A critical systematic review of alcohol-related outcome expectancies

Pain and Hazardous Alcohol Use in Veterans in Primary Care: The Role of Affective Pain Interference and Alcohol Pain-Coping Perceptions

Chronic pain and unhealthy alcohol use commonly co-occur and are associated with negative health outcomes. Veterans may be particularly vulnerable to these conditions, yet limited research has examined factors involved in their co-occurrence. This cross-sectional study aimed to examine the role of affective pain interference and alcohol pain-coping perceptions in the relationship between pain and hazardous alcohol use. As informed by the catastrophizing, anxiety, negative urgency, and expectancy model, we hypothesized that the relationship between pain and hazardous alcohol consumption is mediated by affective pain interference and stronger among those with greater perceptions that alcohol helps cope with pain. Participants were 254 VA primary care patients (87.8% male, Mage = 64.03, 76.4% White) with a history of chronic musculoskeletal pain, past-year alcohol use, and past-week pain. Veterans completed a mailed survey including measures of pain, affective pain interference, alcohol pain-coping perceptions, and hazardous alcohol use. Hypotheses were tested with regression models and PROCESS macros. As hypothesized, affective pain interference mediated the pain-hazardous alcohol use association. Contrary to hypotheses, results showed no moderating effect of alcohol pain-coping perceptions. Findings partially support relationships among theorized constructs and suggest that for Veterans with co-occurring pain and alcohol use it may be important to target pain-related affective interference and perceptions that alcohol helps cope with pain. PERSPECTIVE: This article presents a test of factors involved in the pain and alcohol relationship, as informed by the CANUE model. Findings suggest that for Veterans with co-occurring pain and past-year alcohol use, it may be important to target pain-related affective interference and perceptions that alcohol helps cope with pain.

Development and standardization of Indian Alcohol Photo Stimuli (IAPS) for cue-reactivity paradigms in patients with alcohol use disorder

Background

The availability of appropriate alcohol-related stimuli is a crucial concern for the evaluation and treatment of patients with alcohol dependence syndrome. The study aimed to standardize alcohol-related images with cultural relevance to the Indian setting.

Methods

We produced an extensive database of 203 pictures, the Indian Alcohol Photo Stimuli (IAPS), portraying different categories and types of alcoholic beverages, after removing the confounding effects of low-level stimulus parameters (e.g. brightness and blurriness). Thirty patients with alcohol dependence syndrome, currently abstinent, rated each image on visual analog scale (VAS) ranging from 0 (no craving) to 10 (extreme), to determine how typical the stimuli served as craving-relevant stimuli.

Results

The mean VAS scores across beverages (ordered from highest to lowest) were whiskey >rum >beer >wine >vodka. Repeated-measures analysis of variance (ANOVA) showed a significant difference in mean VAS scores across beverages (F = 2.93, df = 2.9/86.3, P = 0.039, Greenhouse-Geisser corrected); the effect size for the difference was small (ηp2 = 0.092). A post hoc Bonferroni shows significantly higher VAS scores with whiskey compared with vodka (P = 0.029), whereas the scores were similar across other beverages. A two-way repeated-measures ANOVA for interaction between type of alcoholic beverages and activity was not significant (F = 2.67, df = 2.6/76.6, P = 0.061, Greenhouse-Geisser corrected).

Conclusions

We created a standardized alcohol-related image database for studying cue-reactivity paradigms in individuals with alcohol use disorder (AUD). Further research is needed to validate the impact of image features on cue reactivity.

Thinking about drinking: Acculturation and alcohol-related cognitions among college-bound Latinas

Objective: This study examined acculturation with positive alcohol expectancies (PAE) and alcohol use intentions among college-bound Latinas using a bidimensional (ie U.S. acculturation/enculturation) and bidomain (ie behaviors/values) acculturation framework. Participants: A total of 298 Latina young adults between 18 and 20 years old were included in this analysis. Methods: Data were collected the summer before participants began college for the first time. We used an online survey to assess acculturation, PAE, and alcohol use expectancies. Results: Path analyses showed that U.S. acculturation values were related to more PAE and alcohol use intentions. U.S. acculturation behaviors were related to more alcohol use intentions, and the pathway was moderated by PAE. There was also an interaction between U.S. acculturation and enculturation behaviors predicting alcohol use intentions. Conclusion: This study sheds light on how acculturating Latina young women think about alcohol use prior to beginning college, which is an opportune window for targeted prevention programs.

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

OBJECTIVE

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

The effectiveness of a web-based intervention for Japanese adults with problem drinking: An online randomized controlled trial

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We conducted an online randomized controlled trial for a web-based intervention.

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The intervention comprised normative comparison, psychoeducation, and a short quiz.

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Participants were Japanese adults aged 20 years or older and scored AUDIT ≥ 8.

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The weekly drinking quantity at the two- and six-month follow-ups decreased.

Aims

This study aimed (1) to delineate how a web-based intervention affects the problem drinking behaviors of Japanese adults and (2) to examine the moderating effects of disorder levels and alcohol outcome expectancies on intervention outcomes.

Methods

We implemented an online two-armed parallel-group randomized controlled trial with 546 Japanese adults. Adults aged 20 years or older and who scored eight or higher on the Alcohol Use Disorder Identification Test were included in this study. Participants were randomly allocated to the intervention group or the waitlist/control group. The intervention comprised assessment of drinking behavior, personalized normative feedback, psychoeducation about the consequences of problem drinking, and a short quiz. The outcomes were weekly drinking quantity and abstinent days, largest drinking quantity in one day, and alcohol-related consequences reported at baseline and at one-, two-, and six-month follow-ups. A mixed-effects model regression was conducted to compare the intervention and control groups.

Results

The attrition rates at each follow-up were 52.93%, 49.45%, and 32.60%, respectively. The time × condition interaction effect on weekly drinking quantity was significant at the two- and six-month follow-ups, d = 0.28, 95% CI [0.04, 0.51], d = 0.34, 95% CI [0.05, 0.63], respectively. Moderations related to the intervention effect were not statistically significant.

Conclusion

A web-based intervention was found to be effective for two and six months only on drinking quantity measures of Japanese adults with problem drinking. Limitations including high drop-out rates in are discussed.

Expectancies for and Pleasure from Simultaneous Alcohol and E-Cigarette Use among Young Adults

Background: Young adults' use of alcohol and e-cigarettes are of public health concern, as they report among the highest prevalence for use of both substances. Many young adults use alcohol and e-cigarettes simultaneously (i.e., at the same time with overlapping effects) despite heightened risk for adverse effects. Objectives: This study assessed simultaneous use expectancies and changes in pleasure from e-cigarettes as a function of alcohol consumption and simultaneous use frequency. Participants (N = 408; Mage = 23.64 years; 52.7% female) recruited through Amazon MTurk completed measures of alcohol and e-cigarette use, and expectancies, pleasure and frequency of simultaneous use. Results: Separate linear regression models revealed that alcohol consumption was positively associated with expectancies for simultaneous use of e-cigarettes/alcohol and pleasure from simultaneous use (ps ≤ .015). As individuals engaged in simultaneous use more frequently, they also reported greater expectancies for, and increased pleasure from, simultaneous use (ps < .001). Conclusions/Importance: Expectancies for simultaneous use may be greatest among young adults who consume more alcohol and engage in simultaneous use more frequently. Increased pleasure from e-cigarettes while drinking suggests that positive reinforcement may be implicated in simultaneous use patterns. Future research should examine the role of pleasure in simultaneous use trajectories.

