Alcohol Expectancies,Pregaming, Drinking Games,and Hazardous Alcohol Use in a Multiethnic Sample of College Students

Pregaming is a risky drinking behavior that occurs when students drink alcohol before a primary social gathering or event. The paucity of research on pregaming highlights the need for research on the correlates of drinking behaviors, such as alcohol expectancies, that might increase the likelihood of pregaming. Thus, we sought to examine how alcohol expectancies and the valuations (i.e., desirability) of these expectancies are associated with frequency of pregaming, drinking game (DG) participation, and hazardous alcohol use. Students (N = 1327) from nine U.S. colleges and universities completed self-report surveys. Results showed sufficient discriminant validity among pregaming behaviors, DG participation, and hazardous alcohol use. Findings also revealed that pregaming mediated the associations between positive alcohol expectancies and hazardous drinking behaviors. Finally, when we tested for invariance across gender, ethnicity, and legal versus underage alcohol users, we found full invariance across gender and ethnicity, but not for legal versus underage alcohol users. Future research directions and potential implications for prevention efforts are discussed.     

Alcohol Outcome Expectancies Mediate the Relationship Between Social Anxiety and Alcohol Drinking in University Students: The Role of Gender

College alcohol drinking is a public health concern worldwide. A line of research indicates that higher social anxiety is associated with more severe college drinking. However, other studies reveal a protective role of social anxiety against alcohol drinking in college students. Attempting to reconcile contradictory findings, we examined the hypothesis that there are multiple antagonistic pathways that could explain the social anxiety-college drinking relationship. In addition, there may be individual difference variables that moderate these processes. Furthermore, it was expected that the processes could vary as a function of the alcohol drinking outcomes examined. Expectancy theory emphasizes the role of alcohol outcome expectancies in alcohol drinking. Thus, in the present study we tested whether global positive and negative alcohol outcome expectancies partially mediate the relationship between social anxiety, alcohol consumption, and alcohol-related problems in a sample of 245 university students. We also examined the moderating role of gender in these mediating processes. Results revealed parallel but oppositional processes. Higher social anxiety was associated with heavier alcohol drinking and more serious alcohol-related problems via stronger positive alcohol outcome expectancies. However, the mediating role of positive alcohol outcome expectancies varied as a function of gender. It appears that in female students the mediating effect of positive alcohol outcome expectancies was stronger than in male students. On the other hand, higher social anxiety had a protective role against alcohol consumption but not against alcohol-related problems via stronger negative alcohol outcome expectancies. Finally, there was an inverse direct relationship between social anxiety and alcohol consumption.     

Alcohol Expectancies and Drinking Behavior in Adults with Social Anxiety Disorder and Dysthymia

Previous research has found a positive relationship between social anxiety disorder and alcoholism, and that certain alcohol outcome expectancies are related to drinking behaviors. The purpose of this study was to examine the relationship among drinking behaviors and alcohol expectancies in treatment-seeking individuals diagnosed with social anxiety disorder or dysthymia, as well as normal controls. No significant differences were found across the 3 groups in alcohol consumption. As expected, socially anxious participants had higher social assertiveness expectancies than both participants with dysthymia and normal controls. Participants with social anxiety disorder had greater tension reduction and global positive change expectancies than the normal controls, but did not differ from participants with dysthymia. Additionally, the increased social assertiveness, tension reduction, and positive change expectancies were found to predict amount of drinking per month for socially anxious participants. Implications for understanding the relationship between social anxiety disorder and alcoholism are discussed.     

Expecting That Alcohol Use Will Reduce Social Anxiety Moderates the Relation Between Social Anxiety and Alcohol Consumption

We examined the hypothesis that social anxiety and alcohol outcome expectancies interact in relating to the quantity and frequency of alcohol consumption. Two hundred twenty-nine undergraduates completed self-report questionnaires. The results showed situational specificity of alcohol expectancies. Expecting that alcohol would reduce anxiety in social situations moderated the relation between social anxiety and alcohol consumption; no such moderating effect was found for expectancy of general tension reduction. Among those who did not expect alcohol to reduce their anxiety in social situations, high-social-anxiety participants reported lower frequency and quantity of alcohol consumption than did low-social-anxiety individuals. High- and low-social-anxiety participants who expected alcohol to reduce their social anxiety did not differ in their alcohol consumption.     

