Alan Stacy

Claremont Graduate University · PhD Program in Health Promotion Sciences

Background: Past year, month, and lifetime adolescent e-cigarette use rates remain persistently high, despite falling cigarette use rates. Previous investigations have noted a strong relationship between an individual's positive and negative cognitions related to a behavior, and subsequent initiation of that behavior.Objective: This investigation w...

Background The merits and drawbacks of moral relevance models of addiction have predominantly been discussed theoretically, without empirical evidence of these potential effects. This study develops and evaluates a novel survey measure for assessing moral evaluations of patient substance misuse (ME-PSM). Methods This measure was tested on 524 heal...

Purpose This paper aims to apply the Product Life Cycle (PLC) and Product Evolutionary Cycle (PEC) frameworks to the nicotine and tobacco market to predict the impact of television commercials for electronic cigarettes (e-cigarettes) on youth. Design/methodology/approach Surveys were administered over a three-year period to 417 alternative high sc...

Becoming committed to a new health-related goal and pursuing it is difficult for many people. The present study (a) developed and tested the psychometric properties of a brief Goal Ambivalence Scale (GAS) in a sample of dieters and (b) tested the effectiveness of providing dieters with feedback on their scores on the GAS. In Study 1, dieters (n = 3...

Consistent with cognitive models of social anxiety, socially anxious individuals show cognitive biases that magnify their perceived level of threat in the environment. Objectives The first objective was to determine whether attentional bias for socially threatening stimuli occurs after concomitant depression has been controlled. The second objecti...

Impulsivity is a multidimensional construct. The UPPS-P model of impulsivity differentiates five distinct dimensions: negative urgency, positive urgency, lack of premeditation, lack of perseverance, and sensation seeking. The present study, reports the first translation and validation of the recently revised short form of the UPPS-P scale (S-UPPS-P...

In recent years, more than half of all drug overdose deaths in United States involved an opioid. To address this epidemic, antecedents to opioid misuse must be identified and empirically validated. The objective of the current investigation was to examine whether illicit drug use was prospectively associated with nonprescription opioid use among ad...

Introduction. Research indicates a link between adolescent e-cigarette use and combustible tobacco cigarette (CTC) initiation, and recent studies suggest their connection with marijuana uptake. Our 3-year longitudinal cohort study investigated the implications of adolescent, peer, and family e-cigarette use with adolescents’ expectations and willin...

Alternative high school (AHS) students typically report higher levels of alcohol and other drug use compared to students attending traditional high schools. Greater use of such drugs as heroin, methamphetamines, and cocaine in this at-risk population may be driven, in part, by a greater latitude of acceptance toward substance use in general, which...

Purpose: Past research has suggested that executive functions, such as working memory and response inhibition, predict the use of nicotine and tobacco products (NTPs). The current study extends prior research by assessing whether response inhibition and working memory are associated with at-risk youth’s willingness to use NTPs. Methods: A sample of...

Background: Previous research has demonstrated how negative affect (i.e., depression, anxiety, stress) is often a correlate of and precursor to nicotine dependence. Although recent evidence shows a gradual decline in tobacco use in the United States, subgroups that report higher levels of negative affect may continue to be at risk of becoming depe...

We have reported a problem with the scoring of the UPPS-P, and have proposed corrections for the scoring of the scale. (Due to the journals policy, we cannot upload a full-text of the commentary to this website but colleague who have difficulty accessing the article or purchasing it may sent their request to the corresponding author.)

Objectives: In this study, we assessed whether commercials for electronic cigarettes (e-cigarettes) influence the use of e-cigarettes, cigarettes, and cigars among high-risk youth in southern California. Methods: We recruited students (N = 1060) from 29 alternative high schools into a prospective cohort study. We used multilevel Poisson regression...

Numerous studies have examined how youth are influenced by the presence of tobacco retail outlets that use point-of-sale marketing tactics to promote nicotine and tobacco products. The current investigation extends this research by assessing whether tobacco retail outlets function as environmental cues that prompt associative memories linked to the...