Alcohol-Antiretroviral Therapy Interactive Toxicity Beliefs and Intentional Medication Nonadherence: Review of Research with Implications for Interventions

The successful treatment of HIV infection relies on adherence to antiretroviral therapy (ART). Alcohol use remains a threat to ART adherence, including the beliefs held by people who drink alcohol that it is harmful to take ART when consuming alcohol (i.e., alcohol-ART interactive toxicity beliefs, AA-ITB). We reviewed the current research that has investigated AA-ITB and their relationship to intentional ART nonadherence. The review of 17 published studies found that AA-ITB are prevalent among people receiving ART and that AA-ITB are directly associated with ART nonadherence and incomplete HIV suppression. Family, friends and healthcare providers are common sources and reinforcers of AA-ITB. Studies suggest that AA-ITB may best be explained by the Medication Necessity and Concerns Beliefs Model, treating AA-ITB as a specific circumstance of medication concerns. Interventions are needed to communicate the realities of potential medication interactions and dispel myths that it is harmful to mix alcohol with ART, while not inadvertently suggesting that it is safe to drink with all medications, which could undermine adherence to ART by increasing alcohol use.

Effects of within- and between-person assessments of alcohol expectancies and valuations on use and consequences moderated by sex

BACKGROUND

Alcohol expectancies (AE; beliefs about the likelihood of outcomes) and valuations (beliefs about the desirability of outcomes) may help explain alcohol use by young adults. However, it remains unclear how variability in AE and valuations over time are related to alcohol-related outcomes, and whether these associations are moderated by sex. The current study addressed these gaps in knowledge by examining within-person variability among positive and negative AEs, valuations, and alcohol-related outcomes over a 12-month period.

METHODS

Data were collected from 433 college students (M_age  = 20.06; 59.81% women) who completed surveys at 4 timepoints: at baseline and 3-month, 6-month, and 12-month follow-up.

RESULTS

We found substantial within-person variability in both AE and valuations (intraclass correlation coefficients ranged from 50% to 66%), and differences in variability by sex, with women showing more variability than men. Multilevel models revealed that weekly drinking was significantly higher at timepoints in which participants held relatively greater AE for sociability, sexuality, and risk/aggression, but lower when participants expected greater effects on self-perception. Weekly drinking was also higher when participants reported more favorable valuation of risk/aggression. Participants experienced significantly more negative consequences at timepoints in which they held relatively greater AE for sexuality and self-perception. No AEs were associated with a reduced likelihood of negative consequences. Participants experienced more negative consequences at timepoints in which they reported more favorable valuation of self-perception No valuations were associated with fewer consequences. Several between- and within-person associations were moderated by sex.

CONCLUSIONS

These findings suggest that AE and valuations are dynamic, that young adults' beliefs about the effects of alcohol varied over time, and that both negative and positive AE and valuations may be important correlates of alcohol use and consequences. These findings have implications for interventions designed to challenge expectancies and valuations with the goal of reducing alcohol use and associated consequences.

The association between intended drinking contexts and alcohol expectancies in college students: A daily diary study

BACKGROUND

Because of the role alcohol outcome expectancies play in subsequent drinking, it is important to understand factors that can shape alcohol expectancies to guide intervention efforts. This study examined among college students whether intended social contexts for drinking were associated with positive and negative alcohol expectancies at the daily-level.

METHODS

Participants included in analyses were 323 students, ages 18 to 24 years, enrolled at a 4-year university in the Pacific Northwest. At four 2-week measurement bursts across one year, participants were asked each afternoon to report whether they planned to drink alcohol later that day. If so, they were further asked how much they intended to drink, whether they plan to drink alone or with others, whether they plan to drink at home or bar/party, and their positive and negative expectancies of alcohol use that evening.

RESULTS

A total of 2953 person-day observations from planned drinking days were used. Results from linear mixed models, adjusted for covariates including intended number of drinks, showed that students reported greater positive alcohol expectancies on days when they intended to drink with others vs. alone and intended to drink at a bar or party vs. at home. For negative expectancies, only intended drinking with others showed a statistically significant association.

CONCLUSION

This study suggests that contextual factors may shape college students' expectancies about effects of alcohol at the daily-level. Intended drinking contexts may be important to address in event-level interventions to reduce high-risk drinking in young adults.

A measure of expectancies for alcohol analgesia: Preliminary factor analysis, reliability, and validity

Rates of alcohol consumption are substantially higher among persons with pain, and recent research has focused on elucidating bidirectional pain-alcohol effects. Expectancies for alcohol analgesia could influence the degree to which alcohol confers acute pain-relieving effects, and may amplify the propensity to respond to pain with drinking behavior. However, no validated measures of expectancies for alcohol analgesia are available. Therefore, we developed a five-item measure of Expectancies for Alcohol Analgesia (EAA), which assesses the perceived likelihood that alcohol will reduce pain. The goal of this project was to examine psychometric properties of the EAA among a sample of 273 current alcohol users with chronic pain (M_age = 32.9; 34% female) who completed an online survey of pain and substance use. Confirmatory factor analysis (CFA) results indicated that the hypothesized single-factor structure of the EAA provided good model fit (Bollen-Stine bootstrap p = .13). The EAA also showed excellent internal consistency (α = 0.97), and scores were positively associated with quantity/frequency of alcohol use, alcohol outcome expectancies, coping-related drinking motives, and pain severity (ps < 0.01). These findings provide initial support regarding the single-factor structure, reliability, and validity of the EAA. Examination of predictive utility and further validation are important next steps.

