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APA Journal: Psychology of Addictive Behaviors
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There is an imperative to predict hazardous drinking among college students. Implicit measures have been useful in predicting unique variance in drinking and alcohol-related problems. However, they have been developed to test different theories of drinking and have rarely been directly compared with one another. Thus, their comparative utility is unclear. The current study examined five alcohol-related variants of the Implicit Association Test (IAT) in a sample of 300 undergraduates and sought to establish their predictive validity. Results indicated that the Drinking Identity IAT, which measured associations of “drinker” with “me,” was the most consistent predictor of alcohol consumption, alcohol problems, and alcohol cravings. It also had the highest internal consistency and test–retest reliability scores. The results for the Alcohol Excitement and Alcohol Approach IATs were also promising, but their psychometric properties were less consistent. Although the two IATs were positively correlated with all of the drinking outcome variables, they did not consistently predict unique variance in those variables after controlling for explicit measures. They also had relatively lower internal consistencies and test–retest reliabilities. Ultimately, results suggested that implicit drinking identity may be a useful tool for predicting alcohol consumption, problems, and cravings and a potential target for prevention and intervention efforts. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Studies indicate that U.S.-born Latino teens exhibit higher rates of alcohol use compared with their foreign-born counterparts. Different hypotheses have been advanced to explain the mechanisms underlying this immigrant paradox, including the erosion of protective cultural factors across generations and increased exposure to risky peer environments in the United States. The present study examined whether the immigrant paradox applies to drinking initiation and problematic drinking among Latino adolescents, and tested whether generational differences in family protective factors and peer risk factors might explain the immigrant paradox. A nationally representative sample of Latino teens (N = 2,482) of Cuban, Mexican, and Puerto Rican origin from 3 immigrant generations (21% first generation, 33% second generation, and 46% third and later generations) was obtained from the National Longitudinal Study of Adolescent Health. Logistic and negative binomial regression models indicated that early drinking initiation and problematic alcohol use were more prevalent among later-generation youth, supporting the immigrant paradox. Erosion of family closeness and increased association with substance-using peers mediated the relationship between generation and alcohol use patterns in this sample. Results provide support for culturally sensitive interventions that target peer perceptions of substance use and bolster protective family values among Latino adolescents. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
We tested 44 participants with respect to their working memory (WM) performance on alcohol-related versus neutral visual stimuli. Previously an alcohol attentional bias (AAB) had been reported using these stimuli, where the attention of frequent drinkers was automatically drawn toward alcohol-related items (e.g., beer bottle). The present study set out to provide evidence for an alcohol memory bias (AMB) that would persist over longer time-scales than the AAB. The WM task we used required memorizing 4 stimuli in their correct locations and a visual interference task was administered during a 4-sec delay interval. A subsequent probe required participants to indicate whether a stimulus was shown in the correct or incorrect location. For each participant we calculated a drinking score based on 3 items derived from the Alcohol Use Questionnaire, and we observed that higher scorers better remembered alcohol-related images compared with lower scorers, particularly when these were presented in their correct locations upon recall. This provides first evidence for an AMB. It is important to highlight that this effect persisted over a 4-sec delay period including a visual interference task that erased iconic memories and diverted attention away from the encoded items, thus the AMB cannot be reduced to the previously reported AAB. Our finding calls for further investigation of alcohol-related cognitive biases in WM, and we propose a preliminary model that may guide future research. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Heavy drinkers show an increased attentional bias to alcohol-related stimuli compared to moderate drinkers, and this bias is thought to promote motivation for alcohol consumption (Field & Cox, 2008). Studies have begun to examine acute alcohol effects on attentional bias; however, little is known regarding how these effects might differ based on drinker type. Further, the degree to which attentional bias in response to alcohol is associated with excessive alcohol consumption remains unexplored. For the current study, 20 heavy drinkers and 20 moderate drinkers completed a visual probe task in response to placebo and two active doses of alcohol (0.45g/kg and 0.65g/kg). Participants' eye-movements were monitored and attentional bias was calculated as the difference in time spent focused on alcohol compared to neutral images. Participants' alcohol consumption was assessed by a timeline follow-back calendar and a laboratory ad lib consumption task. Results showed that heavy drinkers displayed significantly greater attentional bias than did moderate drinkers following placebo. However, heavy drinkers displayed a dose-dependent decrease in attentional bias following alcohol, whereas the drug had no effect in moderate drinkers. Individual differences in attentional bias under placebo were strongly associated with both self-reported and laboratory alcohol consumption, yet bias following alcohol administration did not predict either measure of consumption. These findings suggest that attentional bias is strongest before a drinking episode begins. As such, an attentional bias might be most influential in terms of initiation of alcohol consumption, and less of a factor in promoting continued consumption within the drinking episode. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Heavy alcohol use and related consequences are common during the college years and are associated with deleterious outcomes for both the students themselves and the college community. Some college students make self-initiated changes to their drinking to avoid such outcomes, but little is known about how such adjustments occur, or characteristics that are associated with making these adjustments. Based on Social Learning Theory (SLT), one cognitive factor that may predict within-person changes in drinking is the subjective evaluations of alcohol consequences (i.e., the extent to which consequences are perceived as negative, aversive, or severe). The aim of the present study was to investigate whether subjective evaluations of recently experienced consequences influence within-person changes in drinking behavior. In 10 weekly, web-based surveys, regularly drinking college students (N = 96, 50 female) reported on their previous week alcohol use and experience of 24 alcohol-related consequences, as well as their subjective evaluations of those consequences. Results demonstrated that evaluations across the consequences varied, and that in addition to differing from one another, students' evaluations of consequences differed at the within-person level over time. Most important, hierarchical linear model tests revealed that students drank less and experienced fewer consequences following weeks in which they rated their consequences as more negative (relative to their own typical subjective evaluations), suggesting that viewing one's recent consequences as aversive prompts self-initiated behavior change. Findings of the present study have potential to inform interventions for college drinking, particularly those that target how individuals think about their behavior and its consequences. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Gaining a better understanding of the natural course of hazardous alcohol consumption could inform the development of brief interventions to encourage self-change. In the current study, hazardous drinkers (based on Alcohol Use Disorders Identification Test score) were recruited using advertisements to participate in a 2-year multiwave prospective study. Participants (n = 206) provided self-reports every six months during the study, including reports of daily alcohol consumption. The current investigation focuses on self-initiated change in participants' frequency of heavy drinking days (i.e., ≥ 5/4 drinks per day for men/women), as predicted by a number of demographic (e.g., age) and psychosocial (e.g., guilt-proneness) variables. Latent growth curve models of the change in percent heavy drinking days over the 2-year period provided an excellent fit to the observed data and indicated a significant decline in percent heavy drinking days over time. Reductions in heavy drinking frequency were predicted by younger age and higher guilt-proneness. The identification of these predictors of reductions in heavy drinking frequency provides information to guide future work investigating self-change among hazardous drinkers. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
This study aimed to investigate attentional bias in alcohol-dependent patients and control participants with regard to individualized (specific) and nonindividualized (general) alcohol-related words. First, it was assumed that alcohol-dependents rather than control participants are more distracted by alcohol-related words, particularly individualized alcohol-related words, than by non–alcohol-related words. Second, words which are derived from participants' individual drinking experiences were assumed to induce the highest Stroop interference over all participants. Alcohol-dependent patients (Diagnostic and Statistical Manual of Mental Disorders IV, n = 39) and healthy control participants with a moderate consume of alcohol (n = 33) completed a modified alcohol Stroop task based on word stimuli derived from four categories: neutral versus negative and specific versus general alcohol-related words. While alcohol-dependents showed similar RTs in the different word categories, control participants showed the slowest reactions after presentation of specific alcohol-related words. Generally, alcohol-dependents had slower RTs than controls did. The results do not corroborate the hypothesis of increased interference caused by specific alcohol-related words in alcohol-dependents—instead, this presumption seems to apply to the control participants only. As we did not find any special impact of personally relevant alcohol-related words outclassing the influence of preselected alcohol-related words in the patient group, the benefit of individualized stimuli should be reconsidered. Our results do not support the relevance of attentional retraining programs. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Previous investigations of attentional bias for alcohol cues in abstinent alcoholics indicate enhanced processing of alcohol cues on the modified Stroop task, and a more complicated “vigilance-avoidance” pattern of attentional bias on the visual probe task. Given that, in general, subjective craving is positively associated with attentional bias, we predicted that attentional biases in abstinent alcoholics would depend on their level of alcohol craving. In the present study 28 alcoholic patients, who had recently commenced a day treatment program, and 26 social drinking controls completed an alcohol Stroop task, a visual probe task with three stimulus durations (200, 500, and 2,000 ms), and self-report assessments of craving and alcohol dependence. On the alcohol Stroop task, abstinent alcoholics showed a greater interference effect for alcohol-related than neutral words, relative to social drinkers. On the visual probe task, alcoholic patients who reported a high level of craving exhibited a greater attentional bias toward alcohol cues, relative to both patients reporting a low level of craving, and social drinker controls. Alcoholics who reported low levels of craving showed avoidance of alcohol cues at 500 ms, relative to social drinkers. Among alcoholics, early dropout from treatment was associated with the severity of alcohol dependence and the strength of subjective craving, but it was not associated with measures of attentional bias. These results clarify the importance of subjective craving as a correlate of attentional biases in abstinent alcoholics. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
In the present study, we examined whether use of protective behavioral strategies mediated the relationship between self-control constructs and alcohol-related outcomes. According to the two-mode model of self-control, good self-control (planfulness; measured with Future Time Perspective, Problem Solving, and Self-Reinforcement) and poor regulation (impulsivity; measured with Present Time Perspective, Poor Delay of Gratification, Distractibility) are theorized to be relatively independent constructs rather than opposite ends of a single continuum. The analytic sample consisted of 278 college student drinkers (68% women) who responded to a battery of surveys at a single time point. Using a structural equation model based on the two-mode model of self-control, we found that good self-control predicted increased use of three types of protective behavioral strategies (Manner of Drinking, Limiting/Stopping Drinking, and Serious Harm Reduction). Poor regulation was unrelated to use of protective behavioral strategies, but had direct effects on alcohol use and alcohol problems. Further, protective behavioral strategies mediated the relationship between good self-control and alcohol use. The clinical implications of these findings are discussed. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
