Understanding the Relationship Between Religiousness, Spirituality, and Underage Drinking: The Role of Positive Alcohol Expectancies

Research has consistently found that religiousness and spirituality are negatively associated with underage drinking. However, there is a paucity of research exploring the mechanisms by which these variables influence this important outcome. With 344 underage young adults (ages 18–20; 61 % women), we investigated positive alcohol expectancies as a mediator between religiousness and spirituality (measured separately) and underage alcohol use. Participants completed the Religious Commitment Inventory-10, Daily Spiritual Experiences Scale, Alcohol Expectancies Questionnaire, and Drinking Styles Questionnaire. Results indicate less positive alcohol expectancies partially mediate the relationship between both religiousness and spirituality and underage alcohol use. This suggests religiousness and spirituality’s protective influence on underage drinking is partly due to their influence on expectations about alcohol’s positive effects. Since underage drinking predicts problem drinking later in life and places one at risk for serious physical and mental health problems, it is important to identify specific points of intervention, including expectations about alcohol that rise from religious and spiritual factors.     

Comorbid interpretation and expectancy bias in social anxiety and alcohol use

Background: In two studies, the present research examined whether being high in both social anxiety and alcohol use disorder symptoms is associated with a comorbid interpretation and expectancy bias that reflects their bidirectional relationship.

Design: Cross-sectional, quantitative surveys.

Methods: Measures of social anxiety and alcohol use disorder symptoms, as well as an interpretation and expectancy bias task assessing biases for social anxiety, drinking, and comorbid social anxiety and drinking.

Results: In Study 1 (N?=?447), individuals high (vs. low) in social anxiety had stronger social threat bias and individuals high (vs. low) in alcohol use disorder symptoms had stronger drinking bias. Those high in both social anxiety and alcohol use disorder symptoms endorsed interpretations and expectancies linking social interaction with alcohol use. Comorbid bias predicted membership into the high social anxiety/drinking group, even after taking into account single-disorder biases. In Study 2 (N?=?325), alcohol use disorder symptoms predicted drinking bias and social anxiety symptoms predicted social anxiety bias. Alcohol use disorder symptoms, social anxiety symptoms, and their interaction predicted comorbid interpretation and expectancy bias.

Conclusion: Results indicate unique cognitive vulnerability markers for persons with comorbid social anxiety and alcohol use disorder symptoms, which may improve detection and treatment of this serious comorbidity.     

Reducing Youth Access to Alcohol: Findings from a Community-Based Randomized Trial

Underage drinking continues to be an important public health problem and a challenge to the substance abuse prevention field. Community-based interventions designed to more rigorously control underage access to alcohol through retailer education and greater enforcement of underage drinking laws have been advocated as potentially effective strategies to help address this problem, but studies designed to evaluate such interventions are sparse. To address this issue we conducted a randomized trial involving 36 communities to test the combined effectiveness of five interrelated intervention components designed to reduce underage access to alcohol. The intervention was found to be effective in reducing the likelihood that retail clerks would sell alcohol to underage-looking buyers, but did not reduce underage drinking or the perceived availability of alcohol among high school students. Post hoc analyses, however, revealed significant associations between the level of underage drinking law enforcement in the intervention communities and reductions in both 30-day use of alcohol and binge drinking. The findings highlight the difficulty in reducing youth drinking even when efforts to curtail retail access are successful. Study findings also suggest that high intensity implementation of underage drinking law enforcement can reduce underage drinking. Any such effects of enhanced enforcement on underage drinking appear to be more directly attributable to an increase in perceived likelihood of enforcement and the resultant perceived inconveniences and/or sanctions to potential drinkers, than to a reduction in access to alcohol per se.     

Effects of physical and verbal aggression,depression, and anxiety on drinking behavior of married partners: a prospective and retrospective longitudinal examination

In an ethnically diverse sample of 195 married couples, we conducted a latent factor growth analysis to investigate the longitudinal link (4 time points over 4½ years) between marital aggression (physical and verbal aggression self‐ and partner‐reports) and individual internalizing symptoms (depression and anxiety) as they relate to trajectories of alcohol use among husbands and wives. Alcohol use was operationalized as a latent factor with self‐ and partner reports of problem drinking as measured by the Michigan Alcoholism Screening Test and the Alcohol Dependence Scale. Verbal aggression by husbands or wives, by itself, has no effect on their alcohol use over time. In conjunction with depression, however, verbally aggressive husbands do have elevated drinking levels. The effects of husbands' and wives' physical aggression on their own and their partners' drinking behavior were also significant. This study is one of the first to examine the change over time in alcohol use for marital partners as related to marital aggression and internalizing symptoms. Our results shed light on areas of marital functioning (aggression, internalizing, alcohol use) that have not been investigated in conjunction with each other in a longitudinal design. Aggr. Behav. 35:296–312, 2009. © 2009 Wiley‐Liss, Inc.     

