Modifying alcohol-related expectancies in grade-school children

Alcohol expectancy profile in late childhood with alcohol drinking and purchasing behaviors in adolescence

BACKGROUND

The study aims to (i) identify the evolving profile of endorsed alcohol expectancies (AEs) during the transition from late childhood into early adolescence, and (ii) examine the connection between such profiles and subsequent alcohol drinking and purchasing in adolescence.

METHODS

A prospective cohort of 928 sixth graders was recruited from 17 elementary schools in northern Taiwan in 2006 with follow-ups conducted in seventh and eighth grade. Information concerning AEs, individual characteristics, and social attributes were collected by self-administered questionnaires at baseline and in seventh grade; drinking behaviors and alcohol purchasing were assessed in eighth grade. Longitudinal latent profile and survey regression analyses were used to evaluate association estimates.

RESULTS

Three distinct profiles of positive AEs were identified: stably low (37%), stably high (35%), and increasing (28%). Regardless of childhood-onset alcohol experience, endorsing the stably high-profile AEs was associated with increased drinking occasions (adjusted relative risk [aRR] = 1.49, 95% CI = 1.24-1.80), and having the increasing-profile AEs may elevate the likelihood of alcohol purchase in adolescence (adjusted odd ratio [aOR] = 2.57, 95% CI = 1.33-4.96). Additionally, parental drinking was the most influential social factor for drinking occasions (aRR = 1.43) whereas peer drinking was prominent for alcohol purchasing (aOR = 3.06).

CONCLUSIONS

The evolving profile of alcohol expectancy in late childhood may predict alcohol drinking occasion and purchasing behaviors in adolescence. Underage drinking prevention efforts should target not only pro-alcohol social environments but also cognitive constructs (e.g., alcohol expectancy).

Reciprocal relations between positive alcohol expectancies and peer use on adolescent drinking: An accelerated autoregressive cross-lagged model using the NCANDA sample

Positive alcohol expectancies (PAE) and associating with drinking peers are reliable predictors of adolescent alcohol use. Knowledge of when and for whom these risk factors are most influential could enhance intervention effectiveness. Reciprocal relations between PAE and adolescent and peer alcohol use were examined between the ages of 13 and 18 in a sample (N = 566; 50% female) from the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA), as well as sex differences in these associations. Associating with drinking peers prospectively predicted more frequent alcohol use for both sexes, although peer socialization was evident earlier for girls compared with boys. Higher PAE influenced later drinking in mid-adolescence, from age 14 to 16, for boys only. PAE influenced peer group selection for both sexes, although the influence was evident earlier in boys than girls. The relative impact of environmental risk factors for problematic alcohol use may vary over time and across developmental periods. These results suggest that prevention and treatment efforts for adolescent drinking can be improved by targeting age-appropriate risk factors. Early adolescent interventions may be best served by minimizing involvement with drinking peers and correcting normative beliefs of peer use. Among adolescent girls, early interventions focused on reducing peer influence may be most effective. Prevention and treatment programs aimed at addressing PAE would likely prove more effective for boys in mid- to late adolescence. (PsycINFO Database Record

Do positive alcohol expectancies have a critical developmental period in pre-adolescents?

OBJECTIVE

Positive outcome expectancies have been shown to predict initiation of alcohol use in children and to mediate and moderate the relationship between dispositional variables and drinking behavior. Negative outcome expectancies for alcohol appear to weaken as children progress to middle adolescence, but positive expectancies tend to increase during this time. Positive alcohol expectancies have been found to increase in children in third and fourth grades, indicating what some investigators have termed a possible critical period for the development of positive expectancies.

METHOD

In the present study, we assessed alcohol expectancies at baseline, 6, 12, and 18 months in 277 second-through sixth-grade students. Children completed the Alcohol Expectancy Questionnaire-Adolescent. Univariate analyses of covariance were conducted.

RESULTS

There were significant main effects for grade on positive alcohol-expectancy change for Global Positive Transformations at 12 and 18 months, Social Behavior Enhancement or Impediment at 6 and 12 months, and Relaxation/Tension Reduction at 6 and 18 months, whereby a consistent pattern emerged in that lower grades did not differ from each other, but they differed significantly from the higher grades.

