The effects of alcohol on cigarette craving in heavy smokers and tobacco chippers.

The authors examined the effects of alcohol consumption on cigarette craving in heavy smokers and tobacco chippers (n = 138) who were instructed not to smoke for 12 hr. Participants were exposed to both smoking cues (a lit cigarette) and control cues. Half received a moderate dose of alcohol, adjusted for gender, and half received a placebo. Results indicated that alcohol consumption produced an increase in urge-to-smoke ratings before smoking cue exposure. Moreover, during cue exposure, alcohol consumption produced a sharper increase in urge ratings than did the placebo. In addition, during smoking cue exposure, alcohol increased the likelihood of displaying facial expressions associated with positive affect. These findings suggest that alcohol consumption influences both the magnitude and the emotional valence of cigarette cravings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol demand, delayed reward discounting, and craving in relation to drinking and alcohol use disorders.

A behavioral economic approach to alcohol use disorders (AUDs) emphasizes both individual and environmental determinants of alcohol use. The current study examined individual differences in alcohol demand (i.e., motivation for alcohol under escalating conditions of price) and delayed reward discounting (i.e., preference for immediate small rewards compared to delayed larger rewards) in 61 heavy drinkers (62% with an AUD). In addition, based on theoretical accounts that emphasize the role of craving in reward valuation and preferences for immediate rewards, craving for alcohol was also examined in relation to these behavioral economic variables and the alcohol-related variables. Intensity of alcohol demand and delayed reward discounting were significantly associated with AUD symptoms, but not with quantitative measures of alcohol use, and were also moderately correlated with each other. Likewise, craving was significantly associated with AUD symptoms, but not with alcohol use, and was also significantly correlated with both intensity of demand and delayed reward discounting. These findings further emphasize the relevance of behavioral economic indices of motivation to AUDs and the potential importance of craving for alcohol in this relationship. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mood and context-dependence: Positive mood increases and negative mood decreases the effects of context on perception.

Five studies show that mood affects context-dependence, such that negative mood promotes attention to a salient target, whereas positive mood enhances attention to both target and context. Judgments of temperature (Study 1), weight (Study 2), and size (Studies 3 and 4) were more strongly affected by the context in a positive than in a negative mood. Moreover, these effects extend to the social domain: When perceiving a target person's emotions, happy people were more influenced by the context than were sad people (Study 5). Thus, positive mood enhanced, and negative mood reduced, the magnitude of perceptual context effects. The results suggest that this pattern is not easily explained in terms of effort or depth of processing differences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of heavy drinking during and following treatment.

Alcohol dependence has been described as a relapsing condition and it has been proposed that alcohol lapses could potentially be explained by dynamic associations between contextual, interpersonal, and intrapersonal risk factors. Yet, few studies have tested the associations between risk factors in the prediction of lapse dynamics. The current study was a secondary analysis of data from the COMBINE study (n = 1,383; COMBINE Study Research Group, 2003). The goal of the current study was to examine static (alcohol dependence severity, treatment history, marital status, psychiatric symptoms) and dynamic (negative affect, craving, stress) predictors of heavy drinking during the course of treatment and up to one year following treatment. Results from dynamic latent difference score models indicated that higher levels of static and dynamic risk and increased dynamic risk over time were significantly associated with greater increases in heavy drinking. Likewise, more frequent heavy drinking and higher static risk predicted higher levels of dynamic risk. In addition, changes in dynamic risk factors significantly mediated the association between changes in heavy drinking and both psychiatric symptoms and treatment history. It is important to note that while the effects of static and dynamic risk factors in the prediction of heavy drinking were statistically significant, the magnitude of the effects were small. The current study provided partial support for a dynamic model of relapse; however future research using intensive longitudinal data collection and more advanced statistical techniques could further elucidate lapse dynamics and potentially improve relapse prevention planning. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Dynamic association between negative affect and alcohol lapses following alcohol treatment.

Clinical research has found a strong association between negative affect and returning to alcohol use after a period of abstinence. Yet little is known about the probability of a lapse given a particular level of negative affect or whether there is a reciprocal relationship between negative affect and alcohol use across time. The goal of the current study was to examine the association between negative affect and drinking behavior in the 1st year following alcohol treatment. The authors applied an associative latent transition analysis to the Project MATCH outpatient data (n = 952) and then replicated the model in the Project MATCH aftercare data (n = 774). Changes in drinking following treatment were significantly associated with current and prior changes in negative affect, and changes in negative affect were related to prior changes in drinking (effect size range = 0.13–0.33). The results supported the hypothesis that negative affect and alcohol lapses are dynamically linked and suggest that targeting the relationship between negative affect and alcohol use could greatly decrease the probability of lapses and improve alcohol treatment outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relations between heavy drinking, gender, and substance-free reinforcement.

