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APA Journal: Psychology of Addictive Behaviors

In search of anticipatory cigarette cravings: The impact of perceived smoking opportunity and motivation to seek treatment.Open in a New Window

Craving has long been considered central to addiction, but it remains unclear just how it contributes to drug use or relapse. Improved understanding of its role in addiction requires a more fine-grained examination of craving, including the context in which it occurs. This study used a novel set of smoking-related and unrelated stimuli to investigate the responses of 227 nicotine-deprived smokers under conditions that manipulated perceived smoking opportunity and motivation to quit smoking. Specifically, we contrasted features of preconsumptive states when active smokers anticipate smoking soon to states when smokers do not have this expectation. Results indicated that under certain conditions (smokers not interested in quitting who expected to be able to smoke soon), exposure to smoking cues becomes attractive. Specifically, these smokers found smoking-related images to be more pleasant than did smokers who were either motivated to quit smoking within the next month or who were informed that they would not be permitted to smoke during the experiment. More broadly, the study raises the possibility that the loss of routinely experienced pleasant cravings upon quitting smoking may yield challenges to staying quit and requires greater clinical attention. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Women with alcohol dependence: A randomized trial of couple versus individual plus couple therapy.Open in a New Window

Couple therapy for women with alcohol use disorders (AUDs) yields positive drinking outcomes, but many women prefer individual to conjoint treatment. The present study compared conjoint cognitive–behavioral therapy (CBT) for women with AUDs to a blend of individual and conjoint therapy. Participants were 59 women with AUDs (95% Caucasian, mean age = 46 years) and their male partners randomly assigned to 12 sessions of Alcohol Behavioral Couple Therapy (ABCT) or to a blend of 5 individual CBT sessions and 7 sessions of ABCT (Blended-ABCT). Drinking and relationship satisfaction were assessed during and for 1-year posttreatment. Treatment conditions did not differ significantly on number of treatment sessions attended, percentage of drinking days (PDD), or percentage of heavy drinking days (PDH), during or in the 12 months following treatment. However, effect size estimates suggested a small to moderate effect of Blended-ABCT over ABCT in number of treatment sessions attended (d = −.41), and first- and second-half within treatment PDD (d = −.41, d = −.28), and PDH (d = −.46, d = −.38). Moderator analyses found that women lower in baseline sociotropy had lower PDH across treatment weeks 1–8 than in Blended-ABCT than ABCT and that women lower in self-efficacy had lower PDH during follow-up in Blended-ABCT than in ABCT. The 2 treatment groups did not differ significantly in within-treatment or posttreatment relationship satisfaction. Results suggest that blending individual and conjoint treatment yields similar or slightly better outcomes than ABCT, is responsive to women’s expressed desire for individual sessions as part of their treatment, and decreases the challenges of scheduling conjoint sessions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Misperception and accurate perception of close friend substance use in early adolescence: Developmental and intervention implications.Open in a New Window

Misperceptions of peer substance use (SU) are believed to be a robust correlate of adolescent SU; however, perceived peer SU is biased in the direction of an adolescent’s own SU raising questions about the validity of perceived peer SU (social norms; Henry, Kobus, & Schoeny, 2011). In addition, social norm theories emphasize inaccurate perceptions of peer SU while other theories emphasize actual peer behavior and selection of friends as motivators of adolescent SU. Furthermore, no theories consider the role of accurate perceptions, suggesting the need to more carefully consider the coevolution of perceived peer norms, actual peer behavior, and adolescent SU. To do this, we modeled the latent structure of accurate and inaccurate perceptions of peer SU while including an adolescent’s own SU using latent class analysis and tested the natural evolution of the classes using latent transition analysis. The design included 3 annual assessments of peer and perceptions of peer SU and 6 assessments of adolescent SU (N = 765; age = 10–13 at Wave 1; female = 53%). Latent class analysis findings largely replicated Henry et al. (2011), suggesting that misperceptions of peer SU were biased by an adolescent’s own SU. We also found 3 distinct pathways to a high risk class that predicted high levels of later adolescent SU, 2 in which adolescent and perceived peer SU preceded peer SU (age = 10–12 and 12–14) and another in which peer SU preceded adolescent SU and perceptions of peer SU (age = 12–14). Implications for peer influence theories are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Coevolution of adolescent friendship networks and smoking and drinking behaviors with consideration of parental influence.Open in a New Window

