Review of alcohol problems in ethnic minority groups.

This article reviews recent research on alcohol use and alcohol problems among Black Americans, Hispanic Americans, and American Indians. Strengths and weaknesses of conventional research methods and lacunae in current information are examined. To date, no studies have systematically documented variations in drinking styles and factors that promote or maintain alcohol abuse. Each minority group is heterogeneous in its drinking patterns; drinking problems; and psychological, medical, and social consequences of alcohol abuse. Collectively, these factors have important implications for evaluating programs to treat minority persons. The author suggests that future research adopt multidisciplinary approaches to more fully characterize ethnopharmacological profiles of alcohol use and abuse among these ethnic minorities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol Use Among Depressed Patients: The Need for Assessment and Intervention.

For many depressed patients, drinking may interfere with the successful treatment of their depression. Even among patients whose alcohol use does not rise to the level of an alcohol-use disorder, drinking can have a deleterious effect on depression and depressive symptoms and may dampen the impact of treatment for depression. However, subclinical drinking may not be addressed during the course of psychological or psychiatric treatment for depression. The authors advocate for the routine assessment of alcohol use, beyond questioning to diagnose alcohol abuse or dependence, in psychological and psychiatric settings. There is reason to believe that once identified, heavy alcohol use among depressed patients could be addressed effectively through the use of brief motivationally focused interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Standardized measures of alcohol-related problems: A review of their use among college students.

College students' alcohol consumption has received considerable attention in the scientific literature and the media for its impact on students and the college community. Misuse of alcohol can lead to a wide range of consequences, the most severe being alcohol abuse, dependence, and death. Researchers have struggled to develop effective methods to assess problems related to alcohol, and the literature on college drinking lacks a strong theoretical framework for such assessment. The authors contend that measures of alcohol-related problems for college students should assess specific dimensions pertaining to 3 main domains: alcohol abuse, alcohol dependence, and what the authors define as risky drinking. The authors examined how existing measures fit into this model. In a comprehensive review of the college literature, the authors identified 9 measures (and their revised versions) assessing alcohol-related problems. Their analysis revealed that most measures do not assess comprehensively the domains outlined, and instead provide only partial assessments of the potential consequences of drinking for college students. The authors include directions for future research so that measurement of drinking consequences for college students can be refined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-awareness theory, family history of alcoholism, and adolescent alcohol involvement.

A recent psychological theory (Hull, 1981) suggests that alcohol use may be motivated by a desire to avoid painful states of self-awareness. Highly self-aware individuals who are receiving failure feedback are hypothesized to use alcohol to reduce their awareness of negative self-relevant information. However, data in support of this theory are derived largely from laboratory studies of adult populations. Two studies were conducted to evaluate the theory in predicting adolescent drinking behavior in the natural environment. The studies also examined the ability of the model to account for phenomena of clinical importance, namely, indicators of adolescent problem drinking and drinking among high-risk adolescents (offspring of problem drinkers). Results showed that adolescent drinking was predictable as a function of demographic variables, self-awareness, failure feedback, and a family history of alcohol abuse. However, the predictions of self-awareness theory were not supported. The results are interpreted with regard to describing boundary conditions within which self-awareness theory is useful in explaining alcohol consumption. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reasons for drinking among psychiatric outpatients: Relationship to drinking patterns.

Alcohol is the most commonly used drug among people with mental disorders; however, few studies have addressed subjective reasons for drinking among the mentally ill. The purpose of this study was to evaluate the relationship between drinking motives and drinking patterns in 67 psychiatric outpatients. Results indicated that both positive and negative reinforcement motives differentiated drinkers from nondrinkers, with both types of motives correlated significantly with maximum quantity consumed in the last year. Enhanced negative (but not positive) reinforcement motives were associated with a history of treatment for alcohol or drug abuse. This study, which yielded findings similar to those found in previous research with nonclinical participants, represents the first psychometric investigation of motives underlying alcohol use among people with mental disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender moderates the relationship between substance-free activity enjoyment and alcohol use.

