Drinking to cope as a statistical mediator in the relationship between suicidal ideation and alcohol outcomes among underage college drinkers.

Etiological models of alcohol use that highlight the role of negative affect and depression have not been applied to the association of suicidality and alcohol use. The authors examined whether a motivational model of alcohol use could be applied to understand the relationship between suicidal ideation and alcohol outcomes in a sample of underage college drinkers who had a history of passive suicidal ideation (n = 91). In this cross-sectional study, regression analyses were conducted to examine whether drinking to cope with negative affect statistically mediated or was an intervening variable in the association between suicidal ideation and alcohol outcomes. Results revealed that drinking to cope was a significant intervening variable in the relationships between suicidal ideation and alcohol consumption, heavy episodic drinking, and alcohol problems, even while controlling for depression. These results suggest that the relationship between suicidal ideation and alcohol outcomes may be due to individuals using alcohol to regulate or escape the distress associated with suicidal ideation. Consideration of alcohol-related models can improve the conceptualization of research on suicidality and alcohol use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of impulsivity in the relationship between depression and alcohol problems among emerging adult college drinkers.

Depression is common among college students and higher levels of depression are associated with greater alcohol-related problems. However, depression is frequently not found to be directly associated with more alcohol use. This study examined whether various aspects of impulsivity (negative urgency, lack of premeditation, lack of perseverance, sensation seeking, and delay discounting) and drinking to cope with negative affect help to account for the relationship between depression and alcohol problems among emerging adult college drinkers who reported at least a minimal level of depressive symptoms. In this cross-sectional study, 143 emerging adult (between 18 and 25 years old) female (69.9%, n = 100) and male (30.1%, n = 43) college drinkers with at least minimal depressive symptoms completed measures of depression, alcohol use and problems, drinking to cope, and impulsivity. A multiple mediation analysis revealed that only negative urgency and drinking to cope partially mediated the depression-alcohol problems relationship. Moderated mediation analyses revealed that impulsivity-related constructs did not significantly interact with drinking to cope to increase alcohol problems. It appears that alcohol use is particularly problematic for students with elevated depression, and this is partly attributable to depression's association with negative urgency, in addition to its association with drinking to cope. Our findings suggest that students who suffer from depression may engage in problematic drinking behavior in part because negative affect is detrimental to their short-term impulse control and decision making, independent of maladaptive attempts to regulate affect through drinking to cope. (PsycINFO Database Record (c) 2011 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)     

Interpreting neutral faces as threatening is a default mode for socially anxious individuals.

The authors of the present study used an incidental learning paradigm to investigate the interpretation of neutral facial expressions in socially anxious individuals. Participants were asked to detect the location of a target following the presentation of a facial picture (i.e., cue). Unbeknownst to participants, the target location was contingent on the valence of the cue, and participants thus learned to associate different target locations with either positive or negative facial expressions. The authors subsequently used this learned association to assess interpretive biases. If socially anxious individuals interpret neutral faces in a negative manner, they should be faster to detect a target that appears in the location that is associated with negative face cues when the target is presented after a neutral face cue. The authors also assessed whether the anticipation of a feared situation influenced interpretive biases by comparing participants with and without a speech threat on this task. Results indicate that socially anxious individuals are characterized by an interpretive bias regardless of the threat manipulation. In contrast, nonanxious individuals interpreted neutral faces in a negative manner only when they were in the threat condition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-administration of alcohol before and after a public speaking challenge by individuals with social phobia.

[Correction Notice: An erratum for this article was reported in Vol 16(3) of Psychology of Addictive Behaviors (see record 2009-17717-001). On page 121, in the abstract, the penultimate sentence incorrectly reads, “As predicted, participants consumed more alcohol following the anxiety challenge than following the control task; however, the opposite pattern was evidenced for drinking following the 2 activities.” The sentence should read as follows: “As predicted, participants consumed more alcohol following the anxiety challenge than following the control task; however, the opposite pattern was evidenced for drinking preceding the 2 activities.”] K. Abrams, M. Kushner, K. Medina, and A. Voight (2001) showed that alcohol attenuates social anxiety symptoms in socially phobic individuals. This article examines whether social anxiety symptoms can lead to increased alcohol use in this same population. Forty-four individuals with social phobia attended 2 laboratory sessions, spaced 1 week apart, in groups of approximately 10. Participants underwent a social anxiety challenge during 1 session and a control task during the other. Half of the sample self-administered alcohol immediately before, and half immediately after, these 2 activities. As predicted, participants consumed more alcohol following the anxiety challenge than following the control task; however, the opposite pattern was evidenced for drinking following the 2 activities. These findings add to an understanding of why social phobia and alcohol problems tend to co-occur. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does alcohol use mediate the association between alcohol evaluations and alcohol-related problems in adolescents?

