Alcohol, sexual arousal, and intentions to use condoms in young men: Applying alcohol myopia theory to risky sexual behavior.

Data from 7 studies were aggregated to examine how reported sexual arousal and alcohol intoxication interact to affect attitudes and intentions toward engaging in unprotected sexual intercourse in college-age men (N?=?358). When participants were in a sober or placebo condition, their self-reports of sexual arousal had no effect on their responses. When participants were intoxicated, however, those who felt sexually aroused reported more favorable attitudes, thoughts, and intentions toward having unprotected sex than did those who did not feel aroused. These findings support alcohol myopia theory (C. A Steele & R. A. Josephs, 1990), which states that alcohol intoxication restricts attentional capacity so that people are highly influenced by the most salient cues in their environment. It is suggested that sexual arousal is a powerful internal cue that interacts with alcohol intoxication to enhance attitudes and intentions toward risky sexual behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol myopia and condom use: Can alcohol intoxication be associated with more prudent behavior?

We tested 2 competing theories about the effects of alcohol on intentions to engage in risky behavior. Disinhibition predicts that intoxicated people will exhibit risky behavior regardless of environmental cues, whereas alcohol myopia (C. M. Steele & R. A. Josephs, 1990) predicts that intoxicated people will be more or less likely to exhibit risky behavior, depending on the cues provided. In 4 studies, we found an interaction between intoxication and cue type. When impelling cues were present, intoxicated people reported greater intentions to have unprotected sex than did sober people. When subtle inhibiting cues were present, intoxicated and sober people reported equally cautious intentions (Studies 1-3). When strong inhibiting cues were present, intoxicated people reported more prudent intentions than did sober people (Study 4). We suggest that alcohol myopia provides a more comprehensive account of the effects of alcohol than does disinhibition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Executive functioning: A conceptual framework for alcohol-related aggression.

The causal mechanisms underlying alcohol-related aggression are not well understood. This article presents a conceptual framework designed to guide thinking and generate new research in this area of study. According to the framework, executive functioning is both a mediator and a moderator of intoxicated aggression. Literatures describing associations between alcohol and aggression, executive functioning and aggression, and the acute effects of alcohol on executive functioning are reviewed. On the basis of these findings, it is proposed that (a) executive functioning mediates the alcohol-aggression relation in that acute alcohol intoxication disrupts executive functioning, which then heightens the probability of aggression, and (b) executive functioning moderates the alcohol-aggression relation in that acute alcohol consumption is more likely to facilitate aggressive behavior in persons with low, rather than high, executive functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive mediation of alcohol's effects on women's in-the-moment sexual decision making.

Objective: To test a cognitive mediation model examining whether cognitive appraisals mediate alcohol consumption effects on condom request and unprotected sex intentions. Design: Female social drinkers (N = 173) participated in an experiment comparing four beverage conditions: control, placebo, target BAL = .04%, and target BAL = .08%. Subjects projected themselves into a hypothetical sexual encounter with a new sex partner. Measures: Appraisals of the situation's sexual potential, impelling and inhibiting cognitions, and behavioral intentions were assessed at several points. Results: Findings support the theoretical model, indicating that alcohol's effects on direct condom request and unprotected sex intentions were mediated through cognitive appraisals. Conclusion: Prevention interventions should include information about alcohol's effects on cognitions that may lead to ineffective condom negotiation and unprotected sex. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effects of acute alcohol intoxication, partner risk level, and general intention to have unprotected sex on women's sexual decision making with a new partner.

Women account for a quarter of all new HIV/AIDS cases, with approximately 65% having contracted the infection via heterosexual contact. Few experimental studies have examined interactions among background, partner, and situational characteristics in predicting women's sexual decisions. The Cognitive Mediation Model provides a useful theoretical framework for assessing likelihood of unprotected sex. Female social drinkers (n = 230) who had answered questions related to their general intention to have unprotected sex were randomly assigned to an experimental condition based on partner risk level (unknown, low, high) and beverage (control, placebo, low dose, high dose). Participants projected themselves into a story depicting a sexual situation with a man and answered questions about their cognitive appraisals, assertive condom request, and likelihood of unprotected sex. Alcohol effects on appraisal of sexual potential differed by partner risk condition. In the unknown and low risk conditions, placebo and alcohol participants appraised the situation as having greater sexual potential than controls whereas in the high risk condition, only those who consumed alcohol did so. Sexual potential appraisals in turn predicted impelling cognitions about having sex, which in turn predicted assertive condom request and unprotected sex intentions. General intention for unprotected sex independently predicted cognitive appraisals and outcomes. These findings highlight the need for prevention programs that focus on teaching women how to pay attention and consider sexual risk cues presented by potential partners, particularly when under the influence of alcohol. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Interactive effects of alcohol outcome expectancies and alcohol cues on nonconsumptive behavior.

