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APA Journal: Psychology of Addictive Behaviors

Meta-analysis of the association between methamphetamine use and high-risk sexual behavior among heterosexuals.Open in a New Window

A large body of research has found that nonheterosexual methamphetamine users engage in substantially higher levels of risky sex compared to nonusers. Considerably fewer studies have examined methamphetamine use and high-risk sex among heterosexuals. The present study is a meta-analysis of the empirical literature on methamphetamine use and high-risk sexual behavior among heterosexual individuals. Four risky sex outcomes were examined: unprotected vaginal intercourse, unprotected anal sex, inconsistent condom use, and sex with multiple partners. Analysis of 24 studies (26 independent samples) including 286,781 individuals found that the pooled mean weighted odds ratios ranged from 1.37 (unprotected vaginal intercourse) to 1.72 (inconsistent condom use), indicating that the odds of engaging in risky sex for heterosexual methamphetamine users is, on average, between 37% and 72% greater than for nonmethamphetamine users. Date of publication, percentage of White Caucasian respondents, and sample size were significant moderators of effect size magnitude. Moreover, symmetry plots revealed little direct evidence for publication bias. It is recommended that future research explore additional categorical and continuous variables as potential moderators of effect size strength. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


The great recession and employee alcohol use: A U.S. population study.Open in a New Window

This is the first study to examine broadly the overall net change in U.S. population estimates of alcohol use related to a recession—The Great Recession—among individuals who remain employed. The alcohol variables included drinker status, usual frequency and quantity of alcohol use, frequency of heavy drinking and intoxication, as well as contextual assessments of the frequency and quantity of alcohol use during the workday and after work. The moderating influence of gender, race, and age also was explored. Data for this repeated cross-sectional study were obtained from 2 national telephone surveys of U.S. workers. The first survey occurred prior to the Great Recession (2002–2003; N = 2,501), whereas the second survey occurred during and after the official end of the Great Recession (2008–2011; N = 2,581). The results revealed that the recession was related to a higher proportion of drinkers among middle-aged employees, but not among young employees. Gender and race did not moderate the relation of the recession to drinker status. Among drinkers, the recession was not related to usual alcohol use (frequency and quantity), but was positively related to the frequency of heavy drinking and intoxication. Further, the recession had a differential relation to the contextual alcohol measures. It was negatively related to the frequency and quantity of workday alcohol use, but was positively related to the frequency and quantity of afterwork alcohol use. Among drinkers, gender, race, and age did not moderate the relation of the recession to alcohol use. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Drinking group characteristics related to willingness to engage in protective behaviors with the group at nightclubs.Open in a New Window

Electronic music dance events (EMDEs) in nightclubs are settings where young adults tend to engage in high-risk behaviors, such as heavy alcohol and drug use. Consequences of these behaviors may be prevented if young adults engage in protective strategies with their drinking group. It is important to identify drinking group characteristics that predict willingness to intervene with peers. Objectives of this study were to (a) examine whether young adults at EMDEs would be willing to intervene with members of their drinking group and (b) identify both individual and group characteristics of drinking groups that predict willingness to intervene. Nightclub patrons (N = 215 individuals; 80 groups) were surveyed anonymously as they entered clubs. Individual- and group-level characteristics were measured in relation to willingness to intervene with peers. Mixed-model regressions were conducted, accounting for nesting by drinking group. Analyses show that participants were willing to intervene with their peers. Groups that knew each other well and had lower expectations for members’ drinking were more willing to intervene. Women, younger, and older participants were also more willing to intervene. Findings show that club patrons are willing to intervene with their drinking groups to protect them from harmful consequences of heavy drinking and drug use. Findings indicate characteristics of both individuals and drinking groups that could be targeted in interventions among young adults largely not being reached by college interventions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Decoding of nonverbal language in alcoholism: A perception or a labeling problem?Open in a New Window