Friendship tie choices in adolescent social networks coevolve simultaneously with youths’ cigarette smoking and drinking. We estimate direct and multiplicative relationships between both peer influence and peer selection with salient parental factors affecting both friendship tie choice and the use of these 2 substances. We utilize 1 sample of 12 small schools and a single large school extracted from the National Longitudinal Study of Adolescent to Adult Health. Using a Stochastic Actor-Based modeling approach over 3 waves, we find: (a) a peer selection effect, as adolescents nominated others as friends based on cigarette and alcohol use levels across samples; (b) a peer influence effect, as adolescents adapted their smoking and drinking behaviors to those of their best friends across samples; (c) reciprocal effect between cigarette and alcohol usage in the small school sample; (d) a direct effect of parental support and the home smoking environment on adolescent friendship tie choice in the small school sample; (e) a direct effect of the home smoking environment on smoking across samples; (f) a direct effect of the home drinking environment on alcohol use across samples; and (g) a direct effect of parental monitoring on alcohol use across samples. We observed an interaction between parental support and peer influence in affecting drinking, and an interaction between the home drinking environment and peer influence on drinking, in the small school sample. Our findings suggested the importance of delineating direct and synergistic pathways linking network processes and parental influence as they affect concurrent cigarette and alcohol use. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Impulsivity moderates the effects of movie alcohol portrayals on adolescents’ willingness to drink.Open in a New Window

This study examined impulsivity as a moderator of adolescents’ reactions to positive versus negative portrayals of drinking in American movie clips. Impulsivity, along with willingness and intentions to drink in the future, were assessed in a pretest session. In the experimental sessions, adolescents viewed a series of clips that showed drinking associated with either positive outcomes (e.g., social facilitation) or negative outcomes (fights, arguments). A third group viewed clips with similar positive or negative outcomes, but no alcohol consumption. All participants then responded to an implicit measure of attentional bias regarding alcohol (a dot probe), followed by explicit alcohol measures (self-reports of willingness and intentions to drink). Hypotheses, based on dual-processing theories, were: (a) high-impulsive adolescents would respond more favorably than low-impulsive adolescents to the positive clips, but not the negative clips; and (b) this difference in reactions to the positive clips would be larger on the willingness than the intention measures. Results supported the hypotheses: Adolescents high in impulsivity reported the highest willingness to drink in the positive-clip condition, but were slightly less willing than others in the negative-clip condition. In addition, results on the dot probe task indicated that RTs to alcohol words were negatively correlated with changes in alcohol willingness, but not intention; that is, the faster their response to the alcohol words, the more their willingness increased. The results highlight the utility of a dual-processing perspective on media influence. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


The role of romantic relationship status in pathways of risk for emerging adult alcohol use.Open in a New Window

Dating several people in emerging adulthood has been associated with higher alcohol use compared with being single or being in an exclusive relationship. As a follow-up to that report, we examined whether romantic relationship status is part of a pathway of risk between antecedent alcohol use risk factors and subsequent alcohol outcomes. Participants were 4,410 emerging adults assessed at 2 time-points during their first year of college. We found that a parental history of alcohol problems was indirectly related to dating several people via 2 modestly correlated pathways. The first pathway was through conduct problems. The second pathway was through positive urgency (i.e., a positive emotion-based predisposition to rash action). In turn, dating several people was associated with higher alcohol use. Our results suggest that these familial and individual-level alcohol risk factors are related to emerging adults’ selection into subsequent romantic relationship experiences that are associated with higher alcohol use. These findings have implications for how romantic relationship experiences may fit into developmental models of the etiology of alcohol use. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Emerging adult identity development, alcohol use, and alcohol-related problems during the transition out of college.Open in a New Window