Experimental research and popular belief suggest that, among its many effects, alcohol consumption reduces tension and facilitates aggression. Such observations could result from direct, pharmacological effects of alcohol on neural control of behavior but also may be accounted for by positing that drinking behavior activates mental representations of relaxation-related or aggression-related alcohol expectancies in long-term memory. Building on this latter view, in 2 experiments, the authors investigated whether rudimentary drinking-related cues, which presumably activate encoded alcohol expectancies, facilitate tension reduction and hostility in the complete absence of actual or placebo alcohol consumption. In Experiment 1, following contextual exposure to alcohol-related words, individuals with stronger expectancies that drinking reduces tension showed an increased willingness to meet with an opposite-gender stranger under relatively anxiety-provoking circumstances, suggesting that they experienced less apprehension regarding the meeting. Analogously, in Experiment 2, following near-subliminal exposure to alcohol-related words, individuals with stronger expectancies that drinking fosters aggression showed greater hostility toward a target person following an experimentally engineered provocation. Neither of the latter effects was obtained following exposure to nonalcoholic beverage words, which presumably did not activate alcohol outcome expectancy representations in long-term memory. Moreover, the strength of relevant, content-specific expectancies (i.e., for tension reduction or aggression, respectively) moderated alcohol cue exposure effects, but the strength of other expectancies (e.g., for sociability or sexual arousal) did not. Together, these findings demonstrate that exposure to rudimentary alcohol cues independently engenders expectancy-consistent behavior, thereby attesting to the remarkable breadth and subtlety of the behavioral impact of alcohol expectancy activation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Executive functioning, irritability, and alcohol-related aggression.

The purpose of this investigation was to examine (a) whether irritability mediates the relation between executive functioning (EF) and alcohol-related aggression and (b) whether the alcohol-aggression relation is better explained by the interactive effects of EF and irritability above and beyond the effects of either variable alone. EF was measured using seven well-established neuropsychological tests. Irritability was assessed with the Caprara Irritability Scale. Participants were 313 male and female social drinkers between 21 and 35 years of age. Following the consumption of an alcohol or a placebo beverage, participants were tested on a laboratory aggression task in which electric shocks were given to and received from a fictitious opponent under the guise of a competitive reaction-time task. Aggression was operationalized as the shock intensities administered to the fictitious opponent. Results indicated that irritability successfully mediated the relation between EF and intoxicated aggression for men only. Despite the fact that irritability and EF both independently moderated the alcohol-aggression relation in previous studies, no significant interaction for their combined effect was detected here. The findings are discussed, in part, within a cognitive neoassociationistic framework for aggressive behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experimentally induced anxiety attenuates alcohol-related aggression in men.

The purpose of this study was to test the hypothesis that state anxiety operates as moderator of the alcohol-aggression relation. Participants were 80 healthy male social drinkers between 21 and 33 years of age. They were randomly assigned to 1 of 4 groups: (a) alcohol + anxiety induction (n = 20), (b) placebo + anxiety induction (n = 20), (c) alcohol + no anxiety induction (n = 20), and (d) placebo + no anxiety induction (n = 20). Anxiety was induced by informing participants that they had to deliver a speech about what they liked and disliked about their body in front of a video camera. A modified version of the Taylor Aggression Paradigm (S. Taylor, 1967) was then used to measure aggressive behavior in a situation where electric shocks were administered to, and received from, a fictitious opponent under the guise of a competitive reaction time task. Results indicated that the anxiety induction was successful in suppressing aggression for participants who received alcohol equal to levels seen in placebo controls. Findings are discussed within the context of a number of theories of alcohol's anxiolytic effects in relation to intoxicated aggression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of alcohol and alcohol expectancies on male perception of female sexual arousal in a date rape analog.