Behavioral economic theory and laboratory research have suggested that substance abuse may be associated with diminished engagement in enjoyable substance-free activities (substance-free reinforcement). However, college students, in particular men, have reported numerous social benefits from drinking that might mitigate the expected inverse relation between drinking and substance-free reinforcement. In this study, we examined the relations between college student heavy drinking, gender, and several categories of substance-free reinforcement (peer, dating, sexual, school, and family activities). Participants were 246 undergraduate students who were classified as a function of their reported frequency of heavy drinking during a typical week in the past month (120 heavy drinkers, 126 light drinkers). Heavy drinking was associated with significantly higher substance-free peer and sexual reinforcement. This association was gender invariant and remained significant in multiple regression models that controlled for gender, ethnicity, and fraternity or sorority membership. Substance-free reinforcement did not predict frequency of heavy drinking in models that included levels of substance-related reinforcement. The results indicate that college student heavy drinking is not associated with global deficits in substance-free reinforcement and is instead associated with increased peer and sexual activity that occurs outside the context of drinking or drug use. Prevention programs should help students to compensate for the potential loss of social reinforcement associated with reductions in drinking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of negative and positive mood phrases on priming of alcohol words in young drinkers with high and low anxiety sensitivity.

This study investigated whether potential emotional cues for drinking activate alcohol concepts in young drinkers. Participants were 84 university freshmen with high or low levels of anxiety sensitivity (AS). A verbal priming task measured activation (i.e., priming) of alcohol concepts (e.g., beer) by positive and negative mood phrases. Time to read alcohol target words was the dependent measure. Negative mood phrases consistently primed alcohol targets; positive mood phrases did not. Degree of negative mood priming did not differ as a function of gender or AS. Reported tendency to drink in bad moods predicted negative mood priming in women, whereas men showed negative mood priming irrespective of their reported drinking tendency. A general association between negative mood priming and severity of alcohol problems also emerged. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interpersonal problems and negative mood as predictors of within-day time to drinking.

Using data collected via handheld electronic diaries (EDs), we examined within-day associations between early-day negative moods and stress and subsequent time to drinking. A sample of 97 (n = 48 women) adults recruited to participate in a drinking-reduction intervention study used EDs to record mood and interpersonal problems at randomly selected times during each of 3 reporting intervals and drinking as it occurred each day for 21 days. Using multilevel hazard models, we tested associations between early-day stress/negative mood ratings and time to drinking as well as potential moderating effects of drinking to cope (DTC) motives on these associations. Whereas previous analyses of these data showed no associations between early-day negative moods and number of drinks consumed later in the day, here we found significant associations between negative moods and time to drinking. Associations involving negative moods, DTC, and hazard for drinking varied depending on time of day, and some mood effects were moderated by DTC. These findings suggest that time to drinking may be more sensitive to the effects of acute negative mood states than is drinking quantity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A multimodal approach to assessing the impact of nicotine dependence, nicotine abstinence, and craving on negative affect in smokers.

We used multimodal measurement to evaluate whether (a) nicotine dependence is associated with baseline and postquit negative affect and craving, (b) smoking relapse is associated with greater negative affect and craving than abstinence, and (c) craving is associated with negative affect. Treatment-seeking smokers were randomly assigned to either a brief behaviorally based smoking-cessation treatment condition or to a delayed treatment control condition. Participants in the treatment condition attended four assessment sessions, 4–5 days prequit (baseline), 1–2 days postquit, 3–5 days postquit, and 10–14 days postquit, while controls attended four sessions spaced over the same intervals. Retrospective questionnaires were collected at the beginning of each session, and corrugator EMG and in-session ratings were collected during viewing of affective and cigarette-related slides. The multimodal measures indicated that more dependent smokers experienced greater negative affect and craving at baseline and postquit, regardless of abstinence status. The self-report measures indicated that both relapsed and abstinent smokers reported greater negative affect and craving than control smokers. Craving was associated with negative affect across measurement modalities. These results highlight the benefits of using multimodal measures to study the impact of nicotine dependence and withdrawal on negative affect and craving. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Rumination, negative cognition, and their interactive effects on depressed mood.

