Positive Social Alcohol Outcome Expectancies,Social Anxiety,and Hazardous Drinking in College Students

Although social anxiety and problematic alcohol use co-occur at alarmingly high rates, the mechanism for this co-occurrence is not well understood. The current study examined the mediating role of positive social alcohol expectancies (i.e., beliefs related to the desirable social effects of drinking) in the relationship between social anxiety and hazardous drinking (i.e., heavy drinking and negative consequences) among an ethnically and racially diverse (87% racial and/or ethnic minority) sample of undergraduate volunteers (n = 610; Mage = 19.1; 69% women). The results of structural equation modeling analyses (using AMOS 7.0) indicated that social (but not tension reduction, sexual enhancement, positive cognitive changes, or negative affective changes) alcohol outcome expectancies partially mediated the association between social anxiety and hazardous drinking; however, social anxiety had a negative direct effect on hazardous drinking. Findings implicate social alcohol outcome expectancies as a mechanism to target in treatment and prevention among socially anxious students.     

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.     

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.     

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.     

Differences in alcohol brand consumption among underage youth by age,gender, and race/ethnicity – United States, 2012

Abstract

Aim: No previous national study has reported the prevalence of alcohol brand consumption among underage youth by demographic characteristics. The aim of this study was to determine the alcohol brand preferences among underage drinkers in different demographic categories.

Methods: We administered an online survey to a national sample of 1031 underage youth, aged 13–20, who had consumed at least one drink of alcohol in the past 30?d. The sample was recruited from a previously established internet survey panel. The main outcome measure was the estimated 30-d consumption prevalence for each of 898 brands by age, gender, and race/ethnicity.

Results: Two beer brands – Bud Light and Budweiser – are uniformly popular among underage drinkers, regardless of age, gender, or race/ethnicity. There are several hard liquor brands whose use increases markedly with age. Two flavored alcoholic beverages sharing the names of hard liquor brands – Smirnoff and Bacardi – are more popular with older youth. Some flavored alcoholic beverages are about twice as popular among female underage drinkers. There are 12 alcohol brands that are uniquely popular among Black underage drinkers, and these brands are heavily promoted in urban music.

Conclusion: There are differential patterns of brand-specific alcohol use among underage drinkers.     

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.     

Evaluating the positive drinking consequences questionnaire: Support for a four-factor structure and measurement invariance

The 14-item Positive Drinking Consequences Questionnaire (PDCQ) was developed to assess experienced positive drinking consequences. The present study sought to advance the psychometric evaluation of the PDCQ via exploratory and confirmatory factor analyses, measurement invariance, criterion-related validity, and internal consistency. Participants were 1,088 traditional-age college students (81% female) who reported drinking in the past month. Exploratory factor analysis supported a four-factor model (i.e. Sociability, Tension Reduction, Liquid Courage, and Sexual Enhancement), and the confirmatory factor analysis indicated the four factors loaded on a higher-order factor (“PDCQ”). Invariance testing supported invariance for the PDCQ across gender. The PDCQ was positively associated with alcohol use and alcohol-related negative consequences, and negatively associated with protective behavioral strategies. Finally, the four factors of the PDCQ were discriminant from positive expectancies. Collectively, positive drinking consequences appear to be more nuanced than originally conceptualized. Evaluation of specific types of positive drinking consequences may assist in more precise prevention and intervention efforts in the future.     

Before You Slip into the Night,You'll Want Something to Drink: Exploring the Reasons for Prepartying Behavior Among College Student Drinkers

Prepartying among college students is an emerging topic of research and clinical focus. Unfortunately for some students, prepartying, or quick drinking before going out for the primary event of the evening, can lead to high blood alcohol levels, further drinking, and subsequent consequences. The present study was designed to explore the reasons for prepartying among a sample of 444 male and female students. Males and females reported arriving to a social event already under the influence, saving money, and making the night more interesting as their most highly endorsed reasons for prepartying. Males endorsed reasons relating to increased social and sexual facilitation with opposite sex peers to a greater extent than females. Although underage and legal drinking age participants did not differ in prepartying frequency or typical quantity, underage students reached higher estimated blood alcohol levels during prepartying. Finally, alcohol-related consequences were significantly and positively associated with nearly all reasons for prepartying for both men and women.     

A School-Based Alcohol,Tobacco, and Drug Prevention Program for Children: The Wise Mind Study

The Wise Mind pilot study compared the efficacy of an environmental Alcohol/Tobacco/Drug (ATD) prevention program with an obesity prevention program of Healthy Eating and Exercise (HEE) as an active control group for modifying expectancies related to alcohol and tobacco use in children. Four Catholic schools (N = 670 students) were randomly assigned to the treatment conditions (2 schools in each condition). Children were followed over two academic years. At an 18-month assessment, the ATD program resulted in healthier alcohol and tobacco expectancies as compared to the HEE program. Children in the ATD program did not differ from those in the HEE program in alcohol, tobacco, or drug use prevalence. However, prevalence rates of use were very low across all schools. Findings can benefit future prevention efforts with young children and suggest that strategies for preventing continued smoking in this age group are needed.     