Alcohol-dependent patients have difficulty recognizing social cues such as emotional facial expressions, prosody, and postures. However, most researchers describing these difficulties rely on labeling tasks. It therefore remains difficult to disentangle genuine emotion-decoding problems from emotion-labeling impairments. In the present study, 35 recently detoxified alcohol-dependent patients were compared with 35 matched controls on four emotion-pairing tasks to explore the distinction between labeling and perceptual abilities. First, 2 tasks were used to assess emotion-labeling ability (labeling task) and working memory (necessary to process emotional stimuli; control matching task). Next, 2 experimental pairing tasks were used to explore unimodal, Face–face or voice–voice) and cross-modal, Face–voice or voice–face) matching abilities in the absence of any labeling requirement. Patients had difficulty accurately processing voices in unimodal tasks and correctly matching emotional stimuli in cross-modal tasks. Specifically, they did not correctly identify neutral stimuli in unimodal or cross-modal tasks and did not correctly identify fear in cross-modal tasks. Reaction times were also slower in these patients. However, accuracy and reaction time (RT) differences between patients and controls were accounted for by including anxiety and depression scores as covariates in the model. These results suggest that emotion-decoding difficulties observed in recently detoxified alcohol-dependent patients are not due to a specific emotion-labeling impairment, but rather involve perceptual difficulties or later integrative processing steps in the brain. Future studies should directly compare depressed or nondepressed alcohol-dependent patients with depressive patients to disentangle the influences of these highly comorbid disorders on nonverbal language perception. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Within treatment therapeutic alliance ratings profiles predict posttreatment frequency of alcohol use.Open in a New Window

Although past research has demonstrated a positive relationship between the therapeutic alliance (TA) and improved drinking outcomes, specific aspects of the alliance have received less attention. In this study, we examined the association between alliance characteristics during treatment and 4-month follow-up drinking reports. Sixty-five treatment-seeking alcohol dependent clients who participated in 12 weeks of individual outpatient treatment provided weekly TA ratings during treatment and reported on pretreatment, during treatment, and posttreatment alcohol use. Latent profile analysis was conducted to discern distinct profiles of client and therapist ratings of therapeutic alliance with similar alliance characteristics. TA profiles were based on clients’ and therapists’ mean alliance rating, minimum alliance rating, maximum alliance rating, the range of alliance ratings, and the difference in session number between maximum and minimum alliance ratings. One- through 4-class models were fit to the data. Model fit was judged by comparative fit indices, substantive interpretability, and parsimony. Wald tests of mean equality determined whether classes differed on follow-up percentage of days abstinent (PDA) at 4-months posttreatment. Three-profile solutions provided the best fit for both client and therapist ratings of the therapeutic alliance. Client alliance rating profiles predicted drinking in the follow-up period, but therapist rating profiles did not. These results suggest that distinct profiles of the therapeutic alliance can be identified and that client alliance rating profiles are associated with frequency of alcohol use following outpatient treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Interactive effects within the prototype willingness model: Predicting the drinking behavior of indigenous early adolescents.Open in a New Window

Drawing on the Prototype/Willingness Model of Adolescent Risk Behavior, we used longitudinal data collected from North American Indigenous early adolescents (ages 10–12 years) to examine the interactive effects of favorable drinker prototypes, perceived drinking norms, and past-year drinking behavior on subsequent drinking behavior (i.e., drinking behavior 1 year later and growth in drinking behavior from 1–5 years later). We found that the positive association between favorable drinker prototypes and drinking 1 year later was strongest for adolescents who were high in past-year drinking and perceived low drinking norms. The interaction pattern for growth in drinking was more complex and suggested an important pattern; specifically, favorable drinker prototypes were positively associated with drinking 5 years later, but only for adolescents who reported no past-year drinking and perceived low drinking norms. The theoretical and practical implications of these results are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Reciprocal relations between internalizing symptoms and frequency of alcohol use: Findings from a longitudinal study of Mexican-origin youth.Open in a New Window