Response styles theory posits that rumination represents a trait vulnerability to depression. Recent evidence has suggested that rumination predicts changes in depression more strongly among individuals with high levels of negative cognition. Three studies evaluated this model of interactive vulnerabilities. Study 1 provided empirical support for the distinction between rumination and negative cognitive content. The next 2 studies investigated the interactive model in the laboratory. Study 2 randomly assigned participants to either ruminate or distract following a sad mood induction. This study found that rumination was more strongly associated with dysphoria among individuals who report high levels of negative cognition. Similarly, Study 3 found that rumination and negative cognition interact to predict changes in dysphoria across a no-task delay period following a sad mood induction. These studies provide support for an interactive model in which rumination amplifies the deleterious effects of negative cognition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of adult aging and induced positive and negative mood on planning.

Changes in executive functions have been found in older adults and also in young adults experiencing positive or negative mood states. The current study investigated the hypothesis that older adults would show greater executive function impairment following mood induction than young adults. Ninety-six participants (half aged 19-37, half aged 53-80) completed a neutral, positive, or negative mood induction procedure, followed by the Tower of London planning task. Significant interactions were found between age and mood such that older adults showed greater planning impairment than young adults in both the positive and negative mood conditions. Emotionally salient events occurring before testing may interfere with executive function in older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trauma-focused imaginal exposure for individuals with comorbid posttraumatic stress disorder and alcohol dependence: Revealing mechanisms of alcohol craving in a cue reactivity paradigm.

With a sample (N = 43) of participants meeting current diagnostic criteria for both alcohol dependence and posttraumatic stress disorder (PTSD), the authors tested the hypothesis that alcohol craving elicited by a trauma cue might be attenuated if trauma-elicited negative emotion were reduced following trauma-focused imaginal exposure. In a laboratory-based experiment, participants were randomly assigned to either trauma-focused imaginal exposure or imagery-based relaxation. A cue reactivity paradigm was used to assess alcohol craving prior to, and after completion of, the 6 clinical sessions. Attrition was high but did not differ between experimental conditions. For study completers, PTSD symptoms decreased in the exposure condition but not in the relaxation condition. Alcohol craving and distress elicited by trauma images decreased in the exposure condition but did not change in the relaxation condition. Results support the hypothesis that negative emotion is a mechanism of alcohol craving. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression, craving, and substance use following a randomized trial of mindfulness-based relapse prevention.

Objective: A strong relation between negative affect and craving has been demonstrated in laboratory and clinical studies, with depressive symptomatology showing particularly strong links to craving and substance abuse relapse. Mindfulness-based relapse prevention (MBRP), shown to be efficacious for reduction of substance use, uses mindfulness-based practices to teach alternative responses to emotional discomfort and lessen the conditioned response of craving in the presence of depressive symptoms. The goal in the current study was to examine the relation between measures of depressive symptoms, craving, and substance use following MBRP. Method: Individuals with substance use disorders (N = 168; mean age 40.45 years, SD = 10.28; 36.3% female; 46.4% non-White) were recruited after intensive stabilization, then randomly assigned to either 8 weekly sessions of MBRP or a treatment-as-usual control group. Approximately 73% of the sample was retained at the final 4-month follow-up assessment. Results: Results confirmed a moderated-mediation effect, whereby craving mediated the relation between depressive symptoms (Beck Depression Inventory) and substance use (Timeline Follow-Back) among the treatment-as-usual group but not among MBRP participants. MBRP attenuated the relation between postintervention depressive symptoms and craving (Penn Alcohol Craving Scale) 2 months following the intervention (?2 = .21). This moderation effect predicted substance use 4 months following the intervention (?2 = .18). Conclusion: MBRP appears to influence cognitive and behavioral responses to depressive symptoms, partially explaining reductions in postintervention substance use among the MBRP group. Although results are preliminary, the current study provides evidence for the value of incorporating mindfulness practice into substance abuse treatment and identifies a potential mechanism of change following MBRP. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Distractibility moderates the relation between automatic alcohol motivation and drinking behavior.

Research suggests that alcohol use is influenced by (a) the strength of automatic motivational responses to alcohol cues and (b) individual differences in self-control. The current study was designed to examine whether the self-control skill of inhibiting response to distracting stimuli would moderate the relation between automatic alcohol motivation and alcohol use. Eighty-seven hazardous drinkers completed baseline measures of automatic alcohol motivation and trait self-control and reported their drinking at a follow-up session 6 weeks later. Regression analyses demonstrated an interaction such that greater distractibility strengthens a positive relation between alcohol use and automatic alcohol motivation. These results contribute to a growing body of work indicating that self-control resources may help to inhibit the influence of automatic processes on alcohol behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examining the role of drinking motives in college student alcohol use and problems.