Alcohol use becomes more frequent during adolescence, with the percentage of youth who drink doubling from 8th grade to 12th grade. The escalation in drinking behavior during adolescence is often associated with increased problems and other risk behavior, such as drunk driving. In this study, adolescents (N?=?557) were recruited from an emergency department to assess their alcohol use, positive and negative evaluations about alcohol, driving after drinking, and problems experienced from drinking. Analyses explored the mediational role of drinking behavior between adolescents' evaluations and problems from drinking and between evaluations and driving after drinking. The findings indicated that drinking behavior partially mediated the association between positive evaluations and problems experienced from drinking but did not mediate the association between evaluations and drunk driving. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social phobia in youth: The diagnostic utility of feared social situations.

The present study evaluated the utility of parent- and child-reported social fears for reaching a diagnosis of social phobia in youth. The diagnostic utility of (a) the number of fears and (b) specific feared social situations was examined. The sample included 140 youth and their parents: youth diagnosed with social phobia (n = 50), youth diagnosed with generalized anxiety disorder or separation anxiety disorder but not social phobia (n = 49), and youth without an anxiety disorder (n = 41). Youth and their parents were interviewed separately using the Anxiety Disorders Interview Schedule for Children and Parents. Analyses indicate that a cut score of 4 parent-endorsed social fears optimally distinguished youth with and without social phobia. Analyses of child-reported fears did not identify a meaningful cut score. Conditional probability and odds ratio analyses indicated that several specific social fears have high diagnostic efficiency, and others were found to have limited diagnostic efficiency. Results are discussed with regard to informing diagnostic interviews and diagnostic systems for social phobia in youth. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A Daily Diary Validity Test of Drinking to Cope Measures.

Data from 2 daily diary studies of stress, negative affect, and drinking were used to examine the correspondence between global self-reports of drinking to cope (DTC) and within-person stress/negative affect-drinking associations. In Study 1, 83 community-residing drinkers recorded data in nightly booklets on negative events, perceived stress, negative affect, and drinking for 60 consecutive days. In Study 2, 88 community-residing drinkers recorded data on negative events and negative interpersonal exchanges nightly and negative affect and drinking in near-real time on palmtop computers for 30 consecutive days. Both studies showed only modest correspondence between self-reported DTC and between-person differences in within-day, daily, and weekly associations between stress/negative affect and drinking. The findings indicate that individuals who report higher DTC simply may drink across a wider variety of conditions than those who report relatively lower DTC. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Self-administration of alcohol before and after a public speaking challenge by individuals with social phobia": Correction to Abrams et al. (2002).

Reports an error in "Self-administration of alcohol before and after a public speaking challenge by individuals with social phobia." by Kenneth Abrams, Matt G. Kushner, Krista Lisdahl Medina and Amanda Voight (Psychology of Addictive Behaviors, 2002[Jun], Vol 16[2], 121-128). On page 121, in the abstract, the penultimate sentence incorrectly reads, “As predicted, participants consumed more alcohol following the anxiety challenge than following the control task; however, the opposite pattern was evidenced for drinking following the 2 activities.” The sentence should read as follows: “As predicted, participants consumed more alcohol following the anxiety challenge than following the control task; however, the opposite pattern was evidenced for drinking preceding the 2 activities.” (The following abstract of the original article appeared in record 2002-01321-005.) K. Abrams, M. Kushner, K. Medina, and A. Voight (2001) showed that alcohol attenuates social anxiety symptoms in socially phobic individuals. This article examines whether social anxiety symptoms can lead to increased alcohol use in this same population. Forty-four individuals with social phobia attended 2 laboratory sessions, spaced 1 week apart, in groups of approximately 10. Participants underwent a social anxiety challenge during 1 session and a control task during the other. Half of the sample self-administered alcohol immediately before, and half immediately after, these 2 activities. As predicted, participants consumed more alcohol following the anxiety challenge than following the control task; however, the opposite pattern was evidenced for drinking following the 2 activities. These findings add to an understanding of why social phobia and alcohol problems tend to co-occur. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fitting in and feeling fine: Conformity and coping motives as mediators of the relationship between social anxiety and problematic drinking.

