Article

Challenging Implicit and Explicit Alcohol-Related Cognitions in Young Heavy Drinkers

July 2005
Addiction 100(6):806-19

DOI:10.1111/j.1360-0443.2005.01064.x

Source
PubMed

Authors:

Reinout W Wiers

University of Amsterdam

Esther van den Wildenberg

Dutch Institute for Alcohol Policy

Fren T Y Smulders

Maastricht University

To test whether an expectancy challenge (EC) changes implicit and explicit alcohol-related cognitions and binge drinking in young heavy drinkers. This is important for theoretical and practical reasons: the EC presents a critical test for the hypothesized mediational role of alcohol cognitions and the EC has been presented as a promising intervention to counter alcohol problems in heavy drinking youth. SETTING, PARTICIPANTS AND INTERVENTION: Ninety-two heavy drinking college and university students (half women) were assigned randomly to the EC or control condition (a sham alcohol experiment in the same bar-laboratory). Explicit alcohol cognitions and alcohol use were assessed with paper-and-pencil measures. Alcohol use was assessed prior to the experiment and during a 1-month follow-up. Implicit alcohol-related cognitions were assessed with two versions of the Implicit Association Test (IAT), adapted to assess implicit valence and arousal associations with alcohol. The EC resulted in decreased explicit positive arousal expectancies in men and women alike. There was some evidence for a differential reduction in implicit arousal associations, but findings depended on the version of the IAT and on the scoring-algorithm used. In men (but not in women) there was a short-lived differential reduction in prospective alcohol use (significant in week 3 of the follow-up), and this reduction was partially mediated by the decrease in explicit positive arousal expectancies. These findings suggest that an EC successfully changes explicit alcohol cognitions and that this may have short-lived beneficial effects in heavy drinking young men.

MEDICIÓN DE LAS ACTITUDES IMPLÍCITAS ASOCIADAS AL CONSUMO DE ALCOHOL EN LOS JÓVENES UNIVERSITARIOS

Article

Full-text available

Oct 2022

El consumo de alcohol se considera un problema de salud pública en la mayoría de sociedades. La investigación sobre procesos cognitivos implícitos y la conducta adictiva se ha expandido enormemente durante la última década. El conocimiento de los procesos implícitos ofrece una visión diferente frente a los tradicionales enfoques cognitivos que explicaban las conductas adictivas, ya que suponen que el comportamiento a menudo no es resultado de una decisión reflexionada que tenga en cuenta los pros y los contras conocidos por el individuo. En este trabajo pretendemos validar una herramienta en idioma español para poder identificar las actitudes positivas y negativas hacia el alcohol a nivel implícito del procesamiento en una población de estudiantes de la Universidad Técnica de Ambato. Existe una novedosa y sugerente línea de investigación en esta área, pero todos los instrumentos utilizados se han desarrollado en lengua inglesa. La importancia de validar una herramienta gratuita y libre en español que permita evaluar a nivel implícito las actitudes (positivas o negativas) asociadas al alcohol facilitará la detección temprana de jóvenes en riesgo, así como desarrollar campañas de prevención de alcohol eficaces. En definitiva, ofrecer una herramienta de libre distribución a la carrera de Psicología de la UTA, eficaz para crear y/o adaptar una tarea estándar de actitud implícita (TAI) para medir procesos cognitivos automáticos. El empleo de este tipo de tareas implícitas suponen un avance para el estudio de las ciencias humanas y se adscriben a novedosas líneas de investigación en el campo de las adicciones. Palabras clave: Alcohol, salud, prevención, procesos cognitivos implícitos, conducta adictiva, herramienta libre psicología, test de asociación implícita, TAI, validación, actitud, desafío, expectativa, dependencia y prevención ABSTRACT: Alcohol consumption is considered a public health problem in most societies. Research on implicit cognitive processes and addic- tive behaviors has increased significantly in the last decade. The knowledge of implicit processes provides a different perspective compared to traditional cognitive approaches to explain addictive behaviors, since they assume that human behavior is not the result of a reflexive decision that considers the pros and cons. In this work, we aim to validate a tool in Spanish to identify the positive and negative attitudes towards the alcohol at an implicit processing level for a population of students at the Technical University of Ambato (UTA). There exists a new and appealing research line at this area, but all the tools were developed in English language. The interest in validating our new free tool in Spanish to evaluate at an implicit level the attitude (i.e. positive or negative) towards alcohol will make easy the early detection of young population at risk. Moreover, it will also help with the development of effective prevention campaigns. In short, we aim in providing this effective free tool to create and/or adapt a standard implicit attitude task (TAI) to measure automatic cognitive processes, to the degree of Psychology in the UTA. The application of this type of task mean a new research line related with addictions and also represents advancement in the study of Social Sciences. Keywords: Alcohol, health, prevention, implicit cognitive processes, addictive behavior, psychology free tool, validation, attitu- de, expectancy challenge, Implicit Association Test (IAT), implicit cognition, mediation, dependency, and prevention.

Avoiding drunk driving with a push

Article

Full-text available

Dec 2019

Abstract The present study explores a novel approach for changing implicit attitudes toward drunk driving with behavioural training. Contrary to explicit attitudes, which people are consciously aware of and therefore can state, implicit attitudes are not necessarily consciously accessible; however, implicit attitudes also direct and affect behaviour. In order to combat problem behaviour such as drunk driving, it is, therefore, crucial to measure and target both types of attitudes. This randomised controlled study first measured implicit drunk driving attitudes. One week later, participants performed a behavioural training procedure, designed to influence implicit drunk driving attitudes, and a subsequent implicit drunk driving attitude test. We randomised young male participants into an experimental group that learned to avoid drunk driving stimuli and a control group performing a neutral version of the training setup. Results showed that behavioural training could change implicit drunk driving attitudes. However, contrary to expectations, the control group’s implicit attitudes also changed. We propose that drivers can hold both positive and negative drunk driving implicit attitudes, and a priming effect may have contributed to the results. We outline and discuss the results.

Tendencias en el estudio de la cognición implícita relacionada con el alcohol

Article

Full-text available

Jan 2017

According to the dual process model, the interaction between explicit (controlled) and implicit (automatic) cognitions would allow the understanding of irrational actions like addictive behaviors. This model has gained great popularity among addiction researchers, leading to an exponential growth in publications on implicit alcohol related cognition (IAC). Hence, the goal of this article is to identify trends in the study of IAC by means of a bibliometric and content analysis of the empirical studies published up to May, 2013. Throughout this paper, the studied topics of IAC were characterized, the most prolific countries, authors and journals were recognized, the most cited publications were detected and the most employed methods were identified.

Trends in the study of implicit alcohol related cognition

Article

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Jul 2017

The Neurophysiology of Implicit Alcohol Associations in Recently Abstinent Patients With Alcohol Use Disorder: An Event‐Related Potential Study Considering Gender Effects

Article

Full-text available

Sep 2020
ALCOHOL CLIN EXP RES

Background Neuroscientific models of alcohol use disorders (AUDs) postulate an imbalance between automatic, implicit, and controlled (conscious) processes. Implicit associations towards alcohol indicate the automatically attributed appeal of alcohol‐related stimuli. First, behavioral studies indicate that negative alcohol associations are less pronounced in patients compared to controls, but potential neurophysiological differences remain unexplored. This study investigates neurophysiological correlates of implicit alcohol associations in recently abstinent patients with AUD for the first time, including possible gender effects. Methods A total of 62 patients (40 males and 22 females) and 21 controls performed an alcohol valence Implicit Association Test, combining alcohol‐related pictures with positive (incongruent condition) or negative (congruent condition) words, while brain activity was recorded using 64‐channel electroencephalography. Event‐related potentials (ERPs) for alcohol‐negative and alcohol‐positive trials were computed. Microstate analyses investigated the effects of group (patients, controls) and condition (incongruent, congruent); furthermore, possible gender effects in patients were analyzed. Significant effects were localized with standardized low‐resolution brain electromagnetic topography analysis. Results Although no behavioral group differences were found, ERPs of patients and controls were characterized by distinct microstates from 320 ms onwards. ERPs between conditions differed only in patients with higher signal strength during incongruent trials. Around 600 ms, controls displayed higher signal strength than patients. A gender effect mirrored this pattern with enhanced signal strength in females as opposed to male patients. Around 690 ms, a group‐by‐valence interaction indicated enhanced signal strength in congruent compared to incongruent trials, which was more pronounced in controls. Conclusions For patients with AUD, the pattern, timing, and source localization of effects suggest greater effort regarding semantic and self‐relevant integration around 400 ms during incongruent trials and attenuated emotional processing during the late positive potential timeframe. Interestingly, this emotional attenuation seemed reduced in female patients, thus corroborating the importance of gender‐sensitive research and potential treatment of AUD.

The relationship between explicit and implicit attitudes towards drunk driving

Article

Full-text available

Oct 2018
PLOS ONE

Despite downward trends, driving under the influence (DUI) remains one of the most salient traffic safety problems. It is crucial to identify the processes behind a problem behaviour to target the most effective measures to address it. One way of exploring precursors of behaviour is measuring attitudes. All persons hold two types of attitudes, explicit and implicit. Although only one of these (explicit) lays the groundwork for current understandings of DUI, it is imperative to explore both types of attitudes. We explore the relationship between explicit and implicit attitudes towards DUI for the first time in the field. Explicit attitudes (what we say we mean) are measured by a questionnaire. Implicit attitudes (which are introspectively unidentified or inaccurately identified traces of past experience) are measured by the Go/No-go Association Task (GNAT) in a sample of young male drivers (n = 101). The results show a relationship between the two types of attitudes, but not completely in the expected way. Depending whether the amount of alcohol is over or under the legal limit, the relationship between explicit and implicit attitudes varies. We discuss the findings and provide directions for future investigations.

Positive Attitude Toward Alcohol Predicts Actual Consumption in Young Adults: An Ecological Implicit Association Test

Article

May 2018

OBJECTIVE: Excessive alcohol drinking, particularly among college students, is a major health concern worldwide. The implicit associations between alcohol-related concepts and affective attributes has been repeatedly postulated as a reliable predictor of these drinking behaviors. The Implicit Association Test (IAT) is considered as one of the most reliable task for measuring these associations and their impact on actual alcohol consumption. However, the majority of these tests used verbal materials as stimuli, thus being unadapted to some categories of participants. The present study aims to develop a new IAT, using pictures exclusively as stimuli, to provide a cross-cultural and language independent evaluation of implicit associations which is more closely related to real-life drinking contexts. METHODS: Sixty-five undergraduate young adults took part in this study. A new visual IAT was used to measure the implicit association between alcohol cues and alcohol-related positive attributes. Pictorial stimuli (eight neutral, eight positive), previously validated, were used to represent both target and attribute categories in seven successive experimental blocks. The IAT was followed by self-reported measures of explicit alcohol-related expectancies and alcohol consumption. RESULTS: The new IAT highlighted significant implicit associations between positively valenced and alcohol-related representations conveyed by pictures, with good internal consistency, thus proving its validity and reliability. Importantly, regression analyses showed that these implicit associations are a strong predictor of self-reported alcohol consumption. CONCLUSIONS: This visual IAT further underscores that positive implicit associations with alcohol constitute an important factor in predicting effective alcohol-related behaviors and offers a more ecological and cross-cultural way to test these associations in non-alcohol-dependent populations. Moreover, this version of the IAT might be implemented in prevention and prophylactic programs.

Implicit Alcohol and Smoking Associations among Young Adult Heavy Drinkers: Associations with Smoking Status and Alcohol-Cigarette Co-Use

Article

Full-text available

Oct 2018
MOTIV EMOTION

Implicit memory associations may play a role in motivation to use alcohol and cigarettes, but the relationship between implicit associations and co-use of alcohol and cigarettes is currently unknown. This study provided an initial examination of alcohol and smoking implicit associations among young adult drinkers who were either nonsmokers or relatively light smokers (i.e., 10 or fewer cigarettes per day) as a function of smoking frequency and daily-level alcohol-cigarette co-use. Drinkers (n = 129) completed alcohol-arousal and smoking-valence variants of the implicit association test as well as a daily-level assessment of past 90-day alcohol and cigarette use. Smokers were grouped according to whether they reported daily or nondaily smoking frequency. Results showed that although implicit alcohol-arousal associations did not differ between smokers and nonsmokers, stronger implicit alcohol-arousal associations were observed for nondaily smokers relative to daily smokers after controlling for drinking frequency. Further, implicit positive-smoking associations were stronger for smokers relative to nonsmokers. Within the subgroup of nondaily smokers, more frequent co-use of alcohol and cigarettes was associated with stronger implicit positive-smoking associations when controlling for total drinking and smoking frequency. The findings suggest that implicit alcohol and smoking associations may be linked with smoking patterns (daily vs. nondaily) and co-use of alcohol and cigarettes among young adult drinkers who are not heavy smokers, highlighting the need for more research on the role of implicit associations in the co-use of cigarettes and alcohol.