This study builds upon prior research on associations between moods, family functioning, and binge eating, using ecological momentary assessment to examine moderating effects of family functioning on associations between moods and binge eating. This study was conducted among a nonclinical sample of urban adolescents. Family functioning was assessed...

Many people enrolled in drug diversion programs are not receiving evidence-based prevention for HIV or hepatitis. This study translated basic research from cognitive science to increase screening for infection and condom use in this population. A parallel three-condition randomized trial was conducted in a drug diversion sample (N = 358), comparing...

Background: Youth from continuation high schools report greater substance use and sensation-seeking than youth from regular high schools, yet their long-term consequences on age at sexual onset and the number of sexual partners are unknown. Objective: To examine substance use, sensation-seeking and sexual behaviors by gender and race/ethnicity a...

Introduction As adolescent tobacco use shifts from traditional cigarettes to alternative products, it is important to understand the influence of point-of-sale (POS) advertising on product use. This research investigated whether the percentage of POS advertising for a particular product, known as the share of advertising voice (SAV), moderated the...

Objective: The Rutgers Alcohol Problem Index (RAPI) has been used extensively as a measure of alcohol-related problems experienced by adolescents and young adults. The present study aimed to comprehensively examine the psychometric profile and criterion-related validity of an 18-item RAPI adapted to measure negative consequences resulting from alc...

Indirect tests of memory associations relevant to cannabis have been shown to be useful in explaining and predicting adolescent cannabis use habits. This study sought to increase the understanding of adolescent cannabis-related associative memory and cannabis use behavior over time. A longitudinal sample of alternative high school students (N = 775...

Introduction This study tested whether exposure to e-cigarette advertising increases e-cigarette use susceptibility among non-smoking young adults by promoting explicit and implicit attitudes towards e-cigarettes as a safer and healthier alternative to combustible cigarettes. Methods Young adult current non-smokers who had never used an e-cigarett...

The understanding of habit processes can be advanced through imaging neurobiological processes that support habit-related associative memories. The implicit association test (IAT) is one method used to examine concept specific associative memory effects. IAT performance in the scanner allows for observation of neural correlates of automatic associa...

Background and Purpose: Youth from continuation high schools (CHS) exhibit riskier sexual behaviors than other high school youth, yet the associations between intrapersonal and interpersonal constructs and condom-using behavior are not fully understood within this population. It is unknown which of these variables may be more strongly associated wi...

Background: Implementation intentions are situation-linked action plans that increase health behaviors such as condom use. Few studies have measured the strength of implementation intentions, especially regarding condom use. Non-injection drug users are at high risk for HIV due to risky sexual practices. Substance use before sex may increase risky...

Despite the general trend of declining use of traditional cigarettes among young adults in the United States, alternative high school students continue to smoke cigarettes and electronic cigarettes at rates much higher than do students attending regular high schools. Challenging life circumstances leading to elevated levels of negative affect may a...

Aims: To test longitudinal additive and synergistic dual process models in youth at documented risk for drug use. The specific dual process approach examined suggests that engaging in drug use behaviors results from a dynamic interplay between automatically-activated associative memory processes and executive reflective/control processes. Design:...

This study examines the point-of-sale marketing practices used to promote electronic cigarettes at stores near schools that serve at-risk youths. One hundred stores selling tobacco products within a half-mile of alternative high schools in Southern California were assessed for this study. Seventy percent of stores in the sample sold electronic ciga...

Background: This study used a dual-process model of cognition in order to investigate the possible influence of automatic and deliberative processes on lifetime alcohol use in a sample of drug offenders. Objective: The objective was to determine if automatic/implicit associations in memory can exert an influence over an individual's alcohol use...

Rationale: Engaging in risky sexual behavior increases transmission of HIV. Objective: The present study used previously elicited salient outcomes of condom use to examine the factor structure and test the predictive utility of a condom use expectancy scale. Methods: Participants were drug offenders from court ordered drug diversion programs i...