The current investigation evaluated nicotine withdrawal symptoms elicited by 12 hours of smoking deprivation on anxious and fearful responding to bodily sensations among daily smokers with and without panic disorder (PD). It was hypothesized that smokers with PD who were experiencing greater levels of nicotine withdrawal would experience the greatest levels of fearful responding to, and delayed recovery from, a 10% carbon dioxide-enriched air (CO₂) biological challenge procedure. Participants were 58 adults who reported smoking 19.72 cigarettes daily (SD = 7.99). Results indicated that nicotine withdrawal and PD status interacted to predict greater postchallenge panic attack symptoms. Also, individuals with PD initially evidenced a quicker decrease in subjective anxiety following the challenge, but their rate of recovery decelerated over time as compared to those without PD. There was, however, no significant interaction for change in subjective anxiety pre- to postchallenge. Results are discussed in relation to the role of nicotine withdrawal in anxious and fearful responding for smokers with PD. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
This study proposed the Reference Group Perspective for smoking cessation, examining smokers' identification with three reference groups: best friends, colleagues, and family members, and hypothesizing that identification with each group would moderate the relationship between injunctive and descriptive norms of the group and smoking cessation self-efficacy. Results of an online questionnaire (N = 208) indicated that injunctive and descriptive norms of all three reference groups significantly affected smoking cessation self-efficacy, and this relationship was moderated by identification. Injunctive norms were stronger in predicting smoking cessation self-efficacy than descriptive norms, with injunctive norms of family members and descriptive norms of best friends having the most significant effect. Positive attitude toward smoking was also significantly associated with smoking cessation self-efficacy. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Little is known about the effect of craving on smoking abstinence among cardiac patients who smoked prior to admission and the mechanisms that might facilitate success in smoking cessation after discharge from hospital. This study examined the mediating effect of self-efficacy on the relationship between craving and smoking abstinence and how this mechanism may be contingent on emotional state at the time of hospital admission. Cardiac patients who smoked prior to admission were recruited from cardiac nursing units in Dutch hospitals. On hospitalization, 244 patients completed a questionnaire on craving, self-efficacy to smoking cessation, and anxiety and depression levels. Six months after discharge patients were interviewed to ascertain their smoking status. Simple mediation and moderated mediation effects of craving and self-efficacy on smoking abstinence were tested. Of the patients who successfully completed the baseline questionnaire and the follow-up interview, 38% were not smoking at 6 months. Self-efficacy mediated the effect of craving on smoking abstinence. However, this indirect effect was more pronounced among patients with relatively low to moderate anxiety at the time of hospitalization. Our findings suggest that craving reduces self-efficacy, which in turn reduces the likelihood of smoking abstinence, although this process applies only to those patients with low to moderate anxiety levels at the time of hospitalization. Interventions for smoking cardiac patients should aim to reduce craving and to enhance patients' self-efficacy to smoking cessation after discharge from hospital. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Incapacitated sexual assault (ISA) is the most common form of sexual victimization experienced by college women. Although ISA victims are at risk for future assaults, few studies have examined mechanisms responsible for ISA revictimization besides heavy drinking. Using a prospective design, the present study examined whether emotion dysregulation, given its association with interpersonal trauma and substance use, increases risk for revictimization among women with a history of ISA above and beyond the effects of substance use. Female college students (n = 229) completed a baseline assessment followed by assessment of incapacitated sexual assault over a 9-week follow-up period. Approximately 36% of participants reported a history of ISA, and 73% of those victimized during the study had a history of ISA. Revictimized women reported higher levels of alcohol-related problems, greater marijuana use, greater emotion dysregulation, and higher levels of fear and guilt prior to experiencing ISA during the study; however, they did not consume more alcohol than previously victimized women. In a logistic regression analysis, guilt, emotion dysregulation, and marijuana use accurately classified 78.9% of ISA revictimized women. Women with a history of ISA are at substantial risk for ISA revictimization. Findings suggest that even very small increases in emotion dysregulation, particularly in impulsivity, as well as marijuana use, impact revictimization risk substantially. Efficacy of interventions to reduce ISA revictimization may be improved if emotion dysregulation is addressed. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Given the widespread use of the Internet, researchers have begun to examine the personal and social consequences associated with excessive online involvement. The present study examined college students' problematic Internet use (PIU) behaviors within the framework of Jessor and Jessor's (1977) problem-behavior theory. Its specific aim was to investigate the links between PIU with both internalizing (depression, social anxiety) and externalizing (substance use and other risky behaviors) problems. Relevant variables from the perceived environmental system, the personality system, and the behavioral system were entered in a canonical correlation analysis. The analysis yielded two distinct functions: the first function, titled traditional problem-behavior syndrome, characterized students who are impulsive, hold socially deviant attitudes and show a propensity to use tobacco and illicit drugs. The second function, titled problematic Internet-behavior syndrome, characterized students who are socially anxious, depressed, report conflictive family relations, and show a propensity toward PIU. Thus, PIU did not share the characteristics typically associated with the traditional problem-behavior syndrome consistent with problem-behavior theory, but showed correlates more consistent with internalizing rather than externalizing problems. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Current cognitive-motivational theories of addiction propose that prioritizing appetitive, reward-related information (attentional bias) plays a vital role in the development and maintenance of substance abuse. This study focused on reward-related attentional processes that might be involved in young-adolescent substance use. Participants were young adolescents (N = 682, mean age = 16.14), who completed a motivated game in the format of a spatial orienting task as a behavioral index of appetitive-related attentional processes and a questionnaire to index substance (alcohol, tobacco, and cannabis) use. Correlational analysis showed a positive relationship between substance use and enhanced attentional engagement, with cues that predicted potential reward and nonpunishment. These results are consistent with the view that adolescents who show a generally enhanced appetitive bias might be at increased risk for developing heavier substance use. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Advances in positive psychology have grown exponentially over the past decade. The addictions field has experienced its own growth in a positive direction, embodied by the recovery movement. Despite parallel developments, and great momentum on both sides, there has been little crosspollination. This article introduces positive psychology and the recovery movement, describes the research on positive psychology in the addictions, and discusses future avenues of theory, research, and intervention based on a positive-psychology framework. A systematic review of positive psychology applied to substance use, addiction, and recovery found nine studies which are discussed according to the following themes: theoretical propositions, character strengths and drinking, positive psychology and recovery, positive interventions, and addiction: feeling good and feeling bad. The current scholarship is scant, but diverse, covering a wide range of populations (adults, adolescents, those in and out of treatment), topics (character strengths, recovery, positive affect), and addictive behaviors (work addiction, cigarette smoking, and alcohol use disorders). There is diversity, too, in country of origin, with work originating in the U.S., U.K., Poland, and Spain. The rigorous application of the lens, tools, and approaches of positive psychology to addiction research generally, and to the aims of the recovery movement specifically, has potential for the development of theory and innovation in prevention and intervention. Further, because the work in positive psychology has primarily focused on microsystems, it may be primed to make contributions to the predominantly macrosystems focus of the recovery movement. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Critical research questions in the study of addictive behaviors concern how these behaviors change over time: either as the result of intervention or in naturalistic settings. The combination of count outcomes that are often strongly skewed with many zeroes (e.g., days using, number of total drinks, number of drinking consequences) with repeated assessments (e.g., longitudinal follow-up after intervention or daily diary data) present challenges for data analyses. The current article provides a tutorial on methods for analyzing longitudinal substance use data, focusing on Poisson, zero-inflated, and hurdle mixed models, which are types of hierarchical or multilevel models. Two example datasets are used throughout, focusing on drinking-related consequences following an intervention and daily drinking over the past 30 days, respectively. Both datasets as well as R, SAS, Mplus, Stata, and SPSS code showing how to fit the models are available on a supplemental website. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Heavy episodic drinking (HED) is a major health problem for young adults. Rates of HED have remained consistently high among young adults for the past two decades. Though research has identified various intrapersonal, interpersonal, and environmental contributors to HED, the majority of research focuses on intrapersonal factors. As such, more research is needed to test the role that specific interpersonal relationships play in perpetuating HED. This study tests the partner influence hypothesis that suggests partners in romantic relationships influence one another's HED over time. A sample of 208 young, nonmarried, heterosexual dating couples completed HED measures at baseline and again 28 days later. Actor–partner interdependence modeling revealed significant actor effects, demonstrating stability in HED within each partner over time. Results also showed significant partner effects where HED in both young men and women in dating relationships positively influenced their partners' future HED over a relatively short time frame. Patterns in the results suggest both women and men are more affected by their own than by their partner's prior level of HED. Nonetheless, small partner effects were present for both women and men. Results support the partner influence hypothesis and suggest HED is a self-propagating behavior sustained, in part, by a pattern of interpersonal influence. These results highlight the importance of considering both intrapersonal and interpersonal factors when implementing prevention and intervention programs for young adults' HED. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Alcohol Myopia Theory (AMT) posits that alcohol restricts the focus of attention, such that behaviors are determined only by highly salient environmental cues. While AMT is most commonly understood in terms of spatial attention, the present study tested the effects of alcohol in the temporal domain of attention. Seventy-one participants consumed either a placebo beverage or one of two doses of alcohol (0.40g/kg or 0.80g/kg ETOH) before performing an auditory discrimination task while event-related potentials (ERPs) were recorded. Consistent with typical sequential effects, placebo participants showed increased P300 amplitude and slowed behavioral responses when the current target differed from the two-back tone. In contrast, alcohol caused increased P300 and response slowing when the target tone differed from the one-back tone. These findings suggest that alcohol increases the salience of more recently encountered information, consistent with the general tenets of AMT. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Social learning mechanisms, such as descriptive norms for drinking behavior (norms) and positive alcohol expectancies (PAEs), play a major role in college student alcohol use. According to the principle of reciprocal determinism (Bandura, 1977), norms and PAEs should be reciprocally associated with alcohol use, each influencing one another over time. However, the nature of these prospective relationships for college students is in need of further investigation. This study provided the first examination of the unique reciprocal associations among norms, PAEs, and drinking together in a single model. PAEs become more stable with age, whereas norms are likely to be more dynamic upon college entry. Thus, we hypothesized that alcohol use would show stronger reciprocal associations with norms than with PAEs for college students. Students (N = 557; 67% women) completed online measures of PAEs, norms, and quantity and frequency of alcohol use in September of their first (T1), second (T2), and third (T3) years of college. Reciprocal associations were analyzed using a cross-lagged panel design. PAEs had unidirectional influences on frequency and quantity of alcohol use, with no prospective effects from alcohol use to PAEs. Reciprocal associations were observed between norms and alcohol use, but only for quantity and not for frequency. Specifically, drinking quantity prospectively predicted quantity norms and quantity norms prospectively predicted drinking quantity. This effect was observed across both years in the model. These findings support the reciprocal determinism hypothesis for norms but not for PAEs in college students and may help to inform norm-based interventions. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Drinking motives are among the most proximal factors for drinking behavior and serve as a mechanism through which more distal factors are mediated. However, it is less clear whether drinking motives are precursors of drinking or, in contrast, shaped by previous drinking experiences (reciprocal effects), or both. Moreover, in adults it is unclear whether drinking motives, usually shaped in adolescence, influence each other over time. In this longitudinal study (N = 2440, 47% women, average age 53 years), drinking motives and drinking behavior (i.e., number of drinks on the heaviest drinking day and number of drinking days; both during the past week) were assessed at 2 time points, separated by 3 months. Full cross-lagged regression models revealed that drinking motives were positively associated with drinking behavior over time and that drinking motives are shaped by the number of drinking days (i.e., reciprocal effects). Furthermore, coping and enhancement motives, as well as social and conformity motives, positively reinforced each other. Moreover, social motives were positively associated with enhancement motives over time. In conclusion, drinking motives influence each other over a 3-month period in adulthood and predict drinking behavior over time, making them important candidates for prevention efforts. Drinking motives are likely to be modifiable and might be used to stimulate drinking decrease. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Use of alcohol mixed with energy drinks (AmED) is an increasingly prevalent trend. However, recent research has suggested that AmED use may result in increased alcohol consumption and engagement in risk behavior postingestion. Although the majority of research has been focused on AmED use outcomes, there is a current paucity of data on the patterns of AmED use and motives for consumption. Four hundred and three participants from an Australian community sample (n = 244 women) ages 18–35 who had consumed alcohol mixed simultaneously with energy drinks (ED) in the preceding 6 months completed an online survey regarding use of EDs, alcohol, and AmED. Although AmED sessions occurred relatively infrequently compared to alcohol sessions, the alcohol and ED quantity consumed in AmED sessions was significantly greater than recommended intake. Reports of AmED use context indicated that participants typically consumed AmED while engaging in heavy drinking in public venues. However, the primary motives for AmED use related to the situational context of use, functional and hedonistic outcomes, as well as the pleasurable taste; few participants reported using AmED to increase alcohol intake, to mask intoxication, to hide alcohol's flavor, or to simulate an illicit drug “high.” AmED users may be coingesting in a context and at a quantity that enhances the possibility of risky alcohol outcomes, despite predominantly consuming AmED for the taste and the functional and hedonistic outcomes. Strong endorsement of motives relating to ease of access and low cost price suggests that alcohol policy reform in relation to licensing restrictions may be necessary to minimize the risk of harm. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Alcohol problems may impede adaptive, proactive responses to disaster-related injury and loss, thus prolonging the adverse impact of disasters on mental health. Previous work suggests that veterans of the U.S. armed forces have a relatively high prevalence of alcohol misuse and other psychiatric disorders. This is the first study to estimate the impact of predisaster alcohol problems on postdisaster depressed mood among veterans, using data that were collected before and after the 1994 Northridge, CA, earthquake. The authors assessed the impact of alcohol problems on postdisaster depressed mood in an existing clinical cohort of veterans who experienced the 6.7-magnitude earthquake that struck Northridge in January 1994. One to 3 months after the disaster, interviewers contacted participants by telephone to administer a follow-up questionnaire based on a survey that had been done preearthquake. Postearthquake data were obtained on 1,144 male veterans for whom there were preearthquake data. We tested a predictive path model of the relationships between latent variables for predisaster alcohol problems, functional limitations, and depressed mood on latent variables representing postdisaster “quake impact” and depressive mood. Results showed that veterans who had more alcohol problems before the earthquake experienced more earthquake-related harms and severely depressed mood after the earthquake, compared with those who had fewer alcohol problems. Programs serving veterans with a high prevalence of alcohol problems should consider designing disaster response protocols to locate and assist these patients in the aftermath of disasters. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Despite major advances and success in finding effective interventions for problematic drinking among college students, personalized feedback interventions (PFIs) continue to include a range of components that vary widely across intervention trials. To facilitate research regarding which feedback components may be most effective, the present research provides preliminary evidence regarding student perceptions of and preferences for different types of feedback components. Undergraduate student drinkers (n = 397, 41% male) rated their affinity for and skepticism of 14 feedback components and identified the feedback components that they most preferred. The majority of students preferred information regarding descriptive normative comparisons and the practical costs of drinking, whereas few reported a desire to learn behavioral strategies to limit risk or didactic information. High-risk drinkers (n = 228) reported lower ratings for all feedback components than did low-risk drinkers, and men (n = 162, 41%) provided significantly lower ratings for all feedback components than did women. This is the first study to document student preferences for the different feedback components included in PFIs. The current study generates hypotheses regarding components that may increase the efficacy of current feedback interventions for high-risk drinking. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