Ecological Momentary Assessment of the Relationship between Positive Outcome Expectancies and Gambling Behaviour

Relapse prevention models suggest that positive outcome expectancies can constitute situational determinants of relapse episodes that interact with other factors to determine the likelihood of relapse. The primary aims were to examine reciprocal relationships between situational positive gambling outcome expectancies and gambling behaviour and moderators of these relationships. An online survey and a 28 day Ecological Momentary Assessment (EMA) were administered to 109 past-month gamblers (84% with gambling problems). EMA measures included outcome expectancies (enjoyment/arousal, self-enhancement, money), self-efficacy, craving, negative emotional state, interpersonal conflict, social pressure, positive emotional state, financial pressures, and gambling behaviour (episodes, expenditure). Pre-EMA measures included problem gambling severity, motives, psychological distress, coping strategies, and outcome expectancies. No reciprocal relationships between EMA outcome expectancies and gambling behaviour (episodes, expenditure) were identified. Moderations predicting gambling episodes revealed: (1) cravings and problem gambling exacerbated effects of enjoyment/arousal expectancies; (2) positive emotional state and positive reframing coping exacerbated effects of self-enhancement expectancies; and (3) instrumental social support buffered effects of money expectancies. Positive outcome expectancies therefore constitute situational determinants of gambling behaviour, but only when they interact with other factors. All pre-EMA expectancies predicted problem gambling severity (OR = 1.61–3.25). Real-time interventions addressing gambling outcome expectancies tailored to vulnerable gamblers are required.

Negative urgency and alcohol-related problems: indirect links with alcohol expectancies and drinking motives

BACKGROUND

Negative Urgency (NU), the tendency to act rashly during negative emotional states, is associated with alcohol misuse through various alcohol cognitions; however, these relationships are often examined in isolation and exclude certain alcohol cognitions. Objective: This study simultaneously modeled NU's association with alcohol-related problems through (a) beliefs about the likelihood of experiencing positive or negative effects from alcohol (i.e., expectancies), (b) desirability of alcohol's positive or negative effects (i.e., valuations), and (c) reasons for consuming alcohol (i.e., drinking motives). Methods: Participants (N = 565) completed measures of NU, expectancies, valuations, drinking motives, and alcohol problems online. Results: NU was indirectly associated with alcohol-related problems through coping motives, positive expectancies, and enhancement motives. Despite a positive association between NU and negative valuations, NU was not associated with alcohol-related problems through valuations. Conclusions: These results further researchers' understanding of how NU is associated with modifiable alcohol cognitions, with clear implications for informing treatment and future research.

The association between child alcohol sipping and alcohol expectancies in the ABCD study

BACKGROUND

Underage drinking is a serious societal concern, yet relatively little is known about child sipping of alcohol and its relation to beliefs about alcohol. The current study aimed to (1) examine the contexts in which the first sip of alcohol occurs (e.g., type of alcohol, who provided sip, sip offered or taken without permission); (2) examine the association between sipping and alcohol expectancies; and (3) explore how different contexts of sipping are related to alcohol expectancies. We expected to find that children who had sipped alcohol would have increased positive expectancies and reduced negative expectancies compared to children who had never sipped alcohol.

METHODS

Data were derived from the 2.0 release of the Adolescent Brain Cognitive Development (ABCD) study, a longitudinal study of children in the United States. We utilized data from 4,842 children ages 9-11; 52% were male, 60% were White, 19% were Hispanic/Latinx, and 9% were Black/African American.

RESULTS

We found that 22% of the sample had sipped alcohol. Children reported sipping beer most frequently, and the drink most often belonged to the child's father. We found that children who had sipped had higher positive alcohol expectancies than children who had not while accounting for variables related to alcohol expectancies. Child sipping was not significantly associated with negative expectancies and the context of the first sip of alcohol was not significantly associated with positive and negative expectancies.

CONCLUSIONS

Providing sips of alcohol to children is associated with them having more favorable expectations about drinking.

A comparison of the associations between alexithymia and both non-suicidal self-injury and risky drinking: The roles of explicit outcome expectancies and refusal self-efficacy

Both non-suicidal self-injury (NSSI) and risky drinking are positively associated with alexithymia, a personality trait characterized by difficulties appraising feelings and an externally orientated thinking style. Although researchers have studied the associations between alexithymia and both NSSI and risky drinking, the underlying factors of both associations are rarely compared. Using path analysis, we compared the mediating effects of behaviour-specific outcome expectancies and self-efficacy beliefs on the associations between alexithymia and both NSSI and risky drinking. A sample of 627 university students (76.10% female, Mage = 20.75, SD = 1.88) completed a battery of questionnaires. Alexithymia exhibited indirect effects on NSSI via affect regulation expectancies, pain expectancies, communication expectancies, and low self-efficacy to resist NSSI. Alexithymia exhibited indirect effects on risky drinking via expectations of increased confidence and negative consequences. However, the indirect effects differed depending on the valance of the emotion the individual had difficulties appraising. Our findings indicate that the underlying factors in the associations between alexithymia and both NSSI and risky drinking could differ. Where individuals who have difficulties appraising negative emotions may engage in NSSI to help regulate negative feelings, they may consume alcohol to gain more confidence in expressing their feelings. Clinical implications are discussed.

Combinations of Drinking Occasion Characteristics Associated with Units of Alcohol Consumed among British Adults: An Event-Level Decision Tree Modeling Study

BACKGROUND

Alcohol consumption is influenced by the characteristics of drinking occasions, for example, location, timing, or the composition of the drinking group. However, the relative importance of occasion characteristics is not yet well understood. This study aims to identify which characteristics, and combinations of characteristics, are associated with units consumed within drinking occasions. It also tests whether accounting for occasion characteristics improves the prediction of consumption compared to using demographic information only.

METHODS

The data come from a cross-sectional, nationally representative, online market research survey. Our sample includes 18,409 British drinkers aged 18 + who recorded the characteristics of 46,072 drinking occasions using 7-day retrospective drinking diaries in 2018. We used decision tree modeling and nested linear regression to predict units consumed in occasions using information on drinking location/venue, occasion timing, company, occasion type (e.g., a quiet night in), occasion motivation, drink type and packaging, food eaten and entertainment/ other activities during the occasion. We estimated models separately for 6 age-sex groups and controlled for usual drinking frequency, and social grade in nested linear regression models. Open Science Framework preregistration: https://osf.io/42epd.

RESULTS

Our 6 final models accounted for between 55% and 71% of the variance in drinking occasion alcohol consumption. Beyond demographic characteristics (1 to 9%) and occasion duration (24 to 60%), further occasion characteristics and combinations of characteristics accounted for 31 to 70% of the total explained variance. The characteristics most strongly associated with heavy alcohol consumption were long occasion duration, drinking spirits as doubles, and drinking wine. Spirits were also consumed in light occasions, but as singles. This suggests that the serving size is an important differentiator of light and heavy occasions.

CONCLUSIONS

Combinations of occasion duration and drink type are strongly predictive of alcohol consumption in adults' drinking occasions. Accounting for characteristics of drinking occasions, both individually and in combination, substantially improves the prediction of alcohol consumption.