Laboratory research suggests that there is an inverse relationship between substance use and substance-free reinforcement, but the relevance of this relationship to the prevention of human substance abuse remains somewhat unclear. The present study evaluated the relationship between alcohol use and enjoyment from substance-free activities in a sample of college students who had previously completed an alcohol intervention (N = 107; 55% women; 45% men). The authors used a modified 30-day timeline follow-back interview to collect data on enjoyment from specific substance-free activities that occurred in the evening. Regression analyses revealed that there was a negative association between alcohol consumption and substance-free activity enjoyment for women but not for men. Women who reported greater enjoyment on abstinent evenings reported lower past-month alcohol consumption. Greater average enjoyment from substance-free activities was associated with greater motivation to change drinking among men and women. Although further research is required to determine procedures for increasing participation in substance-free activities and to explicate possible gender differences, these results suggest that increasing enjoyable substance-free activities may be an important prevention component. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Motivational pathways to alcohol use and abuse among Black and White adolescents.

Using data from a biracial community sample of adolescents, the present study examined trajectories of alcohol use and abuse over a 15-year period, from adolescence into young adulthood, as well as the extent to which these trajectories were differentially predicted by coping and enhancement motives for alcohol use among the 2 groups. Coping and enhancement motivations (M. L. Cooper, 1994) refer to the strategic use of alcohol to regulate negative and positive emotions, respectively. Results showed that Black and White youth follow distinct alcohol trajectories from adolescence into young adulthood and that these trajectories are differentially rooted in the regulation of negative and positive emotions. Among Black drinkers, coping motives assessed in adolescence more strongly forecast differences in alcohol involvement into their early 30s, whereas enhancement motives more strongly forecast differences among White drinkers. Results of the present study suggest that different models may be needed to account for drinking behavior among Blacks and Whites and that different approaches may prove maximally effective in reducing heavy or problem drinking among the 2 groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol-related expectancies predict quantity and frequency of heavy drinking among college students.

Alcohol-related expectancies covary consistently with consumption patterns; limited research also suggests that expectancies can predict future drinking behavior. However, the ability of expectancies to predict high-risk drinking has not been evaluated among college students. Participants were 140 undergraduates who completed an alcohol use assessment at 2 points in time, separated by. 1 month. Using multiple regression analyses, the author determined that alcohol-related expectancies accounted for a small but significant percentage of variance in each of 2 alcohol consumption variables. Global positive expectancies predicted maximum daily quantity, and sexual enhancement expectancies predicted the frequency of intoxication, even when controlling for baseline levels of both variables. These findings support alcohol abuse prevention efforts designed to modify cognitive expectancies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent alcohol expectancies in relation to personal and parental drinking patterns.

Increased expectations of positive effects of alcohol have been associated with severity of drinking across a variety of abusing and nonabusing adult populations. Although alcohol expectancies have been examined among high school adolescents, no study has examined expectancies of identified adolescent abusers in treatment. This study investigated whether adolescent alcohol abusers in treatment expect significantly more reinforcement from alcohol than do nonabusing peers and whether expectancies vary as a function of exposure to parental alcohol abuse. The adolescent version of the Alcohol Expectancy Questionnaire (Christiansen, Goldman, & Inn, 1982) was completed by 116 abusing and nonabusing adolescents. Results indicate that adolescent alcohol abusers expect significantly more reinforcement from alcohol than do demographically comparable nonabusing peers. Adolescents with an alcohol-abusing parent reported expecting more cognitive and motor enhancement from drinking than did adolescents without a family history of abuse. Thus, both personal alcohol use and parental alcohol use are related to adolescent alcohol expectancies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relative reinforcing efficacy of alcohol among college student drinkers.

The construct of relative reinforcing efficacy (RRE) is central to many laboratory and theoretical models of drug abuse, but it has not been widely measured in applied clinical research contexts. The authors used a simulated alcohol purchase task to measure RRE in a sample of 267 college student drinkers. Participants reported their alcohol consumption across a range of prices, and their responses were well-described by a regression equation that has been used to construct demand curves in drug self-administration studies. Several measures of relative reinforcing efficacy were generated, including breakpoint, intensity of demand, elasticity, Pmax (price at which response output is maximized), and Omax (maximum alcohol expenditures). Demand for alcohol was inelastic across the initial range of prices but became elastic as price increased. Students who reported recent heavy drinking reported significantly greater intensity of demand, Omax, and breakpoint. These results provide initial support for the validity of the RRE indices generated with the alcohol purchase task. These results also provide empirical support for programs that attempt to reduce alcohol abuse by eliminating low-cost access to alcohol. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Memory accessibility and association of alcohol use and its positive outcomes.