The present research was conducted to clarify the relationships among social anxiety, alcohol consumption, alcohol-related problems, and negative-reinforcement drinking motives among college students. Heavy drinking students (N = 316, 53.80% female) completed self-report measures of social anxiety, alcohol consumption, alcohol-related problems, and drinking motives. Findings indicated that students higher in social anxiety consumed less alcohol but experienced more negative consequences. Moreover, the relationship between social anxiety and negative consequences was mediated by coping and conformity drinking motives in addition to alcohol consumption. In the context of social anxiety, the current research demonstrates the importance of examining problematic drinking as distinct constructs: alcohol consumption and negative consequences. Findings are also discussed in terms of implications for interventions with socially anxious students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attentional Bias and Drinking to Cope With Social Anxiety.

This study investigated the sensitivity of the emotional Stroop test for identifying individuals who reported drinking to cope with social fears. Community volunteers completed a modified Stroop task during which social threat, alcohol-related, and control words were presented. High scores on drinking-to-cope measures were hypothesized to be associated with longer response latencies to both social threat and alcohol-related words. Consistent with previous studies, alcohol dependence was correlated with latencies for alcohol-related words, and level of social anxiety was correlated with response latency to social threat words. As expected, drinking-to-cope measures predicted response latency to alcohol-related and social threat words. These results suggest that the emotional Stroop test is useful in studying the relationship between social anxiety and alcohol consumption. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Biases in interpretation and memory in generalized social phobia.

Two experiments examined the link between interpretation and memory in individuals diagnosed with Generalized Social Phobia (GSP). In Experiment 1, GSP and control participants generated continuations for nonsocial and ambiguous social scenarios. GSP participants produced more socially anxious and negative continuations for the social scenarios than did the controls. On the subsequent test of recalling the social scenarios, intrusion errors that shared meaning with the original continuations were made more frequently by the GSP group, producing false recall with emotionally negative features. To examine whether nonanxious individuals would also produce such errors if given emotional interpretations, in Experiment 2 the authors asked university students to read the scenarios plus endings produced by GSP participants in Experiment 1. The students either constructed vivid mental images of themselves as the main characters or thought about whether the endings provided closure. Low-anxious students in the closure condition produced fewer ending-based intrusions in recalling the social scenarios than did students in the other 3 conditions. Results illustrate the importance of examining the nature of source-monitoring errors in investigations of memory biases in social anxiety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effect of a single-session attention modification program on response to a public-speaking challenge in socially anxious individuals.

Research suggests that individuals with social anxiety show an attention bias for threat-relevant information However, few studies have directly manipulated attention to examine its effect on anxiety. In the current article, the authors tested the hypothesis that an attention modification program would be effective in reducing anxiety response and improving performance on a public-speaking challenge. Socially anxious participants completed a probe detection task by identifying letters (E or F) replacing one member of a pair of faces (neutral or disgust). The authors trained attention by including a contingency between the location of the neutral face and the probe in one group (Attention Modification Program; AMP). Participants in the AMP group showed significantly less attention bias to threat after training and lower levels of anxiety in response to a public-speaking challenge than did the participants in the Attention Control Condition (ACC) group. Moreover, blind raters judged the speeches of those in the AMP group as better than those in the ACC group. These results are consistent with the hypothesis that attention plays a causal role in the maintenance of social anxiety. (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)     

Working memory capacity in generalized social phobia.

Research suggests that understanding complex social cues depends on the availability of cognitive resources (e.g., Phillips, Channon, Tunstall, Hedenstrom, & Lyons, 2008). In spite of evidence suggesting that executive control functioning may impact anxiety (e.g., Eysenck, Derakshan, Santos, & Calvo, 2007), relatively few studies have examined working memory in individuals with generalized social phobia. Moreover, few studies have examined the role of threat-relevant content in working memory performance in clinically anxious populations. To this end, the present study assessed working memory capacity (WMC) in individuals with generalized social phobia and nonanxious controls using an operation span task with threat-relevant and neutral stimuli. Results revealed that nonanxious individuals demonstrated better WMC than individuals with generalized social phobia for neutral words but not for social threat words. Individuals with generalized social phobia demonstrated better WMC performance for threat words relative to neutral words. These results suggest that individuals with generalized social phobia may have relatively enhanced working memory performance for salient, socially relevant information. This enhanced working memory capacity for threat-relevant information may be the result of practice with this information in generalized social phobia. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Drinking to cope and alcohol use and abuse in unipolar depression: A 10-year model.