Alcohol use generally peaks during the early 20s and declines with age. These declines, referred to as “maturing out,” are presumed to result from the acquisition of adult roles (e.g., marriage, employment) incompatible with alcohol use. Recent empirical evidence suggests that variables other than role transitions (e.g., personality) may also be important in understanding this process. Changes in identity that occur during emerging adulthood may also be linked to the process of maturing out of heavy drinking, though no studies have yet addressed this possibility. Utilizing data from a large sample of graduating college students (N = 907) during senior year (Wave 1) and the 2 following years (Waves 2–3), the current study examined relations between aspects of emerging adult identity and drinking outcomes (alcohol use and problems). Using time-varying covariate growth models, results indicated that several facets of emerging adult identity conferred risk for the failure to mature out of heavy drinking and alcohol-related problems. Experimentation/possibilities emerged as a significant risk factor for both heavy drinking and alcohol problems, but these effects diminished considerably when accounting for personality risk. In contrast, although small in magnitude, effects of self-focus on heavy drinking and negativity/instability on alcohol-related problems were relatively independent of effects of other established predictors. The effect for negativity/instability was evident only at the final wave. The findings have important implications for theories of maturing out and may ultimately inform tailoring or refinement of prevention/intervention approaches for emerging adults. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Problematic drinking, impulsivity, and physical IPV perpetration: A dyadic analysis.Open in a New Window

Alcohol use and impulsivity are 2 known risk factors for intimate partner violence (IPV). The current study examined the independent and interactive effects of problematic drinking and 5 facets of impulsivity (i.e., negative urgency, positive urgency, sensation seeking, lack of premeditation, and lack of perseverance) on perpetration of physical IPV within a dyadic framework. Participants were 289 heavy drinking heterosexual couples (total N = 578) with a recent history of psychological and/or physical IPV recruited from 2 metropolitan U.S. cities. Parallel multilevel actor partner interdependence models were used and demonstrated actor problematic drinking, negative urgency, and lack of perseverance were associated with physical IPV. Findings also revealed associations between partner problematic drinking and physical IPV as well as significant Partner Problematic Drinking × Actor Impulsivity (Negative Urgency and Positive Urgency) interaction effects on physical IPV. Findings highlight the importance of examining IPV within a dyadic framework and are interpreted using the I3 metatheoretical model. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


The associations among prior drinking consequences, subjective evaluations, and subsequent alcohol outcomes.Open in a New Window

Although the many positive and negative psychosocial consequences of alcohol use are well documented, evidence of the association between prior drinking consequences and subsequent alcohol-related outcomes is mixed. Social learning theory highlights that cognitive appraisals of prior drinking consequences play a crucial intermediate role in the relation of prior drinking consequences with subsequent alcohol-related outcomes. This prospective study was designed to test the mediating effects of subjective evaluations (i.e., perceived valence and controllability) in the association of prior drinking consequences with change in binge drinking and drinking consequences over time. Participants were 171 college students (69% female, 74% White, M age = 18.95 years, SD = 1.35) who completed 2 online surveys, with an average interval of 68 days (SD = 10.22) between assessments. Path analyses of the data did not support mediational effects of perceived valence or controllability of prior drinking consequences on subsequent alcohol-related outcomes. Specifically, greater frequency of negative consequences was associated with lower perceived valence and controllability, and greater frequency of positive consequences was associated with lower perceived controllability of the experienced consequences. However, perceptions of valence and controllability were not in turn associated with subsequent binge drinking and drinking consequences. Instead, greater frequency of positive consequences was directly associated with greater subsequent frequency of binge drinking. Findings highlight the importance of prior positive consequences in the escalation of binge drinking over a short period of time, although this relation may not be accounted for by perceptions of valence and controllability of the prior drinking consequences. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Booze cues and attentional narrowing: Neural correlates of virtual alcohol myopia.Open in a New Window

