Beliefs About Drinking Behavior Predict Drinking Consequences

Abstract

Cognitions about drinking, such as positive expectancies and self-efficacy, have been found to profoundly innuence drinking behavior. Although the relationship of self-efficacy and positive expectancies with drinking consumption has been established, the relationship of self-efficacy and alcohol expectancies with the number of reported drinking related consequences has not been examined. One hundred thirteen participants who met criteria for alcohol abuse or dependence were administered the Situational Confidence Questionnaire, the Alcohol Expectancies Questionnaire, the Drinker Inventory of Consequences-Recent, and the Losses of Significance Self-report Questionnaire-Revised. As predicted, lower self-efficacy and greater positive alcohol expectancies predicted greater recent drinking consequences beyond those accounted for by alcohol consumption alone. Greater numbers of positive alcohol expectancies also predicted greater numbers of recent important alcohol related losses. Correcting errant assumptions about alcohol expectancies and strategies designed to increase self-efficacy may reduce harmful drinking consequences even if a client is unwilling to reduce consumption.     

Binge Drinking,Marijuana Use,and Friendships: The Relationship Between Similar and Dissimilar Usage and Friendship Quality

Abstract

While it is commonly understood that the substance use of peers influences an individual's substance use, much less is understood about the interplay between substance use and friendship quality. Using a sample of 2,148 emerging adults nested within 1,074 dyadic friendships, this study separately investigates how concordance and discordance in binge drinking and marijuana use between friends is related to each friend's perceptions of friendship quality. Because “friendship quality” is a complex construct, we employ a measure containing five sub-elements – companionship, a lack of conflict, willingness to help a friend, relationship security, and closeness. Results for both binge drinking and marijuana use reveal that individuals in friendship pairs who are concordant in their substance use perceive significantly higher perceptions of friendship quality than individuals in dyads who are dissimilar in substance use. Specifically, concordant binge drinkers estimate significantly higher levels of companionship, relationship security, and willingness to help their friend than concordant non-users, discordant users, and discordant non-users. However, the highest amount of conflict in friendships is found when both friends engage in binge drinking and marijuana use. Several interpretations of these findings are discussed. Overall, concordance between friends’ binge drinking and marijuana use appears to help some elements of friendship quality and harm others.     

Social Interaction Anxiety,Alexithymia, and Drinking Motives in Australian University Students

ABSTRACT

In young adults at university, social interaction anxiety has been linked to elevated risk of alcohol-related problems, as has alexithymia. The present study sought to assess whether social interaction anxiety is, like alexithymia, associated with the primary motive of drinking to cope with negative affect. There were 126 undergraduates (76 females, 50 males), aged 18–25 years, who were recruited from two southeast Queensland universities to complete validated self-report measures of problematic drinking, alexithymia, drinking motives, and social interaction anxiety. As predicted, social interaction anxiety was positively related to problematic drinking and coping motives for drinking. Alexithymia mediated the relationship of social interaction anxiety with coping motives. Findings were consistent with a developmental hypothesis of the links between social anxiety, alexithymia, and drinking motives. Given the cross-sectional design of the current study, longitudinal research is ultimately needed to confirm such interpretations of alexithymia and alcohol use among socially anxious young adults at university.     

Client's perceived need for treatment and its impact on outcome

Objectives. Based on the concept of “stage of change,”; this study examines the relationship between patients’ motivation for substance abuse treatment and their posttreatment improvements in the areas measured by the Addiction Severity Index (ASI; alcohol, drug, medical, psychiatric). We attempt to answer the following questions: Do clients’ perceptions of “need for drug, alcohol, psychiatric, and medical treatment”; at admission predict their improvements on these problems at 6‐month follow‐up? How do clients’ perceived needs contribute to their use of treatment and their reported change? Methods. Clinical interview data (N = 696) collected using the ASI from the Target Cities Project in the city of Philadelphia in 1993 and 1995. Results. Clients’ motivation made a substantial difference in their improvement following treatment in all problem areas. Clients who said treatment was even slightly important on the ASI at admission made more changes than clients who reported that treatment was “not at all”; important. Even when the motivation groups were approximately equated for lifetime problem severity there was still a significant effect of recent motivation as expressed on the ASI. Conclusions. These data are consistent with other findings from the “stage of change”; literature suggesting that treatment is only important for patients who are ready or at least somewhat motivated to receive it. These findings underscore the importance of efforts to increase patients’ readiness for treatment in order to achieve better treatment effects.     