CONCLUSIONS

Data support a critical developmental period for positive alcohol expectancies, with the greatest change observed between third and fourth grade and between fourth and fifth grade, and only in those expectancies clearly describing positive outcomes (e.g., Relaxation/Tension Reduction) via positive or negative reinforcement versus those with either combined or ambiguous outcomes (e.g., Social Behavior Enhancement or Impediment).

Alcohol expectancies in childhood: change with the onset of drinking and ability to predict adolescent drunkenness and binge drinking

AIMS

We examined the relationship between alcohol expectancies in childhood and onset of drinking, binge drinking and drunkenness in adolescence and the influence of drinking onset on expectancy development.

DESIGN

A prospective, longitudinal study of children assessed for alcohol expectancies and drinking at four time-points between ages 6 and 17 years.

SETTING

Community study of families at high risk for alcoholism conducted in a four-county area in the Midwestern United States.

PARTICIPANTS

The study involved 614 children; 460 were children of alcoholics and 70% were male.

MEASUREMENTS

Expectancies about alcohol effects were measured using the Beverage Opinion Questionnaire and child's drinking by the Drinking and Drug History-Youth Form.

FINDINGS

Partial factor invariance was found for expectancy factors from ages 6 to 17 years. Survival analysis showed that social/relaxation expectancies in childhood predicted time to onset of binge drinking and first time drunk (Wald χ(2) , 1 d.f. = 3.8, P = 0.05 and 5.0, P < 0.05, respectively). The reciprocal effect was also present; when adolescents began drinking, there was an increase in social/relaxation expectancy and a concomitant increase in slope of the expectancy changes lasting throughout adolescence.

CONCLUSIONS

A reciprocal relationship exists between childhood alcohol expectancies and the development of alcohol involvement. Higher expectancies for positive effects predict earlier onset of problem drinking. Onset of use, in turn, predicts an increase in rate of development of positive expectancies.

Marijuana expectancies and relationships with adolescent and adult marijuana use

BACKGROUND

Outcome expectancy is a central construct in models of addiction and relapse. Much expectancy research has been conducted in the context of alcohol; however, less is known about the structure of expectancies for marijuana and their associations with marijuana use outcomes.

METHODS

The data are taken from waves 3 and 4 of a longitudinal high-risk study of parents and adolescent offspring. Of those families who were retained at wave 3, 225 were high-risk and 205 were matched controls (low-risk). In the present study, we examine the factorial structure of marijuana expectancies (wave 3) in the offspring (using an instrument adapted from the alcohol literature) and test whether expectancies mediate the associations of familial risk for substance use, lifetime marijuana use in adolescence (wave 3) and current use in young adulthood (wave 4; reported approximately 5 years later).

RESULTS

We quantified four marijuana expectancy factors similar to those identified in previous studies when the offspring were adolescents (Mn age=15.2) and results of our mediation models suggest that negative marijuana expectancies (but not positive expectancies) together with lifetime adolescent marijuana use completely mediated the association between familial risk and current use of marijuana during young adulthood (Mn age=20.2).

CONCLUSION

Familial risk for current marijuana use in young adulthood appears to be transmitted through two orthogonal, prospective pathways. One pathway involves marijuana use during adolescence, and the second pathway involves reduced expectancies that using marijuana will result in cognitive and behavioral impairments.

Predicting adolescent substance use: the effects of depressed mood and positive expectancies

This study examined whether sixth-graders' depressed mood and positive substance use expectancies predicted increases over the next two years in students' lifetime and 30-day cigarette, alcohol, and marijuana use, and whether sixth graders' positive substance use expectancies moderated the relationship between baseline depressed mood and changes over the next two years in the use of these substances. Study data came from a randomized controlled trial of Project ALERT, a school-based substance use prevention program, in which students from 34 schools completed self-report surveys as sixth (n=5782), seventh (n=5065), and eighth graders (n=4940). Primary analyses were performed using Hierarchical Nonlinear Modeling. Over time, there were significant effects of baseline positive expectancies on each of the six measures of substance use. Baseline depressed mood predicted increases over time only for lifetime use of cigarettes and alcohol, and for 30-day alcohol use. Positive expectancies significantly moderated the effects of adolescent depressed mood only on lifetime marijuana use. Although depressed mood predicted substance use for half of our variables, our results suggest that positive expectancies are a more consistent predictor of adolescent substance use, and that they may moderate the effects of depressed mood on marijuana, but not cigarette or alcohol, use. Substance use prevention programs may benefit from addressing adolescents' perceptions about the positive consequences of drug use.

