Restraint and attributions: Evidence of the abstinence violation effect in alcohol consumption

In this cross-sectional test of the occurrence of the abstinence violation effect (AVE), a community sample of 323 social drinkers completed measures of drinking restraint (perceived efficacy for controlling alcohol consumption and behavioral attempts to limit drinking) and causal attributions for drinking-related events. These measures were included as predictors in a multivariate multiple-regression equation in which three aspects of self-reported drinking served as dependent variables: minimum number of drinks per occasion, maximum number of drinks per occasion, and drinking-related problems. The results indicated differential sets of predictors for each of the dependent variables. Both aspects of restraint predicted minimum consumption, and both aspects of restraint and attributions for positive drinking situations predicted maximum consumption. Perceived efficacy for controlling alcohol consumption and attributions for negative drinking situations predicted alcohol-related problems. The consistency between this pattern of results and Marlatt's (1985a) reformulation of the AVE is discussed.This research was supported by National Institute on Alcohol Abuse and Alcoholism Grant R01-AA07595 awarded to R. Lorraine Collins. Portions of this research were presented at the annual meeting of Association for Advancement of Behavior Therapy, Washington, DC, November 1989. The authors wish to thank Charles Izzo for his assistance in conducting this research.     

Decreased alcohol consumption after pairing alcohol-related cues with an inhibitory response

Prior research indicates that repeatedly pairing a stopping response with alcohol-related stimuli using a modified Go/No-Go (GNG) task decreases self-reported drinking by modifying implicit alcohol-related attitudes. The current study replicated and expanded upon this work to better clarify the intervention’s lasting effects and pilot ideas for potential mechanisms of action for future research. Forty-four heavy drinking young adult males were randomly assigned to inhibit responses to alcohol (alcohol/No-Go [NG]; n = 23) or water (water/NG; n = 21). At baseline and 2-week post-intervention, participants completed measures of alcohol use, implicit attitudes, alcohol expectancies, response inhibition, and alcohol approach/avoidance. At 2-weeks post-intervention, they participated in an ad-lib drinking session to directly measure drinking behavior. Alcohol/NG participants self-reported lower levels of alcohol use at post-intervention than baseline and took longer to start drinking during the ad lib drinking session in comparison to water/NG participants. In contrast to prior research, the intervention appeared to increase avoidance of alcohol and not significantly alter implicit attitudes. Results indicate that alcohol use measured 2 weeks post-intervention was lower than baseline levels for alcohol/NG participants. The GNG training may offer one path to reducing alcohol use among heavy drinking young adult males for at least 2 weeks.     

The alcohol expectancy construct: Overview and clinical applications

Recently there has been much research on cognitive factors in decisions to drink and responses to alcohol. Most of this research has concerned expectancies regarding alcohol effects, but much less attention has been paid to applying these data to clinical practice. In this paper, the potential clinical applications of current knowledge regarding expectancies, with emphases on assessment and intervention, are discussed. Problems of assessment are determining the nature and strength of alcohol expectancies, including their domains, situation specificity, and dose-related influences. Along these lines, representative scales are described. Three aspects of intervention, each pertaining to a phase of drinking behavior, are presented. The first area is initiation of drinking, when drinking decisions are presumed to be motivated by alcohol expectancies. Strategies for (a) attempting to change expectancies and (b) engaging in alternative behaviors to achieve desired, or expected, outcomes are described. The second area concerns the assessment and labeling of drinking effects, with a focus on tracking the relationship between alcohol use and expectancies over the course of a drinking event. The third area deals with subsequent drinking and clinically revolves around the application of altered expectancies to subsequent drinking in that episode or in future drinking situations. The relevance of alcohol expectancies to the maintenance of treatment gains and to the prevention of relapse also is discussed. Finally, throughout this paper there is an emphasis on identifying strategies for investigating clinically relevant questions about alcohol-related expectancies and drinking patterns.     

Consideration of future consequences and alcohol use among Northern Irish adolescents

This study investigated the relationship between consideration of future consequences and alcohol use among adolescents. A cross-sectional design was used and a large sample of 12- to 16-year-old schoolchildren (n = 806) in Northern Ireland were recruited for this study. Alcohol use was assessed using a composite measure of drinking behaviour, the Adolescent Alcohol Involvement Scale. Time perspective was measured using the Consideration of Future Consequences Scale (CFCS). Data were also gathered on self-esteem, three domains of self-efficacy and aggression, all of which have been found to be related to both drinking behaviour and time perspective. Factor analysis of the CFCS revealed support for a two-factor solution, with CFC-I representing present orientation and CFC-F representing future orientation. After controlling for year in school (proxy for age) and gender and for clustering at school level, scores on both subscales were significantly associated with alcohol use. Only CFC-F score remained significant with the addition of psychosocial variables. These results support recent findings of a significant relationship between CFCS score and alcohol use in UK adolescents and University undergraduates, and suggest that in more fully controlled analyses, future orientation, rather than present, is related to adolescent drinking. Results are discussed in relation to health promotion.     