Theoretical predictions involving memory associations between alcohol use and its positive outcomes were examined. In 2 preliminary studies, the availability from memory of outcomes from drinking was investigated. In subsequent studies, a measurement paradigm was used that decreased the accessibility of the association between drinking behavior and positive outcomes so that individual differences in drinking frequency might predict the accessibility of memory responses. In a final study, this paradigm was refined further by manipulating various types of alcohol-related cues. The results converge on a class of theory of memory association in which repeated drinking experiences influence the accessibility of thoughts about alcohol use and its most normatively frequent outcomes. The increased association of this behavior and its outcomes in memory has important implications for the cognitive mediation of alcohol use and abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reasons for drinking alcohol: Relationships with DSM-IV alcohol diagnoses and alcohol consumption in a community sample.

The relationship between self-reported reasons for drinking and the DSM-IV alcohol use disorders and alcohol consumption was examined. Participants were 777 heavy drinking community residents who completed the Alcohol Use Disorders and Associated Disabilities Interview Schedule (B. F. Grant and D. Hasin, 1992) and a self-report assessment battery. Drinking to reduce negative affect was greater among drinkers with a current DSM-IV alcohol dependence diagnosis compared with drinkers with no DSM-IV alcohol use disorder. The DSM-IV alcohol abuse and the no-diagnosis groups did not differ in reasons for drinking. A positive association was demonstrated between drinking to reduce negative affect and frequency of intoxication. Drinking for enjoyment was positively associated with the frequency of binge drinking, frequency of intoxication, and average daily ethanol consumption. However, the relationship between drinking for enjoyment and average daily ethanol consumption was stronger among those with no alcohol disorder compared to those with DSM-IV alcohol dependence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stress and alcohol use: Moderating effects of gender, coping, and alcohol expectancies.

A stressor vulnerability model of stress-induced drinking was tested in a stratified random sample of 1,316 Black and White adult drinkers. Stressors were highly predictive of both alcohol use and drinking problems among men who relied on avoidant forms of emotion coping or held strong positive expectancies for alcohol's effects and accounted for more than 35% of the variance in alcohol use among the subgroup of men who were high in both vulnerability factors. In contrast, stressors were negatively related among men who were low in both and were unrelated among women regardless of their coping or expectancies. These findings suggest that tension reduction theories of alcohol use are overly broad and that individual characteristics must be considered to account for stress-related effects on alcohol use and abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Substance use and abuse among children and teenagers.

During the past several years, there has been a renewed national concern about drug abuse, culminating in the current "war on drugs." In this review, we emphasize that even though child or teenage drug use is an individual behavior, it is embedded in a sociocultural context that strongly determines its character and manifestations. Our focus is on psychoactive substances both licit (cigarettes and alcohol) and illicit (e.g., cannabis and cocaine). We feel that it is critical to draw a distinction between use and abuse of drugs and to do so from a multidimensional perspective that includes aspects of the stimulus (drug), organism (individual), response, and consequences. Our selective review of substance use and abuse among children and adolescents covers epidemiology (patterns and extent of drug use), etiology (what generates substance use), prevention (how to limit drug use), treatment (interventions with drug users), and consequences (effects and outcomes of youthful drug use). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Incorporating social anxiety into a model of college problem drinking: Replication and extension.

Although research has found an association between social anxiety and alcohol use in noncollege samples, results have been mixed for college samples. College students face many novel social situations in which they may drink to reduce social anxiety. In the current study, the authors tested a model of college problem drinking, incorporating social anxiety and related psychosocial variables among 228 undergraduate volunteers. According to structural equation modeling (SEM) results, social anxiety was unrelated to alcohol use and was negatively related to drinking consequences. Perceived drinking norms mediated the social anxiety-alcohol use relation and was the variable most strongly associated with problem drinking. College students appear to be unique with respect to drinking and social anxiety. Although the notion of social anxiety alone as a risk factor for problem drinking was unsupported, additional research is necessary to determine whether there is a subset of socially anxious students who have high drinking norms and are in need of intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sensation seeking–disinhibition and alcohol use: Exploring issues of criterion contamination.