The relationship of microaggressions with alcohol use and anxiety among ethnic minority college students in a historically White institution

Little is known about how microaggressions may impact the health and mental health of college students of color attending historically White universities. In this study, students provided self-report of the number of racial and ethnic microaggressions they had experienced over the previous month, as well as data on anxiety symptoms (Beck Anxiety Inventory), alcohol consumption (Daily Drinking Questionnaire) and consequences (Rutgers Alcohol Problem Index), and self-efficacy to cope with daily hassles (General Self-efficacy Scale) and with high risk drinking situations (Situational Confidence Questionnaire). As expected, students of color reported significantly more microaggressions than their European American counterparts. Microaggressions and self-efficacy were significantly associated with anxiety (Full Model R2 = .20; p < .001), microaggressions and self-efficacy were significantly associated with binge drinking (Full Model R2 = .10; p < .01), and microaggressions, binge drinking events, self-efficacy, and microaggressions × self-efficacy interaction were significantly associated with alcohol related consequences (Full Model R2 = .28; p < .001) among the students of color. Results suggest that microaggressions may represent a health and mental health risk to students of color. Implications of study results and future research directions are discussed.     

The relationship between self-efficacy,readiness to change,and AUDIT risk levels in a sample of active duty emergency department patients

The purpose of this study was to test the relationship between self-efficacy, readiness to change, and Alcohol Use Disorders Identification Test (AUDIT) risk levels in a sample of active duty drinkers who were seeking care in a military emergency department. Civilian health educators screened participants for alcohol use with the AUDIT and collected sociodemographic, service, and drinking-related cognitions data from active duty patients admitted to an emergency department. A total of 787 active duty military personnel participated in the study. Almost half (48%) drank at least once a week and 32% reported consuming five or more alcoholic drinks during a typical drinking episode. One in five participants reported heavy episodic drinking weekly to almost daily. Results of a multinomial logistic regression model showed that active duty service members with a self-reported diagnosis of posttraumatic stress disorder since joining the military were more likely to be an at-risk or high/severe risk drinker relative to a low risk drinker. Higher controlled drinking self-efficacy was associated with a decrease in the odds of being either an at-risk or high/severe risk drinker. Increased readiness to reduce drinking was associated with an increase in the odds of being either an at risk or high/severe risk drinker. The results of this research suggest self-efficacy to control one’s heavy drinking as well as readiness to change may be important factors to consider when designing alcohol education programs within the military.     

Increased sensitivity to the disinhibiting effects of alcohol in binge drinkers.

Heavy episodic alcohol use, or binge drinking, is a serious public health problem. Binge drinking is endemic in college students and has resulted in numerous alcohol-related tragedies, including acute alcohol poisonings, falls, and automobile collisions. Such negative outcomes might occur because binge drinkers are generally more impulsive, and this impulsivity might be exacerbated under alcohol. The purpose of this study was to examine this hypothesis by comparing the acute effects of alcohol on a cognitive measure of behavioral control in binge and nonbinge drinkers. The results indicated that binge drinkers act more impulsively and report feeling more stimulated under an acute 0.65 g/kg dose of alcohol compared to nonbinge drinkers. The present finding of a heightened disinhibitory reaction to alcohol in binge drinkers may help explain the link between impulsivity and problem drinking at a more fundamental level of behavioral control.     

Bullying Victimization and Use of Substances in High School: Does Religiosity Moderate the Association?

Alcohol, tobacco and other drug use continue to pose serious public health concerns among youth. Bullying victimization has been identified as a risk factor and religiosity a protective factor for adolescent substance use. No previous research has examined the potential moderating role of religiosity. We explore the association between bullying victimization and substance use in adolescents with low and high levels of religiosity. A cross-sectional survey was conducted with a representative sample of high school students in greater Beirut. Binary and multinomial logistic models were used, adjusting for demographics, and stratified by level of religiosity. Of the 986 students responding to the survey, 65% were females; 48% had experienced some form of bullying; and 52% self-rated as low in religiosity. Between 10 and 30% were current users of alcohol or tobacco. Students of lower religiosity levels who had been bullied were more likely to use substances than those who self-rated as high religiosity. Religiosity may be a potential moderator of the association between being bullied and substance use, but the exact mechanisms and underlying reasons need further investigation.