Word association tests (WATs) have been widely used to examine associative/semantic memory structures and shown to be relevant to behavior and its underpinnings. Despite successful applications of WATs in diverse research areas, few studies have examined psychometric properties of these tests or other open-ended cognitive tests of common use. Moder...

A substance-related word-association test (WAT) is one of the commonly used indirect tests of substance-related implicit associative memory and has been shown to predict substance use. This study applied an item response theory (IRT) modeling approach to evaluate psychometric properties of the alcohol- and marijuana-related WATs and their items amo...

Background: HIV infection is problematic among all drug users, not only injection drug users. Drug users are at risk for contracting HIV by engaging in risky sexual behaviors. Objective: The present study sought to determine whether inhibitory processes moderate the relationship between problematic drug use and HIV-risk behaviors (unprotected se...

We used confirmatory factor analysis to compare convergence/divergence across self-report measures of social self-control, sensation seeking, and impulsivity in a sample of high-risk adolescents. In addition, we tested baseline social self-control as a predictor of cigarette use one year later, controlling for baseline cigarette use, impulsivity/se...

This research assessed activation in neural substrates involved in implicit associative processes through functional magnetic resonance imaging of an alcohol-Implicit Association Test (IAT) focused on positive outcomes of alcohol use. Comparisons involved 17 heavy and 19 light drinkers, ranging in age from 18 to 22, during compatible and incompatib...

The Habitual & Neurocognitive Processes in Adolescent Obesity Prevention is a project consisting of a series of five studies that will culminate in the creation of a novel intervention strategy to improve nutrition behavior and reduce risk for obesity among adolescents. The first of these five studies seeks to identify cues to habitual dietary beha...

Introduction: Prefrontally mediated impulse control and sensitivity to reward (mediated by subcortical systems) are relevant to the food choices individuals make frequently on a daily basis. An imbalance of these inhibitory systems can lead to deficits in decision-making that are relevant to food ingestion and can be detected with neurocognitive ta...

Introduction: Eating behaviors may become habitual such that certain cues trigger the behavior without conscious deliberation on the action. Cue-behavior links such as these could be important targets for interventions designed to improve dietary habits. Cues associated with consuming sweetened drinks and snacks among adolescents were identified in...

Introduction: Family characteristics such as parenting style and family functioning (e.g., cohesion, flexibility) have been associated with adolescent dietary behavior. The present study examines the association of family influences with Body Mass Index (BMI), binge eating and obesity-related dietary behaviors (e.g., sugar sweetened beverages). Fam...

Abstract Approximately 36% of HIV cases are related to substance abuse. Substance abusers, including non-injection drug users, are at a high-risk for contracting HIV due to risky behaviors, including unprotected sex. Due to these behavioral and infection risks, feasible interventions that focus on condom use within this population are imperative. T...

This study examined the factor structure and validity of the Acculturation Gap Conflicts Inventory (AGCI), a new instrument developed to measure the types of recurring conflicts that young people experience as part of the parent–child acculturation gap. Participants included 283 Hispanic young adults who completed the AGCI and existing measures of...

Objective: This study used prospective data to test the hypothesis that exposure to alcohol advertising contributes to an increase in underage drinking and that an increase in underage drinking then leads to problems associated with drinking alcohol. Methods: A total of 3890 students were surveyed once per year across 4 years from the 7th throug...

This study evaluated effects of a key session from a nationally recognized drug abuse prevention program on basic memory processes in 211 high-risk youth in Southern California. In a randomized, between-subject design, the authors manipulated assignment to a Myth and Denial program session and the time of assessment (immediate vs. 1-week delay). Th...

This study evaluated dual process interaction models of HIV-risk behavior among drug offenders. A dual process approach suggests that decisions to engage in appetitive behaviors result from a dynamic interplay between a relatively automatic associative system and an executive control system. One synergistic type of interplay suggests that executive...