Examining the effects of gambling-relevant cues on gambling outcome expectancies

Article

Jun 2017

There is a consensus in the addictions literature that exposure to addiction-relevant cues can precipitate a desire to engage, or actual engagement, in the addictive behaviour. Previous work has shown that exposure to gambling-relevant cues activates gamblers’ positive gambling outcome expectancies (i.e. their beliefs about the positive results of gambling). The current study examined the effects of a new, arguably more ecologically valid cue manipulation (i.e. exposure to a gambling lab environment vs. sterile lab environment) on 61 regular gamblers’ explicit and implicit gambling outcome expectancies. The authors first tested the internal consistency of their implicit reaction time measure of gambling outcome expectancies, the Affective Priming Task. Split-half reliabilities were satisfactory to high (.72 to .88), highlighting an advantage of this task over other characteristically unreliable implicit cognitive measures. Unexpectedly, no predicted between-lab condition differences emerged on most measures of interest, suggesting that peripheral environmental cues that are not the focus of deliberate attentional allocation may not activate positive outcome expectancies. However, there was some evidence that implicit negative gambling outcome expectancies were activated in the gambling lab environment. This latter finding holds clinical relevance as it suggests that presenting peripheral gambling-related cues while treating problem gamblers may facilitate processing of the negative consequences of gambling.

Metadehumanization, fundamental needs and coping strategies: A comparison of drinkers at low versus high risk of alcohol use disorder

Article

Sep 2023
ALCOHOL

The interpersonal difficulties documented in chronic excessive drinking might foster the evolution towards severe alcohol use disorder (SAUD). Characterizing these interpersonal difficulties and their commonalities with patients already presenting a diagnosed SAUD is needed to develop targeted prophylactic interventions. Patients with SAUD present metadehumanization (i.e., the perception of being considered as less than human by others), which is associated with deleterious consequences (e.g., reduced fundamental needs satisfaction, increased negative emotions, reduced self-esteem, disrupted coping strategies) involved in the persistence of this disorder. No study investigated metadehumanization among individuals not diagnosed with SAUD but at high risk of alcohol use disorder. We measured metadehumanization, emotions, self-esteem, coping strategies and fundamental needs threat among such high-risk drinkers (N=86; AUDIT score higher than 15), and matched low-risk drinkers (N=100, AUDIT score < 8). Compared to low-risk drinkers, high-risk drinkers felt more dehumanized and reported increased fundamental needs threat, negative emotions, anxiety, depression, and more frequent use of both adaptive and maladaptive coping strategies, including alcohol use. Mediation analyses controlling for anxiety/depression revealed that the differences in emotions and coping strategies were explained by metadehumanization and fundamental needs threat. Despite not being diagnosed with SAUD and being untreated, high-risk drinkers are more similar to patients with SAUD than to low-risk drinkers. In view of its links with factors favoring SAUD, metadehumanization should be considered in experimental studies among high-risk drinkers and tackled by specific interventions.

Approach avoidance training versus Sham in veterans with alcohol use disorder: protocol for a randomized controlled trial

Article

Full-text available

Jul 2023
BMC PSYCHIATRY

Background Alcohol use disorder (AUD) is highly prevalent and commonly co-occurs with other psychiatric disorders among Veterans. Provisional evidence supports the use of Approach Avoidance Training (AAT) - a form of computer-delivered cognitive bias modification designed to target implicit approach bias for alcohol-related cues - as an adjunctive program to treat AUD. However, the extent to which AAT is effective for improving AUD recovery outcomes in outpatient Veteran samples and those with psychiatric comorbidities has been understudied to date. Here we describe a double-blind randomized controlled trial of AAT versus a comparison condition (Sham) being conducted in Veterans with comorbid psychiatric conditions completing outpatient standard care. Methods One hundred thirty-six Veterans currently receiving outpatient treatment for AUD will be recruited for this randomized controlled trial with parallel group assignment. Participants will be randomized to either 6 weeks of AAT (n = 68) or Sham (n = 68) training in conjunction with usual care. Assessments will occur at baseline and 6 weeks, 3 months, and 6 months post-baseline. Primary outcome variables will include functional consequences of drinking. Secondary outcome variables will include alcohol consumption, and behavioral indicators of alcohol approach bias. A subset of participants (n = 51) will also complete functional magnetic resonance imaging (fMRI) to assess neural response during an alcohol approach bias assessment. Discussion This study is the first randomized controlled trial of AAT administered as an adjunctive treatment to standard care in Veterans with AUD and comorbid psychiatric disorders. Additionally, behavioral and neuroimaging data will be used to determine the extent to which AAT targets approach bias for alcohol cues. If effective, AAT may be a promising low-cost adjunctive treatment option for individuals with AUD. Registry name AAT for Alcohol Use Disorder in Veterans. Trial registration ClinicalTrials.gov: NCT05372029; Date of Registration: 5/9/2022.

ABC-training as a new intervention for hazardous alcohol drinking: Two proof-of-principle randomized pilot studies

Article

Full-text available

Jun 2023
ADDICTION

Background and aims: ABC-training is a new intervention to encourage health behavior change that targets the automatic activation of adaptive beliefs (i.e. automatic inferences). The aim of this proof-of-principle study was to test the effectiveness of web-based ABC-training to change outcome expectancies of alcohol drinking in a sample of hazardous drinkers. Design: One exploratory and one confirmatory experiment with two between-subject conditions (online ABC- and control-training) and assessments at baseline and 1 week later (after three sessions of training). Setting: Participants recruited on Prolific Academic completed the web-based study. Participants: Adults with self-reported hazardous alcohol drinking (Experiment 1: 193 adults, United Kingdom, age mean = 46.7 years; Experiment 2: 282 adults, different nationalities, age mean = 38.3 years). Intervention and comparator: ABC-training involved completing an online task that required choosing personally relevant alternative behaviors to drinking alcohol in personally relevant antecedent contexts to attain personally important outcomes. Comparator was control-training, in which participants selected both the alternative behaviors and alcohol drinking an equal number of times. Training was completed at baseline, after 3 days and after 1 week. Measurements: Primary outcome was change in automatic and self-reported (negative/positive) outcome expectancies of alcohol drinking from baseline to after 1 week. Secondary outcomes were change in weekly alcohol consumption, self-efficacy, craving and motivation (and approach-alcohol associations in Experiment 1). Moderators were baseline outcome scores, motivation, age and alcohol dependency. Findings: Findings of this study are as follows: stronger increase in negative outcome expectancies after ABC- than control-training (Experiment 1: self-report, 95% confidence interval of difference scores (CIdiff ) = [0.04, Inf]; automatic, CIdiff = [0.01, Inf]; Experiment 2: self-report, CIdiff = [0.16, Inf]; automatic, CIdiff = [0.002, Inf]). Stronger reduction in self-reported positive outcome expectancies after ABC- than control-training (Experiment 1: CIdiff = [-Inf, -0.01]; Experiment 2: CIdiff = [-Inf, -0.21]) but mixed findings on automatic positive outcome expectancies (Experiment 1: CIdiff = [-Inf, 0.02]; Experiment 2: CIdiff = [-Inf, -0.001]). Conclusions: ABC-training may change outcome expectancies of alcohol consumption, but testing of clinically relevant effects in other samples is warranted.

Protocol for an RCT on cognitive bias modification for alcohol use disorders in a religion-based rehabilitation program

Article

Full-text available

Sep 2022

Introduction Alcohol-related cues trigger relapse in patients with alcohol use disorders (AUDs). These cues may automatically activate motivational approach tendencies. Through computerised cognitive bias modification (CBM), the tendencies of patients with AUD to approach alcohol can be reduced. The present protocol describes a training intervention with approach bias modification (ApBM) incorporating religion-related stimuli as an alternative to alcohol to improve the effectiveness of CBM in a religion-based rehabilitation centre. AUD is often related to patients’ religious attitudes in this treatment context. The religion-adapted ApBM, therefore, combines training in avoidance of alcohol-related motivational cues and an approach to religion-based motivational cues. This combination’s effectiveness will be compared with a standard ApBM and to a sham ApBM. Methods and analysis Using a double-blind multiarm parallel randomised controlled trial procedure (ratio 1:1:1), 120 patients with AUD will be randomised into 1 of 3 conditions (religion-adapted ApBM, standard ApBM or sham ApBM) with personalised stimuli. The interventions are delivered over 4 consecutive days during an inpatient detoxification programme in addition to treatment as usual. Assessments occur before the start of the training and after the fourth training session, with follow-up assessments after 1 and 4 months. A multivariate analysis of variance will be used with the primary outcomes, the percentage of days abstinent and meaning in life 4-month follow-up. Secondary outcomes include differences in reported training satisfaction and symptoms of AUD. Ethics and dissemination This study has been reviewed and approved by the Medical Research Ethics Committee Academic Medical Center Amsterdam (Reference number: 2020_251). Further, study results will be published in peer-reviewed journals and presented at international conferences. Trial registration number NL75499.018.20.

Examining Subtypes of Emerging Adult Situational Drinking: A Replication and Extension Study

Article

Full-text available

Nov 2021

Background: Emerging adulthood is associated with heavy drinking. Despite overall heavy use, studies show considerable heterogeneity in emerging adult drinking habits. Lau-Barraco and colleagues (2016 b) identified three subtypes (high, moderate, low) of emerging adult heavy drinkers based on patterns of use across common drinking situations. Heavy situational drinkers had more alcohol problems, mental health symptoms, and coping/conformity motives for alcohol use. Objective: Our goal was to replicate and extend the aforementioned study, expecting to find the same subgroups, then examining whether certain risk factors predicted subgroup membership. Methods/Results: Undergraduates (N = 497) completed online self-report measures and a latent profile analysis (LPA) found support for three similar subtypes; low, “moderate” (higher endorsement of pleasant emotion/social pressure situations, relative to the low group), and high. Univariate ANOVAs, followed by pairwise comparisons, found that heavy situational drinkers scored highest on measures of alcohol problems, problem gambling, drug use, depression, and anxiety compared to the other two groups, and consistent with previous findings. Conclusions: This study showed that emerging adults who drink heavily across various situations are likely to engage in other addictive behaviors and struggle with mental health symptoms. Identifying one’s personal risk factors and their riskiest drinking situations is critical for developing targeted intervention programs and increasing the understanding of the heterogeneous nature of drinking behaviors in emerging adults in Canada.

Drinking frequency matters: Links between consumption pattern and implicit/explicit attitudes towards alcohol.

Article

Full-text available

Jun 2021
PSYCHOPHARMACOLOGY

Rationale: Attitudes towards alcohol constitute a central factor to predict future consumption. Previous studies showed that young adults with risky alcohol consumption present positive implicit and explicit attitudes towards alcohol. Objectives: It appears crucial to disentangle the relationship between specific consumption patterns (e.g., binge drinking or moderate daily drinking) and these alcohol-related attitudes. Methods: We compared implicit/explicit positive attitudes towards alcohol among 101 university students distributed in 4 groups [control low-drinking participants (CP), daily drinkers (DD), low binge drinkers (LBD), high binge drinkers (HBD)] differing regarding alcohol consumption profile, to explore the impact of consumption characteristics on alcohol-related attitudes. Participants performed a visual version of the Implicit Association Test (evaluating implicit attitudes towards alcohol), followed by self-reported measures of explicit alcohol-related attitudes and expectancies. Results: HBD and DD (but not LBD) presented stronger implicit positive attitudes towards alcohol than CP. All drinkers explicitly considered alcohol consumption as pleasant, but only DD qualified it as something good. Conclusion: Beyond and above the quantity consumed and the presence of binge drinking habits, consumption frequency appears as a central factor associated with high implicit/explicit positive attitudes towards alcohol in young drinkers. This underlines the need to consider this factor in future studies exploring implicit/explicit attitudes, but also in the development of prevention and intervention campaigns in youth.