Disinhibition has been theorized to increase risk for alcohol abuse. Because a major index of disinhibition, the Disinhibition subscale of the Sensation Seeking Scales (DIS; M. Zuckerman, 1979, 1987), includes items that explicitly ask about alcohol use (see M. Zuckerman, 1994), the nature and extent of predictor-criterion contamination merits investigation. Using structural equation modeling, this study examined the factor structure and predictive validity of the DIS with drinking in 1,217 college students. A 3-factor model best fit the DIS, and prediction of drinking by these factors varied based on their intrinsic levels of alcohol relatedness. Hence, the relationship between alcohol abuse risk and the DIS may require reconsideration. The factor structure of the DIS also varied between light and heavy drinkers; the clinical and psychometric implications of this finding are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of drinking protective behavioral strategies in association to sex-related alcohol negative consequences: The mediating role of alcohol consumption.

Alcohol use has been implicated as a risk factor for sexual negative consequences, such as unprotected sexual intercourse. The present research was conducted to examine the relationship between drinking protective behavioral strategies and consensual sex-related alcohol negative consequences, and whether this relationship varied by gender. Additionally, typical number of drinks during sexual behavior was evaluated as a potential mediator of this association. Heavy drinking, sexually active college students (N = 297, 50.2% women) completed self-report measures of drinking protective behavioral strategies, alcohol consumption, and sex-related alcohol negative consequences. Findings indicated that women who used drinking protective behavioral strategies more frequently were less likely to experience sex-related alcohol negative consequences whereas this relationship was not significant for men. For women, this relationship was mediated by the typical number of drinks consumed during sexual behavior. The current research demonstrates that use of drinking protective behavioral strategies is related to a reduction in women's sex-related risks when drinking. Findings are discussed in terms of alcohol myopia theory. Implications for interventions aimed to reduce higher risk sexual behavior among college students are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disclosure of sexual orientation and subsequent substance use and abuse among lesbian, gay, and bisexual youths: Critical role of disclosure reactions.

Research on whether disclosure of sexual orientation promotes lower substance use among lesbian, gay, and bisexual (LGB) individuals has been inconsistent. One reason for this may be that disclosure results in accepting and rejecting reactions. The current report longitudinally examines whether the types of reactions to disclosure are associated with substance use and abuse among 156 LGB youths (ages 14–21). Neither the number of disclosures nor the numbers of accepting or neutral disclosure reactions were associated with substance use or abuse. However, the number of rejecting reactions to disclosure was associated with current and subsequent alcohol, cigarette, and marijuana use, even after controlling for demographic factors, social desirability, and emotional distress. Further, accepting reactions were found to moderate or protect youths from the negative role of rejecting reactions on alcohol use, but not other substances. This research indicates that, rather than disclosure per se, it is the number of accepting and rejecting reactions in response to disclosure that are critical to understanding substance use among LGB youths. Further, the results suggest that to be maximally effective, substance use prevention and treatment efforts should address rejecting reactions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Using focus group interviews to identify salient issues concerning college students' alcohol abuse

Despite extensive efforts to decrease alcohol abuse among college students, prevention approaches have had limited success. This study attempted to clarify reasons for this limited success and to identify directions for future interventions by directly interviewing college students on this topic. Five issues were discussed in the focus group interviews: (1) reasons for drinking alcohol, (2) reasons for not drinking alcohol, (3) circumstances surrounding overconsumption of alcohol, (4) topics and methods for prevention, and (5) gender differences in drinking patterns. The focus group interviews were found to be a valid tool for elucidating sensitive aspects of these issues and the relative importance of these issues to each other. The students revealed how susceptible they are to societal pressures to drink alcohol and how the limitations of their intrapersonal skills affect their alcohol consumption, most notably regarding sexuality issues. The authors contend that improving intrapersonal skills should be a major focus of programs to prevent alcohol abuse.     

Cognitive preoccupation with alcohol and binge drinking in college students: Alcohol-induced priming of the motivation to drink.

This research examined alcohol-induced motivation to drink as a factor that contributes to preoccupation with drinking. Forty undergraduates rated their degree of preoccupation with drinking. The author determined the relationship between the undergraduates' preoccupation and the degree to which alcohol primed their motivation to drink by having them rate their desire for alcohol after they consumed a dose of alcohol or a placebo. Results showed that individual differences in preoccupation were predicted by the priming effects displayed after alcohol was consumed. More preoccupied individuals reported greater priming effects. Priming effects following placebo were minimal and were not related to preoccupation. The research shows that reinforcing effects of alcohol may contribute to cognitive preoccupation with drinking and promote patterns of alcohol abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)