The impact of alcohol and alcohol expectancies on men's perception of female sexual arousal and men's ability to discriminate accurately female sexual intentions in a dating situation was examined. In a 2 (alcohol)?×?2 (expectancy) balanced placebo design, men were exposed to an audiotape of a date rape and asked to signal when the man should stop making sexual advances. On 4 occasions during the vignette, participants rated how sexually aroused the woman on the tape was at that moment. Relative to controls, participants who consumed alcohol or expected to consume alcohol took significantly longer to identify the inappropriateness of the man's sexual behavior toward his date. Similarly, alcohol participants also rated the woman's sexual arousal level significantly higher at the first 2 refusals. Implications of the results are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Decision making in altered states: Effects of alcohol on attitudes toward drinking and driving.

A laboratory experiment and 2 field studies tested the hypothesis that alcohol affects attitudes and intentions toward drinking and driving. Sober and intoxicated participants completed a questionnaire assessing their attitudes and intentions to drink and drive in a number of situations. Results indicated that when asked general or noncontingent questions, sober and intoxicated participants were equally negative about this behavior. However, when a contingency was embedded in the question (e.g., "would you drink and drive only a short distance?"), intoxicated participants were significantly less negative about drinking and driving. These results are consistent with alcohol myopia (C. M. Steele & R. A. Josephs, 1990)—the notion that alcohol intoxication decreases cognitive capacity so that people are more likely to attend to only the most salient cues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Prospective Study of Sensation Seeking and Alcohol Use as Predictors of Sexual Risk Behaviors Among Men and Women Receiving Sexually Transmitted Infection Clinic Services.

Sensation seeking, the propensity to seek optimal stimulation and engage in risk behaviors, correlates with alcohol expectancies, which are related to alcohol use in sexual situations, potentially increasing risks for sexually transmitted infections (STIs). In the current prospective study of 313 male and 140 female STI clinic patients, path analyses showed that sensation seeking predicted unprotected intercourse 6 months later. Sensation seeking also predicted alcohol outcome expectancies, which predicted alcohol use in sexual contexts 6 months later, which in turn predicted unprotected sex. Tests for mediation showed that alcohol expectancies accounted for the association between sensation seeking and alcohol use in sexual contexts. These findings replicate previous research, with the prospective design confirming directional hypotheses and supporting causal conclusions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aggressiveness, family history of alcoholism, and the heart rate response to alcohol intoxication.

Some sons of male alcoholics (SOMAS) are characterized by an increased heart rate (HR) response to alcohol intoxication, which is thought to reflect increased sensitivity to alcohol-induced reward. Such a response has also been related to increased physical aggression. However, the confounding effect of aggression in SOMAS may be obscuring the interpretation of these findings. The HR response to alcohol was therefore assessed in 4 groups: high/low aggressive SOMAS and high/low aggressive non-SOMAS. Results indicate that aggressive SOMAS had the highest intoxicated HR response and that they reported the most alcohol consumption. This suggests that in some cases the high comorbidity between alcohol misuse and aggression is related to an increased sensitivity to alcohol-induced reward. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex-related alcohol expectancies predict sexual risk behavior among severely and persistently mentally ill adults.

Three hundred three adults (57% male, average age 42 years) with severe and persistent mental illness receiving treatment at community mental health clinics completed a survey, which included B. C. Leigh's (1990) sex-related alcohol expectancy scale and measures of alcohol use and sexual risk behavior. Hierarchical logistic regression analyses, controlling for drinking behavior, revealed that participants with stronger expectancies that drinking would lead to enhanced sexual experience were more likely to have drank prior to intercourse and that, among participants who drank prior to intercourse, those with stronger expectancies that alcohol would lead to riskier sexual behavior were more likely to have engaged in sexual risk behavior. Implications for preventing HIV infection among people with severe mental illness are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of sexual arousal and sexual partner characteristics in HIV+ MSM's intentions to engage in unprotected sexual intercourse.

Objective: This study investigated the effects of sexual arousal and sexual partner characteristics as determinants of HIV+ men who have sex with men's (MSM) intentions to engage in unprotected sex. Design: In a computer-based controlled experiment, 67 HIV+ MSM underwent a sexual arousal manipulation and indicated their intentions to engage in unprotected sex with hypothetical partners who differed in terms of HIV serostatus, physical attractiveness, relationship type, and preference for condom use. Main Outcome Measures: Computer-delivered questions assessed HIV+ MSM's intentions to engage in various sexual acts with each hypothetical partner. Results: As predicted, sexually aroused HIV+ MSM indicated stronger intentions to engage in unprotected sex than nonaroused HIV+ MSM; and having a partner who was attractive, HIV+, long term, or who preferred not to use condoms, also led to riskier intentions. Several significant interactions among these factors were found, which were generally consistent with predictions and with theory and research on cognitive processing and decision making. Conclusions: These findings have implications for understanding risky sexual behavior among HIV+ individuals and for the development of interventions to reduce this risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The link between alcohol use and aggression toward sexual minorities: An event-based analysis.