Going against the Norm: A Mixed Methods Analysis of College Students' Arguments against the College Drinking Culture

College alcohol beliefs (e.g. "College is a time for experimentation with alcohol") are highly predictive of heavy drinking and its consequences. Yet, current college alcohol interventions do not address this belief system even though researchers have recommended that these beliefs be targeted. Using a mixed methods approach, we conducted two studies to generate arguments against the college drinking culture and to evaluate the effectiveness of such arguments. In Study 1, freshman students (N = 104, 65% women) wrote an essay to a fictitious roommate presenting arguments against the college drinking culture. Responses were reliably coded into a 19-category scheme. The most common arguments included that (1) one's focus should be on academics, (2) drinking will lead to academic consequences, and (3) drinking is not a rite of passage in college. In Study 2, college students (N = 488) rated the effectiveness of prototype arguments drawn from each Study 1 category. According to their ratings, the most effective arguments were that (1) one's focus should be on academics, (2) drinking could have a negative impact on one's career, and (3) one could do potential harm to others. The student-generated arguments against the college drinking culture identified in his research have inherent ecological validity and will help inform the development of new interventions to counter such beliefs. We offer suggestions for translating our findings into clinical interventions.The problem of college student drinking has been long-standing (Kilmer et al., 2014) and remains a significant public health issue today (Hingson et al., 2017). Decades of research on college student drinking and its consequences have identified key cognitive factors that underlie drinking and its consequences, such as the misperception of norms for drinking (Borsari & Carey, 2003) and the positive expectancies students hold about the effects of drinking (Jones et al., 2001; Monk & Heim, 2013). The robust relationships between these cognitive variables and alcohol consumption among college students have led to the development of interventions that target these variables. Social norms marketing campaigns (DeJong et al., 2006), personalized normative feedback (Lewis & Neighbors, 2006), and expectancy challenge techniques (Scott-Sheldon et al., 2012) have been a part of interventions designed to correct students' misperceptions about the percentage of and amount students drink and the effects that alcohol has on their functioning in social situations. Reviews of the literature have demonstrated that interventions containing these components are effective for first year students (Scott-Sheldon et al., 2014) and mandated students (Carey et al., 2016), except for interventions targeting student members of Greek letter organizations (Scott-Sheldon et al., 2016). Effect sizes in most interventions across freshman and mandated students tend to be modest and not very durable in the long-term (Carey et al., 2016; Scott-Sheldon et al., 2014). However, recent research reveals that a variety of new intervention strategies may be useful in addressing the problem of college student drinking (Dunn et al., 2020; Kazemi et al., 2020; King et al., 2020; Magill et al., 2017; Pedrelli et al., 2020; Young & Neighbors, 2019). Aside from social norms and positive alcohol expectancies, another cognitive variable has been found to be a very robust predictor, mediator, and moderator of college student drinking and its consequences - college alcohol beliefs (Crawford & Novak, 2006; Osberg et al., 2010).

Relevance of Athlete-Specific Psychosocial Factors in High School Student-Athlete Alcohol Consumption

Background: Research suggests that adolescent student-athletes are at heightened risk for alcohol consumption. The identification of unique, modifiable risk factors for alcohol use in this population is needed. Purpose/Objectives: Building on previous work highlighting the importance of each of athlete-specific drinking motives and alcohol expectancies, this study investigated whether athlete-specific psychosocial predictors optimize our ability to predict adolescent athlete alcohol consumption after accounting for general psychosocial predictors. Methods: Participants were 352 current high school student-athletes who completed a self-report questionnaire about their alcohol use attitudes, behaviors, and cognitions. Results: Hierarchical regression revealed that among the total sample, gender, class year, liquid courage/sociability, sexuality, and negative alcohol expectancies, and negative athletic-functioning alcohol expectancies predicted alcohol consumption. Among lifetime drinkers, gender, class year, enhancement motives, conformity motives (negative), negative athlete-functioning alcohol expectancies, and sport-related coping motives predicted alcohol consumption. Conclusions/Importance: Negative athletic-functioning alcohol expectancies and sport-related coping motives emerged as important, athlete-specific predictors of adolescent athlete alcohol use. These factors provide important opportunities for targeted prevention efforts.

The conditional association of problematic drinking with suicidal ideation by alcohol expectancies

PURPOSE

Theory has identified alcohol expectancies as a facilitating factor in the association between problematic drinking and suicidal ideation. In the first test of this question, we explored whether the impact of problematic drinking on suicidal ideation depended on alcohol expectancies.

METHODS

We conducted a secondary analysis of cross-sectional, observational, survey data from a convenience sample of 444 individuals court-ordered to domestic violence intervention programs (69.5% non-Hispanic White; 78.6% Male-identified; Mage = 32.53, SDage = 10.10).

RESULTS

Parallel analysis and exploratory factor analysis revealed a three-factor structure of the Effects of Drinking Alcohol Scale, including alcohol expectancies related to 1) disinhibition and negative mood, 2) positive mood, and 3) physical and cognitive effects. Multiple linear regression employing bootstrapping procedures tested the moderating effects of these expectancies on the association between problematic drinking and suicidal ideation, while controlling for gender and depressive symptoms. Problematic drinking was negatively associated with suicidal ideation at low levels of disinhibition and negative mood expectancies, and this association became more positive as these expectancies increased. Problematic drinking was negatively associated with suicidal ideation at high levels of positive mood and became more positive as these expectancies decreased.

DISCUSSION

These preliminary findings suggest that expectancies related to the mood-altering and disinhibiting effects of alcohol may play a role in whether problematic drinking facilitates suicidal thinking. Future intensive longitudinal designs are needed to test whether this moderation is replicated during periods of acute alcohol intoxication and when other psychiatric symptoms are controlled.

Contextual characteristics of adults' drinking occasions and their association with levels of alcohol consumption and acute alcohol-related harm: a mapping review

BACKGROUND AND AIMS

There is a growing literature using event-level methods to estimate associations between contextual characteristics of drinking occasions, consumption levels and acute harms. This literature spans many research traditions and has not been brought together as a whole. This mapping review aimed to identify and describe the theoretical approaches to conceptualizing drinking occasions, study designs, predictors and outcome measures used in existing research with a view to identifying dominant approaches, research gaps and areas for further synthesis.

METHODS

Eligible papers studied adults' drinking occasions using quantitative event-level methods and considered one or more contextual characteristics (e.g. venue, timing or company) and at least one event-level consumption or acute alcohol-related harm outcome. We systematically searched Ovid MEDLINE, PsycInfo and the Web of Science Social Sciences Citation Index, extracting data on studies' theoretical approach, data collection methods, settings, populations, drinking occasion characteristics and outcome measures.

RESULTS

Searches identified 278 eligible papers (from 1975 to 2019), predominantly published after 2010 (n = 181; 65.1%). Most papers reported research conducted in the United States (n = 170; 61.2%) and half used student participants (n = 133; 47.8%). Papers typically lacked a stated theoretical approach (n = 203; 73.0%). Consistent with this, only 53 (19.1%) papers studied three or more occasion characteristics and most used methods that assume occasion characteristics do not change during an occasion (n = 189; 68.0%). The most common outcome type considered was consumption (n = 224; 80.6%) and only a few papers studied specific acute harm outcomes such as unprotected sex (n = 24; 8.6%), drink driving (n = 14; 5.0%) or sexual violence (n = 9; 3.2%).