This study examined drinking to cope with distress and drinking behavior in a baseline sample of 412 unipolar depressed patients assessed 4 times over a 10-year period. Baseline drinking to cope operated prospectively as a risk factor for more alcohol consumption at 1-, 4, and 10-year follow-ups and for more drinking problems at 1- and 4-year follow-ups. Findings elucidate a key mechanism in this process by showing that drinking to cope strengthened the link between depressive symptoms and drinking behavior. Individuals who had a stronger propensity to drink to cope at baseline showed a stronger connection between depressive symptoms and both alcohol consumption and drinking problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A dual-process model of the alcohol–behavior link for social drinking.

A dual-process model of the alcohol–behavior link is presented, synthesizing 2 of the major social–cognitive approaches: expectancy and myopia theories. Substantial evidence has accrued to support both of these models, and recent neurocognitive models of the effects of alcohol on thought and behavior have provided evidence to support both as well. While proponents of these theories have not suggested that they are mutually exclusive views on how alcohol affects behavior, attempts to synthesize the 2 have been conspicuously absent. The dual-process model presented suggests that the alcohol–behavior link is better reconceptualized as involving a “preconsumption” and a “consumption” phase. This is achieved in the context of contemporary models of automaticity in social behavior, emphasizing the commonality of both controlled and automatic processes in drinking-related behavior. It is argued that a complete understanding of the alcohol–behavior link requires an appreciation of the ways in which the mind may become “intoxicated” even in the absence of alcohol consumption. Suggestions for further research in this area, testing the present dual-process model of the alcohol–behavior link, are also discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Unipolar Depression, Life Context Vulnerabilities, and Drinking to Cope.

This study followed baseline samples of 424 unipolar depressed patients and 424 community controls across 10 years to investigate the association between depression and alcohol-related coping and to examine how life context vulnerabilities underlie the risk for depressed individuals to rely on drinking to cope. Findings supported all hypotheses. Depressed patients engaged in more drinking to cope than did community controls. Within individuals, more negative life events and less family support were associated with more drinking to cope across the 4 observations. Depressed patients experienced more negative life events and less family support than did community controls. These underlying life context vulnerabilities explained the relationship between depressed patient status and drinking to cope. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Help-seeking for alcohol-related problems in college students: Correlates and preferred resources.

Despite the development of a variety of efficacious alcohol intervention approaches for college students, few student drinkers seek help. The present study assessed students' history of help-seeking for alcohol problems, as well as their estimates of how likely they would be to use various help-seeking resources, should they wish to change their drinking. Participants were 197 college students who reported recent heavy drinking (46% male, 68.5% White, 27.4% African-American). Participants completed measures related to their drinking and their use (both past use and likelihood of future use) of 14 different alcohol help-seeking options. Repeated-measures analyses of variance revealed that students preferred informal help-seeking (e.g., talking to friends and family) over formal (e.g., talking with a counselor or medical provider) and anonymous resources (e.g., internet- or computer-based programs). Higher self-ideal discrepancy, greater depressive symptoms, and more alcohol-related consequences were positively associated with actual past help-seeking. Alcohol-related problems and normative discrepancy were negatively associated with hypothetical likelihood of utilizing all three help-seeking resources. These results suggest that heavy drinking college students prefer low-threshold intervention options including peer, family, computerized, and brief motivational interventions. Only 36 participants (18.3% of the sample) reported that they had utilized any of the help-seeking options queried, suggesting that campus prevention efforts should include both promoting low-threshold interventions and attempting to increase the salience of alcohol-related risk and the potential utility of changing drinking patterns. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attention training in individuals with generalized social phobia: A randomized controlled trial.

The authors conducted a randomized, double-blind placebo-controlled trial to examine the efficacy of an attention training procedure in reducing symptoms of social anxiety in 44 individuals diagnosed with generalized social phobia (GSP). Attention training comprised a probe detection task in which pictures of faces with either a threatening or neutral emotional expression cued different locations on the computer screen. In the attention modification program (AMP), participants responded to a probe that always followed neutral faces when paired with a threatening face, thereby directing attention away from threat. In the attention control condition (ACC), the probe appeared with equal frequency in the position of the threatening and neutral faces. Results revealed that the AMP facilitated attention disengagement from threat from pre- to postassessment and reduced clinician- and self-reported symptoms of social anxiety relative to the ACC. The percentage of participants no longer meeting Diagnostic and Statistical Manual (4th ed.) criteria for GSP at postassessment was 50% in the AMP and 14% in the ACC. Symptom reduction in the AMP group was maintained during 4-month follow-up assessment. These results suggest that computerized attention training procedures may be beneficial for treating social phobia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)