A motivational model of alcohol misuse in emerging adulthood

Many emerging adults who have dropped out of high school are known to misuse alcohol. Expectancies and motives for drinking are pivotal in shaping the drinking behavior of emerging adults, especially those related to social influences. We tested a motivational model of problematic alcohol use using drinking motives (enhancement, social, conformity, coping) as multiple mediators to explain the association between social alcohol expectancies and alcohol misuse. A community sample of 104 individuals between ages 16 and 21 attending a General Educational Development (GED) program completed self-report measures of alcohol expectancies, drinking motives, quantity and frequency of drinking, and a structured interview that assessed the symptoms of alcohol use disorders. Results of multiple regression analysis testing multiple mediators indicated that social alcohol expectancies were associated with alcohol misuse through the mediated pathways of enhancement drinking motives.

Parental alcohol involvement and adolescent alcohol expectancies predict alcohol involvement in male adolescents

Current models of adolescent drinking behavior hypothesize that alcohol expectancies mediate the effects of other proximal and distal risk factors. This longitudinal study tested the hypothesis that the effects of parental alcohol involvement on their children's drinking behavior in mid-adolescence are mediated by the children's alcohol expectancies in early adolescence. A sample of 148 initially 9-11 year old boys and their parents from a high-risk population and a contrast group of community families completed measures of drinking behavior and alcohol expectancies over a 6-year interval. We analyzed data from middle childhood (M age = 10.4 years), early adolescence (M age = 13.5 years), and mid-adolescence (M age = 16.5 years). The sample was restricted only to adolescents who had begun to drink by mid-adolescence. Results from zero-inflated Poisson regression analyses showed that 1) maternal drinking during their children's middle childhood predicted number of drinking days in middle adolescence; 2) negative and positive alcohol expectancies in early adolescence predicted odds of any intoxication in middle adolescence; and 3) paternal alcoholism during their children's middle childhood and adolescents' alcohol expectancies in early adolescence predicted frequency of intoxication in middle adolescence. Contrary to predictions, child alcohol expectancies did not mediate the effects of parental alcohol involvement in this high-risk sample. Different aspects of parental alcohol involvement, along with early adolescent alcohol expectancies, independently predicted adolescent drinking behavior in middle adolescence. Alternative pathways for the influence of maternal and paternal alcohol involvement and implications for expectancy models of adolescent drinking behavior were discussed.

Expectancies related to thinness, dietary restriction, eating, and alcohol consumption in women with bulimia nervosa

OBJECTIVE

To investigate behavior-outcome expectancies relating to thinness, dietary restriction, eating, and alcohol consumption in women with bulimia nervosa (BN).

METHOD

Women with BN (N = 29), women with BN and a co-morbid lifetime alcohol use disorder (AUD; N = 18), and control women (N = 24), completed interviews and questionnaires assessing eating- and alcohol-related symptoms, as well as questionnaires measuring expectancies relating to thinness, dietary restriction, eating, and alcohol consumption.

RESULTS

Compared with the control group, both bulimic groups reported greater positive expectancies relating to thinness, dietary restriction and eating; expectancy endorsements were also predictive of the severity of eating-related symptoms. Compared with the other groups, the bulimic group with comorbid lifetime AUD had elevated positive alcohol-related expectancies, and alcohol expectancy endorsements predicted severity of alcohol-related symptoms.