Subjective Responses to Alcohol in the Development and Maintenance of Alcohol Use Disorder

Article

Jan 2021

Objective: Alcohol use disorder (AUD) remains an urgent public health problem. Longitudinal data are needed to clarify the role of acute subjective responses to alcohol in the development and maintenance of excessive drinking and AUD. The authors report on 10 years of repeated examination of acute alcohol responses in the Chicago Social Drinking Project. Methods: Young adult drinkers (N=190) participated in an initial alcohol challenge (0.8 g/kg of alcohol compared with placebo) that was repeated 5 and 10 years later. They were also assessed on drinking behavior and AUD symptoms at numerous intervals across the decade. Retention was high, as 184 of the 185 (99%) nondeceased active participants completed the 10-year follow-up, and 91% (163 of 179) of those eligible for alcohol consumption engaged in repeated laboratory testing during this interval. Results: At the end of the decade, 21% of participants met criteria for past-year AUD. Individuals who reported the greatest alcohol stimulation, liking, and wanting at the initial alcohol challenge were most likely to have developed AUD 10 years later. Further, alcohol-induced stimulation and wanting increased in reexamination testing among those with the highest AUD symptoms as the decade progressed. Conclusions: Initial stimulant and rewarding effects of alcohol predicted heavy alcohol use, and the magnitude of these positive subjective effects increased over a 10-year period in those who developed AUD compared with those who did not develop the disorder. The findings demonstrate systematic changes in subjective responses to alcohol over time, providing an empirical basis for prevention, early intervention, and treatment strategies.

Implicit and explicit measures of teaching self‐efficacy and their relation to cultural heterogeneity: differences between preservice and in‐service teachers

Article

Dec 2019
J Res Spec Educ Needs

In this preliminary study, we explored preservice and in‐service teachers’ sense of teaching self‐efficacy with a well‐established questionnaire and a newly adapted implicit measure of the self‐concept Single‐Target Implicit Association Test. Teaching self‐efficacy is an important construct when it comes to the handling of culturally heterogeneous classes. Hence, teaching self‐efficacy might also contribute to teachers’ motivational orientations regarding and beliefs about ethnic minority students. Using a quasi‐experimental design, we presented preservice and in‐service teachers with both the implicit and explicit measures of teaching self‐efficacy and found no differences due to teacher expertise on the explicit measure. However, the implicit measure revealed that preservice teachers had much weaker cognitive associations between the construct of teaching self‐efficacy and their self‐concepts. Motivational orientations regarding and beliefs about ethnic minority students showed substantial correlations with the explicit measure of teaching efficacy, while the implicit measure correlated with the self‐efficacy regarding the teaching of ethnic minority students, but only for in‐service teachers. The findings highlight the importance of the consideration of implicit and explicit teaching efficacy for the teaching in culturally heterogeneous classes. These first results should inspire researchers to consider both kinds of measures in future research, particularly when investigating the relationship between teaching self‐efficacy and teachers’ beliefs about and motivational orientations regarding the inclusion of ethnic minority students.

The Impact of Nicotine Dose and Instructed Dose on Smokers’ Implicit Attitudes to Smoking Cues: An ERP Study

Article

Full-text available

Oct 2019

It is unclear whether nicotine and perceived nicotine exposure can influence automatic evaluations of cigarette stimuli. In the present study, we investigated the effects of nicotine dose and instructed dose on motivational responses to smoking cues. Forty overnight nicotine-deprived smokers completed an Implicit Association Test (IAT) at each of the four laboratory sessions in a balanced-placebo design that crossed nicotine dose (Given-NIC [given nicotine] vs. Given-DENIC [given denicotinized]) with instructed dose expectancy (Told-NIC [told-nicotine] vs. Told-DENIC. [told-denicotinized]). We measured participants' behavioral performance, including reaction time (RT) and accuracy rate, and the early posterior negativity (EPN) component using the event-related potential (ERP) technique to the target pictures. During congruent trials when the categorization condition was smoking or unpleasant, smokers had greater classification accuracy, shorter RT latency, and greater EPN amplitudes compared to the incongruent trials when the categorization condition was smoking or pleasant. The Given-NIC condition was associated with increased classification accuracy, longer RT latency, and decreased EPN amplitudes compared to the Given-DENIC condition. Similarly, the Told-NIC condition was associated with increased accuracy and decreased EPN amplitudes compared to the Told-DENIC condition, but with shorter RT latency. Cigarette-related pictures produced greater EPN amplitudes than neutral pictures. Both behavioral and ERP results suggest that smokers have negative implicit attitudes toward smoking. While both nicotine dose and expected dose facilitated stimulus categorization, there was no evidence that either factor altered smokers' negative attitudes toward smoking cues. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

An Atheist Perspective on Self-Esteem and Meaning Making While Under Death Awareness

Article

Full-text available

Aug 2019

(forthcoming in the journal Secular Studies) In accordance with Terror Management Theory research, secular beliefs can serve an important role for mitigating existential concerns by providing atheists with a method to attain personal meaning and bolster self-esteem. Although much research has suggested that religious beliefs are powerful defense mechanisms, these effects are limited or reveal more nuanced effects when attempting to explain atheists’ (non)belief structures. The possibility of nonbelief that provides meaning in the “here and now” is reinforced by the importance placed on scientific discovery, education, and social activism by many atheists. Thus, these values and ideologies can, and do, allow for empirically testable claims within a Terror Management framework. Although religious individuals can and largely do use religion as a defense strategy against existential concerns, purely secular ideologies are more effective for atheists providing evidence for a hierarchical approach and individual differences within worldview defenses. Evidence for and implications of these arguments are discussed.

An inkblot for beliefs: The Truth Misattribution Procedure

Article

Full-text available

Jun 2019
PLOS ONE

An increasing body of evidence shows the importance of accommodating relational information within implicit measures of psychological constructs. Whereas relational variants of the Implicit Association Test (IAT) have been proposed in the past, we put forward the Truth Misattribution Procedure (TMP) as a relational variant of the Affect Misattribution Procedure (AMP) that aims to capture implicit beliefs. Across three experiments, we demonstrate that TMP effects are sensitive to the relational information contained within sentence primes, both in the context of causal stimulus relations of a known truth value (e.g., “smoking causes cancer” vs. “smoking prevents cancer”), as well as in the domain of gender stereotypes (e.g., “men are arrogant” vs. “men should be arrogant”). The potential benefits of the TMP are discussed.

Delivering Personalized Protective Behavioral Drinking Strategies via a Smartphone Intervention: a Pilot Study

Article

Jun 2019

Background Smartphone-based interventions are a potentially effective way to minimize alcohol-related harm in young adult, non-dependent drinkers. This pilot study is the first to evaluate the benefits and feasibility of a personalized alcohol harm-minimization intervention delivered via smartphones. Methods Within a single-blind, randomized controlled design, 45 young adults were randomly assigned to either the intervention app (n = 25; 18 females; Mage = 21.36 years, SDage = 4.15 years) or the control app (n = 20; 18 females; Mage = 22.75; SDage = 4.41). The two primary outcomes were frequency of risky drinking and drinking-related harms, and the secondary outcome was frequency of protective behavioral strategies (PBS) use. All outcomes were measured at baseline and immediately post-intervention. Using the Enlight framework [1], usability was evaluated via structured one-on-one phone interviews with a subgroup of six participants from the intervention group (3 females; Mage = 19.5 years, SDage = 1.64). Results There was no significant reduction in the primary outcomes from baseline to post-intervention across the groups. For the secondary outcome, the application of PBS within drinking contexts increased at follow-up for those in the intervention group but not for control participants. End-users rated the app as highly usable but had some concerns with repetition of the app-recommended strategies. Conclusions This intervention, designed to reduce risky drinking behaviors among young adults, was rated as highly usable and was shown to increase the application of harm minimization strategies within drinking contexts. While the intervention and its delivery show promise, it did not appear to mitigate risky drinking behaviors. Implications of this research and future directions are discussed. Trial Registration This trial is registered at the Australian New Zealand Clinical Trials Registry: BLINDED.

The Medical Cannabis Expectancy Questionnaire: Adult Medical Marijuana Users’ Expectancies Associated with Combustible, Vaporized, and Edible Cannabis Use for Medical Purposes

Article

Jan 2019

Smoking, Implicit Attitudes, and Context-Sensitivity

Chapter

Jan 2019

This chapter focuses on implicit attitudes toward smoking and provides the first systematic review of research in this domain. Implicit attitudes are suggested to guide automatic behavior, thereby playing a pivotal role for automatic processes inherent in addictive behaviors. This chapter further explores the extent to which implicit attitudes are context-sensitive. More specifically, it reviews studies that have focused on the differential effects of external cues such as warning labels and internal cues (e.g., deprivation). Results of 32 studies show that although smokers generally have more positive implicit attitudes than non-smokers, the valence of implicit attitudes varies as a result of the applied method or stimuli. Studies reveal that implicit attitudes toward smoking partly depend on external cues, especially outcome expectancies. Similarly, internal cues affect implicit attitudes whereby the level of nicotine deprivation seems vital. Implications for intervention and future research are indicated in the discussion.

Mood and Implicit Alcohol Expectancy Processes: Predicting Alcohol Consumption in the Laboratory

Preprint

Nov 2018

Background—Implicit positive alcohol expectancy (PAEs) processes are thought to respond phasically to external and internal stimuli – including mood states – and so they may exert powerful proximal influences over drinking behavior. Although social learning theory contends that mood states activate mood-congruent implicit PAEs, which in turn lead to alcohol use, there is a dearth of experimental research examining this mediation model relative to observable drinking. Moreover, an expectancy theory perspective might suggest that, rather than influencing PAEs directly, mood may moderate the association between PAEs and drinking. To test these models, the present study examined the role of mood in the association between implicitly measured PAEprocesses (i.e., latency to endorse PAEs) and immediate alcohol consumption in the laboratory. Gender differences in these processes also were examined.Method—College students (N=146) were exposed to either a positive, negative, or neutral mood induction procedure, completed a computerized PAE reaction time (RT) task, and subsequently consumed alcohol ad libitum.Results—The mood manipulation had no direct effects on drinking in the lab, making the mediation hypothesis irrelevant. Instead, gender and mood condition moderated the association between RT to endorse PAEs and drinking in the lab. For males, RT to tension reduction PAEs was a stronger predictor of volume of beer consumed and peak BAC in the context of general arousal (i.e., positive and negative mood) relative to neutral mood. RT to PAEs did not predict drinking in the lab for females.Conclusions—The results show that PAE processes are important determinants of immediate drinking behavior in men, suggesting that biased attention to mood-relevant PAEs – as indicated by longer RTs – predicts greater alcohol consumption in the appropriate mood context. The findings also highlight the need to consider gender differences in PAE processes. This study underscores the need for interventions that target automatic cognitive processes related to alcohol use.

An Inkblot for Beliefs: The Truth Misattribution Procedure

Preprint

Full-text available

Nov 2018

An increasing body of evidence shows the importance of accommodating relational information within implicit measures of psychological constructs. Whereas relational variants of the Implicit Association Test (IAT) have been proposed in the past, we put forward the Truth Misattribution Procedure (TMP) as a relational variant of the Affect Misattribution Procedure (AMP) that aims to capture implicit beliefs. Across three experiments, we demonstrate that TMP effects are sensitive to the relational information contained within sentence primes, both in the context of causal stimulus relations of a known truth value (e.g., “smoking causes cancer” vs. “smoking prevents cancer”) , as well as in the domain of gender stereotypes (e.g., “men are arrogant” vs. “men should be arrogant”). The potential benefits of the TMP are discussed.

The Role of Attitudes in the Use of Tobacco, Alcohol, and Cannabis. In Albarracin & Johnson (Eds.), Handbook of Attitudes: Applications.

Chapter

Full-text available

May 2018

Development and evaluation of a theory- and evidence-based smartphone app to help reduce excessive alcohol consumption

Thesis

Full-text available

Apr 2017

Claire Garnett

This PhD research programme aimed to develop and evaluate a smartphone app to reduce excessive alcohol consumption and used the theoretical framework of the Behaviour Change Wheel to guide its development and evaluation. There are many different factors influencing alcohol consumption that can be targeted in an intervention to reduce excessive alcohol consumption. This thesis focuses on the cognitive and motivational factors affecting alcohol consumption. The thesis involves three stages: i) work informing intervention content to prioritise for inclusion; ii) the development of the app; and iii) evaluation of the app. The first stage involved four studies about who uses apps to reduce excessive alcohol use; how theory is currently used in existing digital alcohol interventions; people’s knowledge about how their drinking compares with others, and experts’ opinions on modules likely to be most effective in apps for reducing excessive alcohol consumption. Initial development and the first version of the app was based on pragmatic considerations as to how to deliver the intervention content, app developers’ opinion based on previous experience, previous delivery of similar intervention content, and frameworks for engagement and design. A person-based approach was taken in two usability studies conducted to inform further iterations and the final version. The app was evaluated using a factorial RCT to assess which intervention modules were most effective. The results of the trial relating to the cognitive and motivational factors suggest that the normative feedback and cognitive bias re-training modules may assist with drinking reduction and are worthy of including in an optimised app for further development and evaluation in a full-scale RCT.