     

Resisting temptation: alcohol specific self-efficacy mediates the impacts of compensatory health beliefs and behaviours on alcohol consumption

Awareness of health risks linked with excessive alcohol consumption appears to have little influence on how much some people drink. Compensatory health beliefs (CHBs), in which the consequences of unhealthy behaviour are considered to be neutralised by additional healthy behaviours, are one way of justifying poor health choices. Currently, the role of CHBs within the context of drinking behaviour is not well understood. This research examined associations between alcohol specific compensatory health beliefs (ACH-Beliefs) and behaviours (ACH-Behaviours), alcohol consumption and alcohol specific self-efficacy (ASE), via an online survey completed by 249 participants, aged 18 + years (63.1% female; M age = 41.62 years; SD = 14.80). Higher ACH-Beliefs were associated with increases in ACH-Behaviours. While both predicted alcohol consumption, a greater proportion of variance was explained by ACH-Behaviours. ASE was a significant mediator of those relationships, suggesting that those with higher ASE may be better equipped to regulate drinking behaviour. Recommendations for future research include measuring both CHBs and behaviours within an experimental design, and further investigation of related cognitions such as compensatory behaviour intentions. Alcohol misuse interventions may wish to consider the potential roles of CHBs and behaviours in facilitating maladaptive coping strategies, and how addressing these may reduce harms.     

A multiple mediation model of trait worry and hazardous drinking among treatment-seeking smokers: the roles of coping and conformity drinking motives

ABSTRACT

Alcohol use is associated with poorer smoking cessation-related outcomes, and smokers with elevated levels of worry experience greater smoking cessation problems. Yet, little is known about the explanatory mechanisms that may underlie the relationship between trait worry and hazardous drinking among smokers. Therefore, this study explored the explanatory roles of coping and conformity drinking motives in the relationship between trait worry and hazardous drinking outcomes including alcohol consumption, alcohol problems, maximum number of drinks, and the number of prior alcohol quit attempts among treatment-seeking smokers. Participants included 377 treatment-seeking smokers who consumed at least one alcoholic drink in the last year (48% female; 86.2% Caucasian; M _age = 34.83 years, SD = 13.38). Results showed a significant indirect effect of trait worry through coping-related drinking motives in relation to alcohol consumption, alcohol problems, maximum number of drinks, and number of prior drinking quit attempts. These findings were evident after controlling for gender, cigarette dependence, and current psychopathology. These findings suggest that coping drinking motives are one mechanism that may explain the relation between trait worry and hazardous drinking outcomes among treatment-seeking smokers.     

Possible contributors to the gender differences in alcohol use and problems

Research on alcohol use and problems has demonstrated a much higher rate of alcohol use disorders (AUDs) among men compared with women. The authors review the most frequently researched biological and psychosocial factors that may play a role in the gender differences in alcohol use and problems. Among the biological factors, women might carry a lower genetic risk for AUDs and tend to suffer more negative biological consequences from drinking as compared with men. Regarding psychosocial factors, men appear to be more likely than women to manifest certain risk factors for alcohol use and problems (e.g., fewer perceived social sanctions for drinking, positive expectancies for alcohol use, personality traits such as impulsivity) and have fewer protective factors. Although these findings have helped to explain some of the gender differences in alcohol use and problems, there are inconsistencies in the literature. Additionally, many studie may not have enough statistical power to detect gender differences. The authors suggest that the biological and social consequences of alcohol abuse for women may be especially potent protective factors against AUDs and discuss the possibility of public health campaigns developed on the basis of this idea.     