The continuing development and refinement of empirically supported interventions to increase participation in posttreatment care and promote sustained abstinence from illicit drug use is a priority for the addictions field. The purpose of this study was to assess the combined and relative effectiveness of four types of counseling styles, delivered by telephone, relative to a no call control condition. Stimulant users (N = 302) were randomized to one of four low-cost, telephone support protocols (unstructured/nondirective, unstructured/directive, structured/nondirective, structured/directive) or a standard referral to aftercare without telephone counseling (control). All of the study participants were nearing the completion of (or had completed) an intensive phase of structured, outpatient stimulant abuse treatment. Drug use and aftercare participation were assessed at 3 and 12 months following randomization. Intent-to-treat analyses showed no significant time-by-group interactions for these primary outcomes. Subsequent analyses, however, revealed a significant difference between the aggregated call groups and the control group at the time of the 3-month follow-up. The mean ASI drug use severity composite score for subjects in the call conditions declining from .058 at baseline to .048 at 3 months, whereas the no call/control group average score increased from .053 to .062 (χ (1) = 4.95, p = .026). A similar—and slightly stronger—effect was found when the study sample was restricted to those reporting any use during the month prior to the baseline interview (n = 152). This study provides modest support for the telephone-based counseling approaches strategies examined in this project. Subsequent research will assess interactions between patient characteristics and counseling styles, and improved identification of which treatment graduates might be more likely to benefit from this type of continuing support. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Marijuana use on college campuses is prevalent and associated with high rates of abuse and dependence. The Marijuana Decisional Balance (MDB) scales measure perceived pros and cons toward marijuana use. Evidence supports reliability and concurrent validity of these scales, but the predictive validity has not yet been assessed. The current study evaluated the prospective predictive validity of pros and cons scales for marijuana use, as well as explored predictive validity for marijuana problem indicators. Secondary analyses included test–retest reliability and internal consistency, to provide additional evidence of psychometric properties. A total of 149 college students (57% recent marijuana users, 77% lifetime users) participated in a baseline survey, then completed a second survey one month later. All provided data on marijuana pros and cons, as well as use status in the past month. Users at each time point reported on use frequency, problems, and disorder symptoms. In the month between assessments, 55% of the students used marijuana. Both pros and cons subscales prospectively predicted use status in the subsequent month, but not use frequency. Pros prospectively predicted marijuana problems and dependence symptoms at follow-up, and remained a significant predictor of later dependence symptoms even after controlling for baseline dependence symptoms. In contrast, pros only marginally predicted abuse. Cons did not predict problems, abuse, or dependence symptoms. Pros and cons showed strong test–retest reliability (rs = 0.80–0.85) and internal consistency (alphas = 0.92–0.95). In a college sample, pros and cons of marijuana use demonstrated stability over one month, and prospectively predicted use. Pros may also have utility in predicting problems and dependence potential on college campuses. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Socially anxious individuals appear especially vulnerable to cannabis-related problems. However, the nature of the social anxiety–cannabis relation remains unclear. The present study examined the timing and specificity of cannabis craving in response to a social anxiety induction task among 82 (71% female) cannabis users randomly assigned to either a social interaction or reading task. Participants completed ratings of substance (cannabis, alcohol, cigarette) craving at baseline (prior to being informed of task assignment), before, during, and after task. The Time × Condition interaction was significant such that cannabis craving increased from before to during the task among participants in the social interaction condition, but not among those in the reading condition. This effect was specific to cannabis craving and was not observed for craving for alcohol or cigarettes. Data suggest that increases in state social anxiety may play a role in cannabis use behaviors. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Both the cue reactivity and startle reflex modulation paradigms have been used in addiction research to investigate the motivational mechanism of craving. However, while there is a growing body of literature that indicates the utility of 3D technology in addiction-relevant cue reactivity research, no study has been reported on its utility using the startle reflex modulation paradigm. The aim of the present study was to extend the 3D technology to research on tobacco craving using the startle reflex methodology. Participants were 32 university students who smoked more than 10 cigarettes daily. They participated in a psychophysiological testing to assess the modulation of the startle reflex induced by viewing pleasant, unpleasant, and tobacco-related 3D immersive environment stimuli (3D-IEs). Results confirmed that 3D-IEs were effective in inducing emotional states to modulate the startle response. Pleasant and unpleasant 3D-IEs modulated the startle response, as expected: The reflex was increased while viewing unpleasant stimuli and decreased while viewing pleasant ones. Tobacco-related 3D-IEs were similar to unpleasant stimuli in increasing the startle response. However, they were subjectively evaluated as positive, which suggests that the mechanism underlying craving coactivates both aversive and appetitive motivational tendencies. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
A survey was administered anonymously to 45 mental health providers who delivered smoking cessation treatment integrated into posttraumatic stress disorder care (integrated care) as part of a multisite clinical trial. Survey items assessed key factors associated with successful implementation of research-based practices from the perspective of treating providers. Factors assessed included prior experiences with cessation treatment, compatibility of integrated care with current practices, feasibility of adopting integrated care into regular practice, and adequacy of training. More than half of respondents reported that integrated care delivery was feasible, and they would be considerably or extremely likely to continue delivery in routine practice. Positive prestudy beliefs and more experience delivering cessation care were associated with stronger endorsement of delivering integrated care after the study. The most frequently cited obstacle to delivering integrated care involved time limitations. Future efforts should focus on developing treatment adaptations that address provider-identified barriers and identifying clinic- and administrative-level supports that facilitate delivery of integrated care and assist providers who incorporate integrated care into clinical practice. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Exposure to prosmoking media (e.g., smoking in movies, advertising in magazines) contributes to smoking in young people. However, the extent to which the impact of exposure depends on the social context in which those exposures occur has not been investigated. This study used ecological momentary assessment to examine the moderating role of social context in the relationship between college students' exposure to prosmoking media and their smoking refusal self-efficacy and intention to smoke. College students (n = 134) carried handheld computers for 21 days, recording their exposure to all forms of prosmoking media during the assessment period. They also responded to three investigator-initiated control prompts (programmed to occur randomly) each day of the assessment. After each exposure to prosmoking media and after each control prompt, participants answered questions about smoking refusal self-efficacy and their intentions to smoke; they also indicated whether they were with friends, with family, with a romantic partner, or alone (i.e., their social context). When participants were with friends, prosmoking media exposures were associated with stronger smoking intentions and lower smoking refusal self-efficacy; these associations were not present when participants were alone. Being with family members or with a romantic partner did not moderate the impact of prosmoking media exposure on either dependent variable. These results suggest a new role for peers in the development of youth smoking. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Elucidating interrelations between prior affective experience, current affective state, and acute urge to smoke could inform affective models of addiction motivation and smoking cessation treatment development. This study tested the hypothesis that prior levels of positive (PA) and negative (NA) affect predict current smoking urge via a mediational pathway involving current state affect. We also explored if tobacco deprivation moderated affect-urge relations and compared the effects of PA and NA on smoking urge to one another. At a baseline session, smokers reported affect experienced over the preceding few weeks. At a subsequent experimental session, participants were randomly assigned to 12-hr tobacco deprived (n = 51) or nondeprived (n = 69) conditions and reported state affect and current urge. Results revealed a mediational pathway whereby prior NA reported at baseline predicted state NA at the experimental session, which in turn predicted current urge. This mediational pathway was found primarily for an urge subtype indicative of urgent need to smoke and desire to smoke for NA relief, was stronger in the deprived (vs. nondeprived) condition, and remained significant after controlling for PA. Prior PA and current state PA were inversely associated with current urge; however, these associations were eliminated after controlling for NA. These results cohere with negative reinforcement models of addiction and with prior research and suggest that: (a) NA plays a stronger role in smoking motivation than PA; (b) state affect is an important mechanism linking prior affective experience to current urge; and (c) affect management interventions may attenuate smoking urge in individuals with a history of affective disturbance. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
A failure to set and adhere to monetary limits has been implicated in the development of problematic gambling. A randomized controlled experiment (N = 59) with 2 conditions (i.e., monetary limit pop-up reminder vs. no monetary limit pop-up reminder) was conducted to assess the value of monetary limit pop-up messages in increasing adherence to self-proclaimed monetary limits. The current research also examined dissociation as a potential mechanism by which gambling symptomatology may undermine adherence to monetary limits. Results revealed that participants who received a monetary limit pop-up reminder were significantly more likely to adhere to monetary limits than participants who did not. As predicted, dissociation mediated the relationship between gambling symptomatology and adherence to monetary limits, but only among those who did not receive a monetary limit pop-up reminder. Importantly, the forced stop in play created by the pop-up message did not heighten craving to continue gambling. The efficacy of monetary limit pop-up messages as a tool to facilitate responsible gambling is discussed. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
The U.S. Spanish-speaking population has rapidly increased in recent decades and there is a need for psychometrically supported assessment measures for researchers and clinicians who work with this population. A Spanish version of a self-report measure of gamblers' cognitive distortions [Gamblers' Beliefs Questionnaire (GBQ); Steenbergh, Meyers, Whelan, & May, 2002] was translated and psychometrically evaluated in a sample of 219 Spanish-speaking Hispanics residing in the southeast United States. The GBQ-S showed high internal consistency (α = .95). Factor analytic data supported a factor structure similar to the initial psychometric evaluation of the English version. Probable pathological gamblers reported significantly more cognitive distortions on the GBQ-S than nongamblers and nonpathological gamblers. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
This study investigated the association between religion, religiosity, and gambling using a cross-sectional sample of 570 American University of Beirut students, who self-filled an anonymous English questionnaire. About half (55%) were lifetime gamblers, of which 12% screened as problem/pathological gamblers. Controlling for other demographics and lifetime substance use, Christian students (vs. Muslims) had higher odds of lifetime gambling [6.6 (3.6, 12.2)], any strategic gambling [2.7 (1.2, 5.9)], social nonproblem gambling (SNPG) [7.6 (4.6, 12.3)], and problem/pathological gambling (PG) [6.8(1.8, 26.5)]. Students who never/rarely practiced their faith were 3.6 times as likely [95% CI: 1.5, 8.7] to report lifetime gambling, 3.7 times as likely to report SNPG (vs. NG) [95% CI: 1.3, 10.6], and 7 times as likely to screen for PG (vs. NG) [95% CI: 1.8, 27.4]. Decreased religious importance was associated with greater odds of lifetime gambling, SNPG and PG (vs. nongambling). Stronger associations were observed among Muslims. Religion and religiosity seem to play a protective role, particularly among Muslims whose faith strictly prohibits gambling. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
The South Oaks Gambling Screen–Revised for Adolescents (SOGS-RA) is one of the most widely used measures of adolescent gambling. We aimed to provide evidence of its suitability as a screening tool applying item response theory (IRT). The scale was administered to 981 adolescents (64% males; mean age = 16.57 years, SD = 1.63 years) attending high school. Analyses were carried out with a sample of 871 respondents, that is, adolescents who have gambled at least once during the previous year. Once the prerequisite of unidimensionality was confirmed through confirmatory factor analysis, unidimensional IRT analyses were performed. The 2-parameter logistic model was used in order to estimate item parameters (severity and discrimination) and the test information function. Results showed that item severity ranged from medium to high, and most of the items showed large discrimination parameters, indicating that the scale accurately measures medium to high levels of problem gambling. These regions of the trait were associated with the greatest amount of information, indicating that the SOGS-RA provides a reliable measure for identifying both problem gamblers and adolescents at risk of developing maladaptive behaviors deriving from gambling. The IRT-based evidence supports the suitability of the SOGS-RA as a screening tool in adolescent populations. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