Exposure to alcohol cues reduces the breadth of attentional scope, called “virtual myopia.” Past researchers have suggested approach motivation as a possible mechanism that underlies this myopia in response to alcohol cues. We expanded on these findings in the current study by identifying the neural underpinnings of the relationship between attentional narrowing, approach motivation, and exposure to alcohol cues. Participants completed 64 trials that consisted of neutral or alcohol-related stimuli followed by a measure of attentional narrowing (i.e., Navons letter task). Electroencephalography (EEG) was recorded during the experiment to assess greater left frontal hemispheric asymmetry, a measure of approach motivation. Results revealed that alcohol cues led to greater “virtual myopia” as measured by narrowed attentional scope. Greater left frontal activation to alcohol cues related to greater myopia, suggesting that approach motivation is associated with virtual myopia. Left frontal activation appears to be a neural correlate of cognitive narrowing related to approach motivation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Anticipated effects of alcohol stimulate craving and impair inhibitory control.Open in a New Window

A considerable evidence base has demonstrated that priming doses of alcohol impair inhibitory control and activate motivation to consume alcohol. There is, however, a lack of studies investigating the effect of placebo-alcohol on these processes and their association with alcohol outcome expectancies (AOE). We investigated the effect of placebo-alcohol on craving and inhibitory control, and the extent to which placebo effects correlated with AOE in 32 nondependent drinkers. Participants completed questionnaires assessing typical alcohol use (fortnightly alcohol consumption, AUDIT) and AOE (measured using the Alcohol Outcome Expectancy Scale). On a within-subjects basis participants consumed a placebo-alcohol drink and control drink. Measures of craving were taken pre- and postdrink, and participants completed a go/no-go task following the drink. Craving was increased by the placebo-alcohol and, importantly, placebo-alcohol impaired inhibitory control. Furthermore expectancies of cognitive and behavioral impairment were correlated with go/no-go task performance following a placebo. Increases in craving were associated with a range of elevated outcome expectancies. This suggests that the anticipated effects of alcohol can impair inhibitory control and increase craving; therefore studies using placebo versus alcohol comparisons relative to studies using a pure no-alcohol control are underestimating the real-world effect of alcohol on these processes, which is a combination of pharmacological and anticipated effects of alcohol. Furthermore, individual differences in AOE may influence reactivity to the anticipated effects of alcohol. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Attempts to stop or reduce daily cannabis use: An intensive natural history study.Open in a New Window

We attempted to replicate and add to our prior study of attempts to stop or reduce cannabis use among daily cannabis users trying to change on their own, by observing a larger sample and adding further clinically relevant outcomes. Daily users (n = 193) who intended to stop or reduce sometime in the next 3 months called an Interactive Voice Response system each morning for 3 months to report on cannabis use, attempts to stop or reduce, withdrawal symptoms, and so forth, on the prior day. This study replicated our prior findings that (a) cannabis users trying to change make many, and often rapid, transitions among use as usual, reduction, and abstinence; (b) reduction attempts are more common than abstinence attempts; (c) quit and reduction attempts are short-lived and few participants achieve long-term abstinence; (d) alcohol and drug use are not greater on abstinence days; and (e) few users seek treatment. Novel findings included (f) a greater number of days of abstinence or intentional reduction predicted a greater decline in cannabis dependence, (g) most users do not prepare before their quit attempt, (h) coping outcomes during abstinence predict increased duration of abstinence, (i) tobacco use is less common on days of abstinence, and (j) withdrawal symptoms occur even with short quit attempts. Replication tests in more generalizable samples and of longer duration are indicated. Further natural history studies are likely to provide information to help improve the content of psychological treatments for cannabis use. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Moderating effects of perceived social benefits on inhalant initiation among American Indian and White youth.Open in a New Window