Cognitive Behavioral Group Therapy for Patients with Co-Existing Social Anxiety Disorder and Substance Use Disorders: A Pilot Study

Social anxiety disorder (SAD) frequently co-occurs with substance use disorders (SUDs). Although the efficacy of separate cognitive behavioral treatments for each disorder has been widely documented, there is a dearth of studies investigating treatment outcome for patients with co-existing SAD and SUDs. This paper presents preliminary data from a pilot study that investigated whether cognitive behavioral group therapy—modified to explicitly address the link between social anxiety and substance use—could lead to reductions in social anxiety-related symptoms and improvements in affect and unrealistic alcohol expectancies in a sample of 59 patients diagnosed with co-existing SAD and SUDs. Results indicated significant reductions across treatment in social anxiety-related symptoms and negative affect, whereas no changes in positive affect or unrealistic alcohol expectancies were found. The results warrant a randomized controlled trial to explore the specificity of these effects.     

Moods and expectancies of female alcohol drinking – an exploratory study

Scand J Caring Sci; 2010; 24; 472–481
Moods and expectancies of female alcohol drinking – an exploratory study Gaining access to information concerning mood states and expectations of change preceding a typical drinking occasion is important for understanding the trigger factors for drinking, and for alcohol abuse treatment planning. The objective of the present study was twofold: (i) to explore self‐reported states of mood and expectancies preceding a typical drinking occasion vs. relations with parents and drinking outcome; and (ii) to investigate if vulnerability factors in terms of personality and health are related to severity of alcohol problems. The population consisted of 50 women attending a Swedish alcohol clinic. Semi‐structured interviews were conducted. A mixed‐methods design was used encompassing qualitative interview‐data and quantitative data from questionnaires and medical journals. Nine out of ten patients had a diagnosis of alcohol dependence, and four out of five had parents with dependency problems. As compared to a female norm group, the patients displayed significantly higher anxiety‐related traits and irritability. Moods were described by patients as mostly negative and expectancies of change were evenly distributed between reducing, enhancing or flight from feeling. An expectancy of flight when drinking was also related to a positive relation to mother. The findings pointed to the need for differentiating between coping with and expectancies of drinking. Further, a hierarchical cluster analysis resulted in two groups, indicating one group characterized by higher risk values on personality scales and more severe consequences of drinking. The contribution of a treatment design informed through a gender and culture perspective to treatment outcome was discussed.     

Difficulty Disengaging Attention from Social Threat in Social Anxiety

Selective attention to threat is believed to maintain social anxiety, yet the nature of attentional processing remains unclear. It has been posited that difficulty disengaging from threat cues may be implicated. The present study tested this hypothesis using an eye tracking paradigm to directly examine eye fixations in a non-clinical sample (N = 46). Eye movements were tracked during presentation of social cues (happy or disgust faces) embedded with non-social cues matched on dimensions of valence, threat, and arousal. Stimuli were presented for 2,000 ms to allow for examination of attention over time. Results suggest that individuals with higher social anxiety may demonstrate relative difficulty disengaging from negative social cues (i.e., disgust faces). Social anxiety was unrelated to eye movements concerning happy faces. Implications for the maintenance and etiology of social anxiety are discussed.     