DISCUSSION

Women with BN endorsed more positive expectancies relating to thinness, dietary restriction, and eating, whereas women with BN and a lifetime comorbid AUD endorsed more positive alcohol expectancies. The results are consistent with expectancy theory in that positive expectancy endorsements were associated with symptom severity in a syndrome-specific manner. Expectancies related to thinness, dietary restriction, eating, and alcohol consumption in women with BN.

Transitions into underage and problem drinking: developmental processes and mechanisms between 10 and 15 years of age

Numerous developmental changes occur across levels of personal organization (eg, changes related to puberty, brain and cognitive-affective structures and functions, and family and peer relationships) in the age period of 10 to 15 years. Furthermore, the onset and escalation of alcohol use commonly occur during this period. This article uses both animal and human studies to characterize these multilevel developmental changes. The timing of and variations in developmental changes are related to individual differences in alcohol use. It is proposed that this integrated developmental perspective serve as the foundation for subsequent efforts to prevent and to treat the causes, problems, and consequences of alcohol consumption.

Prevention of methamphetamine abuse: can existing evidence inform community prevention?

Little research exists on effective strategies to prevent methamphetamine production, distribution, sales, use, and harm. As a result, prevention practitioners (especially at the local level) have little guidance in selecting potentially effective strategies. This article presents a general causal model of methamphetamine use and harms that reflects the available findings from either research specific to methamphetamine or from alcohol and other illegal drugs, and suggests prevention approaches and strategies that communities might use based upon research evidence and experience. Community methamphetamine prevention can use the public health and safety perspective applied to other substance abuse prevention. Analyses of the complex system of intermediate variables that interact to affect methamphetamine use and harms suggest that multiple reinforcing prevention interventions may have the greatest potential effectiveness.

The alcohol-aggression link: children's aggression expectancies in marital arguments as a function of the sobriety or intoxication of the arguing couple

Children's expectancies of man-woman and woman-man aggression during arguments between individuals who were either intoxicated or sober were examined. The role of child and familial characteristics in influencing these expectancies was assessed. We examined children's expectations of interadult verbal/psychological and physical aggression during simulated arguments presented to children on videotapes. A community sample (N = 156) of children and young adolescents (6-14-year olds) participated. Children expected higher levels of aggression during conflict when they thought that one or both participants in conflict were intoxicated versus sober. Further, higher levels of verbal versus physical interadult conflict were expected during the disputes. These findings build on the literature by demonstrating that elementary school age children and young adolescents exhibit expectancies that link the consumption of alcohol with increased verbal and physical aggression in marital arguments. These alcohol-aggression expectancies were robust and were evident in relation to either the man's or woman's perpetration of aggression against the spouse. Elucidation of factors that can influence associations between aggression and alcohol consumption are of importance and have broad implications for family functioning.

Interactive effects of alcohol outcome expectancies and alcohol cues on nonconsumptive behavior

Experimental research and popular belief suggest that, among its many effects, alcohol consumption reduces tension and facilitates aggression. Such observations could result from direct, pharmacological effects of alcohol on neural control of behavior but also may be accounted for by positing that drinking behavior activates mental representations of relaxation-related or aggression-related alcohol expectancies in long-term memory. Building on this latter view, in 2 experiments, the authors investigated whether rudimentary drinking-related cues, which presumably activate encoded alcohol expectancies, facilitate tension reduction and hostility in the complete absence of actual or placebo alcohol consumption. In Experiment 1, following contextual exposure to alcohol-related words, individuals with stronger expectancies that drinking reduces tension showed an increased willingness to meet with an opposite-gender stranger under relatively anxiety-provoking circumstances, suggesting that they experienced less apprehension regarding the meeting. Analogously, in Experiment 2, following near-subliminal exposure to alcohol-related words, individuals with stronger expectancies that drinking fosters aggression showed greater hostility toward a target person following an experimentally engineered provocation. Neither of the latter effects was obtained following exposure to nonalcoholic beverage words, which presumably did not activate alcohol outcome expectancy representations in long-term memory. Moreover, the strength of relevant, content-specific expectancies (i.e., for tension reduction or aggression, respectively) moderated alcohol cue exposure effects, but the strength of other expectancies (e.g., for sociability or sexual arousal) did not. Together, these findings demonstrate that exposure to rudimentary alcohol cues independently engenders expectancy-consistent behavior, thereby attesting to the remarkable breadth and subtlety of the behavioral impact of alcohol expectancy activation.