Aims: Alcohol consumption and internalizing symptoms, which often co-occur, pose considerable risk to the developing adolescent and have lasting public health consequences. Previous research has documented concurrent associations between alcohol use and symptoms of anxiety and depression, but the dearth of longitudinal research, particularly for ethnic minority youth, raises questions about the replicability and causal direction of these effects. The goal of the present research was to clarify these issues, and investigate whether different facets of anxiety and depression are uniquely associated with alcohol use in adolescence. Method: The present research examined cross-lagged relations between frequency of alcohol use and internalizing symptoms, using data from a longitudinal study of 674 Mexican-origin youth (50% female) assessed at ages 14 and 16. Results: Alcohol use at age 14 prospectively predicted increases in overall internalizing symptoms, and overall internalizing symptoms at age 14 prospectively predicted increases in alcohol use. Reciprocal effects were consistently found for the general distress and anxious arousal facets, but not for anhedonic depression and a scale measuring the cognitive aspects of anxiety. Conclusions: The findings provide evidence of reciprocal relations between alcohol use and internalizing symptoms, but also highlight the danger of treating all symptoms of anxiety and depression as interchangeable components of a single broad domain. Instead, symptoms common to both anxiety and depressive disorders (e.g., general distress) have the most robust reciprocal relations with alcohol use. Thus, intervention programs aimed at reducing early alcohol use by Mexican-origin youth should target this component of the internalizing domain. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Attitude ambivalence, social norms, and behavioral intentions: Developing effective antitobacco persuasive communications.Open in a New Window

This study assessed the moderating effects of attitude ambivalence on the relationship between social norms, attitudes, and behavioral intentions to use tobacco. It was predicted that people would use social norms to reduce attitude ambivalence, and that reduced ambivalence would lead to changes in attitudes and behavioral intentions. To test this hypothesis, participants (N = 152) were exposed to persuasive communications designed to influence attitude ambivalence and perceived social norms regarding tobacco use. Analysis indicated that providing a social norm antagonistic to tobacco use significantly reduced ambivalence among participants reading the ambivalence message (p < .001). Examining changes in tobacco attitudes from pre- to postpersuasive communications demonstrated a significant decrease in tobacco attitudes only for participants reading the ambivalence message who were provided with the antitobacco use norm (p < .001). Ambivalent message participants also expressed significantly lower intentions to use tobacco when provided with social norms indicating antitobacco sentiments (p < .02), and this significant decrease in intentions was associated with changes in attitudes toward tobacco. These results point to the important role of social norms in mediating the effects of attitude ambivalence on subsequent behavior in preventative programs targeting tobacco use. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Immediate effects of plain packaging health warnings on quitting intention and potential mediators: Results from two ecological momentary assessment studies.Open in a New Window

The purpose of this study is to examine the immediate, everyday impact of health warnings on cigarette packages on potential smoking cessation mediators and to test for differences in immediate reactions to branded and plain tobacco packaging during the transition phase when plain packs where first introduced in Australia. Two Ecological Momentary Assessment studies tested whether smokers report higher risk appraisals, self-efficacy, and quitting intentions immediately after seeing a warning compared to random times of the day (Study 1), and whether smoking from plain packs results in higher quitting intention, risk appraisal, and self-efficacy than smoking from branded packs (Study 2). There was no immediate increase in self-efficacy, risk appraisal, or intention after encountering health warnings, and no differences in cognitions when using plain compared with branded packs. Moreover, cognitions were not different when warnings were encountered in proximity to smoking compared to nonsmoking events. However, self-efficacy and risk appraisal were significantly associated with quitting intention. Current health warnings do not seem to have an immediate impact on important predictors of quitting intention and might benefit from including messages that place a stronger focus on increasing smokers’ confidence that they can quit. Replication of the results with larger sample and cluster sizes is warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Higher stimulus control is associated with less cigarette intake in daily smokers.Open in a New Window