It has been proposed that both trait negative urgency (NU; the tendency to act rashly when distressed) and learned outcome expectancies for eating and restricting behavior contribute to the development of symptoms of bulimia nervosa (BN). The current study provides the first prospective test of whether these factors, and their interaction, predict increases in bulimic symptoms over time. In a sample of 355 first-year college women assessed at the start and then at the end of the first semester, prospective tests indicated that (a) baseline NU and eating expectancy endorsement predicted increased odds of binge eating at Time 2; (b) and baseline NU and thinness/restricting expectancies interacted to predict increased frequency of purging at Time 2. These findings are consistent with the hypothesis that NU and learned expectancies together increase risk for symptoms of BN. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Desire thinking is a voluntary cognitive process involving verbal and imaginal elaboration of a desired target. Recent research has revealed that desire thinking and craving are distinct constructs and that desire thinking may play a significant role in the escalation of craving. The goal of this study was to explore the effect of desire thinking induction on craving in a nonclinical sample. Forty-five volunteers with no current diagnosis of psychological disorders chose a desired activity and were randomly allocated to three thinking manipulation tasks: distraction, verbal reasoning, and desire thinking. Craving was measured before and after manipulation and during a 3-day period of abstinence from the desired activity. Findings showed that desire thinking had a significant effect on craving after manipulation. This effect appeared to be independent of baseline levels of craving and desire thinking as well as perceived stress changes during the manipulation. Both distraction and verbal reasoning inductions did not lead to a significant change in craving. Desire thinking impacts craving and is a risk factor for craving-related problems. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Assessment of the adverse consequences of substance use serves an important function in both clinical and research settings, yet there is no universally agreed upon measure of consequences relevant to multiple types of substance use disorders. One of the most commonly used measures, the Short Inventory of Problems (SIP), has been adapted and evaluated in several specific populations, but evidence is needed of its reliability and validity across broader samples of persons with substance use disorders. This study evaluated the psychometric properties of a revised version of the SIP (SIP-R) in a large combined sample of alcohol and drug use disorder treatment seekers, with participants pooled from two national, multisite, randomized clinical trials. A total of 886 participants across 10 outpatient treatment facilities completed a common assessment battery that included the SIP-R, Addiction Severity Index (ASI), University of Rhode Island Change Assessment (URICA), HIV Risk Behavior Scale (HRBS), and a substance use calendar. Results supported the SIP-R's internal reliability (α = .95). Confirmatory factor analysis demonstrated that the hypothesized 5-factor model with one higher-order factor produced the best fit. Convergent validity was evident through the SIP-R's correlation with several composite scores from the ASI and the URICA, and analyses supported its conceptual distinction from quantity indices of drug/alcohol use. The SIP-R also demonstrated an ability to predict treatment retention, with higher scores associated with poorer retention. These results provide support for the SIP-R's psychometric properties as a measure of consequences across a broad sample of treatment-seeking drug and alcohol users. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
The number of text messaging interventions designed to initiate and support behavioral health changes have been steadily increasing over the past 5 years. Messaging interventions can be tailored and adapted to an individual's needs in their natural environment—fostering just-in-time therapies and making them a logical intervention for addiction continuing care. This study assessed the acceptability of using text messaging for substance abuse continuing care and the intervention preferences of individuals in substance abuse treatment in order to develop an interactive mobile text messaging intervention. Fifty individuals enrolled in intensive outpatient substance abuse treatment completed an assessment battery relating to preferred logistics of mobile interventions, behavior change strategies, and types of messages they thought would be most helpful to them at different time points. Results indicated that 98% participants were potentially interested in using text messaging as a continuing care strategy. Participants wrote different types of messages that they perceived might be most helpful, based on various hypothetical situations often encountered during the recovery process. Although individuals tended to prefer benefit driven over consequence driven messages, differences in the perceived benefits of change among individuals predicted message preference. Implications for the development of mobile messaging interventions for the addictions are discussed. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
Smoking is often used as a maladaptive weight control strategy among female smokers. Many of the perceived benefits accrued from smoking, including enhanced mood, reduced anxiety, and weight control, can also be achieved through physical activity. The purpose of this study was to examine the effects of a novel behavioral task (body-image exposure) that was designed to elicit body image and weight concerns on urge to smoke among 18–24 year old female smokers who vary in levels of physical activity. Using a cue-reactivity paradigm, 16 sedentary (SE) and 21 physically active (PA) female smokers (≥5 cigarettes/day for past 6 months) were exposed to a pilot tested body-image exposure session. Self-reported urge and latency to first puff were obtained before and after exposure session. Paired sample t tests showed significant increases in self-reported urge (p < .01) and quicker latency to first puff (p < .01) at posttest for the entire sample compared with pretest. Results of partial correlation (controlling for body mass index [BMI], nicotine dependence, withdrawal, and depressive symptoms) showed that increased time engaging in vigorous intensity physical activity was associated with lower self-reported urge to smoke at post (r = −0.44; p = .01) but not with latency to first puff (r = −.10; p = .62). These results suggest that among weight-concerned female smokers, physical activity may attenuate smoking urges in a context where weight concerns are increased. Future research should continue to explore effects of physical activity on reactivity to body image and smoking cues and variability in smoking cue-reactivity related to physical activity. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
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