A motivational model of alcohol involvement (M. L. Cooper, M. R. Frone, M. Russell, & P. Mudar, 1995) was replicated and extended by incorporating social antecedents and motives and by testing this model cross-sectionally and longitudinally in a sample of college students. Participants (N = 388) completed a questionnaire battery assessing alcohol use and problems, alcohol expectancies, sensation seeking, negative affect, social influences, and drinking motives. Associations among psychosocial antecedents, drinking motives, and alcohol involvement differed from those found by M. L. Cooper et al. (1995). These findings point to the importance of social influences and of positive reinforcement motives but not to the centrality of drinking motives in this population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early cessation success or failure among women attempting to quit smoking: Trajectories and volatility of urge and negative mood during the first postcessation week.

Aversive symptoms of abstinence from nicotine have been posited to lead to smoking relapse and research on temporal patterns of abstinence symptoms confirms this assumption. However, little is known about the association of symptom trajectories early after quitting with postcessation smoking or about the differential effects of tonic (background) versus phasic (temptation-related) symptom trajectories on smoking status. The current study examined trajectories of urge and negative mood among 300 women using the nicotine patch during the first postcessation week. Ecological momentary assessments collected randomly and during temptation episodes were analyzed using hierarchical linear modeling yielding four individual trajectory parameters: intercept (initial symptom level), linear slope (direction and rate of change), quadratic coefficient (curvature), and volatility (scatter). Early lapsers, who lapsed during the first postcessation week, exhibited more severe tonic urge and phasic negative mood immediately after quitting, and more volatile tonic and phasic urge compared to abstainers. Late lapsers, who were abstinent during the first week but lapsed by 1 month, exhibited more severe tonic urge immediately after quitting compared to abstainers. These results demonstrate the importance of early postcessation urge and negative affect and highlight the value of examining both tonic and phasic effects of abstinence from nicotine. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Examining the associations among severity of injunctive drinking norms, alcohol consumption, and alcohol-related negative consequences: The moderating roles of alcohol consumption and identity.

This study examined a range of injunctive norms for alcohol use and related consequences from less severe behaviors (e.g., drinking with friends) to more severe behaviors (e.g., drinking enough alcohol to pass out), and their relationship with alcohol consumption and alcohol-related negative consequences among college students. In addition, this research aimed to determine whether these relationships between injunctive norms and consequences were moderated by alcohol consumption and level of identification with the typical same-gender college student. A random sample (N = 1,002) of undergraduates (56.9% women) completed a Web-based survey that was comprised of measures of drinking behavior, perceived approval of drinking behaviors that ranged in severity (i.e., injunctive norms), and level of identification with the typical same-gender college student. Results suggest that the association between negative consequences and injunctive drinking norms depend on one's own drinking behavior, identification with other students, and the severity of the alcohol use and related consequences for which injunctive norms are assessed. Findings are discussed in terms of false consensus and false uniqueness effects, and deviance regulation perspectives. Implications for preventive interventions are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A prospective test of the negative affect model of substance abuse: Moderating effects of social support.

The authors tested whether dimensions of negative affect--specifically, trait levels of negative emotionality and state levels of depressive symptoms--increased risk for substance abuse onset and whether perceived social support moderated this relation using data from a 5-year prospective study of 496 school-recruited adolescent girls. Initial negative emotionality, but not depressive symptoms, and deficits in parental, but not peer, support predicted future substance abuse onset in a multivariate hazard model. Tests of the interaction between negative affect dimensions and social support suggested that support did not moderate the relation of negative affect to risk for substance abuse onset. Results provide prospective support for the etiological role in the onset of substance abuse of trait-linked negative affect and of parental support. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized trial of a brief primary-care based intervention for reducing at-risk drinking practices.

This randomized trial evaluated an intervention for reducing at-risk drinking practices in a sample of 307 patients. Eligible drinking patterns included chronic drinking (≥ 2 drinks per day in the past month), binge drinking (≥ 5 drinks per occasion at least twice in the past month), and drinking and driving (driving after ≥ 2 drinks in the past month). Members of the intervention group received a message from their physician during their regularly scheduled visit, a self-help manual, written personalized feedback, and up to 3 telephone counseling calls. Dropout was significantly higher in the intervention than control group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)