The current study used an event-based assessment approach to examine the day-to-day relationship between heterosexual men's alcohol consumption and perpetration of aggression toward sexual minorities. Participants were 199 heterosexual drinking men between the ages of 18–30 who completed (1) separate timeline followback interviews to assess alcohol use and aggression toward sexual minorities during the past year, and (2) written self-report measures of risk factors for aggression toward sexual minorities. Results indicated that aggression toward sexual minorities was twice as likely on a day when drinking was reported than on nondrinking days, with over 80% of alcohol-related aggressive acts perpetrated within the group context. Patterns of alcohol use (i.e., number of drinking days, mean drinks per drinking day, number of heavy drinking days) were not associated with perpetration after controlling for demographic variables and pertinent risk factors. Results suggest that it is the acute effects of alcohol, and not men's patterns of alcohol consumption, that facilitate aggression toward sexual minorities. More importantly, these data are the first to support an event-based link between alcohol use and aggression toward sexual minorities (or any minority group), and provide the impetus for future research to examine risk factors and mechanisms for intoxicated aggression toward sexual minorities and other stigmatized groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence of Physical Attractiveness and Alcohol on Men's Perceptions of Potential Sexual Partners and Sexual Behavior Intentions.

The current research presents the results of 2 related experimental studies designed to evaluate the influence of physical attractiveness and a moderate dose of alcohol on men's perceptions of potential sexual partners and sexual behavior intentions. Analyses revealed significant effects of physical attractiveness on partner perceptions and sexual behavior intentions. Although no main effects of alcohol were observed, alcohol differentially moderated the relations between perceived risk and sexual behavior intentions by limb of absorption. Results suggest that greater attention should be focused on identifying the specific physical characteristics of a potential sexual partner--beyond attractiveness--that influence perceptions of risk and intentions to engage in safer sex behaviors and highlight the importance of assessing limb of absorption in evaluating the complex association between alcohol and risky sexual behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Condom use with a casual partner: What distinguishes college students' use when intoxicated?

Determining alcohol's precise role in sexual risk taking has proven to be an elusive goal. Past research has produced mixed results, depending on characteristics of individuals, their partners, and the situation, as well as how the link between alcohol consumption and sexual behavior was assessed. In this study, cross-sectional predictors of the frequency of condom use were examined for 298 heterosexual college students at a large urban university. In hierarchical multiple regression analyses that controlled for frequency of condom use when sober, alcohol expectancies regarding sexual risk taking and self-efficacy regarding condom use when intoxicated were significant predictors of frequency of condom use when intoxicated. These findings highlight the importance of targeting beliefs about alcohol's disinhibiting effects in STD- and HIV-prevention programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intoxicated behavioral disinhibition and the heart rate response to alcohol.

This study examined the association between the heart rate (HR) response to alcohol intoxication, which is thought to reflect sensitivity to alcohol-induced reward and alcohol-induced behavioral disinhibition. High- and low-HR responders to alcohol participated in a go/no-go task, under sober and intoxicated conditions. Errors of commission on this task have previously been related to behavioral disinhibition. High-HR responders made more intoxicated commission errors as compared with low-HR responders. High-HR responders also reported increased alcohol consumption, and controlling for the latter did not alter the significant association between high-HR responders and increased intoxicated errors of commission. These results are consistent with previous findings of an increased risk for addictive and disinhibited behavioral propensities in individuals with a high-HR response to alcohol intoxication. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol expectancies regarding sex, aggression, and sexual vulnerability: Reliability and validity assessment.

This study was designed to validate the Alcohol Expectancies Regarding Sex, Aggression, and Sexual Vulnerability Questionnaire. This instrument includes alcohol expectancies in 4 domains (aggression, sexual affect, sexual drive, and vulnerability to sexual coercion) for 3 targets (self, women, and men). Confirmatory factor analyses with 715 undergraduates supported the hypothesized factor structure for the entire sample, as well as for gender and ethnic subgroups. Each of the subscales had high internal consistency reliability, moderate test-retest reliability, and good discriminant validity. Multivariate analyses of variance supported the hypothesis that participants' alcohol expectancies for other people conformed to gender role stereotypes. Participants saw themselves as being less influenced by alcohol than were others. Implications for sexual assault prevention programs are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)