Development of a Scale to measure outcome expectancy in alcoholics

Self-efficacy theory postulates that altering expectation of personal mastery is the major cognitive process involved in behavior change. Two classes of expectancy are discussed: (a) efficacy expectancy: the belief or confidence one has in being able to successfully perform a specific behavior, and (b) outcome expectancy: the belief one has about the consequences that will follow successful performance. Application of the theory to relapse prevention in alcoholism has addressed the role of efficacy expectancy but not outcome expectancy, the focus of this study. A 34-item scale was developed to measure outcome expectancy in alcoholics, with outcome expectancy defined as the consequences anticipated subsequent to a change in drinking behavior. The scale, consisting of both a strength and a valence component, was administered to 204 male patients admitted to two alcoholism treatment centers. Factor analysis yielded two subscales: the BENEFITS Scale (21 items), a measure of the advantages expected should a change in drinking behavior occur, and the COSTS Scale (13 items), a measure of disadvantages expected should a change in drinking behavior occur. Evidence for reliability and construct validity is presented. Future research and clinical uses of the scale are discussed.This research was conducted by the first author in partial fulfillment for the degree of Doctor of Philosophy, The Ontario Institute for Studies in Education, University of Toronto. The views expressed in this document are those of the authors and do not necessarily reflect those of the Addiction Research Foundation. The authors wish to thank Ms. Toby Levinson, Addiction Research Foundation, and Dr. Brian McLatchie, Pinewood Centre, Oshawa, for permission to include their clients in this study. Appreciation is also extended to Dr. Ed Larkin, and his staff in the Assessment Unit, Addiction Research Foundation, for help with part of the data collection.     

The heightened role of external responsiveness in the alcohol consumption of restrained drinkers

Restrained drinking, a style of drinking control that is characterized by a psychological conflict between impulses to drink and effortful resistance to these impulses, may be an early diagnostic clue that intervention efforts are needed to prevent the development or worsening of alcohol problems. This study examined an important aspect of the drinking behavior of individuals with a restrained drinking style — that is, the role of differential responsiveness to external beverage preference cues. Fifty-nine social drinkers, classified on the basis of a pretest as restrained or unrestrained drinkers, were given access to brands of beer that had been identified through pretesting as preferred and nonpreferred for that individual. In the guise of a tasterating task, the level of consumption of each beverage was unobtrusively measured. Restrained drinkers showed heightened differential responsiveness to the external beverage preference cues, drinking significantly more of their preferred beers and similar amounts of their nonpreferred beers compared with unrestrained drinkers. This pattern of heightened preferential drinking was also individually associated with three separate measures of drinking experience: present habitual drinking level, lifetime amount of alcohol consumption, and variety of beer-testing experiences. However, differences in drinking experience did not seem to be responsible for the obtained relationship between drinking restraint and heightened differential responsiveness. Prevention efforts with those social drinkers who may be at increased risk for alcohol problems should consider the important role of heightened responsiveness to situational factors such as the availability of a preferred alcoholic beverage as stimuli for increased levels of consumption.This research was supported by National Institute on Alcohol Abuse and Alcoholism Research Grant No. AA-06319. We would like to thank Claude Steele for his valuable comments on various aspects of the study, and Kirsten Christ, Bill Jochim, Brent Henneman, and Karen Livingston for their help in the data-collection phase. Parts of this study were presented at the annual meeting of the American Psychological Association, Atlanta, Georgia, August 1988.     

