood. The symposium combined two topics of recent interest in studies of alcohol expectancies: cognitive mechanisms in expectancy challenge studies, and context-related changes of expectancies. With increasing recognition of the substantial role played by alcohol expectancies in drinking, investigators have begun to develop and evaluate expectancy challenge procedures as a potentially promising new prevention strategy. The two major issues addressed in the symposium were whether expectancy challenges result in changes in expectancies that mediate intervention (outcome relations), and the influence of simulated bar environments ("bar labs," in which challenges are usually done) on expectancies. The presentations were (1) An introduction, by Jack Darkes; (2) Investigating the utility of alcohol expectancy challenge with heavy drinking college students, by Mark D. Wood; (3) Effects of an expectancy challenge on implicit and explicit expectancies and drinking, by Reinout W. Wiers; (4) Effects of graphic feedback and simulated bar assessments on alcohol expectancies and consumption, by William R. Corbin; (5) Implicit alcohol associations and context, by Barry T Jones; and (6) A discussion by Kenneth J. Sher, who pointed out that it is important not only to study changes of expectancies in the paradigm of an expectancy challenge but also to consider the role of changing expectancies in natural development and in treatments not explicitly aimed at changing expectancies.

Brief group alcohol interventions with college students: examining motivational components

The utility of brief interventions with at-risk college drinkers would be enhanced if they could also be delivered in group settings without the need for risk prescreening. The current study therefore explored whether components of brief interventions could be effectively administered to mixed groups of drinking and non-drinking students. Specifically, the outcomes of two methods aimed toward increasing motivation for change were compared to controls. One intervention focused on enhancing actual-ideal drinking behavior discrepancy through a structured group discussion, while the other focused on enhancing self-norm drinking behavior discrepancy through the provision and discussion of didactic information. Among at-risk drinkers, significant reductions in heavy drinking episode frequency at four-week follow-up were found for the self-norm (S-N) group only, while reductions in alcohol problems were obtained in both the S-N and control groups. Results suggest that self-norm discrepancy enhancement strategies may be more effective than actual-ideal discrepancy strategies when used with a mixed drinking group.

Negative emotional expectancies and readiness to change among college student binge drinkers

While expectancies are considered to be an important cognitive variable in the etiology and maintenance of substance use, less is known about their role in attitudes toward addictive behavior change. It has recently been suggested that negative alcohol expectancies, in particular, might play a fundamental role in motivation to change. Among a population of college student binge drinkers, the differential ability of positive and negative expectancies to predict total readiness to change (RTC) scores was examined. Hierarchical regression analyses revealed that controlling for level of consumption and number of drinking-related problems, negative and not positive expectancies significantly predicted RTC. In an examination of expectancy subtypes, negative emotional expectancies emerged as the only significant predictor of change motivation. Possible explanations for the findings and implications for interventions with undergraduate heavy drinkers are discussed.

Evaluation of a treatment-appropriate cognitive intervention for challenging alcohol outcome expectancies

The current study evaluated an alcohol expectancy challenge (EC) that did not require alcohol administration and could therefore be implemented in a treatment setting. Participants in the treatment group directly challenged alcohol expectancies endorsed on an expectancy questionnaire. A total of 62 male and female undergraduates completed the study (32 control participants, 30 EC participants). Self-report questionnaires were collected pre- and post-intervention, and alcohol logs were kept during the study. The EC resulted in significant reductions in alcohol expectancies across multiple expectancy dimensions. Although the analysis for alcohol consumption was not significant, there was a trend toward better outcomes for male participants in the EC condition. In contrast to study hypotheses, women in the EC condition increased their alcohol consumption from pre to post-test to a greater degree than did control participants.