Examining the role of positive drinking consequences on the relationship between social anxiety and negative drinking consequences

Positive drinking consequences are gaining more attention in the college student drinking literature due to their degree of saliency in predicting hazardous drinking. However, the research is limited on the relationship between psychological constructs, such as social anxiety, and positive drinking consequences. The current study explored the moderating role of positive drinking consequences on the relationship between social anxiety and negative drinking consequences in a sample of hazardous drinking college students. A sample of 222 hazardous drinking undergraduate students completed measures of social anxiety and positive and negative drinking consequences. As predicted, social anxiety and positive consequences were positively related to negative consequences. Contrary to our predictions, interaction results revealed that students with more social anxiety reported more negative consequences when they reported fewer rather than more positive consequences. Thus, students with more social anxiety may not obtain the social benefits from drinking, which appears to be contributing to their experience of negative drinking consequences. Briefly, alcohol intervention clinicians should consider how to incorporate discussions of positive drinking consequences for these students to facilitate ways to foster social engagement while minimizing alcohol-related harm.     

Coping Responses and Alcohol Outcome Expectancies in Alcohol Abusing and Nonabusing Social Phobics

This study examined coping responses and alcohol outcome expectancies in alcohol abusing and nonabusing social phobics. The sample consisted of social phobics with current alcohol abuse or dependence (SPAs, n = 19), social phobics without lifetime alcohol use disorders (SPs, n = 19), and normal controls (NCs, n = 21). As predicted, SPs reported less problem-focused coping than did NCs in nonalcohol social situations and rated themselves as less skillful in interpersonal role-plays. However, observers did not rate SPs as less skillful than NCs in these role-plays. Consistent with the predicted situation-specific effects, SPAs reported less problem-focused coping than did SPs during alcohol-accessible social situations, but not during alcohol-inaccessible social situations. However, observer-rated and self-report results from role-plays of high-risk alcohol situations did not show the predicted lower drink refusal skills among SPAs compared to SPs. SPAs reported higher positive alcohol expectancies of tension reduction than did SPs but did not differ in negative alcohol expectancies of cognitive and behavioral impairment. These results are in several ways consistent with cognitive and social-learning theories of social phobia and alcohol abuse.     

The Role of Mindful Attention in Regard to the Relation Between Negative Affect Reduction Outcome Expectancies and Emotional Vulnerability Among Adult Cigarette Smokers

The present investigation examined the role of mindful attention in regard to the relation between negative affect reduction smoking outcome expectancies and anxious arousal and anhedonic depression symptoms and difficulties with emotion regulation among 174 (46% women; M _age = 25.32 years, SD = 10.51) daily cigarette smokers. As predicted, there was a significant interaction for negative affect reduction smoking outcome expectancies and mindful attention in relation to anxious arousal symptoms and emotion regulation difficulties. Individuals endorsing both higher levels of negative affect reduction outcome expectancies and lower levels of mindful attention reported the greatest anxious arousal symptoms and difficulties with emotion regulation, while those reporting both lower levels of negative affect reduction expectancies and higher levels of mindful attention were associated with lesser anxious arousal symptoms and the least difficulties with emotion regulation. There was no interactive effect for anhedonic depression symptoms. Findings are discussed in relation to better understanding the clinically meaningful interplay between mindful attention and negative affect reduction outcome expectancies among cigarette smokers in terms of affective vulnerability.     

A Tale of Two Threats: Social Anxiety and Attention to Social Threat as a Function of Social Exclusion and Non-Exclusion Threats

To attain and maintain social acceptance, people may attend to cues of possible social rejection or exclusion. Attention to such cues can be influenced by social anxiety. Two competing theories address social anxiety and attention: hypervigilance to versus avoidance of negative social cues. We propose a synthesis of these models such that, in the absence of social exclusion, socially anxious people may be hypervigilant to negative social cues. However, after experiencing social exclusion, they may avoid negative cues in favor of cues signaling social acceptance. Eyetracking was used to examine attention to negative, happy, and neutral faces after social exclusion threat or a non-exclusion threat (N = 27, 69.2% female). Fear of negative evaluation, a core component of social anxiety, was assessed using the Brief Fear of Negative Evaluation (BFNE) scale (Leary 1983). Among individuals with high BFNE, non-exclusion threat elicited greater attention toward negative faces than did social exclusion threat. However, social exclusion threat relative to non-exclusion threat was related to greater attention to positive faces among those with high BFNE. These effects were not observed among those with low BFNE. Thus, data provide preliminary support for a synthesized model.     