Supplementary Material

Data

Full-text available

Mar 2018

The Role of Memory Associations in Excessive and Problem Gambling

Article

Aug 2017

Outcome expectancies (OEs), or beliefs about the consequences of engaging in a particular behaviour, are important predictors of addictive behaviours. In Study 1 of the present work, we assessed whether memory associations between gambling and positive outcomes are related to excessive and problem gambling. The Gambling Behaviour Outcome Association Task (G-BOAT) was administered to a sample of 96 community-recruited gamblers. On the G-BOAT, participants responded to a list of positive outcome phrases with the first two behaviours that came to mind. Those with more problematic gambling (as measured on the Problem Gambling Severity Index) and greater gambling involvement (as measured by time and money spent gambling on the Gambling Timeline Followback) responded to positive outcome phrases on the G-BOAT with more gambling-related responses. In Study 2, we administered G-BOAT to a community-recruited sample of 61 gamblers, who also completed a computerized reaction time measure of implicit gambling OEs, an explicit self-report measure of gambling OEs, and a measure of gambling frequency. Consistent with Strack and Deutch’s (2004) reflective-impulsive model, memory associations on the G-BOAT and positive OE scores on the explicit Gambling Expectancy Questionnaire each predicted unique variance in frequency of gambling behaviour. These studies are among the first to demonstrate the important role of memory associations in excessive and problem gambling.Les résultats escomptés (RE), c’est-à-dire la croyance dans les conséquences d’un comportement donné, constituent une importante variable explicative des comportements liés à la dépendance. L’étude 1 a évalué si des associations mémorielles entre le jeu et des résultats positifs sont reliées aux problèmes de jeu compulsif. La tâche d’association de résultats découlant de comportements liés au jeu (Gambling Behaviour Outcome Association Task [G-BOAT]) a été administrée à un échantillon de 96 joueurs recrutés au sein de la collectivité. Dans le cadre de la G-BOAT, une liste de locutions exprimant un résultat positif était présentée aux participants et ceux-ci devaient répondre en indiquant pour chacune des locutions les deux premiers comportements qui leur venaient à l’esprit. Ceux qui présentaient un problème de jeu plus grave (selon l’indice de jeu problématique) et qui s’adonnaient davantage au jeu (selon le suivi du temps passé à jouer et de l’argent dépensé effectué à l’aide de l’outil Gambling Timeline Followback) ont donné des réponses liées au jeu plus fréquemment que les autres. Dans le cadre de l’étude 2, la G-BOAT a été administrée à un échantillon de 61 joueurs recrutés au sein de la collectivité. Ceux-ci ont en outre fait l’objet d’une mesure informatisée du temps de réponse (TR) pour les RE liés au jeu implicites, d’une autoévaluation des RE liés au jeu explicites et d’une mesure de la fréquence des comportements liés au jeu. Conformément au modèle de réflexion et impulsion de Strack et Deutch (2004), les associations mémorielles obtenues dans le cadre de la G-BOAT et les résultats relatifs aux RE positifs obtenus dans le cadre du questionnaire sur les attentes quant au jeu ont dans les deux cas permis de prévoir une variance unique concernant la fréquence des comportements liés au jeu. Ces études fournissent ainsi un premier ensemble de données probantes relativement à l’importance des associations mémorielles dans l’apparition des problèmes de jeu compulsif.

Augmenting Outpatient Alcohol Treatment as Usual With Online Alcohol Avoidance Training: Protocol for a Double-Blind Randomized Controlled Trial

Article

Full-text available

Mar 2018

Background: Recent theoretical models emphasize the role of impulsive processes in alcohol addiction, which can be retrained with computerized Cognitive Bias Modification (CBM) training. In this study, the focus is on action tendencies that are activated relatively automatically. Objective: The aim of the study is to examine the effectiveness of online CBM Alcohol Avoidance Training using an adapted Approach-Avoidance Task as a supplement to treatment as usual (TAU) in an outpatient treatment setting. Methods: The effectiveness of 8 online sessions of CBM Alcohol Avoidance Training added to TAU is tested in a double-blind, randomized controlled trial with pre- and postassessments, plus follow-up assessments after 3 and 6 months. Participants are adult patients (age 18 years or over) currently following Web-based or face-to-face TAU to reduce or stop drinking. These patients are randomly assigned to a CBM Alcohol Avoidance or a placebo training. The primary outcome measure is a reduction in alcohol consumption. We hypothesize that TAU + CBM will result in up to a 13-percentage point incremental effect in the number of patients reaching the safe drinking guidelines compared to TAU + placebo CBM. Secondary outcome measures include an improvement in health status and a decrease in depression, anxiety, stress, and possible mediation by the change in approach bias. Finally, patients' adherence, acceptability, and credibility will be examined. Results: The trial was funded in 2014 and is currently in the active participant recruitment phase (since May 2015). Enrolment will be completed in 2019. First results are expected to be submitted for publication in 2020. Conclusions: The main purpose of this study is to increase our knowledge about the added value of online Alcohol Avoidance Training as a supplement to TAU in an outpatient treatment setting. If the added effectiveness of the training is proven, the next step could be to incorporate the intervention into current treatment. Trial registration: Netherlands Trial Register NTR5087; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5087 (Archived at WebCite http://www.webcitation.org/6wuS4i1tH).

Shame mediates the relationship between depression and addictive behaviours

Article

Feb 2018
ADDICT BEHAV

Background Alcohol and gambling problems are common in young adults. Self-medication theory states that young adults with depression drink and/or gamble to escape negative emotions. Research shows that depression is a risk factor for drinking/gambling problems, but more work is needed to examine mediators underlying these associations. One potential mediator is shame. Shame is a self-directed emotion that follows a negative life event and is characterized by intense feelings of inferiority, worthlessness, and embarrassment. Depressed individuals are especially susceptible to shame (and associated emotions). Shame has also been implicated in risk for addiction. Accordingly, we predicted that elevated shame would explain why depression is associated with both alcohol and gambling problems. Methods A longitudinal design was used to examine this hypothesis. Undergraduates (N = 210) completed self-reports of depression at baseline (Time 1) and then completed self-reports of shame, alcohol misuse, gambling problems one month later (Time 2). Results Results showed that individuals with elevated depression at Time 1 endorsed high levels of shame at Time 2, which in turn predicted more gambling (β = .038, 95% CI [.010, .087]) and alcohol problems (β = .249, 95% CI [.123, .435]) at Time 2. We found that increased levels of shame explained the effects of depression on problem drinking and gambling. Conclusions Study findings improve our understanding of the depressive pathway to addiction by providing evidence for shame as a potential mechanism of this pathway. Impact Reducing shame can be a target of clinical interventions for young adults with depression and alcohol/gambling problems. https://www-sciencedirect-com.uml.idm.oclc.org/science/article/pii/S0306460318300881

Development of alcohol expectancies and early alcohol use in children and adolescents: A systematic review

Article

Feb 2018
CLIN PSYCHOL REV

Purpose: Developmental changes in alcohol expectancies (AE) have been proposed to lead to alcohol use initiation and later alcohol use in adolescence. This systematic review aims to provide longitudinal evidence of the development of AE and the relation of AE to alcohol outcomes from childhood to late adolescence (4-18 years old). Methods: A computer-assisted search of relevant articles identified 1602 studies, of which 43 studies (conducted between 1996 and 2016) were selected. Results: First, negative AE decline and positive AE increase in early adolescence. Moreover, alcohol use (initiation) seems to strongly influence changes in AE. Second, AE predict alcohol use initiation and drinking patterns over time. Third, longitudinal predictors of AE could be divided into individual predictors (i.e., alcohol-related cognitions, psychopathology, and genetics) and environmental predictors (i.e., family, peer, and media influences). Lastly, the results indicated that AE function as mediators of the relations between the various individual and environmental predictors and adolescent's alcohol use. Conclusions: Alcohol expectancies form an important framework through which drinking behavior can be explained over time. Due to the diverse findings on the predictors of AE, future longitudinal studies should further clarify the factors that are essential in the development of AE and adolescent's later alcohol use.

Métodos indirectos para evaluar cogniciones implícitas hacia el alcohol: una revisión conceptual

Article

Full-text available

Jan 2016

ResumenDesde su aparición, en la década del 70, el Modelo del Doble Procesamiento (MDP) ha ganado una gran popularidad en diversos ámbitos de la psicología, entre ellos, en el estudio de las adicciones. Según este modelo existirían dos sistemas cognitivos: uno explícito, conciente y controlable; y otro implícito, automático y más ligado a la intuición y al afecto. El MDP se ha empleado para comprender los factores que subyacen a los comportamientos relacionados con el alcohol y en poco tiempo se produjo un crecimiento exponencial de las investigaciones que utilizan métodos indirectos para evaluar cogniciones implícitas hacia el alcohol (CIA). Si bien estos métodos comparten algunas características básicas, difieren en aspectos importantes (evidencias de validez disponibles, condiciones de administración, etc). Por ello, con este trabajo pretendemos ofrecer un panorama comprensivo de las distintas formas de evaluar la CIA. Esperamos que esta revisión resulte de utilidad no solo para los investigadores, sino también para los profesionales que se ocupan de los problemas relacionados con el alcohol en el ámbito clínico.Palabras Clave: alcohol, cogniciones implícitas, métodos indirectos, modelo del doble procesamiento, revisión. AbstractSince its emergence in the 70s, the Dual Process Model (DPM) has gained wide popularity in different fields of psychology, including the study of addictions. According to this model, there are two cognitive systems: one explicit, conscious and controllable; and another implicit, automatic and linked to intuition and affection. The DPM has been used to understand mechanisms underlying alcohol related behaviors, and quickly an exponential growth of research using indirect measures to evaluate implicit cognitions toward alcohol (ICA) occurred. While these methods share some basic features, they differ in important aspects such as validity evidence available, administration procedures, etc. Therefore, in this paper we provide a comprehensive overview of the different ways to evaluate ICA. We hope this review will be useful not only for researchers but also for professionals working in the clinical area with alcohol-related problems.Key words: alcohol, implicit cognitions, indirect measures, dual process model, review.

The Potential Usefulness of Cognitive Bias Modification (CBM) in the Treatment of Problematic Alcohol Use in Individuals with Mild to Borderline Intellectual Disability

Article

Full-text available

Feb 2017

Reinout W Wiers

The Role of Memory Associations in Excessive and Problem Gambling

Article

Dec 2016

An implicit pictorial methodology for measuring and retraining smokers' reactivity to pictures of pros and cons of smoking: Development protocol

Article

Full-text available

Oct 2016

Objectives: The last decades, there has been increased interest in the application of implicit pictorial tasks (e.g. Visual Probe Task (VPT), Approach Avoidance Task (AAT)) to target addictive behaviors. The present study reports on the development of implicit pictorial assessment and modification tasks aimed at targeting cognitive biases underlying motivational smoking-related cognitions (i.e. the pros and cons of smoking). Methods: Respondents were adult daily smokers not motivated to quit smoking within six months (N = 33). A cross-sectional four-step approach using qualitative and quantitative strategies was utilized to identify and match pictures of pros and cons of smoking. Results: The study resulted in 30 pro-con picture pairs matched on valence, arousal and complexity: the picture pairs were used to develop a VPT assessment and training for attentional biases and an AAT assessment and training for approach-avoidance biases. Conclusions: The developed measurement and training tasks will be used to explore and change cognitive biases regarding pros and cons of smoking. This may consequently influence the perceived pros and cons of smoking and yield positive effects with regard to the motivation to quit smoking.

MÉTODOS INDIRECTOS PARA EVALUAR COGNICIONES IMPLÍCITAS HACIA EL ALCOHOL: UNA REVISIÓN CONCEPTUAL INDIRECT METHODS TO ASSESS IMPLICIT COGNITIONS TOWARDS ALCOHOL: A CONCEPTUAL REVIEW

Article

Full-text available

Jan 2016

Resumen Since its emergence in the 70s, the Dual Process Model (DPM) has gained wide popularity in different fields of psychology, including the study of addictions. According to this model, there are two cognitive systems: one explicit, conscious and controllable; and another implicit, automatic and linked to intuition and affection. The DPM has been used to understand mechanisms underlying alcohol related behaviors, and quickly an exponential growth of research using implicit measures to evaluate alcohol related cognitions occurred. While these methods share some basic features, they differ in important aspects such as validity evidence available, administration procedures, etc. Therefore, in this paper we provide a comprehensive overview of the different ways to evaluate implicit alcohol related cognitions. We hope this review will be useful not only for researchers but also for professionals working in the clinical area with alcohol-related problems. Keywords: alcohol, implicit cognitions, implicit measures, dual process model, review. Desde su aparición, en la década del 70, el Modelo del Doble Procesamiento (MDP) ha ganado una gran popularidad en diversos ámbitos de la psicología, principalmente en el ámbito de las adicciones. Según este modelo existen dos sistemas cognitivos: uno explícito, conciente y controlable; y otro implícito, automático y más ligado a la intuición y al afecto. El MDP se ha empleado para comprender los factores que subyacen a los comportamientos relacionados con el alcohol y en poco tiempo se produjo un crecimiento exponencial de las investigaciones que utilizan medidas implícitas para evaluar cogniciones relacionadas hacia el consumo de alcohol. Si bien estos métodos comparten algunas características básicas, difieren en aspectos importantes (evidencias de validez disponibles, condiciones de administración, etc). Por ello, este trabajo pretende ofrecer un panorama comprensivo de las distintas formas de evaluar la cognición implícita hacia el alcohol. Esperamos que esta revisión resulte de utilidad no solo para los investigadores, sino también para los profesionales que se ocupan de los problemas relacionados con el consumo de alcohol en el ámbito clínico. Palabras clave: alcohol, cogniciones implícitas, medidas implícitas, modelo del doble procesamiento, revisión.