CONCLUSIONS

Studies from 1975 to 2019 using event-level methods to estimate associations between contextual characteristics of drinking occasions, consumption levels and acute harms were largely focused on students and consumption outcomes, and most have considered a limited range of contextual characteristics.

Context Matters for the Socially Anxious: Moderating Role of Drinking Context on Alcohol Outcome Expectancies

Background: Moderating effects of alcohol outcome expectancies (AOE) on the social anxiety (SA)-alcohol misuse relationship are mixed. This may be explained by differential relationships between SA and context-specific AOE. Gender may further moderate these associations, as it influences SA, AOE, and drinking behaviors. Objectives: To examine the moderating role of drinking context (i.e. convivial, negative coping, or personal-intimate) and gender on the relationships between SA and three AOE (i.e. tension reduction, sociability, and sexuality). Methods: Participants (n = 436, M_age=19.32, 72% female, 85.8% White) were 218 undergraduates with elevated SA (high SA group) and a gender-matched low SA group (n = 218) drawn from a larger undergraduate sample (N = 1,015). Participants completed three versions of an AOE measure, differing by drinking context considered. Results: A significant SA group x context x gender interaction was found for tension reduction AOE; compared to men, women in the low SA group reported greater tension reduction AOE in negative coping contexts. Significant SA group and context main effects suggest that sociability and sexuality AOE are endorsed more in the high (vs. low) SA group, and in convivial and personal-intimate compared to negative coping contexts. Conclusions/Importance: Tension reduction AOE vary depending on the drinking context, SA, and gender. Assessment of AOE in specific drinking contexts may help to identify which individuals may be at greatest risk for alcohol misuse and help inform treatment of SA-related problem drinking.

Acute alcohol and cognition: Remembering what it causes us to forget

Addiction has been conceptualized as a specific form of memory that appropriates typically adaptive neural mechanisms of learning to produce the progressive spiral of drug-seeking and drug-taking behavior, perpetuating the path to addiction through aberrant processes of drug-related learning and memory. From that perspective, to understand the development of alcohol use disorders, it is critical to identify how a single exposure to alcohol enters into or alters the processes of learning and memory, so that involvement of and changes in neuroplasticity processes responsible for learning and memory can be identified early. This review characterizes the effects produced by acute alcohol intoxication as a function of brain region and memory neurocircuitry. In general, exposure to ethanol doses that produce intoxicating effects causes consistent impairments in learning and memory processes mediated by specific brain circuitry, whereas lower doses either have no effect or produce a facilitation of memory under certain task conditions. Therefore, acute ethanol does not produce a global impairment of learning and memory, and can actually facilitate particular types of memory, perhaps particular types of memory that facilitate the development of excessive alcohol use. In addition, the effects on cognition are dependent on brain region, task demands, dose received, pharmacokinetics, and tolerance. Additionally, we explore the underlying alterations in neurophysiology produced by acute alcohol exposure that help to explain these changes in cognition and highlight future directions for research. Through understanding the impact that acute alcohol intoxication has on cognition, the preliminary changes potentially causing a problematic addiction memory can better be identified.

Traditional gender roles and alcohol use among Latinas/os: A review of the literature

Research indicates alcohol use among Latinas/os occurs within a gendered context. Scholars surmise this is due to traditional gender roles (TGRs) of Latina/o culture, but without an analysis of the literature these assertions are unclear. Thus, this article provides a narrative review of the extant TGRs and alcohol use literature among Latinas/os. Thirteen articles met inclusion criteria. Across studies, findings were mixed, aside from those suggesting TGRs composed of hypermasculinity (i.e., traditional machismo) were robustly related to drinking. Tests of mediation and moderation indicated TGRs and alcohol use should be assessed within a multivariate framework. Future research should address these inconsistencies through methodological refinements. In addition, we suggest the integration of existing theoretical perspectives to assist with scholarly development in this area.

Identifying Triggers of Alcohol Craving to Develop Effective Virtual Environments for Cue Exposure Therapy

Background: Many studies have indicated that alcohol craving is a core mechanism in the acquisition, maintenance, and precipitation of relapse in alcohol use disorder (AUD). A common treatment approach in AUD is cue exposure therapy (CET). New technologies like virtual reality (VR) have the potential to enhance the effectiveness of CET by creating realistic scenarios in naturalistic environments. In this study, we aimed to determine relevant triggers of alcohol craving in patients with AUD.

Methods: We enrolled 75 outpatients diagnosed with AUD according to the DSM-5 criteria Participants completed the Alcohol Use Disorder Identification Test and a self-administered questionnaire to assess alcohol craving. The variables included in the craving questionnaire were as follows: presence of others, situations, time of the day, day of the week, mood, and type of alcoholic beverage.

Results: Greater levels of alcohol craving were seen in many situations, including being at a party, in a restaurant, in a bar or pub, and at home. Drinking alone and drinking with two or more friends were equally associated with higher levels of craving. Drinking at night and drinking at weekends also emerged as triggers for alcohol craving. Emotional states like anxiety or tension, sadness, stress, frustration, or irritability were highly associated with urges to drink alcohol. The alcoholic drinks most highly associated with increased levels of craving were beer, wine, and whisky. Gender and age implications were discussed.

Conclusion: This study is part of a larger project aiming to develop and validate CET based on VR technology for patients with AUD who are resistant to classical treatment. The identified triggers have been used to develop relevant VR environments for CET, and further research is ongoing to implement our findings.

Alcohol Use and Unprotected Sex Among HIV-Infected Ugandan Adults: Findings from an Event-Level Study

While alcohol is a known risk factor for HIV infection in sub-Saharan Africa (SSA), studies designed to investigate the temporal relationship between alcohol use and unprotected sex are lacking. The purpose of this study was to determine whether alcohol used at the time of a sexual event is associated with unprotected sex at that same event. Data for this study were collected as part of two longitudinal studies of HIV-infected Ugandan adults. A structured questionnaire was administered at regularly scheduled cohort study visits in order to assess the circumstances (e.g., alcohol use, partner type) of the most recent sexual event (MRSE). Generalized estimating equation logistic regression models were used to examine the association between alcohol use (by the participant, the sexual partner, or both the participant and the partner) and the odds of unprotected sex at the sexual event while controlling for participant gender, age, months since HIV diagnosis, unhealthy alcohol use in the prior 3 months, partner type, and HIV status of partner. A total of 627 sexually active participants (57% women) reported 1817 sexual events. Of these events, 19% involved alcohol use and 53% were unprotected. Alcohol use by one's sexual partner (aOR 1.70; 95% CI 1.14, 2.54) or by both partners (aOR 1.78; 95% CI 1.07, 2.98) during the MRSE significantly increased the odds of unprotected sex at that same event. These results add to the growing event-level literature in SSA and support a temporal association between alcohol used prior to a sexual event and subsequent unprotected sex.