Socio-environmental influences on adolescents' alcohol outcome expectancies: a prospective analysis

AIMS

To investigate the prospective influence of social influence and social bonding variables on the development of alcohol outcome expectancies among adolescents with and without drinking experience.

DESIGN

Longitudinal data from students in the control schools of a field trial designed to evaluate a school-based drug prevention program.

SETTING

A total of 19 middle schools in South Dakota, USA.

MEASUREMENTS

An alcohol outcome expectancy scale administered to 1410 students in grades 8 and 9. After using confirmatory factor analysis (CFA) to develop an expectancies measure, multiple-group (grade 8 drinkers versus grade 8 non-drinkers) path analysis was used to model 9th grade alcohol expectancies. Grade 8 social influence and bonding variables were used as predictors, controlling for grade 8 expectancies.

FINDINGS

At the bivariate level, peer and adult influences and social bonding variables were related consistently to alcohol outcome expectancies among drinkers and non-drinkers. A bivariate relationship between alcohol advertising and alcohol expectancies was found among drinkers only. In the multivariate model, greater alcohol use by important adults predicted independently increased alcohol positivity among drinkers; greater perceived approval of alcohol use by parents and peers predicted diminished perceived potency of alcohol among non-drinkers. Advertisement exposure and social bonding variables were not independent predictors of alcohol expectancies in the multivariate model.

CONCLUSIONS

These findings suggest that attempts to alter adolescents' alcohol expectancies are likely to fail unless they address the influence of immediate social models on these beliefs.

Adolescent alcohol misuse: methodological issues for enhancing treatment research

AIMS

The objective of this article is to present an overview of the current state of the field of adolescent alcohol treatment research and to discuss several priorities for future research directions.

METHOD

The authors identified trends in adolescent alcohol treatment research from multiple sources, including searches of the National Institutes of Health grantee listings, proceedings from annual meetings of the Research Society on Alcoholism and relevant English-language journal articles available in MEDLINE and PSYCHLIT databases over the past decade.

RESEARCH RECOMMENDATIONS

This field must build on its major strength, which has been its success in appreciating the unique developmental characteristics of adolescence and meaningfully incorporating them into adolescent alcohol treatment approaches. Priorities for future research include: empirically investigating the potential value of harm reduction approaches for promoting public health and reducing total harm for adolescents; developing efficacious interventions across a wide range of intensities and settings; increasing the reach and relevance of randomized treatment efficacy trials and their products, with a particular focus on enhancing the recruitment and retention of diverse treatment samples; increasing a focus on key individual difference variables such as co-occurring diagnoses, that may serve as the basis for treatment tailoring; and exploration of the potential benefits of transdisciplinary research.

Lowering risk for early alcohol use by challenging alcohol expectancies in elementary school children

Altering alcohol expectancies has reduced alcohol use among young adults and may lead to successful prevention of early alcohol use. The authors randomly assigned 216 4th-grade children to an expectancy challenge or control condition and used individual-differences scaling to map expectancies into memory network format, with preference mapping to model likely paths of association. After expectancy intervention, children exhibited a greater likelihood to associate alcohol use with negative and sedating consequences and a decreased likelihood to associate alcohol with positive and arousing consequences. Children and adults who emphasize negative and sedating effects have been found to be less likely touse alcohol. Therefore, expectancy challenge interventions that have been successful at modifying expectancies and subsequently decreasing alcohol consumption of adults may be useful in reducing the likelihood of early alcohol use among children.