Alcohol Expectancies and Alcohol Use Frequency: Does Drinking Context Matter?

Although alcohol use varies across settings, current measures of alcohol outcome expectancies (i.e., perceived likelihood of experiencing a drinking outcome; AOE) and valuations (i.e., desirability of specific drinking outcomes) do not specify the drinking context explicitly. Therefore, the contextual factors (which may affect both AOE and valuations) respondents use when completing these measures are unknown and make interpretation of measures potentially challenging. As such, the present study examined AOE and valuations among 334 college student drinkers (71.0 % women; M _age = 21.05; 74 % Hispanic) as a function of three drinking contexts: convivial (e.g., at a party, a bar), negative coping (e.g., when experiencing negative affect), and personal-intimate (e.g., with a romantic partner, on a date). As expected, results indicated that endorsement of AOE and valuations differed by context. Participants generally perceived the effects of alcohol—both positive (e.g., I would be friendly) and negative (e.g., I would be clumsy)—as being less likely to occur and less desirable in the negative coping context than in convivial and personal-intimate contexts. Patterns of AOE and valuations for convivial and personal-intimate context varied by specific drinking outcomes; however, all valuations of negative effects were rated highest in the personal-intimate context. Further, certain context-specific beliefs about the effects of alcohol were differentially associated with reported frequency of alcohol use in each context. Findings suggest that context should be made explicit by researchers and clinicians in assessment and intervention of college student drinking.     

Social factors,alcohol expectancy,and drinking behavior: A comparison of two college campuses

Background: Though college students have high rates of heavy drinking, few studies have examined the various pathways through which risks affect drinking and whether this varies by institution. We examined whether alcohol expectancy mediates the relationship between social factors (i.e., hooking up, friends drinking, Greek affiliation, entitlement) and drinking behavior comparing college students from one Midwestern and one Southeastern university. Methods: In the 2013–14 academic year, 1,482 college students (51% female) enrolled in undergraduate courses at two public universities completed a paper and pencil survey of attitudes and experiences about dating, sexuality, and substance use. Multiple group path analysis was used to compare two institutions. Results: Drinking behavior was positively associated with hooking up more often, Greek affiliation, being male, having close friends who consume more alcohol, and greater alcohol expectancies. We found unique differences in the mediating pathways for the two campuses. Conclusion: This study provides a more nuanced understanding of risk factors for heavy drinking. Moreover, it adds to the scarce body of literature concerning entitlement and drinking and the unique pathways between two college campuses. Finally, the results could lead to the development of more specific intervention strategies to reduce risky drinking among U.S. college students.     

Evaluating the Role of Anxiety Sensitivity in Smoking Outcome Expectancies Among Regular Smokers

The present study evaluated the association between the lower-order facets of anxiety sensitivity construct (physical, mental incapacitation, and social concerns) and positive (expectancies about negative affect reduction) and negative (expectancies about negative personal consequences) smoking outcome expectancies. Participants were 90 young adult regular smokers [37 females; M _age = 23.4 years (SD = 8.9); mean number of cigarettes/day = 11.7 (SD = 6.1)] with no history of psychopathology or nonclinical panic attacks recruited from the general population. Anxiety sensitivity physical concerns and mental incapacitation concerns, as indexed by the Anxiety Sensitivity Index (ASI; S. Reiss, R. A. Peterson, M. Gursky, & R. J. McNally, 1986), were significantly and incrementally associated with smoking outcome expectancies, as indexed by the Smoking Consequences Questionnaire (SCQ; T. H. Brandon & T. B. Baker, 1991), for negative affect reduction as well as negative personal consequences; the observed effects were over and above the variance accounted for by theoretically relevant smoking history characteristics, gender, and negative affectivity. Results are discussed in relation to better understanding motivational processes for smoking among groups at heightened risk for developing panic psychopathology.     