A Randomized Trial of Personalized Cognitive-Behavior Therapy for Alcohol Use Disorder in a Public Health Clinic

Background: Tailored psychological interventions based on individual risk factors are likely to improve treatment for Alcohol Use Disorders (AUDs). Key risk factors for poor treatment outcome include alcohol craving, positive expectations of alcohol consumption, and impulsivity. Design: Pragmatic randomized Cognitive-Behavioral Treatment (CBT) trial. Setting: Public hospital alcohol and drug clinic. Participants: Three-hundred seventy-nine patients (65% male; AgeyearsM = 44.32, SD = 10.75) seeking treatment for AUD. Procedure: Patients were randomly allocated into treatment as usual (TAU) or targeted treatment. Patients in targeted treatment were allocated one of three treatment modules focusing on craving, positive expectancy, or impulsivity based on assessment results. Treatment included eight, 1 h sessions of CBT over 12 weeks delivered by clinical psychologists. Hypotheses: Targeted treatment was expected to have fewer drinking days and consume less alcohol during the treatment period than TAU. Improvement in targeted mechanisms was predicted to be greatest for patients within matched conditions. Results: Patients attended an average of 4.4 sessions with 93 (25%) completing the whole 12-week treatment episode. The mean proportion of drinking days between sessions was 5% with an average consumption of 64 grams of ethanol. No significant effect of targeted treatment was identified on drinking days or consumption. The craving (b = -18.97, 95% CI = -31.44, -6.51) and impulsivity (b = -26.65, 95% CI = -42.09, -11.22) modules demonstrated significant reductions in their targeted constructs over treatment, above TAU. Only reduction in craving was associated with reduced drinking days [exp(b) = 0.958, p = 0.003] and alcohol consumption [exp(b) = 0.962, p = 0.02]. Significant indirect effects for the targeted craving module through craving reduction were identified for reduction in drinking days (β = -0.72, 95% CI = -1.50, -0.158) and alcohol consumption (β = -0.78, 95% CI = -1.72, -0.11). Conclusions: In the context of a public health service, the effectiveness of individualized treatment targeting risk mechanisms identified during pre-treatment assessment was not confirmed. Some evidence was found for improved treatment response to the implementation of a manualized craving module when pre-treatment craving was high.

Development and initial psychometric validation of the Brief-Caffeine Expectancy Questionnaire (B-CaffEQ)

Caffeine is the most widely available and consumed psychoactive substance in the United States. Extant work indicates that across substances, use expectancies play a marked role in the development and maintenance of consumption patterns. Despite a burgeoning line of etiological and intervention-oriented research focused on expectancies (e.g., alcohol), there is a limited literature regarding caffeine use effect expectancies, specifically. To facilitate this work, the Caffeine Expectancy Questionnaire (CaffEQ) was developed and psychometrically validated; however, the length of the CaffEQ (i.e., 47 items) may hinder widespread adoption of this tool. As such, the current study provides an initial psychometric validation of a brief, 20-item version-the Brief-Caffeine Expectancy Questionnaire (B-CaffEQ)-in a multiethnic sample of undergraduate students (N = 975). Results showed that the B-CaffEQ replicated the 7-factor structure of the original CaffEQ using both constrained (confirmatory factor analysis) and less constrained (exploratory structural equation modeling) structural models and evidenced good internal consistency across subscales. The B-CaffEQ also demonstrated concurrent validity with caffeine use frequency indices, replicated and extended convergent validity between caffeine expectancy subscales and related behavioral and psychological constructs, and demonstrated discriminant validity with other related, but notably distinct, stimulant use metrics (e.g., cocaine, Ritalin). Lastly, the B-CaffEQ appears to provide an invariant measure of expectancies across types of caffeine users. These findings indicate that the B-CaffEQ is a reliable assessment of caffeine use effect expectancies, with acceptable-to-good psychometric properties-comparable in length to other substance use expectancies measures-that may be more readily incorporated into research and clinical settings. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Alcohol expectancies pre-and post-alcohol use disorder treatment: Clinical implications

BACKGROUND AND AIMS

Modification of elevated positive expectations of alcohol consumption (alcohol outcome expectancies; AOEs) is a key feature of Cognitive Behaviour Therapy (CBT) approaches to Alcohol Use Disorders (AUDs). Despite extensive research supporting the efficacy of CBT for AUD, few studies have examined AOE change. This study aimed to assess AOE change following completion of CBT for AUD and its association with drinking behaviour.

METHOD

One-hundred and seventy-five patients who completed a 12-week CBT program for AUD were administered the Drinking Expectancy Questionnaire (DEQ) at pre-treatment assessment and upon completion of treatment. Abstinence was achieved by 108 (61.7%) of completing patients. For patients who lapsed, the mean proportion of abstinent days was 93%.

RESULTS

DEQ scales assessing expectations of positive alcohol effects on tension reduction, assertiveness, and cognitive enhancement were significantly lower post-treatment (p<0.001). Expectations of negative effects on mood were higher post-treatment (p<0.001). The largest AOE change occurred on the tension reduction scale. Greater percentage of abstinent days over treatment was associated with lower pre-and post-treatment tension reduction expectancy scores (p<0.05). Drinking during treatment was associated with smaller changes in expectations of negative effects of alcohol on mood (p<0.05).

CONCLUSIONS

Individuals who completed CBT treatment for AUD showed significant AOE change. Tension reduction and affective change expectancies may be particularly important for abstinence and useful markers of lapse risk.

Alcohol expectancies longitudinally predict drinking and the alcohol myopia effects of relief, self-inflation, and excess

INTRODUCTION

Alcohol myopia theory posits that alcohol consumption attenuates information processing capacity, and that expectancy beliefs together with intake level are responsible for experiences in myopic effects (relief, self-inflation, and excess).

METHODS

Adults (N=413) averaging 36.39 (SD=13.02) years of age completed the Comprehensive Effects of Alcohol questionnaire at baseline, followed by alcohol use measures (frequency and quantity) and the Alcohol Myopia Scale one month later. Three structural equation models based on differing construct manifestations of alcohol expectancies served to longitudinally forecast alcohol use and myopia.

RESULTS

In Model 1, overall expectancy predicted greater alcohol use and higher levels of all three myopic effects. In Model 2, specifying separate positive and negative expectancy factors, positive but not negative expectancy predicted greater use. Furthermore, positive expectancy and use explained higher myopic relief and higher self-inflation, whereas positive expectancy, negative expectancy, and use explained higher myopic excess. In Model 3, the seven specific expectancy subscales (sociability, tension reduction, liquid courage, sexuality, cognitive and behavioral impairment, risk and aggression, and self-perception) were simultaneously specified as predictors. Tension reduction expectancy, sexuality expectancy, and use contributed to higher myopic relief; sexuality expectancy and use explained higher myopic self-inflation; and risk and aggression expectancy and use accounted for higher myopic excess. Across all three predictive models, the total variance explained ranged from 12 to 19% for alcohol use, 50 to 51% for relief, 29 to 34% for self-inflation, and 32 to 35% for excess.