Motivational interviewing with hazardous drinkers

PURPOSES: To test the effectiveness of motivational interviewing in a population of hazardous drinkers utilizing community health care centers in rural southeastern Idaho. DATA SOURCES: This study targeted rural people at risk for alcohol dependence utilizing low-income community health care centers in rural southeastern Idaho. The Alcohol Use Disorders Identification Test (AUDIT) was used to screen interested clients' alcohol use. Clients achieving an AUDIT score indicating hazardous alcohol use were recruited into the study and randomized into a control or treatment group. Twenty-six hazardous drinkers attending five low-income community health centers participated in the study. The experimental group participated in one motivational interviewing session with the investigator, a family nurse practitioner (NP). The comparison group received no treatment. Alcohol use was tracked for 6 weeks after successful recruitment into the program. CONCLUSIONS: Participants in the study significantly decreased their average number of drinks per day. At time 1 (pretreatment), the control group drank 4.37 drinks per day and the treatment group drank 4.65 drinks per day. At time 2 (posttest), the control group drank 3.77 drinks per day and the treatment group drank 1.95 drinks per day. The effects of the motivational interviewing treatment on hazardous drinking also were measured by serum gamma-glutamyltransferase (GGT), a liver function test. There was also a significant decrease in the GGT from pretest to posttest in the treatment group. IMPLICATIONS FOR PRACTICE: The results of this investigation found that motivational interviewing shows promise as an effective intervention for hazardous drinkers attending low-income community clinics. Although other possible explanations could be postulated for the positive changes in sample participants, the data indicate that the motivational interviewing approach was responsible for a significant portion of the positive changes within the current sample. The information collected from the study adds to the literature on hazardous drinking, research, and treatment of this significant problem. Negotiating change in behavior is part of the practice of NPs. People struggling with alcohol use are more likely to encounter NPs, family doctors, or social workers than counselors specializing in alcohol treatment. Motivational interviewing is specifically designed for preparing people for change. Because most people resist being told what to do, that is, "you have to stop drinking," use of motivational interviewing principles can decrease resistance and optimize change. Additionally, identifying and intervening with hazardous drinking in a primary care setting can reduce healthcare costs and reduce the stigma of specialist care. Adding this valuable communication skill to the competencies of NPs is important to both clients and NPs.     

Barroom aggression perpetration by Australian women: Associations with heavy episodic drinking,trait aggression,and conformity to gender norms

Heavy episodic drinking (HED), trait aggression, and conformity to masculine norms increase the risk of barroom aggression (BA) perpetration in men; however, research examining these factors relative to female BA perpetration is lacking. This study assessed the associations of HED, trait aggression, and conformity to masculine and feminine norms with BA perpetration in Australian women. Female university students (N = 148) aged 18–54 (M_age = 24.19; SD_age = 6.84) completed an online questionnaire including measures of BA perpetration and HED, as well as the Brief Aggression Questionnaire, the Conformity to Feminine Norms Inventory (CFNI), and the Conformity to Masculine Norms Inventory (CMNI). Negative binomial regression analyses found HED, trait aggression, and the Violence and Playboy subscales of the CMNI were positively associated with BA perpetration, while the Domestic and Sexual Fidelity subscales of the CFNI were negatively associated with BA perpetration. Norms supporting the use of violence and having multiple sexual partners are associated with increased likelihood of female BA perpetration, while norms valuing domesticity and monogamy are associated with decreased likelihood of female BA perpetration. These findings suggest BA perpetration by women is related to how much they drink, trait aggression, and socialized gender norms.     

Associations between alcohol-related concerns,normative perceptions of peer alcohol use,and veterans’ drinking behavior over six months

Abstract

The Veterans Health Administration (VHA) has implemented initiatives to increase rates of brief alcohol counseling (BAC). Half of eligible veterans do not receive such care. Understanding patient characteristics associated with drinking behavior may identify patients for whom BAC may be acceptable. Data collected from veterans between January 2010 and September 2011 (N?=?167) were examined. Results find that alcohol-related concerns and perceptions of peer alcohol consumption are associated with reduced drinking behavior. These findings suggests that assessing drinking concerns and perceptions of peer alcohol use may help to identify patients interested in changing drinking behavior, receiving care, and assist providers in delivering appropriate counseling.     

The importance of clinical experience for mental health nursing - part 2: relationships between undergraduate nursing students' attitudes, preparedness, and satisfaction

Clinical experience is consistently emphasized in research findings as the primary influence in encouraging more positive attitudes to mental health nursing. The available research, however, presents two major limitations. First, it does not measure the specific factors that might contribute to a positive clinical experience. Second, it does not consider the relationship between clinical experience and attitudes towards people experiencing a mental illness or towards mental health nursing. This is the second of a two-part paper presenting findings from a statewide survey of undergraduate nursing students in Victoria. A pre-/post-test design was used to measure the impact of clinical experience on the following subscales: (i) attitudes towards people experiencing a mental illness; (ii) attitudes toward mental health nursing; and (iii) preparedness for mental health practice. Subscale (iv) satisfaction with clinical experience was also measured in the post-test phase. The findings demonstrated an improvement on all three subscales in the post-test phase and a high level of satisfaction with clinical experience. Furthermore, a relationship between all four subscales was evident.