Dual process models of decision-making suggest that behavior is mediated by a spontaneous behavior selection process or by a more deliberative evaluation of behavioral options. We examined whether the deliberative system moderates the influence of spontaneous cognition on HIV-risk behaviors. A measure of spontaneous sex-related associations (word a...

Decision-making is a social process whereby behaviors are often driven by social influences and social consequences. Research shows that social context also plays an integral role in decision-making processes. In particular, evidence suggests that implicit or non-conscious cognitions are linked to social information in memory and that implicit atti...

This paper contrasts dual-process and personality approaches in the prediction of addictive behaviors and related risk behaviors. In dual-process models, behavior is described as the joint outcome of qualitatively different “impulsive” (or associative) and “reflective” processes. There are important individual differences regarding both types of pr...

Cognitive associations with alcohol predict both current and future use in youth and young adults. Much cognitive and social cognitive research suggests that exposure to information may have unconscious influences on thinking and behavior. The present study assessed the impact of information statements on the accessibility of alcohol outcome expect...

Research on implicit cognition and addiction has expanded greatly during the past decade. This research area provides new ways to understand why people engage in behaviors that they know are harmful or counterproductive in the long run. Implicit cognition takes a different view from traditional cognitive approaches to addiction by assuming that beh...

Moss and Albery presented a dual-process model of the alcohol-behavior link, integrating alcohol expectancy and alcohol myopia theory. Their integrative theory rests on a number of assumptions including, first, that alcohol expectancies are associations that can be activated automatically by an alcohol-relevant context, and second, that alcohol sel...

The goal of the current investigation was to address whether affective decision making would serve as a unique neuropsychological marker to predict drinking behaviors among adolescents. We conducted a longitudinal study of 181 Chinese adolescents in Chengdu city, China. In their 10th grade (ages 15-16), these adolescents were tested for their affec...

Research on beliefs about the expected effects of alcohol has suggested a major role for these expectancies in motivating drinking behavior. Measures developed to assess these expectancies, however, are likely to cue subject's responses and may not represent the expected effects that are the most salient for an individual. Expected effects of alcoh...

Both implicit and explicit cognitions play an important role in the development of addictive behavior. This study investigated the influence of a single-session motivational interview (MI) on implicit and explicit alcohol-related cognition and whether this intervention was successful in consequently decreasing alcohol use in at-risk adolescents. Im...

This study analyzed quantitative data on tobacco use and dependency for 3,589 high-school students, qualitative data for 448 students, and outcome data for a randomized trial comparing the efficacy of two cessation interventions and a control condition for 337 students. Data were collected from 1988 through 1992 in California and Illinois as part o...

This study assessed incidental recognition of Alcohol and Neutral words in adolescents who encoded the words under distraction. Participants were 171 (87 male) 10th grade students, ages 14-16 (M=15.1) years. Testing was conducted by telephone: Participants listened to a list containing Alcohol and Neutral (Experimental--Group E, n=92) or only Neutr...

The model of addiction proposed by Redish et al. shows a lack of fit with recent data and models in psychological studies of addiction. In these dual process models, relatively automatic appetitive processes are distinguished from explicit goal-directed expectancies and motives, whereas these are all grouped together in the planning system in the R...

Some theories suggest that spontaneously activated, drug-related associations in memory may have a "freer reign" in predicting drug use among individuals with lower working memory capacity. This study evaluated this hypothesis among 145 at-risk youth attending continuation high schools (CHS). This is the 1st study to evaluate this type of dual-proc...

This study addressed the question of whether poor decision making would be associated with adolescent past 7-day smoking. We conducted a cross-sectional study of 208 10th-grade adolescents in Chengdu City, China. We used the Iowa Gambling Task (IGT) to assess decision-making, and the Self-ordered Pointing Task (SOPT) to assess working memory capaci...

Dual process models of addiction suggest that the influence of alcohol-related cognition might be dependent on the level of executive functioning. This study investigated if the interaction between implicit and explicit alcohol-related cognitions and working memory capacity predicted alcohol use after 1 month in at-risk youth. Implicit and explicit...