It is well established that environmental stimuli influence smoking in light, and to a lesser degree, heavy smokers. A 2-factor model of dependence suggests that the influence of stimulus control is masked among heavier smokers who primarily smoke for nicotine maintenance. The current study aimed to assess the influence of stimulus control across a range of moderate to heavy daily smokers. Furthermore, as local tobacco control policies may change the role of stimulus control, the study aimed to replicate previous U.S. findings on stimulus control in an Australian setting marked by strong tobacco control policies. In 2 Ecological Momentary Assessment studies, 420 participants monitored antecedents of smoking and nonsmoking situations. In a set of idiographic logistic regression analyses, situational antecedents were used to predict smoking occasions within each individual’s data. Linear regression analysis was used to test for the association between stimulus control and smoking rate, and to test for differences between the 2 samples. Daily smokers’ smoking was under considerable stimulus control, which was weaker at higher smoking rates. Overall, there was greater stimulus control in the Australian sample. Daily smokers also experience a degree of stimulus control, which is less influential in heavier smokers. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Development and psychometric properties of the Smoking Restraint Questionnaire.Open in a New Window

Restraint is a component of self-control that focuses on the deliberate reduction of an undesired behavior and is theorized to play a role in smoking reduction and cessation. However, there exists no instrument to assess smoking restraint. This research aimed to develop the Smoking Restraint Questionnaire (SRQ) to meet this need. Participants were 406 smokers (48% female; 52.2% nondaily) with a mean age of 38.83 years (SD = 12.05). They completed a baseline questionnaire designed to assess smoking restraint. They also completed 21 days of ecological momentary assessment (EMA), during which they recorded each cigarette smoked and answered questions related to planned restraint every morning, and restraint attempts every evening. The 4-item questionnaire of smoking restraint was found to fit a single factor (root mean square error of approximation = .038, comparative fit index = .99, Tucker-Lewis index = .99), and the resulting composite was reliable (composite reliability = 0.74). The questionnaire contains items that assess the setting of weekly restraint goals and attempts at not lighting up when tempted to smoke. Participant SRQ scores positively correlated with EMA data on plans to restrain (p < .001) and frequency of restraint attempts (p < .001). These correlations suggest that the SRQ has good predictive validity in relation to the intention and behaviors of smoking reduction. The SRQ is promising as a measure of smoking restraint and may enable further research and insights into smoking reduction and cessation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Intraindividual covariation between e-cigarette and combustible cigarette use in Korean American emerging adults.Open in a New Window

Critical gaps exist in understanding the patterns and correlates of dual use of electronic cigarettes (ECs) and combustible cigarettes (CCs), particularly in ethnic minority populations. In this study, we assessed CC and EC use in the naturalistic environment using ecological momentary assessment (EMA). We hypothesized that within-subject variation in EC use (yes/no each day) would be inversely associated with within-subject variation in number of CCs consumed and craving during that same day. We also examined gender and nicotine dependence as moderators of the EC-CC and EC-craving covariations. Korean American emerging adult (KAEA; 18–25 years old) smokers (N = 78) completed 7 days of EMA. Participants completed EMA surveys throughout the day, which assessed CC craving, and end-of-day surveys, which assessed EC use and the number of CCs smoked that day. Generalized linear mixed models were used to predict day-level EC use, with number of CCs smoked and craving during that same day, gender, and nicotine dependence as predictors (n = 501). We found that within-subject variation in CC use was not associated with same-day EC use; neither was within-subject variation in craving (ps > .27). Gender moderated the relationship between craving and EC use on a given day (p = .03); only for females, on the days with higher craving, the likelihood of their EC use that day was significantly heightened. This study does not suggest that EC use is linked with lower CC smoking quantity, at least at the day level and among KAEA smokers. CC craving may play a role in dual EC-CC use for KAEA female smokers. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


The relationship between addictive use of social media and video games and symptoms of psychiatric disorders: A large-scale cross-sectional study.Open in a New Window