Attentional Biases to Social and Health Threat Words in Individuals With and Without High Social Anxiety or Depression

Relative and absolute attentional biases in response times and error rates to social and health threat words were investigated in a sample of female undergraduates with high and low social anxiety (n = 63; mean age = 20.22) and high and low depression (n = 63; mean age = 20.30). A dot-probe paradigm measured attention to (1) social threat versus neutral words, (2) social threat versus health threat words, and (3) health threat versus neutral words. Participants with low social anxiety displayed an absolute bias in response times but not error rates away from social threat words. In contrast, participants with high social anxiety displayed an absolute bias in error rates but not response times toward social threat words. Findings suggest that attention toward social threat may not be unique to social anxiety, and that individuals with high social anxiety may lack a protective bias away from social threat.     

Components of social anxiety prevent cannabis use in adolescents

Background: Social anxiety is often reported as a risk factor for cannabis-related problems during adulthood. However, this disorder may also prevent adolescents from using cannabis. Objectives: This longitudinal study focuses on the relationship between social anxiety and cannabis (prevalence, frequency, problems) in adolescents. Expectancies and specific markers of social anxiety were evaluated. Methods: A questionnaire was administered three times at 1-year intervals (T1, T2, T3), assessing cannabis use, effect expectancies, social anxiety, trait anxiety, and depression, in a sample of 611 teenagers (M = 15.54 years at baseline, age range = 14–18, SD = 0.78, 49.26% women). Results: After controlling for relevant variables (T1), social anxiety (T1) significantly prevents cannabis use (T3) among nonclinical adolescents, but was not significantly related to frequency/problems among users. This relationship is mediated by negative behavioral effect expectancies (T2). Markers of social anxiety (anxiety/avoidance in social interaction/performance situations) prevent cannabis use. Conclusions: Results are discussed in terms of clinical implications concerning cannabis use among adolescents.     

Social Anxiety and Positive Outcome Expectancies on Risk-Taking Behaviors

We examined the hypothesis that under specific conditions, socially anxious individuals may be risk-prone as opposed to risk-averse in domains such as heavy drinking, illicit drug use, unsafe sexual practices, and aggression. A college-aged sample, predominantly women, completed a series of questionnaires on social anxiety and risk-taking behavioral intentions. Results of hierarchical regression analyses indicated that positive outcome expectancies moderated relationships between social anxiety and sexual risk-taking and aggression. Socially anxious individuals expecting desirable outcomes reported the greatest risk-taking behavioral intentions. Socially anxious individuals expecting less desirable outcomes reported the least risk-taking intentions. Social anxiety interaction effects were not accounted for by other anxiety and depressive symptoms. Data suggested that social anxiety was also positively related to illicit drug use. Although preliminary, these significant findings suggest that a subset of socially anxious individuals may engage in risky activities that likely serve the purpose of regulating emotions.

Social Anxiety and Bulimic Behaviors: The Moderating Role of Perfectionism

Despite the high rates of co-occurrence between social anxiety and bulimic behaviors, research investigating the mechanisms underlying these associations is lacking. Given that perfectionism is strongly related to both social anxiety and bulimic behaviors, we tested whether individuals with elevated social anxiety and higher perfectionism would evince greater bulimic behaviors in a non-referred sample. Participants with clinically significant social anxiety (n = 89) were compared to a matched control group (n = 89). We also examined specificity by investigating whether perfectionism moderated the relations between social anxiety and drive for thinness or body dissatisfaction. Participants in the high social anxiety group evinced higher bulimic behaviors, body dissatisfaction, and drive for thinness. Yet, perfectionism only moderated the relationship between social anxiety group and bulimic behaviors, such that individuals scoring high on both social anxiety and perfectionism demonstrated the greatest number of bulimic behaviors. Clinical implications are discussed.     

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.