Evaluating the effectiveness of a smartphone app to reduce excessive alcohol consumption: Protocol for a factorial randomised control trial

Article

Full-text available

Jul 2016
BMC PUBLIC HEALTH

Background: Excessive alcohol consumption is a leading cause of death and morbidity worldwide and interventions to help people reduce their consumption are needed. Interventions delivered by smartphone apps have the potential to help harmful and hazardous drinkers reduce their consumption of alcohol. However, there has been little evaluation of the effectiveness of existing smartphone interventions. A systematic review, amongst other methodologies, identified promising modular content that could be delivered by an app: self-monitoring and feedback; action planning; normative feedback; cognitive bias re-training; and identity change. This protocol reports a factorial randomised controlled trial to assess the comparative potential of these five intervention modules to reduce excessive alcohol consumption. Methods: A between-subject factorial randomised controlled trial. Hazardous and harmful drinkers aged 18 or over who are making a serious attempt to reduce their drinking will be randomised to one of 32 (2(5)) experimental conditions after downloading the 'Drink Less' app. Participants complete baseline measures on downloading the app and are contacted after 1-month with a follow-up questionnaire. The primary outcome measure is change in past week consumption of alcohol. Secondary outcome measures are change in AUDIT score, app usage data and usability ratings for the app. A factorial between-subjects ANOVA will be conducted to assess main and interactive effects of the five intervention modules for the primary and secondary outcome measures. Discussion: This study will establish the extent to which the five intervention modules offered in this app can help reduce hazardous and harmful drinking. This is the first step in optimising and understanding what component parts of an app could help to reduce excessive alcohol consumption. The findings from this study will be used to inform the content of a future integrated treatment app and evaluated against a minimal control in a definitive randomised control trial with long-term outcomes. Trial registration: ISRCTN40104069 Date of registration: 10/2/2016.

Psycho-Social Strengthening Program for High-School Students: Targeting Female Students’ Attitudes Toward Drug Use

Article

Full-text available

May 2016

Background: Adopting caring behaviors in adolescence is very important since alcohol and drug use among teenagers has become a pressing social problem and is also a predictor of school drop-out rates and academic failure. Research has shown that there is lack of awareness about drug and alcohol use. Objectives: The present study describes a psycho-social strengthening program aimed at changing female students’ attitudes toward drug use. Patients and Methods: The research design involved an experimental group that participated in a pre-test and post-test, as well as a control group. The study population comprised female students in the first grade of high school in Tehran city during the educational year 2014 - 2015. Random cluster sampling was used to select 60 students in total. Mohammad Khani’s (2006) risk and protective factors questionnaire (RAPQ) was used to collect the data. The treatment group participated in the united nations office on drugs and crime (UNDOC) “psycho-social strengthening program in the schools” package over eleven 90-minute sessions. Covariance analysis was used to analyze the data. Results: The significance of covariance F at the level of P < 0.05 showed that psycho-social strengthening is effective in changing female students’ attitudes toward drug use. Conclusions: Given the importance of caring about high-risk behaviors and the role of psycho-social strengthening in changing female students’ attitudes toward drug use, it is better to carry out such interventions at an early age in school to ensure more preventative and sustainable effects.

Impulsivity Moderates the Effects of Movie Alcohol Portrayals on Adolescents' Willingness to Drink

Article

Full-text available

Apr 2016

This study examined impulsivity as a moderator of adolescents' reactions to positive versus negative portrayals of drinking in American movie clips. Impulsivity, along with willingness and intentions to drink in the future, were assessed in a pretest session. In the experimental sessions, adolescents viewed a series of clips that showed drinking associated with either positive outcomes (e.g., social facilitation) or negative outcomes (fights, arguments). A third group viewed clips with similar positive or negative outcomes, but no alcohol consumption. All participants then responded to an implicit measure of attentional bias regarding alcohol (a dot probe), followed by explicit alcohol measures (self-reports of willingness and intentions to drink). Hypotheses, based on dual-processing theories, were: (a) high-impulsive adolescents would respond more favorably than low-impulsive adolescents to the positive clips, but not the negative clips; and (b) this difference in reactions to the positive clips would be larger on the willingness than the intention measures. Results supported the hypotheses: Adolescents high in impulsivity reported the highest willingness to drink in the positive-clip condition, but were slightly less willing than others in the negative-clip condition. In addition, results on the dot probe task indicated that RTs to alcohol words were negatively correlated with changes in alcohol willingness, but not intention; that is, the faster their response to the alcohol words, the more their willingness increased. The results highlight the utility of a dual-processing perspective on media influence. (PsycINFO Database Record

Cognitions implicites et comportements autodestructeurs : Études des processus implicites dans les addictions et le suicide

Thesis

Oct 2018

Nina Tello

Cette thèse a pour objectif de tester la fiabilité de résultats majeurs de psychologie montrant que des mesures implicites permettraient de prédire et de changer des comportements autodestructeurs. Cela semble particulièrement important dans le contexte de crise de confiance traversé actuellement par les sciences et plus particulièrement par la psychologie. À cette fin, nous avons mené trois études préenregistrées. Dans une première série d'études, nous avons répliqué les résultats de Houben, Havermans, et Wiers (2010) montrant qu'un conditionnement évaluatif permettrait de changer l'évaluation implicite de l'alcool ainsi que les consommations d'alcool (Houben, Havermans, et al., 2010). Notre première étude, une réplication conceptuelle, ne réplique que partiellement les effets originaux. Nous ne trouvons en effet pas de réduction des biais implicites envers l'alcool après un conditionnement évaluatif ; cependant, nous répliquons l'effet montrant une réduction des consommations d'alcool. Notre deuxième étude, une réplication exacte, ne réplique aucun des deux résultats originaux. Néanmoins, nous trouvons dans cette étude une réduction des consommations d'alcool, après un conditionnement évaluatif, chez les individus ayant une consommation à risque. Une deuxième série d'études visait ensuite à tester la fiabilité et le consensus de résultats montrant qu'un test d'association implicite permettrait de discriminer les individus suicidaires et de prédire les futures tentatives de suicide (Nock et al., 2010). Pour cela, nous avons réalisé une petite méta-analyse afin de tester s'il existe un consensus dans la littérature scientifique sur la validité prédictive des mesures implicites dans les comportements suicidaires. Cette méta-analyse montre une taille d'effet moyenne dans la discrimination et la prédiction des comportements suicidaires par les mesures implicites. Enfin, dans une dernière étude qui s'est étendue sur une période de trois ans, nous avons voulu réaliser une réplication exacte des effets de Nock et al. (2010). Les résultats répliquent partiellement ceux de l'étude originale. Dans notre étude, le test d'association implicite suicide ne discrimine pas les patients suicidaires des autres patients mais prédit bien les futures tentatives de suicide à six mois au-delà des facteurs de risque habituels. Les résultats présentés dans cette thèse démontrent que les mesures implicites joueraient un rôle dans la prédiction et la modification des comportements autodestructeurs. Les implications théoriques et cliniques sont discutées.

Expectancy Challenge Interventions to Reduce Alcohol Consumption Among High School and College Students: A Meta-Analysis

Article

Full-text available

Apr 2021

Objective: Alcohol expectancies are a critical factor in the development of problematic alcohol use. Expectancy challenge (EC) interventions aim to manipulate positive alcohol expectancies to reduce or prevent alcohol use among young people. The present meta-analysis investigated the effects of ECs at changing expectations and alcohol use among high school and college students, and moderating effects of study and individual characteristics on these changes. Method: A total of 23 EC studies (N = 4,122; mean age = 19.0; 57% males) was included as they reported enough information to calculate effect sizes, had a control condition that did not receive an active intervention, and were presented as of August 1, 2020. Two independent coders coded relevant variables and calculated effect sizes at posttest using a random-effects model. Results: ECs showed significant yet small effects at modifying alcohol consumption and alcohol expectancies in the desired direction (g's ranged from -.18 to -.42). Changes in social, tension, liquid courage, and risk aggression expectancies explained significant variance in change in alcohol use. The effects of ECs at changing social, sexual, tension, and liquid courage expectancies were stronger among college students compared to high school students. More favorable results were observed for interventions delivered at a higher dose. Conclusions: ECs targeting high school and college students produce small effects at reducing alcohol use and changing alcohol expectancies. Future efforts are needed to determine under which circumstances and among which subgroups ECs are expected to produce greater effects. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Don’t drink and drive, it’s a prime: Cognitive effects of priming alcohol-congruent and incongruent goals among heavy versus light drinkers

Article

Full-text available

Jun 2020

The present experiment assessed implicit alcohol motivations and explicit alcohol expectancies following the interaction between alcohol-congruent (i.e. social drinking) versus incongruent (i.e. driving safety) goal primes and recent drinking habits among college students (n = 176). Heavy drinkers exhibited greater implicit alcohol approach and explicit tension reduction expectancies following social goal primes, while displaying greater implicit alcohol avoidance and explicit cognitive and behavioural impairment expectancies after driving safety goal primes. These findings indicate recent drinking habits interact with goal salience to influence explicit and implicit responses to alcohol, which has implications for the development of interventions to reduce college drinking.

Multiple Memory Systems, Addiction, and Health Habits: New Routes for Translational Science

Chapter

Aug 2020

Not by Associations Alone: The Role of Contextual Factors, Individual Differences, and Propositional Learning in the Malleability of Implicit Alcohol Attitudes

Article

Full-text available

May 2020
ADDICT BEHAV

Alcohol attitudes predict unique variance in drinking behavior and have been the target of manipulations and interventions to reduce high-risk alcohol use among youth and adults. However, whether these manipulations create long-lasting changes in alcohol-related attitudes and drinking behavior is unclear. The current mini-review focuses on evaluative conditioning (EC), a manipulation which pairs alcohol-related stimuli repeatedly with affectively valanced stimuli to create new semantic associations in memory; such associations underlie reflexive or impulsive behaviors like high-risk alcohol use. Across experimental studies, EC has been shown to promote negative alcohol attitudes and reduce alcohol consumption. However, recent evidence suggests the effectiveness of EC may depend on the depth of learning facilitated during the task, which may strengthen the semantic associations through propositional learning. While researchers have experimentally promoted greater depth of learning through the manipulation of contextual factors, we review evidence that alcohol-related individual differences also impact the effectiveness of alcohol EC, particularly when these factors are explicitly linked to the stimuli used during the manipulation. This review provides future directions for researchers and practitioners aiming to shape alcohol-related attitudes and behaviors. Specifically, the malleability of alcohol-related attitudes may depend on propositional learning facilitated by contextual and individual factors. Researchers and practitioners should incorporate these factors into interventions like EC aiming to reduce high-risk alcohol consumption.

Of Two Minds About Alcohol: Specific Effects of Evaluative Conditioning on Implicit, but Not Explicit, Alcohol Cognitions Among Heavy Versus Light Drinkers

Article

Full-text available

Mar 2019

Heavy episodic drinking (HED) is a dangerous and pervasive problem in college populations. Two experiments examined the asymmetric effects of evaluative conditioning (EC) on cognitions underlying HED in a nonclinical, student sample. Based on the associative-propositional evaluation (APE) model, we predicted that negative EC would result in stronger implicit alcohol avoidance motivation compared to neutral EC but would not impact explicit alcohol expectancies; further, we hypothesized stronger negative EC effects among students reporting HED compared to light drinkers. Experiment 1 supported these hypotheses. In Experiment 2, participants were required to focus on either feelings or knowledge about alcohol following EC. Replicating Experiment 1, negative EC was effective in promoting implicit alcohol avoidance motivation among students reporting HED compared to neutral EC, whereas no differences in explicit alcohol expectations or urges emerged. However, greater implicit alcohol avoidance predicted lower explicit alcohol urges among participants instructed to focus on alcohol-related feelings, but not alcohol-related knowledge, regardless of condition. Findings suggest students reporting HED, but not light drinkers, may exhibit implicit alcohol avoidance following negative EC and that instructions to focus on alcohol-related feelings may align explicit and implicit responses. Results have implications for interventions aimed at retraining implicit alcohol cognitions among college students. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Altering micro-environments to change population health behaviour: towards an evidence base for choice architecture interventions.