All it takes is one: drinking games,prepartying, and negative drinking consequences among high school students

Abstract

Prepartying (i.e. drinking before a social event/gathering) and participation in drinking games are two high-risk drinking behaviors practiced by adolescents.?Engaging in both these drinking behaviors may contribute to a multiple risk paradigm, wherein the risk associated with one’s general drinking is combined with the additional risk of rapidly ingesting alcohol as a result of one or both these activities.?The present study examines this paradigm among high school students who reported alcohol use (N?=?240).?Controlling for age and typical alcohol consumption, results indicated that participation in prepartying or drinking games was associated with more negative alcohol-related outcomes than non-participation. However, participation in both risky behaviors, as opposed to one, did not give rise to negative additive effects. Thus, students who participate in just one of these activities warrant the same attention from health professionals and school personnel as those who participate in both.?Importantly, results also showed that students who reported drinking games participation and prepartying endorsed social and coping drinking motives just as frequently as students who only reported drinking games participation.?However, students who engaged in multiple high-risk drinking behaviors were more inclined to drink to enhance the intensity of the “high” associated with alcohol use.     

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.     

Increased Detection of Alcohol Consumption and At-risk Drinking with Computerized Alcohol Screening

Background

The impact of alcohol use has been widely studied and is considered a public health issue. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends Screening and Brief Intervention and Referral Treatment (SBIRT), but the actual practice in the Emergency Department (ED) is constrained due to limited provider time and financial resources.

Objectives

To assess the effectiveness of alcohol screening using Computerized Alcohol Screening and brief Intervention (CASI) compared to alcohol screening by triage nurse during Medical Screening Examination (MSE) in the ED.

Methods

Retrospective review of CASI/MSE database from January 2008 through December 2009, collected in the tertiary, Level I Trauma ED was performed. Inclusion criteria included age ≥18 years, and completion of both the MSE and CASI. We analyzed the database by comparing age, gender, primary language (English, Spanish), and Alcohol Use Disorders Identification Test scores using McNemar's test.

Results

Data were available for 5835 patients. CASI showed a significant increase in detection of at-risk drinking over MSE across all ages, gender, and primary language (p < 0.05). MSE found 2.5% at-risk drinkers and CASI found 11.5% at-risk drinkers (odds ratio [OR] 8.88, 95% confidence interval [CI] 6.89–11.61). Similar results were found in 18- to 20-year-old patients. MSE identified 1.8% at-risk drinkers and CASI reported 15.94% (OR 19.33, 95% CI 6.30–96.47).

Conclusion

CASI increased detection of at-risk alcohol drinkers compared with MSE across all ages, gender, and primary language. CASI is a promising innovative method for alcohol screening in the ED for the adult population, including under-aged drinkers.     

Gender, ethnicity, and cardiovascular disease

Although the influence of gender and ethnicity on cardiovascular disease has been understudied, cardiovascular nurse researchers have contributed significantly to the existing body of knowledge. This article distinguishes between the constructs of "gender versus sex' and "ethnicity versus race,' acknowledging that the terms are often used interchangeably in research. A sampling of the substantial contributions of cardiovascular nurse researchers related to gender and ethnicity in the areas of symptoms of cardiovascular disease; risk factors and prevention; delay in seeking care, diagnosis, and treatment; recovery and outcomes; and cardiac rehabilitation is highlighted. Recommendations for future research include publishing research data by gender and ethnicity subgroups even though statistical comparisons may not be feasible, and increasing cardiovascular disease research in minority populations such as Asian Americans, Pacific Islanders, Native Americans, and Hispanics. Finally, we challenge cardiovascular nurse researchers to shift from the documentation of disparities toward designing and testing of interventions to eliminate health disparities.     

Predictors of hazardous drinking among home drinkers

Introduction and Aims: The United Kingdom has witnessed a shift from drinking in bars to drinking at home; to date, this phenomenon has received little international attention. The aim of this study was to examine the predictors of hazardous drinking (HD) levels when drinking at home. Design: An internet survey of university staff (n = 488) was given. Methods: Following an elimination process (p ≤ 0.05), a regression analysis was conducted using AUDIT scores as cutoffs of ≥6 females, and ≥8 males; these are consistent with most international research. Results: There were 286 hazardous drinkers (HD) (181, females 63.3%) and (105, males 36.7%). The variables that predicted HD were female (OR = 5.42 95% CI 1.87–15.66), younger age, greater frequency of consuming alcohol at home, preloading (drinking before going out), purchasing alcohol in an off license, and drinking alcohol at home because it is cheaper than drinking out. Discussion and Conclusions: These findings point to an interaction of gender, age purchasing patterns, and motivations contributing to hazardous drinking at home and indicate further profitable areas of national and international research.     