Women's roles and women's drinking: A comparative study in four European countries 1

The present study analyzes the influence of role combinations on heavy drinking in four European countries: Finland, France, Germany, and Switzerland. Data sets come from nationally representative surveys. A growing number of studies have investigated the influence of social roles on alcohol consumption. Different theories such as role accumulation, role overload, and role deprivation aim to explain the association between roles and poor mental health, including heavy alcohol consumption. The results show that roles and role combinations influence heavy drinking differently in each country. The findings also indicate that the social position of women in a country is strongly connected to the differing associations between specific role combinations and heavy drinking across countries. No single role theory can be applied cross‐culturally. Large‐scale surveys are needed to test statistically the association between role combinations and heavy drinking.     

Independent clinical correlates of severe alcohol withdrawal

This retrospective cohort study sought to identify clinical variables that independently correlate with severe alcohol withdrawal and to quantify risk in a clinically useful manner. The records of 284 inpatients admitted to an acute detoxification unit at a Veterans Affairs teaching hospital were reviewed. Clinical data were recorded on standardized forms at the time of admission and abstracted by a physician reviewer. Alcohol withdrawal severity was prospectively measured with the revised Clinical Institute Withdrawal Assessment for Alcohol (CIWA‐Ar) scale. Seventy‐one patients (25% of cohort) had severe withdrawal. We identified six independent correlates of severe withdrawal: use of a morning eye‐opener (adjusted odds ratio [OR], 5.6; 95% confidence interval [CI], 1.2–25.9), an initial CIWA‐Ar score ≥ 10 (OR, 5.1; 95% CI, 2.4–10.6), a serum aspartate aminotransferase ≥ 80 U/L (OR, 4.2; 95% CI, 2.0–8.8), past benzo‐diazepine use (OR, 3.6; 95% CI, 1.3–9.9), self‐reported history of “delirium tremens”; (OR, 2.9; 95% CI, 1.3–6.2), and prior participation in two or more alcohol treatment programs (OR, 2.6; 95% CI, 1.3–5.6). Significantly higher risk was observed in subjects with three or more independent correlates. In conclusion, several readily available clinical variables correlate with the occurrence of severe alcohol withdrawal. Ascertainment of these variables early in the course of alcohol withdrawal has the potential to improve triage and treatment decisions.     

Inside the Physician's Black Bag: Critical Ingredients of Brief Alcohol Interventions

ABSTRACT

Brief primary care interventions structured around patient workbooks have been shown to be effective in modifying hazardous drinking behavior. However, the critical ingredients of such interventions are not well understood, possibly contributing to their underutilization. Seventeen campus-based clinicians trained in a brief, workbook-based alcohol intervention participated in a qualitative study to identify the most promising clinician-patient interaction components within this shared approach, utilizing a focus group with the clinicians and ranking of the 24 workbook ingredients. Based on the clinicians’ collective experience, consensus emerged around the perceived strength of 5 main components: (1 Harwood, H. Updating Estimates of the Economic Costs of Alcohol Abuse in the United States: Estimates, Update Methods, and Data Report prepared by The Lewin Group for the National Institute on Alcohol Abuse and Alcoholism, 2000. Based on estimates, analyses, and data reported in Harwood, H.; Fountain, D.; and Livermore, G. The Economic Costs of Alcohol and Drug Abuse in the United States 1992. Report prepared for the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Department of Health and Human Services. Rockville, MD: National Institutes of Health; 1998. NIH publication no. 98-4327 [Google Scholar]) providing a summary of the patient's drinking level, (2 Grant, B F, Dawson, D A, Stinson, F S, Chou, S P, Dufour, M C and Pickering, R P. 2004. The 12-month prevalence and trends in DSM-IV alcohol abuse and dependence: United States, 1991–1992 and 2001–2002. Drug Alcohol Depend., 74: 223–234. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) discussing drinking likes and dislikes, (3 Hingson, R, Heeren, T, Winter, M and Wechsler, H. 2005. Magnitude of alcohol-related mortality and morbidity among U.S. college students ages 18–24: changes from 1998 to 2001. Annu Rev Public Health., 26: 259–279. [Crossref], [PubMed], [Web of Science ®] , [Google Scholar]) discussing life goals, (4 Hingson, R, Zha, W and Weitzman, E R. 2009. Magnitude of and trends in alcohol-related mortality and morbidity among U.S. college students ages 18–24, 1998–2005. J Stud Alcohol Drugs., : 12–20. [Crossref], [Web of Science ®] , [Google Scholar]) encouraging a risk-reduction agreement, and (5 Wechsler, H, Lee, J E, Kuo, M, Seibring, M, Nelson, T F and Lee, H. 2002. Trends in college binge drinking during a period of increased prevention efforts: findings from 4 Harvard School of Public Health college alcohol study surveys: 1993–2001. J Am Coll Health., 50: 203–217. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar]) asking patients to track their drinking (on cards provided for this purpose). This is the first paper to examine primary care physician perspectives on potentially critical components of effective brief alcohol intervention.     