Article

Full-text available

Dec 2013

Background The idea that behaviour can be influenced at population level by altering the environments within which people make choices (choice architecture) has gained traction in policy circles. However, empirical evidence to support this idea is limited, especially its application to changing health behaviour. We propose an evidence-based definition and typology of choice architecture interventions that have been implemented within small-scale micro-environments and evaluated for their effects on four key sets of health behaviours: diet, physical activity, alcohol and tobacco use. Discussion We argue that the limitations of the evidence base are due not simply to an absence of evidence, but also to a prior lack of definitional and conceptual clarity concerning applications of choice architecture to public health intervention. This has hampered the potential for systematic assessment of existing evidence. By seeking to address this issue, we demonstrate how our definition and typology have enabled systematic identification and preliminary mapping of a large body of available evidence for the effects of choice architecture interventions. We discuss key implications for further primary research, evidence synthesis and conceptual development to support the design and evaluation of such interventions. Summary This conceptual groundwork provides a foundation for future research to investigate the effectiveness of choice architecture interventions within micro-environments for changing health behaviour. The approach we used may also serve as a template for mapping other under-explored fields of enquiry.

Relationship of nicotine deprivation and indices of alcohol use behavior to implicit alcohol and cigarette approach cognitions in smokers

Article

Dec 2016

Alcohol and smoking frequently co-occur and alcohol is a primary trigger for smoking behavior and relapse back to smoking. This study examined whether several indices of alcohol use behavior and consequences of use would be associated with changes in implicit alcohol-approach versus implicit cigarette-approach cognitions under cigarette deprived and non-deprived cognitions in a 109 smokers who drank at risky or non-risky levels. An Implicit Association Task (IAT) measured how quickly respondents paired alcohol and cigarette pictures with approach and avoid words. Regression analyses examined the associations of quantity/frequency, proportion heavy drinking days, number of DSM-IV alcohol use disorder (AUD) symptoms, and risky drinking status to IAT scores under deprived conditions, controlling for IAT order effects, non-deprived IAT score, and deprived cigarette craving and withdrawal. Interactions with craving and withdrawal intensity were also examined. Results showed a significant positive association between proportion of heavy drinking days and stronger alcohol-approach than cigarette-approach motivations when deprived. There was also a conditional association of AUD symptoms to alcohol-approach motivations among respondents reporting more intense withdrawal when deprived. Alcohol quantity and frequency, as well as risky drinking status were unrelated to change in IAT scores. Findings suggest that cigarette deprivation may magnify motivation to drink, rather than smoke, among smokers who engage in more frequent bouts of heavy drinking and who report more alcohol-related problems. Results also show relative momentary and unconscious “preference” or choice for alcohol over cigarettes in some high-risk smokers, when cigarette craving and withdrawal are high.

Impulsivity, implicit attitudes and explicit cognitions, and alcohol dependence as predictors of pathological gambling

Article

Aug 2016

Impulsivity, implicit attitudes and explicit cognitions regarding gambling, and alcohol abuse have been pointed out by past research as significant contributors to the development and maintenance of gambling disorders. In this study, we tested the relationship among these contributors and pathological gambling. Forty-four pathological gamblers (DSM-5 criteria), of whom 23 were active gamblers and 17 were alcohol dependent, were compared with 100 controls, consisting of patients with a lifetime history of alcohol use disorder in remission for at least 2 years. The following protocol was used for the comparison: National Opinion Research Center Diagnostic Screen for Gambling Disorders, Barratt Impulsiveness Scale Version 11 (BIS-11), Gambling Related Cognitions Scale (GRCS), Obsessive Compulsive Drinking Scale, Alcohol Use Disorders Identification Test, and Gambling Implicit Association Test (IAT). Impulsivity (BIS-11) and changes in implicit attitudes (IAT) were able to discriminate between pathological gamblers and controls, the latter being less impulsive and having fewer implicit attitudes towards gambling. Cognitive impulsivity (BIS-11), explicit gambling cognitions (GRCS), and alcohol dependence were able to discriminate between active and non-active pathological gamblers, the latter having less cognitive impulsivity and less explicit gambling cognitions and alcohol dependence. Using these simple tools can help clinicians in the assessment of pathological gambling.

Can alcohol make you happy? A subjective Wellbeing approach

Article

Full-text available

Mar 2016
SOC SCI MED

There are surprisingly few discussions of the link between wellbeing and alcohol, and few empirical studies to underpin them. Policymakers have therefore typically considered negative wellbeing impacts while ignoring positive ones, used gross overestimates of positive impacts via a naïve 'consumer surplus' approach, or ignored wellbeing completely. We examine an alternative subjective wellbeing method for investigating alcohol and wellbeing, using fixed effects analyses of the associations between drinking and wellbeing within two different types of data. Study 1 examines wave-to-wave changes in life satisfaction and past-week alcohol consumption/alcohol problems (CAGE) from a representative cohort of people born in Britain in 1970, utilising responses at ages 30, 34 and 42 (a sample size of 29,145 observations from 10,107 individuals). Study 2 examines moment-to-moment changes in happiness and drinking from an iPhone-based data set in Britain 2010-13, which is innovative and large (2,049,120 observations from 31,302 individuals) but unrepresentative. In Study 1 we find no significant relationship between changing drinking levels and changing life satisfaction (p = 0.20), but a negative association with developing drinking problems (-0.18 points on a 0-10 scale; p = 0.003). In contrast, Study 2 shows a strong and consistent moment-to-moment relationship between happiness and drinking events (+3.88 points on a 0-100 scale; p < 0.001), although associations beyond the moment in question are smaller and more inconsistent. In conclusion, while iPhone users are happier at the moment of drinking, there are only small overspills to other moments, and among the wider population, changing drinking levels across several years are not associated with changing life satisfaction. Furthermore, drinking problems are associated with lower life satisfaction. Simple accounts of the wellbeing impacts of alcohol policies are therefore likely to be misleading. Policymakers must consider the complexity of different policy impacts on different conceptions of 'wellbeing', over different time periods, and among different types of drinkers.

Implicit and Explicit Alcohol-Related Cognitions in Heavy and Light Drinkers

Article

Full-text available

Nov 2002

Implicit and explicit alcohol-related cognitions were measured in 2 dimensions: positive-negative (valence) and arousal-sedation, with 2 versions of the Implicit Association Test (IAT; A. G. Greenwald, D. E. McGhee, & J. L. Schwartz) and related explicit measures. Heavy drinkers (n = 24) strongly associated alcohol with arousal on the arousal IAT (especially men) and scored higher on explicit arousal expectancies than light drinkers (n = 24). On the valence IAT, both light and heavy drinkers showed strong negative implicit associations with alcohol that contrasted with their positive explicit judgments (heavy drinkers were more positive). Implicit and explicit cognitions uniquely contributed to the prediction of 1-month prospective drinking. Heavy drinkers' implicit arousal associations could reflect the sensitized psychomotor-activating response to drug cues, a motivational mechanism hypothesized to underlie the etiology of addictive behaviors.

Examining Alcohol Outcome Expectancies in Laboratory and Naturalistic Bar Settings: A Within-Subject Experimental Analysis

Article

Full-text available

Sep 2001

Using a within-subject design, this study investigated the situational-specificity hypothesis, namely that alcohol outcome expectancies (AOEs), subjective evaluations of AOEs, and the speed with which AOEs are accessed from memory vary as a function of environmental setting. Thirty-nine undergraduates (20 women), of legal drinking age, responded to the Comprehensive Effects of Alcohol questionnaire (K. Fromme, E. Stroot, & D. Kaplan, 1993) that was presented on a laptop computer in 2 counterbalanced contexts: a laboratory setting and an on-campus bar. Response latencies served as dependent measures for memory accessibility. Consistent with previous research (A.-M. Wall, S. A. McKee, & R. E. Hinson, 2000), evidence in support of the situational-specificity hypothesis was found. Specifically, environmental context influenced undergraduates’ expectations concerning alcohol’s effects and subjective evaluations of AOEs, as well as the speed with which specific AOEs were accessed from memory. Overall, these findings suggest the need for greater attention to situational variation in AOEs.

Expectancy Challenge and Drinking Reduction: Process and Structure in the Alcohol Expectancy Network

Article

Full-text available

Feb 1998

Expectancies' mediational (control) role in alcohol consumption has been supported by both correlational and experimental evidence (J. Darkes & M. S. Goldman, 1993; M. S. Goldman, P. E. Greenbaum, & J. Darkes, 1997; L. Roehrich & M. S. Goldman, 1995). This study assigned participants (n = 54) to 1 of 2 expectancy challenges targeting the expectancy dimensions of either arousal or sociability identified by B. C. Rather and M. S. Goldman (1994), or to a no-treatment control, to examine the relationship of the structure and process of change in alcohol expectancies. Both challenges resulted in reduced consumption and expectancies immediately posttreatment and 6 weeks later after a short “booster” session. These results may reflect the lack of “discrete” expectancy structure and provide further support for the exploration of these methods as a possible prevention strategy.

Implicit Social Cognition: Attitudes, Self-Esteem, and Stereotypes

Article

Full-text available

Jan 1995

Social behavior is ordinarily treated as being under conscious (if not always thoughtful) control. However, considerable evidence now supports the view that social behavior often operates in an implicit or unconscious fashion. The identifying feature of implicit cognition is that past experience influences judgment in a fashion not introspectively known by the actor. The present conclusion—that attitudes, self-esteem, and stereotypes have important implicit modes of operation—extends both the construct validity and predictive usefulness of these major theoretical constructs of social psychology. Methodologically, this review calls for increased use of indirect measures—which are imperative in studies of implicit cognition. The theorized ordinariness of implicit stereotyping is consistent with recent findings of discrimination by people who explicitly disavow prejudice. The finding that implicit cognitive effects are often reduced by focusing judges’ attention on their judgment task provides a basis for evaluating applications (such as affirmative action) aimed at reducing such unintended discrimination.

Expectancy Challenge and Drinking Reduction: Experimental Evidence for a Mediational Process

Article

Full-text available

Apr 1993

Substantial correlational evidence supports a causal (mediational) interpretation of alcohol expectancy operation, but definitive support requires a true experimental test. Thus, moderately to heavily drinking male college students were randomly assigned to 1 of 3 conditions in a pre–post design: Expectancy challenge (designed to manipulate expectancy levels), “traditional” information, and assessment-only control. Expectancy challenge produced significant drinking decreases, compared with the other 2 groups. Decreases in measured expectancies paralleled drinking decreases in the challenge condition. Significant increases in alcohol knowledge in the traditional program were not associated with decreased drinking. These experimental findings support a causal (mediational) interpretation of expectancy operation. The implications for a cognitive (memory) model of expectancies and for prevention and intervention programs for problem drinking and alcoholism are discussed.

Confidence Limits for the Indirect Effect: Distribution of the Product and Resampling Methods

Article

Full-text available

Jan 2004
MULTIVAR BEHAV RES

The most commonly used method to test an indirect effect is to divide the estimate of the indirect effect by its standard error and compare the resulting z statistic with a critical value from the standard normal distribution. Confidence limits for the indirect effect are also typically based on critical values from the standard normal distribution. This article uses a simulation study to demonstrate that confidence limits are imbalanced because the distribution of the indirect effect is normal only in special cases. Two alternatives for improving the performance of confidence limits for the indirect effect are evaluated: (a) a method based on the distribution of the product of two normal random variables, and (b) resampling methods. In Study 1, confidence limits based on the distribution of the product are more accurate than methods based on an assumed normal distribution but confidence limits are still imbalanced. Study 2 demonstrates that more accurate confidence limits are obtained using resampling methods, with the bias-corrected bootstrap the best method overall.

The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations

Article

Full-text available

Jan 1986
J PERS SOC PSYCHOL

In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators. (46 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Understanding and Using the Implicit Association Test: I. An Improved Scoring Algorithm

Article

Full-text available

Aug 2003

In reporting Implicit Association Test (IAT) results, researchers have most often used scoring conventions described in the first publication of the IAT (A. G. Greenwald, D. E. McGhee, & J. L. K. Schwartz, 1998). Demonstration IATs available on the Internet have produced large data sets that were used in the current article to evaluate alternative scoring procedures. Candidate new algorithms were examined in terms of their (a) correlations with parallel self-report measures, (b) resistance to an artifact associated with speed of responding, (c) internal consistency, (d) sensitivity to known influences on IAT measures, and (e) resistance to known procedural influences. The best-performing measure incorporates data from the IAT's practice trials, uses a metric that is calibrated by each respondent's latency variability, and includes a latency penalty for errors. This new algorithm strongly outperforms the earlier (conventional) procedure.