Over the last decade, research into “addictive technological behaviors” has substantially increased. Research has also demonstrated strong associations between addictive use of technology and comorbid psychiatric disorders. In the present study, 23,533 adults (mean age 35.8 years, ranging from 16 to 88 years) participated in an online cross-sectional survey examining whether demographic variables, symptoms of attention-deficit/hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), anxiety, and depression could explain variance in addictive use (i.e., compulsive and excessive use associated with negative outcomes) of two types of modern online technologies: social media and video games. Correlations between symptoms of addictive technology use and mental disorder symptoms were all positive and significant, including the weak interrelationship between the two addictive technological behaviors. Age appeared to be inversely related to the addictive use of these technologies. Being male was significantly associated with addictive use of video games, whereas being female was significantly associated with addictive use of social media. Being single was positively related to both addictive social networking and video gaming. Hierarchical regression analyses showed that demographic factors explained between 11 and 12% of the variance in addictive technology use. The mental health variables explained between 7 and 15% of the variance. The study significantly adds to our understanding of mental health symptoms and their role in addictive use of modern technology, and suggests that the concept of Internet use disorder (i.e., “Internet addiction”) as a unified construct is not warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Type of gambling as an independent risk factor for suicidal events in pathological gamblers.Open in a New Window

Individuals with pathological gambling have an increased risk for suicidal events. Additionally, the prevalence of comorbid psychiatric disorders is high among pathological gamblers. This study analyzes whether the type of gambling is associated with suicidal events in pathological gamblers independently from comorbidity. Participants were recruited in 4 different ways: via random telephone sample from the general population, via individual invitation for study participation in gambling locations, through various media and the distribution of a leaflet in various settings, and via inpatient treatment facilities for pathological gambling. The final sample included 442 participants with a lifetime diagnosis of pathological gambling. A standardized clinical interview was conducted. High financial losses were associated with suicidal events (odds ratio [OR] = 1.94, 95% 95% confidence interval [CI], [1.11, 3.37]), as were mood disorders (OR = 7.70, 95% CI, [4.44, 13.37]) and female gender (OR = 2.52, 95% CI, [1.20, 5.28]). Gambling on electronic gambling machines in gambling halls or bars was associated with increased odds of suicidal events (OR = 2.94, 95% CI, [1.38, 6.24]). Other types of gambling, such as casino games or betting on sports, or the number of DSM–IV criteria for pathological gambling were not associated independently with suicidal events. Our findings suggest that gambling on electronic gambling machines in gambling halls or bars is associated with suicidal events in pathological gamblers independently of comorbidity. This result shows that the type of gambling needs to be considered as a relevant factor in gambling research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Exposure to and engagement with gambling marketing in social media: Reported impacts on moderate-risk and problem gamblers.Open in a New Window

Digital advertising for gambling and specifically marketing via social media have increased in recent years, and the impact on vulnerable consumers, including moderate-risk and problem gamblers, is unknown. Social media promotions often fall outside of advertising restrictions and codes of conduct and may have an inequitable effect on susceptible gamblers. This study aimed to investigate recall of exposure to, and reported impact on gamblers of, gambling promotions and marketing content on social media, with a focus on vulnerable users currently experiencing gambling problems. Gamblers who use social media (N = 964) completed an online survey assessing their exposure to and engagement with gambling operators on social media, their problem gambling severity, and the impact of social media promotions on their gambling. Gamblers at moderate risk and problem gamblers were significantly more likely to report having been exposed to social media gambling promotions and indicated actively engaging with gambling operators via these platforms. They were more likely to self-report that they had increased gambling as a result of these promotions, and over one third reported that the promotions had increased their problems. This research suggests that gamblers at moderate risk or those experiencing gambling problems are more likely to be impacted by social media promotions, and these may play a role in exacerbating disordered gambling. Future research should verify these self-reported results with behavioral data. However, the potential influence of advertisements via these new platforms should be considered by clinicians and policymakers, given their potential role in the formation of this behavioral addiction. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
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