CONCLUSIONS

Findings support that the type of alcohol myopia experienced is a concurrent function of self-fulfilling alcohol prophecies and drinking levels. The interpreted measurement manifestation of expectancy yielded different prevention implications.

What Did You Expect? Substance Use Expectancies Mediate the Relationships Between Dark Triad Traits, Substance Use, and Substance Preference

This study explores the role of substance use expectancies as mediators between the Dark Triad of personality, substance use, and substance use preferences. A sample of college students ( M = 19.38, SD = 2.63, N = 207) completed an online questionnaire that assessed the Dark Triad traits, substance use history, substance preferences, and substance use expectancies. Three specific substance use expectancies-increased confidence, tension reduction, and cognitive enhancement-were shown to either partially or fully mediate the relationships between the Dark Triad and substance use behaviors and preference for certain substances of abuse. These findings may hold clinical implications for the treatment of substance use disorders and further the understanding of factors contributing to the etiology and progression of substance abuse and substance use disorders.

Understanding Drinking Game Behaviors: A Consideration of Alcohol Expectancies and Motives to Play and Drink

Drinking motives have been theorized as "the final common pathway" to alcohol use, and have been found to be associated with certain drinking patterns and related outcomes. Given the importance of the context in which people drink, researchers have also begun to pay close attention to motives that are specific to participation in a drinking game. The present study builds on this burgeoning body of work by testing how sociability and liquid courage alcohol outcome expectancies and valuations are indirectly associated with drinking game behaviors by way of drinking game motives. Participants consisted of 686 students from eight U.S. colleges/universities (ages 18-23, mean age = 19.45; 73.8% female; 68.2% white) who completed a self-report questionnaire which asked about drinking game behaviors and motives for playing, alcohol outcome expectancies and valuations, general drinking motives, and typical alcohol use. Controlling for demographics, general drinking motives, and typical alcohol use, results indicated that liquid courage (alcohol outcome expectancies) and sociability (alcohol outcome expectancies and valuations) were indirectly associated with drinking game behaviors by way of enhancement/thrills and social lubrication motives for playing drinking games, respectively. Findings suggest that motives specific to playing drinking games operate similarly to general drinking motives as the "final common pathway" to drinking game behaviors. Implications for motivation-matched and expectancy challenge strategies aimed at reducing drinking games participation on college campuses are discussed.

Factor Structure of the Brief Comprehensive Effects of Alcohol Scale in Adolescents

Alcohol use among adolescents is a public health concern; therefore, it is important that studies that examine factors associated with adolescent drinking behaviors utilize measures that are well-validated for use with this population. The current study examined the factor structure and convergent validity of the Brief Comprehensive Effects of Alcohol scale, a measure of alcohol outcome expectancies and evaluations of expected outcomes, among adolescents ( N = 1,074; 50% girls; M_age = 15.96 years, SD = 1.13, range = 13-18; 74% White) drawn from three independent studies ( n_{site 1} = 594; n_{site 2} = 97; and n_{site 3} = 383). Results yielded support for a four-factor structure for alcohol expectancies and two-factor structure for valuations. Moreover, the factor structure was partially or fully invariant across gender, age, and site. Thus, findings are similar, yet unique, to those identified in college samples. The convergent validity of the modified measure was supported, suggesting that the Brief Comprehensive Effects of Alcohol scale may be useful for assessing adolescents' beliefs about alcohol.

The Role of Positive Expectancies in Risk Behavior

Abstract. Background: Alcohol use and nonsuicidal self-injury (NSSI) appear to share a conceptual overlap in functions (e.g., tension reduction). Alcohol use has been identified as a risk factor for NSSI, and higher rates of alcohol use have been documented among those with NSSI history. Aims: This study examined whether NSSI-related alcohol expectancies affect relations between NSSI and alcohol use. Method: Participants were 367 college students (73% female) asked to complete an online survey about their drinking behavior and lifetime NSSI. Results: NSSI and alcohol use were highly prevalent in this sample: 56% endorsed lifetime NSSI and 74% endorsed current alcohol use. Of note, 43% (n = 147) endorsed both behaviors. Positive NSSI-related alcohol expectancies showed a significant association with lifetime NSSI. In addition, positive NSSI-related alcohol expectancies were associated with more frequent drinking behavior for individuals with a history of NSSI, particularly those who had engaged in two or more methods of lifetime NSSI. Conclusion: Alcohol use and NSSI represent high-risk behaviors commonly employed to regulate unwanted affective states. Interventions targeting substance use and/or NSSI may consider assessing positive NSSI and substance use expectancies, as the presence of these beliefs suggests a higher risk profile.

[Heavy episodic drinking, cannabis use and unsafe sex among university students]

OBJECTIVE

To determine the incidence of unsafe sex among university students and its association with heavy episodic drinking (HED) and cannabis use.

METHOD

A cohort study was carried out from 2005 to 2011 among university students of the Compostela Cohort (n=517). HED was measured using the third question of the Alcohol Use Disorders Identification Test (AUDIT). Unsafe sex was considered to be sex under the influence of alcohol (SUA) and sex without a condom (SWC). Logistic regression models were created.

RESULTS

The incidence of SUA was 40.9% for women and 53.0% for men, while the SWC incidence ranged from 13.7% for women to 25.7% for men. HED and cannabis use were associated with SUA in both women (OR=2.08, 95% CI: 1.03-4.21; OR=2.78, 95%CI: 1.57-4.92) and men (OR=4.74 (95%CI: 1.49-15.09; OR=4.37, 95%CI: 1.17- 16.36). Moreover, cannabis use in women was associated with SWC (OR=2.96, 95%CI: 1.52-5.75). The population attributable fractions of SUA for HED were 24.7% and 52.9% for women and men, respectively.

CONCLUSIONS

HED and cannabis use represent a public health problem due to their association with a variety of problems, including engagement in unsafe sex. Our results suggest that a significant proportion of unsafe sex could be avoided by reducing this consumption pattern of alcohol.

Smells like inhibition: The effects of olfactory and visual alcohol cues on inhibitory control

RATIONALE

How the smell of alcohol impacts alcohol-related thoughts and behaviours is unclear, though it is well-documented that alcohol-related stimuli and environments may trigger these.

OBJECTIVES

The current study, therefore, aimed to investigate the priming effects of both visual and olfactory alcohol cues on inhibitory control.

METHOD

Forty individuals (M age = 23.65, SD = 6.52) completed a go/no-go association task (GNAT) which measured reaction times, response accuracy and false alarm rates whilst being exposed to alcohol-related (or neutral) olfactory and visual cues.