Sources of Implicit Attitudes

Article

Full-text available

Apr 2004

Laurie Rudman

Response latency measures have yielded an explosion of interest in implicit attitudes. Less forthcoming have been theoretical explanations for why they often differ from explicit (self-reported) attitudes. Theorized differences in the sources of implicit and explicit attitudes are discussed, and evidence consistent with each theory is presented. The hypothesized causal influences on attitudes include early (even preverbal) experiences, affective experiences, cultural biases, and cognitive consistency principles. Each may influence implicit attitudes more than explicit attitudes, underscoring their conceptual distinction.

Alcohol and Other Drug Use Among Students in 35 European Countries

Article

Full-text available

Jan 2003

Implicit and Explicit Attitudes Toward Cigarette Smoking: the Effects of Context and Motivation

Article

Full-text available

Feb 2003
J SOC CLIN PSYCHOL

Two studies examined the effects of context and motivational state on two implicit measures of attitudes toward smoking (priming [Fazio, Jackson, Dunton, & Williams, 1996] and the Implicit Association Test [IAT; Greenwald, McGhee, & Schwartz, 1998]) as well as on explicit attitudes among nonsmokers and smokers. The priming measure was sensitive to changes in the salience of different aspects of smoking and to changes in motivational state (nicotine deprivation). There were only modest relations between explicit and implicit attitudes, and the two implicit measures were generally uncorrelated. These results have implications for the complexity and ambivalence of attitudes toward smoking held by smokers and for interventions that seek to change their attitudes and smoking behavior.

Implicit Cognition in the Prediction of Substance Use Among Drug Offenders

Article

Full-text available

Dec 1998

This research evaluated the utility of motivationally relevant implicit memory measures in predicting marijuana and alcohol use in a sample of culturally diverse drug offenders. In addition, the authors examined whether cultural variables interacted with these predictive effects. Implicit memory was assessed with measures of word association (cue-behavior and outcome-behavior association) that implicitly activates drug-related memory associations to drug cues. Results indicate that the implicit memory measures used in this research were significant predictors of alcohol and marijuana use. Acculturation, ethnicity, and gender did not modify the relationships between implicit memory and substance use. The results are consistent with psychopharmacological theories contending that (a) repeated experience with drugs influences motivationally relevant associations in memory and (b) these associations perpetuate drug use. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Screening and Brief Intervention for High-Risk College Student Drinkers: Results From a 2-Year Follow-Up Assessment

Article

Full-text available

Aug 1998

This randomized controlled trial evaluated the efficacy of a brief intervention designed to reduce the harmful consequences of heavy drinking among high-risk college students. Students screened for risk while in their senior year of high school (188 women and 160 men) were randomly assigned to receive an individualized motivational brief intervention in their freshman year of college or to a no-treatment control condition. A normative group selected from the entire screening pool provided a natural history comparison. Follow-up assessments over a 2-year period showed significant reductions in both drinking rates and harmful consequences, favoring students receiving the intervention. Although high-risk students continued to experience more alcohol problems than the natural history comparison group over the 2-year period, most showed a decline in problems over time, suggesting a developmental maturational effect. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Multivariate Analysis Versus Multiple Univariate Analyses

Article

Full-text available

Mar 1989

The argument for preceding multiple analysis of variance ({anovas}) with a multivariate analysis of variance ({manova}) to control for Type I error is challenged. Several situations are discussed in which multiple {anovas} might be conducted without the necessity of a preliminary {manova}. Three reasons for considering multivariate analysis are discussed: to identify outcome variable system constructs, to select variable subsets, and to determine variable relative worth. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

In Search of the Seven Dwarves: Issues of Measurement and Meaning in Alcohol Expectancy Research

Article

Full-text available

May 1989

Barbara C. Leigh

Discusses substantive issues in predicting drinking patterns from expectancies, as well as issues of content and measurement of the scales developed to measure these expectancies. In recent years, much research has suggested that alcohol expectancies--or the beliefs that individuals hold about the effects of alcohol on their behavior, moods, and emotions--are an important factor in motivating drinking behavior. Although measures of these expectancies have consistently been shown to be correlated with measures of alcohol use, conceptual and methodological problems remain to be addressed. In order to progress in understanding this potentially important psychosocial factor in abusive and nonabusive drinking, alcohol expectancy research, which has been atheoretical in nature, should attend to potential contributions from other areas of research in psychology.

Toward the assessment of adolescent problem drinking

Article

Full-text available

Feb 1989

Longitudinal data were obtained from a nonclinical sample of 1,308 male and female adolescents covering the age range from 12 to 21. Factor analyses of 52 symptoms and/or consequences of alcohol use yielded three problem dimensions. In addition, a unidimensional, 23-item scale (the Rutgers Alcohol Problem Index, RAPI) was constructed with an internal consistency of .92. Correlations between RAPI and alcohol-use intensity were moderately strong for all age groups at each test occasion (ranging from .20 to .57), yet low enough to suggest that identification of problem drinkers requires both types of measures. The results suggest that the RAPI may be a useful tool for the standardized and efficient assessment of problem drinking during adolescence.

The Moderator-Mediator Variable Distinction in Social Psychological Research

Article

Full-text available

Dec 1986

Analysis of mediating variables in prevention and intervention research

Article

Full-text available

Feb 1994

David MacKinnon

Mediational analysis is one way to test specific hypotheses derived from theory. Although this analysis has been suggested in the prevention literature, mediation analysis rarely is conducted. As the field of prevention matures, more questions about how prevention programs work (or fail to work) will emerge. Studies of mediation can address these questions, thereby reducing the cost and enhancing the impact of prevention programs. The methods outlined here can be applied in the evaluation of primary, secondary, and tertiary prevention programs. Since most prevention studies include measurement of some mediating constructs, mediation effects can be assessed on many existing data sets. Mediation analysis can be used to test ideas about prevention.

Memory Activation and Expectancy as Prospective Predictors of Alcohol and Marijuana Use

Article

Full-text available

Feb 1997

Alan Stacy

This study examined whether indicators of drug-related memory associations predicted drug use prospectively. The predictive effects of outcome expectancies, sensation seeking, and other variables also were investigated. The results revealed that the memory association measures significantly predicted subsequent drug use. Outcome expectancies and sensation seeking predicted alcohol use, but not marijuana use. The findings suggest 2 possibly different aspects of cognition involved in drug use motivation: (a) a memory activation or implicit cognition component, representing the effects of memory associations that are prompted relatively spontaneously by the prevailing motivational and situational circumstances and (b) an outcome expectancy component, which is more likely to reflect explicit cognitions involved in introspection and deliberate decision-making processes.

Measuring Individual Differences in Implicit Cognition: The Implicit Association Test

Article

Full-text available

Jun 1998

An implicit association test (IAT) measures differential association of 2 target concepts with an attribute. The 2 concepts appear in a 2-choice task (2-choice task (e.g., flower vs. insect names), and the attribute in a 2nd task (e.g., pleasant vs. unpleasant words for an evaluation attribute). When instructions oblige highly associated categories (e.g., flower + pleasant) to share a response key, performance is faster than when less associated categories (e.g., insect & pleasant) share a key. This performance difference implicitly measures differential association of the 2 concepts with the attribute. In 3 experiments, the IAT was sensitive to (a) near-universal evaluative differences (e.g., flower vs. insect), (b) expected individual differences in evaluative associations (Japanese + pleasant vs. Korean + pleasant for Japanese vs. Korean subjects), and (c) consciously disavowed evaluative differences (Black + pleasant vs. White + pleasant for self-described unprejudiced White subjects).

Screening and brief intervention for high-risk college student drinkers: Results from a 2-year follow-up assessment

Article

Full-text available

Sep 1998

Stalking the perfect measure of implicit self-esteem: The blind men and the elephant revisited? Journal of Personality and Social Psychology, 79, 631-643

Article

Full-text available

Oct 2000

Recent interest in the implicit self-esteem construct has led to the creation and use of several new assessment tools whose psychometric properties have not been fully explored. In this article, the authors investigated the reliability and validity of seven implicit self-esteem measures. The different implicit measures did not correlate with each other, and they correlated only weakly with measures of explicit self-esteem. Only some of the implicit measures demonstrated good test-retest reliabilities, and overall, the implicit measures were limited in their ability to predict our criterion variables. Finally, there was some evidence that implicit self-esteem measures are sensitive to context. The implications of these findings for the future of implicit self-esteem research are discussed.

Performance on Indirect Measures of Race Evaluation Predicts Amygdala Activity

Article

Full-text available

Oct 2000

We used fMRI to explore the neural substrates involved in the unconscious evaluation of Black and White social groups. Specifically, we focused on the amygdala, a subcortical structure known to play a role in emotional learning and evaluation. In Experiment 1, White American subjects observed faces of unfamiliar Black and White males. The strength of amygdala activation to Black-versus-White faces was correlated with two indirect (unconscious) measures of race evaluation (Implicit Association Test [IAT] and potentiated startle), but not with the direct (conscious) expression of race attitudes. In Experiment 2, these patterns were not obtained when the stimulus faces belonged to familiar and positively regarded Black and White individuals. Together, these results suggest that amygdala and behavioral responses to Black-versus-White faces in White subjects reflect cultural evaluations of social groups modified by individual experience.

Changes in Activation of Alcohol Expectancies in Memory in Relation to Changes in Alcohol Use After Participation in an Expectancy Challenge Program

Article

Full-text available

Nov 2000

Memory model-based expectancy studies have shed light on the process by which expectancies may influence drinking but have not related changes in expectancy activation to drinking changes. In the present study, 38 undergraduates completed a drinking measure and factor-based and memory model-based expectancy measures, before and after an expectancy challenge intervention designed to alter expectancies. Expectancies were mapped into memory network format with individual differences scaling and likely paths of activation were modeled with preference mapping. Results indicated that exposure to the expectancy challenge led to a change in likely activation of expectancies for men, but not for women. In the 30 days after the intervention, alcohol use among men decreased significantly but did not change among women. Therefore, changes in likely activation corresponded to changes in drinking. These findings support a memory model conceptualization of expectancy influence on drinking.

Handbook of Implicit Cognition and Addiction

Book

Jan 2005

For the first time, research on implicit cognitive processes relevant for the understanding of addictive behaviors and their prevention or treatment is brought together in one volume! The Handbook of Implicit Cognition and Addiction features the work of an internationally renowned group of contributing North American and European authors who draw together developments in basic research on implicit cognition with recent developments in addiction research. Editors Reinout W. Wiers and Alan W. Stacy examine recent findings from a variety of disciplines including basic memory and experimental psychology, experimental psychopathology, emotion, and neurosciences.

Stalking the perfect measure of implicit self-esteem: The blind men and the elephant revisited?

Article

Oct 2000

Recent interest in the implicit self-esteem construct has led to the creation and use of several new assessment tools whose psychometric properties have not been fully explored. In this article, the authors investigated the reliability and validity of seven implicit self-esteem measures. The different implicit measures did not correlate with each other, and they correlated only weakly with measures of explicit self-esteem. Only some of the implicit measures demonstrated good test–retest reliabilities, and overall, the implicit measures were limited in their ability to predict our criterion variables. Finally, there was some evidence that implicit self-esteem measures are sensitive to context. The implications of these findings for the future of implicit self-esteem research are discussed.

Cognitive processes in alcohol use: Expectancy and the balanced placebo design

Article

Jan 1980
Adv Alcohol Subst Abuse

Alcohol expectancy theory: The application of cognitive neuroscience

Article

Jan 1999

Addictive drugs as reinforcers: Multiple partial actions on memory systems

Article

Jul 1996

N M White

This review applies some new experimental findings and theoretical ideas about how reinforcers act on the neural mechanisms of learning and memory to the problem of how addictive drugs affect behaviour. A basic assumption of this analysis is that all changes in behaviour, including those involved in drug addiction and the initiation of drug self-administration, require the storage of new information in the nervous system. Animal studies suggest that such information is processed in several (this review deals with three) more or less independent learning and memory systems in the mammalian brain. Reinforcers can interact with these systems in three ways: they activate neural substrates of observable approach or escape responses, they produce unobservable internal states that can be perceived as rewarding or aversive, and they modulate or enhance the information stored in each of the memory systems. It is suggested that each addictive drug maintains its own self-administration by mimicking some subset of these actions. Evidence supporting the notion of multiple memory systems and data on the actions of several drugs (amphetamine, cocaine, nicotine, alcohol and morphine) on these systems are briefly reviewed. The utility of the concept of ''reward'' for understanding the effects of drugs on behaviour is discussed. Evidence demonstrating actions of drugs on multiple neural substrates of reinforcement suggests that no single factor is likely to explain either addictive behaviour in general or self-administration in particular. Some of the findings on the development and maintenance of self-administration by animals of the five exemplar drugs are discussed in the context of these ideas.