Intoxication and binge and high-intensity drinking among US young adults in their mid-20s

ABSTRACT

Background: Alcohol use is a key risk factor for young adult mortality and disease, but limited research has focused on high-risk alcohol use among individuals moving from early young adulthood into building and maintaining an initial structure of adult life. This study estimated the prevalence of a range of alcohol use behaviors among US young adults aged 25/26, examined evidence for historical change in prevalence rates, and estimated associations between alcohol use and key demographic, substance use, and adult social role characteristics. Methods: Data were obtained from 3542 individuals selected for follow-up from the nationally representative 12th-grade student Monitoring the Future study. Respondents self-reported alcohol use behaviors at age 25/26 during calendar years 2005–2014. Results: Two fifths (39.9%) of young adults aged 25/26 reported being intoxicated at least once in the past 30 days; 25.6% reported usually experiencing a sustained high of 3 or more hours when drinking alcohol. Past-2-week binge drinking (5+ drinks in a row) was reported by 36.3% of respondents. Past-2-week high-intensity drinking (10+ drinks in a row) was reported by 12.4%. These age 25/26 alcohol use prevalence rates remained stable over the 10 years of data examined, in contrast to significant declines over historical time in alcohol prevalence rates among these same individuals at age 18. High-risk drinking was particularly associated with being male, white, unmarried, employed, a nonparent, and an alcohol user before finishing high school. Conclusions: Among US young adults in their mid-20s, alcohol use was highly normative and frequently included participation in high-risk drinking behaviors. High-risk alcohol use prevention approaches developed specifically to reach young adults in their mid-20s are needed, as well as efforts to increase proactive clinician screening to identify young adults participating in high-risk alcohol use.     

Revision of the Self-Administered Alcoholism Screening Test (SAAST-R): A Pilot Study

The original Self-Administered Alcoholism Screening Test () is a self-report alcoholism screening measure intended for use with adult medical patients. However, the SAAST does not indicate the recency of alcohol use–related problems, not all items use the appropriate verb tense for assessing lifetime experience of alcohol use–related problems, many of the items contain out-dated language, and the diagnostic criteria for alcohol dependence and alcohol abuse are not fully represented. The SAAST was revised to address these issues. This paper describes the rationale for revision and the process through which the SAAST was revised. Preliminary information about comparability of the original SAAST and the revised version (SAAST-R) was obtained. Data are presented from two intervention trials for smokers in which both the SAAST and SAAST-R were administered. One sample was comprised of participants in recovery from alcoholism (N = 60; 82% male) and the other sample consisted of participants not meeting criteria for alcohol abuse or dependence within the previous year (N = 98; 45% male). The results suggest that the SAAST-R is highly correlated with the original SAAST, has a similar factor structure, good internal consistency, and correctly identifies those in recovery from alcoholism. Areas for refinement in the format and items of the SAAST-R were identified and suggestions for further validation studies are presented.