RESULTS

Alcohol-related visual cues elicited lower false alarm rates, slower reaction times and higher accuracy rates relative to neutral pictorial cues. False alarm rates were significantly higher for those exposed to alcohol as opposed to neutral olfactory cues.

CONCLUSIONS

By highlighting that exposure to alcohol-related olfactory cues may impede response inhibition, the results indicate that exposure to such stimuli may contribute to the activation of cognitive responses which may drive consumption.

Does Drinking Improve the Quality of Sexual Experience?: Sex-Specific Alcohol Expectancies and Subjective Experience on Drinking Versus Sober Sexual Occasions

The present study compared the self-reported quality of emotional experiences on sexual occasions that differed in levels of alcohol consumption to determine whether widely held beliefs about alcohol's positive effects on sex are borne out in people's everyday sexual experience. Multilevel models were estimated using data from 7442 discrete sexual events collected over a 10+ year period from a community sample of 1946 Black and White young adults. Tests of between-person differences revealed that beliefs that drinking both enhances and disinhibits sexual experience are widely endorsed, and that those who hold strong expectancies for enhancement drink significantly more on sexual occasions than those who do not. Nevertheless, tests of within-person differences revealed that people's sexual experiences were generally less positive on drinking than sober occasions, even after controlling for a host of individual difference and event-level characteristics. Moreover, cross-level expectancy × alcohol interaction tests showed that even those who strongly endorsed alcohol's positive effects failed to report more positive sexual experiences on drinking versus sober occasions, with a single exception: Those with strong expectancies for sexual enhancement reported greater arousal at high consumption levels, whereas those with weak enhancement expectancies reported lower arousal. In short, drinking on sexual occasions failed to deliver any benefit for the majority of individuals across the majority of outcomes. Why positive beliefs are maintained in the face of largely contradictory experience, and how this information can be used to inform intervention and prevention is explored.

Alcohol Expectancies, Posttraumatic Stress Disorder, and Alcohol Use in College Students With a History of Childhood Trauma

OBJECTIVE

Prior research has emphasized that the key mediator in the posttraumatic stress disorder (PTSD) symptom-alcohol use relationship is the expectancy of alcohol's tension-reducing properties. This study extends the literature by examining various alcohol outcome expectancies.

METHODS

Cross-sectional data were obtained from 198 college students who reported experiencing at least one traumatic event in childhood. Participants answered surveys measuring PTSD symptoms, alcohol outcome expectancies, and three measures of alcohol consumption and related problems.

RESULTS

Participants included 131 males (mean age = 19.65 years, SD = 1.06, range = 18 to 24) and 67 females (mean age = 19.43 years, SD = 0.82, range = 18 to 23), who were predominantly European-American (82%). For males and females, results of the multivariate analyses suggested that self-perception expectancies mediated the effects of PTSD symptoms on alcohol use severity, whereas sociability expectancies mediated the effects of PTSD symptoms on monthly alcohol use. For women, risk and aggression and sexuality expectancies mediated the relationship between PTSD symptoms and alcohol use severity, while risk and aggression expectancies mediated the relationship between PTSD symptoms and alcohol use consequences. For men, sociability expectancies mediated the effects of PTSD symptoms on alcohol use severity. Across genders, tension-reduction expectancies did not mediate the relationship between PTSD symptom and the three alcohol measures.

CONCLUSIONS

This study was unable to find support for the self-medication hypothesis via the tension-reduction outcome expectancy pathway. However, other significant findings can be interpreted in light of the self-medication hypothesis. For example, alcohol may aid in coping with social impairments related to PTSD symptoms, particularly in a college sample. This study also highlighted gender differences in the association between PTSD symptoms and alcohol consumption and related problems.

Psychosocial Correlates of AUDIT-C Hazardous Drinking Risk Status: Implications for Screening and Brief Intervention in College Settings

The current study identified psychosocial variables associated with AUDIT-C hazardous drinking risk status for male and female college students. Logistic regression analysis revealed that AUDIT-C risk status was associated with alcohol-related negative consequences, injunctive norms, and descriptive norms for both male and female participants. Sociability and self-perception outcome expectancies predicted risk status for females. Cognitive and behavioral impairment expectancies predicted risk status for men in the sample. Implications for screening and brief intervention programming efforts are discussed.

The Relationship Between Psychological Distress, Negative Cognitions, and Expectancies on Problem Drinking: Exploring a Growing Problem Among University Students

Few studies have sought to understand the concurrent relationship between cognitive and affective processes on alcohol use and negative alcohol-related consequences, despite both being identified as predictive risk factors in the college population. More research is needed to understand the relationships between identified factors of problem drinking among this at-risk population. The purpose of this study was to test if the relationship between psychological distress and problem drinking among university students (N = 284; M-age = 19.77) was mediated by negative affect regulation strategies and positive alcohol-related expectancies. Two latent mediation models of problem drinking were tested using structural equation modeling (SEM). The parsimonious three-path mediated latent model was supported by the data, as evidenced by several model fit indices. Furthermore, the alternate saturated model provided similar fit to the data, but contained several direct relationships that were not statistically significant. The relationship between psychological distress and problem drinking was mediated by an extended contributory chain, including negative affect regulation and positive alcohol-related expectancies. Implications for prevention and treatment, as well as future directions, are discussed.

"I have no clue what I drunk last night" using Smartphone technology to compare in-vivo and retrospective self-reports of alcohol consumption

Aim

This research compared real-time measurements of alcohol consumption with retrospective accounts of alcohol consumption to examine possible discrepancies between, and contextual influences on, the different accounts.

Method

Building on previous investigations, a specifically designed Smartphone technology was utilized to measure alcohol consumption and contextual influences in de facto real-time. Real-time data (a total of 10,560 data points relating to type and number of drinks and current social / environmental context) were compared with daily and weekly retrospective accounts of alcohol consumption.

Results

Participants reported consuming more alcoholic drinks during real-time assessment than retrospectively. For daily accounts a higher number of drinks consumed in real-time was related to a higher discrepancy between real-time and retrospective accounts. This effect was found across all drink types but was not shaped by social and environmental contexts. Higher in-vivo alcohol consumption appeared to be related to a higher discrepancy in retrospectively reported weekly consumption for alcohol beverage types other than wine. When including contextual factors into the statistical models, being with two or more friends (as opposed to being alone) decreased the discrepancy between real-time and retrospective reports, whilst being in the pub (relative to being at home) was associated with greater discrepancies.

Conclusions

Overall, retrospective accounts may underestimate the amount of actual, real-time alcohol consumed. Increased consumption may also exacerbate differences between real-time and retrospective accounts. Nonetheless, this is not a global effect as environmental and social contexts interact with the type of alcohol consumed and the time frame given for reporting (weekly vs. daily retrospective). A degree of caution therefore appears warranted with regards to the use of retrospective self-report methods of recording alcohol consumption. Whilst real-time sampling is unlikely to be completely error free, it may be better able to account for social and environmental influences on self-reported consumption.