The primary aim of this study was to test the hypothesis that adolescent binge drinkers, but not lighter drinkers, would show signs of impairment on tasks of affective decision-making as measured by the Iowa Gambling Test (IGT), when compared to adolescents who never drank. We tested 207 10th grade adolescents in Chengdu City, China, using two vers...

Studies of the association between substance use and condom use in specific sexual encounters often do not separate the effects of alcohol and different types of drugs. Because the pharmacological effects and social settings of various substances differ, their effects on unprotected intercourse may vary as well. This study examined the relationship...

Recently, there has been increased interest in the role of implicit cognitive processes in the development of addictive behaviors. In this study, the authors compared 3 indirect measures of alcohol-related cognitions in the prospective prediction of alcohol use in at-risk adolescents. Implicit alcohol-related cognitions were assessed in 88 Dutch at...

To test whether a social network tailored substance abuse prevention program can reduce substance use among high-risk adolescents without creating deviancy training (iatrogenic effects). A classroom randomized controlled trial comparing control classes with those receiving an evidence-based substance use prevention program [Towards No Drug Abuse (T...

The cognitive associative structure of 2 populations was studied using network analysis of free-word associations. Structural differences in the associative networks were compared using measures of network centralization, size, density, clustering, and path length. These measures are closely aligned with cognitive theories describing the organizati...

In this study, the authors compared indirect measures that attempt to quantify the level of marijuana associations among adolescents. They also evaluated whether these various methods overlap or tap different aspects of associative processes that may act in concert to influence marijuana use. Automatic drug-relevant associations were assessed in 12...

Cronbach's a is widely used in social science research to estimate the internal consistency of reliability of a measurement scale. However, when items are not strictly parallel, the Cronbach's a coefficient provides a lower-bound estimate of true reliability, and this estimate may be further biased downward when items are dichotomous. The estimatio...

This pilot study demonstrates that it is feasible to administer brief individualized interventions on alternative high school campuses to students who are at risk of substance abuse. Students actively participated in brief motivational interviews and showed some improvement in five of nine outcomes at three-month follow-ups.

This paper presents a review and a model of the development of addictive behaviors in (human) adolescents, with a focus on alcohol. The model proposes that addictive behaviors develop as the result of an imbalance between two systems: an appetitive, approach-oriented system that becomes sensitized with repeated alcohol use and a regulatory executiv...

Extensive recent research has begun to unravel the more implicit or automatic cognitive mechanisms in addiction. This effort has increased our understanding of some of the perplexing characteristics of addictive behaviors. The problem, often, is not that substance abusers do not understand that the disadvantages of continued use outweigh the advant...

Addiction research has a long history, but it is only recently that experimental psychologists and neuroscientists have begun to investigate the cognitive aspects of addictive behaviours. This has revealed a complex inter-play of cognitive mechanisms that subserve subjective experiences associated with addiction, such as drug craving. This has led...

Drug-use myths, questionable beliefs regarding the effects of drug use, may help to explain why people engage in self-injurious drug-use behavior. While clinicians and applied social researchers have used this concept of drug-use myths extensively when developing substance abuse prevention or cessation programs, drug belief-type myth measures have...

This study investigated the moderating influence of expectancy accessibility on the relation between outcome expectancies and drug use intentions. Specifically, it was hypothesized that expectancies made temporarily more accessible would predict smokeless tobacco intentions to a greater degree than would less accessible expectancies. In addition, i...

This study provides a cross-sectional analysis of the relations between group self-identification and adolescent drug use in 3 samples of youth: comprehensive high-school, continuation high-school, and runaway/street youth. Youth identified with discrete groups in all 3 samples, and similar general groups were formed. In most comparisons, a high-ri...

Theories of cognitive processes and risk behavior have not usually addressed spontaneous forms of cognition that may co-occur with, or possibly influence, behavior. This study evaluated whether measures of spontaneous cognition independently predict HIV risk behavior tendencies. Whereas a trait-centered theory suggests that spontaneous cognitions a...