Das Alkoholkonzept von Grundschulkindern

Zusammenfassung. In der vorliegenden Studie wurden das Alkoholkonzept und die mit Alkoholkonsum verbundenen Einstellungen und Vorstellungen anhand von standardisierten Erhebungsverfahren bei 67 Kindern (37 männlich, 30 weiblich) im Alter von 6 bis 10 Jahren untersucht. Die Ergebnisse zeigen, dass etwas mehr als die Hälfte der untersuchten Grundschüler über ein Alkoholkonzept verfügen, wobei der Anteil jener Kinder in den höheren Altersstufen größer ist. Die persönliche Einstellung zum Alkoholkonsum wird mit zunehmendem Alter negativer und ist unabhängig vom Geschlecht des Kindes und des Alkoholkonsumenten. Weiterhin wurde deutlich, dass bereits die jüngsten Kinder über klare Vorstellungen hinsichtlich der mit dem Alkoholkonsum verbundenen Konventionen verfügen. Die Ergebnisse der Untersuchung werden in Bezug auf die vorhandene Forschungslage und hinsichtlich ihrer Bedeutung für die Prävention diskutiert. Thematisiert werden in der Diskussion ebenso die Schwierigkeiten, die mit der Durchführung von empirischer Forschung in diesem Bereich verbunden sind.

Age differences in alcohol and cocaine expectancies and attitudes

Positive and negative expectancies regarding the behavioral effects of alcohol and cocaine were assessed and used to predict attitudes toward their use across four age groups (5-7, 8-10, 11-14, and 18-25, N = 121). Regardless of gender and minority status, children and early adolescents appeared to overgeneralize their beliefs about alcohol to a less familiar drug, cocaine, perceiving the effects of the two drugs similarly. Only college students differentiated between drugs, perceiving cocaine as less likely than alcohol to produce drunkenness and more likely to have stimulant and elation/empowerment effects. With age and other expectancies controlled, expectancy of drunkenness was the best predictor of disapproval of alcohol use; attitudes toward cocaine use were unrelated to expectancies but became more negative with age. Drug prevention programs should rest on data regarding children's preexisting beliefs about the consequences of drug use and should help them understand that different drugs (for example, stimulants and depressants) pose different dangers.

Integrating disinhibition and learning risk for alcohol use

In this study the authors tested the acquired preparedness model of problem drinking, which holds that trait disinhibition, defined as neurotic extraversion by C. M. Patterson and J. P. Newman (1993), leads to the biased formation of positive over negative alcohol expectancies. Positive expectancies thus mediate disinhibition's influence on drinking. The authors also hypothesized that disinhibition moderates the expectancy-drinking relationship such that disinhibited individuals are more likely to act on their positive expectancies. In Study 1, positive expectancies both mediated and moderated the disinhibition-drinking relationship. In Study 2, learning task results indicated that disinhibited individuals sought reward, even when passive avoidance of punishment was indicated. Study 2 also replicated Study I hypotheses for men but generally not for women.

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.

Primary prevention of alcohol misuse: overview and annotated bibliography

Following an overview of conceptual and methodological issues related to alcohol misuse primary prevention and a brief discussion of the most frequently employed primary prevention strategies, a comprehensive annotated bibliography of the alcohol misuse primary prevention literature is presented. Several benefits of presenting detailed annotations, such as allowing readers to (a) examine the various prevention program components, (b) identify the presence or absence of methodological shortcomings, (c) identify whether or not high-risk groups were included as program participants, and (d) evaluate the feasibility of program implementation, are also highlighted. The present article complements previous reviews which have often mixed together the findings of primary and secondary prevention studies and which have typically reported the effects of prevention programming on multiple substance misuse outcomes simultaneously. The practice of simultaneously reporting multiple substance misuse outcomes has made it difficult to interpret the specific effects that primary prevention programs have had on alcohol misuse per se.

Children's beliefs about drinking

This paper reports the results of a study in which age (grade level), racial/ethnic, and gender differences in beliefs and perceived norms about drinking were examined in a multi-ethnic urban sample of 4th through 7th grade children. Results showed that older children held beliefs and perceived norms that were more favorable toward drinking than younger children. The major difference between older and younger children lay in their differential estimates of the likelihood of certain consequences occurring and not in their evaluation of these consequences of drinking. Further, older children not only displayed less motivation to comply with their parents and greater motivation to comply with their peers, but they also perceived their parents, as well as their peers, as less disapproving of drinking than did younger children. There were few gender or race/ethnicity differences at these ages in children's beliefs and perceived norms about drinking.