Half full or half empty, the glass still does not satisfactorily quench the thirst for knowledge on alcohol expectancies as a mechanism of change [5]

Article

Jan 2001

Barry Jones

Alcohol Motivations as Outcome Expectancies

Chapter

Jan 1998

In search of the seven dwarves: Issues of measurement and meaning in alcohol expectancy research.

Article

May 1989

Barbara C. Leigh

Further Comparative Analyses of Pretest-Posttest Research Designs

Article

Nov 1983

Nan Laird

An alternative method of analysis for randomized pretest-posttest experiments is proposed. It yields treatment contrasts identical to those from ordinary analysis of covariance and also provides adjusted gain scores for each treatment group.

Using Mulivariate Statistics

Book

Jan 2012

Handbook on Implicit Cognition and Addiction

Article

Jan 2006

The Malleability of Automatic Stereotypes and Prejudice

Article

Aug 2002

The present article reviews evidence for the malleability of automatic stereotypes and prejudice. In contrast to assumptions that such responses are fixed and ines- capable, it is shown that automatic stereotypes and prejudice are influenced by, (a) self- and social motives, (b) specific strategies, (c) the perceiver's focus of atten- tion, and (d) the configuration of stimulus cues. In addition, group members' indi- vidual characteristics are shown to influence the extent to which (global) stereo- types and prejudice are automatically activated. This evidence has significant implications for conceptions of automaticity, models of stereotyping and prejudice, and attitude representation. The review concludes with the description of an initial model of early social information processing. Given a thimbleful of facts we rush to make general- izations as large as a tub. … Life is short, and the de- mands upon us for practical adjustments so great, that we cannot let our ignorance detain us in our daily transactions. (Allport, 1954, p. 9)

Applied Multiple Regression/Correlation Analysis For The Behavioral Sciences

Article

Jun 1985

Risk for Substance Abuse: Memory as a Common Etiological Pathway

Article

May 1999

Mark S. Goldman

Memory processes may be part of the causal chain by which known antecedents of alcohol and drug abuse influence drinking. Recent findings on alcohol expectancies are consistent with a memory model and help articulate how consumption may be influenced by memory representations of biological and environmental characteristics. This line of research suggests novel prevention and intervention strategies.

Government Printing Office

Article

D. C. Washington

Half full or half empty, the glass still does not satisfactorily quench the thirst for knowledge on alcohol expectancies as a mechanism of change.

Article

Nov 2001

Comments on an article by B. T. Jones et al (see record 2001-16310-005) which concerned expectancy theory and the association between alcohol outcome expectancies and consumption. The authors conclude in this recent review of expectancy research that although there are countless studies which show expectancies are associated with alcohol consumption and alcohol-related problems, there is scant evidence that changing expectancies is an effective means of changing drinking. The authors do not believe we have misrepresented the expectancy literature nor expectancy theory in any way in their review and stand by their view that there is little current evidence that changing expectancies is an effective means to change medium to long term alcohol consumption. Regardless of whether the glass is half full or half empty, the thirst for knowledge about alcohol expectancies has yet to be quenched. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Self-report issues in alcohol abuse: State of the art and future directions

Article

Jan 1990
Behav Assess

Notes that alcohol abusers' verbal self-reports are likely to be an accurate reflection of drinking behavior and examines possible research strategies for further enhancing the accuracy of self-reports and for predicting inaccurate self-reports. These strategies include (1) determining how response error can be reduced in the question-answering process, (2) developing procedures to enhance accuracy beyond normal recall, (3) determining what amount of response variability is tolerable, (4) examining group vs individual levels of agreement, and (5) investigating whether wording of questions significantly affects response. Challenges to the use of self-reports in the field of alcohol abuse are noted. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

High and low dose expectancies and the differential associations with drinking in male and female adolescents and young adults

Article

Jul 1997
ADDICTION

A Dutch questionnaire was developed consisting of positive and negative expectancies relating to low and high doses of alcohol. The associations of these four types of expectancies with current alcohol consumption were investigated in three samples: secondary school pupils of 11-15 years old, secondary school pupils of 16 and older, and university undergraduate students (total n = 554). Using restrictive factor analyses, a common factor-model of the expectancies was shown to fit adequately across subgroups. Which expectancies were associated with current alcohol consumption varied substantially across the subgroups. As expected from previous research, inclusion of high dose expectancies did not substantially improve the prediction of drinking in university students. However, positive and negative high-dose expectancies were found to be powerful predictors of current alcohol consumption in secondary school boys of 16 and older, the subgroup with the highest average alcohol consumption on each occasion. Possible implications are discussed for future research and interventions.

Binge Pattern Ethanol Exposure in Adolescent and Adult Rats: Differential Impact on Subsequent Responsiveness to Ethanol

Article

Aug 2000
ALCOHOL CLIN EXP RES

Background: Recent evidence indicates that adolescent animals are more sensitive than adults to the disruptive effects of acute ethanol exposure on spatial learning. It is not yet known whether adolescent animals are also more sensitive than adults to the enduring neurobehavioral effects of repeated ethanol exposure. In this study, animals were exposed to ethanol in a binge-pattern during either adolescence or adulthood. At a time when all subjects were adults, spatial working memory was examined in the absence and presence of an acute ethanol challenge. Methods: Rats were exposed to ethanol (5.0 g/kg intraperitoneally) or isovolumetric saline at 48 hr intervals over 20 days. Exposure began on either postnatal day 30 (adolescent group) or 70 (adult group). Twenty days after the final injection, a time at which all animals were adults, the subjects were tested on an elevated plus maze and then were trained to perform a spatial working memory task on an eight-arm radial maze. At the beginning of each session of training on the working memory task, subjects retrieved food rewards on four of the eight arms. After a delay, subjects were placed on the maze and allowed to retrieve food from the remaining four arms. Results: Prior exposure to ethanol did not influence behavior on the plus maze. Performance of the groups did not differ during acquisition of the spatial working memory task with a 5 min delay or during subsequent testing with a 1 hr delay. However, animals treated with ethanol during adolescence exhibited larger working memory impairments during an ethanol challenge (1.5 g/kg intraperitoneally) than subjects in the other three groups. Conclusions: The findings indicate that binge pattern exposure to ethanol during adolescence enhances responsiveness to the memory-impairing effects of ethanol in adulthood.

Expectancy challenge and drinking reduction: Process and structure in the alcohol expectancy network

Article

Feb 1998

Expectancies' mediational (control) role in alcohol consumption has been supported by both correlational and experimental evidence (J. Darkes & M. S. Goldman, 1993; M. S. Goldman, P. E. Greenbaum, & J. Darkes, 1997; L. Roehrich & M. S. Goldman, 1995). This study assigned participants (n = 54) to 1 of 2 expectancy challenges targeting the expectancy dimensions of either arousal or sociability identified by B. C. Rather and M. S. Goldman (1994), or to a no-treatment control, to examine the relationship of the structure and process of change in alcohol expectancies. Both challenges resulted in reduced consumption and expectancies immediately posttreatment and 6 weeks later after a short "booster" session. These results may reflect the lack of "discrete" expectancy structure and provide further support for the exploration of these methods as a possible prevention strategy.

Implicit Social Cognition: Attitudes, Self-Esteem, and Stereotypes

Article

Feb 1995

Social behavior is ordinarily treated as being under conscious (if not always thoughtful) control. However, considerable evidence now supports the view that social behavior often operates in an implicit or unconscious fashion. The identifying feature of implicit cognition is that past experience influences judgment in a fashion not introspectively known by the actor. The present conclusion--that attitudes, self-esteem, and stereotypes have important implicit modes of operation--extends both the construct validity and predictive usefulness of these major theoretical constructs of social psychology. Methodologically, this review calls for increased use of indirect measures--which are imperative in studies of implicit cognition. The theorized ordinariness of implicit stereotyping is consistent with recent findings of discrimination by people who explicitly disavow prejudice. The finding that implicit cognitive effects are often reduced by focusing judges' attention on their judgment task provides a basis for evaluating applications (such as affirmative action) aimed at reducing such unintended discrimination.

Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption-II

Article

Jul 1993

The Alcohol Use Disorders Identification Test (AUDIT) has been developed from a six-country WHO collaborative project as a screening instrument for hazardous and harmful alcohol consumption. It is a 10-item questionnaire which covers the domains of alcohol consumption, drinking behaviour, and alcohol-related problems. Questions were selected from a 150-item assessment schedule (which was administered to 1888 persons attending representative primary health care facilities) on the basis of their representativeness for these conceptual domains and their perceived usefulness for intervention. Responses to each question are scored from 0 to 4, giving a maximum possible score of 40. Among those diagnosed as having hazardous or harmful alcohol use, 92% had an AUDIT score of 8 or more, and 94% of those with non-hazardous consumption had a score of less than 8. AUDIT provides a simple method of early detection of hazardous and harmful alcohol use in primary health care settings and is the first instrument of its type to be derived on the basis of a cross-national study.

Expectancy Challenge and Drinking Reduction: Experimental Evidence for a Mediational Process

Article

May 1993

Substantial correlational evidence supports a causal (mediational) interpretation of alcohol expectancy operation, but definitive support requires a true experimental test. Thus, moderately to heavily drinking male college students were randomly assigned to 1 of 3 conditions in a pre-post design: Expectancy challenge (designed to manipulate expectancy levels), "traditional" information, and assessment-only control. Expectancy challenge produced significant drinking decreases, compared with the other 2 groups. Decreases in measured expectancies paralleled drinking decreases in the challenge condition. Significant increases in alcohol knowledge in the traditional program were not associated with decreased drinking. These experimental findings support a causal (mediational) interpretation of expectancy operation. The implications for a cognitive (memory) model of expectancies and for prevention and intervention programs for problem drinking and alcoholism are discussed.

White NM. Addictive drugs as reinforcers: multiple partial actions on memory systems. Addiction (Abingdon, England) 91: 921-949; discussion 951-965

Article

Aug 1996

Norman M. White

This review applies some new experimental findings and theoretical ideas about how reinforcers act on the neural mechanisms of learning and memory to the problem of how addictive drugs affect behaviour. A basic assumption of this analysis is that all changes in behaviour, including those involved in drug addiction and the initiation of drug self-administration, require the storage of new information in the nervous system. Animal studies suggest that such information is processed in several (this review deals with three) more or less independent learning and memory systems in the mammalian brain. Reinforcers can interact with these systems in three ways: they activate neural substrates of observable approach or escape responses, they produce unobservable internal states that can be perceived as rewarding or aversive, and they modulate or enhance the information stored in each of the memory systems. It is suggested that each addictive drug maintains its own self-administration by mimicking some subset of these actions. Evidence supporting the notion of multiple memory systems and data on the actions of several drugs (amphetamine, cocaine, nicotine, alcohol and morphine) on these systems are briefly reviewed. The utility of the concept of "reward" for understanding the effects of drugs on behaviour is discussed. Evidence demonstrating actions of drugs on multiple neural substrates of reinforcement suggests that no single factor is likely to explain either addictive behaviour in general or self-administration in particular. Some of the findings on the development and maintenance of self-administration by animals of the five exemplar drugs are discussed in the context of these ideas.

High- and low-dose alcohol-related expectancies and the differential associations with drinking in male and female adolescents and young adults

Article

Aug 1997

Prevalence of psychiatric disorder in the general population: Results of The Netherlands Mental Health Survey and Incidence Study (NEMESIS)

Article

Jan 1999

This article reports the initial results of a prospective study on the prevalence of psychiatric disorders in the Dutch population aged 18-64. The objectives and the design of the study are described elsewhere in this issue. A total of 7076 people were interviewed in person in 1996. The presence of the following disorders was determined by means of the CIDI: mood disorders, anxiety disorders, eating disorders, schizophrenia and other non-affective psychoses, and substance use disorders. Psychiatric disorders were found to be quite common. Some 41.2% of the adult population under 65 had experienced at least one DSM-III-R disorder in their lifetime, among them 23.3% within the preceding year. No gender differences were found in overall morbidity. Depression, anxiety, and alcohol abuse and dependence were most prevalent, and there was a high degree of comorbidity between them. The prevalence rate encountered for schizophrenia was lower (0.4% lifetime) than generally presumed. A comparison with findings from other countries is made. Relevant determinants of psychiatric morbidity were analysed.

Challenging Implicit and Explicit Alcohol-Related Cognitions in Young Heavy Drinkers

Abstract

No full-text available

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