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.     

Psychometric properties of a single-item assessing drunkenness to identify hazardous drinking: a replication study

Background: The Alcohol Use Disorders Identification Test (AUDIT-C) is a commonly used scale to screen for hazardous alcohol use in various settings, including primary and emergency care settings. In such settings, brevity of effective screening tools is needed; therefore, single items have been developed and tested for detecting at-risk alcohol use behaviors.

Purpose: This study replicates previous work validating the ability of a non-quantity-based single item assessing drunkenness to effectively identify signs of hazardous alcohol use.

Methods: During fall 2013, alcohol use data were collected from 781 self-reported current drinkers. Concurrent validity of a drunkenness item to detect hazardous drinking behaviors was assessed against gender-based AUDIT-C thresholds. Convergent validity of the drunkenness item was assessed against biologic BrAC samples.

Results: The single drunkenness item accounted for 0.856 of the area-under-the-received operating characteristics (ROC) curve for hazardous alcohol use (p?<?0.001). Using a specific cut-off of 1, the drunkenness item was 99.8% sensitive in detecting hazardous drinking behavior and was 93.5% specific in identifying non-hazardous drinking behaviors.

Conclusion: In a new sample, initial psychometric findings of the single drunkenness item to accurately detect hazardous alcohol use were replicated, providing additional support for the utility of this item.     

Maladaptive Cognitive Schemas in Alcohol Dependence: Changes Associated with a Brief Residential Abstinence Program

Previous research has suggested that alcohol dependency may be associated with particular cognitive schemas. The objective of this study was to examine the severity of reported maladaptive schemas, and of anxiety and depression levels of an alcohol dependent group prior to and following a period of abstinence, and in comparison with a non-clinical sample. A total of 100 participants, comprising an alcohol dependent clinical (ADC) group (n = 50) and a non-clinical group (n = 50), were recruited. Data were collected on demographic characteristics, drinking patterns, severity of alcohol dependence, depression, anxiety, and maladaptive schemas. ADC participants reported higher levels of depression and anxiety than did the non-clinical group immediately before a period of abstinence. The groups differed significantly on 6 of 15 schema beliefs. Following a brief (3-week) period of abstinence and participation in a psycho-educational program, the ADC group demonstrated significant improvements in relation to depression, anxiety, and 13 out of 15 maladaptive schema beliefs. Further research is required to understand the association and potential relevance of particular schemas to alcohol dependency.     

Linkages between young adult dating partners’ daily alcoholic drinks: risk for alcohol problems as a moderator

Dating relationships during young adulthood provide an important interpersonal context for individuals’ health behaviors, including alcohol use. To better understand dating partners’ alcohol-use associations and implications, this study examined within-couple daily linkages between daily alcoholic drinks reported by males and females and further investigated the potential role of hazardous drinking as a moderator of the daily links. Dyadic data from 57 young adult, heterosexual couples were obtained across global self-report questionnaires and daily-diary methods. Multilevel modeling results indicated positive within-couple associations between dating partners’ reports of daily drinks, such that on days when males and females reported drinking more than their average number of daily drinks, their partner also drank more. In addition, both males’ and females’ elevated risks for hazardous drinking moderated these associations by weakening the positive within-couple links between partners’ daily drinks. The study extends our understanding of young adults’ alcohol use in the context of intimate relationships, shedding particular light on the implications of within-couple daily fluctuations in number of drinks and partners’ risks for hazardous drinking.     

Drinking and Thinking: Alcohol Effects on Post-event Processing in Socially Anxious Individuals

We examined the effects of drinking alcohol at the time of a social event on later post-event processing among socially anxious individuals. A sample of 84 (43 males, M _age = 21.36 years, SD _age = 2.06) undergraduates were randomly assigned to an alcohol (n = 44; mean blood alcohol concentration = .057 %), or a no alcohol (n = 40) condition. Following beverage consumption and absorption, they participated in a social interaction with an opposite-gendered confederate. Four days later, participants completed a measure of post-event processing of this interaction. A significant beverage condition by gender interaction was observed on levels of post-event processing: post-event processing levels were lower in the alcohol versus the no alcohol condition for females, whereas they were higher in the alcohol versus the no alcohol condition for males. This pattern of alcohol reinforcement might help explain observed gender differences in the odds of alcohol use disorders in social anxiety disorder.