This study examined whether perceived social benefits moderated the relationship between social influence variables (school attachment, peer inhalant use, perceived family caring, and parental monitoring) and stage of inhalant initiation (Study 1) and lifetime inhalant use (Study 2). Participants were 7th to 12th grade students attending schools on or near American Indian reservations, with comparisons made between American Indian and White students. A total of 3,498 American Indian and 1,596 White students were surveyed. Differences in mean levels of social influence variables were found across ethnicity and stage of inhalant initiation and lifetime inhalant use. Structural equation models were evaluated to examine variable relationships for the 2 studies. For Study 1, social influence variables did not clearly differentiate early versus later inhalant initiators, and perceived social benefits failed to serve as a moderator. More differences were observed between users and nonusers across measures of social influence (Study 2). Perceived social benefits generally did not moderate the relationships, with 2 exceptions. Low perceived social benefits provided greater protection against the influence of peers on lifetime inhalant use among White students, whereas high perceived social benefits increased risk of peer influence among American Indian students. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Differences in the relationship of marijuana and tobacco by frequency of use: A qualitative study with adults aged 18–34 years.Open in a New Window

Co-use of marijuana and tobacco is increasing among adults in the United States, but little research exists examining why co-use occurs. Changing marijuana policies make understanding the relationship between marijuana and tobacco critical. This study aimed to assess how adult co-users of marijuana and tobacco qualitatively conceptualize and describe their use and whether variation exists by frequency of use. Forty-eight past-month co-users aged 18–34 years completed semistructured, 1-on-1 qualitative interviews in Washington State (United States) in 2014. Interviews were digitally recorded, transcribed verbatim, coded, and analyzed overall and across frequency of use strata (high-tobacco/high-marijuana, high-tobacco/low-marijuana, low-tobacco/high-marijuana, and low-tobacco/low-marijuana). High-tobacco use was daily use; high-marijuana use was use on ≥20 of the past 30 days. The relationship between tobacco and marijuana varied by frequency of use and was strongest among high-tobacco use groups. Participants described the following patterns of and reasons for use: sequential use (e.g., using within short succession; due to addiction/habit, to enhance the high, or to counteract the effects of 1 substance), substitution (e.g., using in different times/places; due to liking the general act of smoking, limitations on when/where they could use a substance, or as a way to quit or cut down on 1 substance), or coadministration (e.g., simultaneous use; to adjust the dose of either tobacco or marijuana or to modulate the high/improve the flavor). Relationships between tobacco and marijuana varied based on frequency of use. These data can inform future surveillance and aid in the development of theoretical frameworks to explain why co-use occurs. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Prevalence and correlates of cannabis use in an outpatient VA posttraumatic stress disorder clinic.Open in a New Window

Recent research has documented high rates of comorbidity between cannabis use disorders and posttraumatic stress disorder (PTSD) in veterans. However, despite possible links between PTSD and cannabis use, relatively little is known about cannabis use in veterans who present for PTSD treatment, particularly among samples not diagnosed with a substance use disorder. This study examined the prevalence of cannabis use and the psychological and functional correlates of cannabis use among a large sample of veterans seeking treatment at a Veterans Affairs (VA) PTSD specialty clinic. Male veterans (N = 719) who presented at a VA specialty outpatient PTSD clinic completed measures of demographic variables, combat exposure, alcohol, cannabis and other drug use, and PTSD and depressive symptoms. The associations among demographic, psychological, and functional variables were estimated using logistic regressions. Overall, 14.6% of participants reported using cannabis in the past 6 months. After controlling for age, race, service era, and combat exposure, past 6-month cannabis use was associated with unmarried status, use of tobacco products, other drug use, hazardous alcohol use, PTSD severity, depressive symptom severity, and suicidality. The present findings show that cannabis use is quite prevalent among veterans seeking PTSD specialty treatment and is associated with poorer mental health and use of other substances. It may be possible to identify and treat individuals who use cannabis in specialty clinics (e.g., PTSD clinics) where they are likely to present for treatment of associated mental health issues. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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