Motives and Consequences of Alcohol Use in People With Social Anxiety Disorder: A Daily Diary Study

People with social anxiety disorder (SAD) are at increased risk for alcohol-related problems. Most research exploring social anxiety and alcohol use has examined negative drinking consequences, with less consideration of positive consequences—namely positive social experiences—that may reinforce alcohol use. In this daily diary study, we examined how adults diagnosed with SAD (N = 26) and a psychologically healthy control group (N = 28) experienced positive drinking consequences in naturally occurring drinking episodes during the study period. For 14 consecutive days, participants answered questions about alcohol use, motives for drinking, and positive consequences of drinking. On days when participants drank, those with SAD were more likely than healthy controls to perceive a reduction in anxiety, but the two groups did not differ in their likelihood of experiencing positive social drinking consequences. For both groups, on days when they were more motivated to drink to enhance social experiences (affiliation motives) or cope with distress (coping motives), they were more likely to obtain positive consequences from drinking. Compared to controls, participants with SAD endorsed stronger trait and daily coping motives (anxiety-coping, social anxiety-coping, and depression-coping). Results are discussed in the context of reinforcement mechanisms that may maintain social anxiety and alcohol use.     

Affordances for drinking alcohol: A non‐participant observation study in licensed premises

Alcohol misuse is a pressing area of public health concern. This non‐participant observational study investigated the functional characteristics of on‐licensed premises where alcohol is consumed. Seven different licensed premises from South Central England were visited and observed for similar three hour periods on Saturday evenings. Observations within these ecological niches were grouped using a functional taxonomy of affordances and effectivities related to alcohol drinking. Affordances provide a theoretically grounded and useful concept for evaluating how individuals behave in drinking contexts, while identifying action opportunities for inhibiting and promoting consumption. Identified alcohol‐related affordances were related to: Alcohol access, regulations, furnishing, alternative opportunities for action, décor and lighting, drink and accessory availability, and action opportunities provided by others. This research has implications for understanding alcohol consumption in real‐time, social environments, with direct implications for preventing excessive consumption within community alcohol outlets.     

Aggression is associated with greater subsequent alcohol consumption: A shared neural basis in the ventral striatum

Alcohol use and abuse (e.g., binge drinking) are among the most reliable causes of aggressive behavior. Conversely, people with aggressive dispositions (e.g., intermittent explosive disorder) are at greater risk for subsequent substance abuse. Yet it remains unknown why aggression might promote subsequent alcohol use. Both aggressive acts and alcohol use are rewarding and linked to greater activity in neural reward circuitry. Through this shared instantiation of reward, aggression may then increase subsequent alcohol consumption. Supporting this mechanistic hypothesis, participants’ aggressive behavior directed at someone who had recently rejected them, was associated with more subsequent beer consumption on an ad‐lib drinking task. Using functional MRI, both aggressive behavior and beer consumption were associated with greater activity in the bilateral ventral striatum during acts of retaliatory aggression. These results imply that aggression is linked to subsequent alcohol abuse, and that a mechanism underlying this effect is likely to be the activation of the brain's reward circuitry during aggressive acts.

     

Eliminating Categorical Exclusion Criteria in Crisis Standards of Care Frameworks

Abstract

During public health crises including the COVID-19 pandemic, resource scarcity and contagion risks may require health systems to shift—to some degree—from a usual clinical ethic, focused on the well-being of individual patients, to a public health ethic, focused on population health. Many triage policies exist that fall under the legal protections afforded by “crisis standards of care,” but they have key differences. We critically appraise one of the most fundamental differences among policies, namely the use of criteria to categorically exclude certain patients from eligibility for otherwise standard medical services. We examine these categorical exclusion criteria from ethical, legal, disability, and implementation perspectives. Focusing our analysis on the most common type of exclusion criteria, which are disease-specific, we conclude that optimal policies for critical care resource allocation and the use of cardiopulmonary resuscitation (CPR) should not use categorical exclusions. We argue that the avoidance of categorical exclusions is often practically feasible, consistent with public health norms, and mitigates discrimination against persons with disabilities.     

Stress-Induced Drinking in Parents of Boys with Attention-Deficit-Hyperactivity Disorder: Heterogeneous Groups in an Experimental Study of Adult-Child Interactions

Research on whether parents of children with externalizing disorders are at elevated risk for alcohol problems is equivocal. To reduce this ambiguity, we examined how individual differences in stress reactivity might moderate the drinking behavior of such parents. Parents (119 mothers, 44 fathers) of ADHD sons interacted with different child confederates during each of two counter-balanced sessions. In one, the confederate portrayed a friendly, cooperative, “normal” boy; in the other, the confederate portrayed a “deviant” boy who exhibited behavior characteristic of externalizing disorders. Following each interaction, parents were given an opportunity for ad lib consumption of alcohol while anticipating a second interaction. Latent class analysis identified three subgroups of parents using distress scores and alcohol consumption: minimal stress reactivity; reacts to child deviance with increased distress, but not increased drinking; marked stress-induced drinking. Decisions about the nature and proper treatment of parents raising children with ADHD may be compromised by failure to attend to individual differences in stress reactivity and inclinations to use drinking to cope.     

Drinking,drug use and road rage in Turkish drivers

Alcohol or drug use and road rage behaviors in drivers are threats to traffic safety. The purpose of this research is to examine the relationship between alcohol or drug use and aggression in Turkish drivers, and to evaluate the mediating role of driving anger in this relationship. 270 amateur and professional Turkish drivers (170 male, 100 female) have filled up Driving Anger Scale (DAS), Driver Aggression Indicators Scale (DAIS), Alcohol Use Disorders Identification Test (AUDIT) and the Questionnaire Form. 15.9% of the participants scored 8 and higher on the AUDIT scale (alcohol problem). The most prevalent substance is cannabis, used at least once in a lifetime (20%). The results of mediated regression analysis indicates that driving anger has an increasing mediating role in the relationship between alcohol use and driver aggression. Due to limitations in the data, we could not reveal the relationship between substance use and driver aggression. These findings have led us to think that drinking use may contribute to being a perpetrator and/or a victim of the road rage. Taking precautions against drinking driving and road rage and going over the current implementations is important in order to create a safer traffic environment. Scientific researches carried out in this field must aim to provide the desired efficiency on prevention and intervention programs that reduce the prevalance of such dangerous acts.     

Getting a grip on drinking behavior: training working memory to reduce alcohol abuse

Alcohol abuse disrupts core executive functions, including working memory (WM)--the ability to maintain and manipulate goal-relevant information. When executive functions like WM are weakened, drinking behavior gets out of control and is guided more strongly by automatic impulses. This study investigated whether training WM restores control over drinking behavior. Forty-eight problem drinkers performed WM training tasks or control tasks during 25 sessions over at least 25 days. Before and after training, we measured WM and drinking behavior. Training WM improved WM and reduced alcohol intake for more than 1 month after the training. Further, the indirect effect of training on alcohol use through improved WM was moderated by participants' levels of automatic impulses: Increased WM reduced alcohol consumption in participants with relatively strong automatic preferences for alcohol. These findings are consistent with the theoretical framework and demonstrate that training WM may be an effective strategy to reduce alcohol use by increasing control over automatic impulses to drink alcohol.     

Stages of change for health-related behaviours in 18 year-old Australians

Abstract

This study investigated the validity of a Stages of Change algorithm with respect to independent measures of physical activity and fitness. dietary intake and alcohol consumption in 18 year-old Ausmlian men (n = 301) and women (n = 282). Stage of Change categories were related to fat and fibre intakes in men and fibre intake in women as well as hit and vegetable intakes in men and women. Physical activity and fitness for men and women also showed significant linear associations with Stage of Change categories. Alcohol consumption was significantly associated with Stage of Change categories for men but not for women although recorded alcohol consumption was very variable for women. However, the algorithm was valid for both men and women when drinking alcohol consistent with national guidelines on safe drinking was used. In summary, with reference to actual health behaviours, the Stages of Change algorithm was valid for young men and women for diet. physical activity and alcohol drinking. Independent behavioural data were not available for smoking behaviours. Using the algorithm, there were significant associations in men between prccontemplation status for diet and drinking and diet and physical activity, in women between diet and smoking and in both men and women between drinking and smoking. Covariance between precontemplation status for different health behaviours therefore suggests the need for multimodal interventions.     

Risk Factors for Suicidality Among a Nationally Representative Sample of High School Students

Using the 2005 Youth Risk Behavior Surveillance data (n = 13,917) of high school students, we examined the association between four domains of risk factors (alcohol/drug use, aggression, HIV risk‐related behaviors, and health problems) and indicators of suicidality (considering a suicide attempt, making a plan to attempt suicide, and actually attempting suicide). Logistic regressions showed that drug use (e.g., recent smoking, drinking before 13), victimization (e.g., threatened at school, hit by girl/boyfriend), risky sexual behavior (e.g., forced to have sex, used a condom) and two health problems (health as fair/poor, has disability/health problem) were associated with all three indicators of suicidality. These findings suggest that programs to prevent alcohol/drug use, address aggression, promote safety, and prevent unsafe sexual practices may also prevent suicidality.