The role of patients' ability to pay, gender, and smoking history on public attitudes toward cardiac transplant allocation: an experimental investigation.

This study assessed public attitudes toward organ allocation through vignettes that were varied by patient's ability to pay (insured or uninsured), gender, and smoking history (current, former, or never). Participants were 681 adults contacted at a state driver's license office who read a vignette about a heart transplant candidate and subsequently rated their likelihood and priority of offering transplantation. Results revealed main effects for patient smoking history exclusively. Post hoc analyses for likelihood of offering transplantation revealed that participants gave higher ratings for never smokers than current smokers. For priority of transplantation, analyses revealed higher ratings for never smokers than for both former smokers and current smokers. Results suggest that public opinion about organ allocation may include the consideration of smoking history but not ability to pay or gender.     

Alcoholism and the Force of Education

Education in regard to alcoholism has not been a noted success. This problem is examined by approaching the situation from a psychoanalytic view, as well as through the review of the history of the use, abuse, and prohibition of alcohol in this country. Attitudes toward alcohol share much in common with the attitudes to the other instinctual gratifications. Because of the many repressions involved, the problems of transference make their appearance in the performance of the alcoholism educator, as well as the student. The conscious avoidance of patronizing, prohibitionist, and similar attitudes might allow the teacher to present both the advantages and the dangers in the use of alcohol, and thus open the subject to more wholesome consideration.     

Prospective analysis of comorbidity: tobacco and alcohol use disorders

Alcohol use disorders (AUD) and tobacco use disorders (TD) frequently co-occur. The authors examined AUD-TD comorbidity over time using a state-trait (ST) model. The ST model represents variance in AUD/TD as a traitlike factor that spans measurement occasion and identifies distinct sources of variance in AUD-TD comorbidity. The ST model was evaluated on 450 young adults (baseline age = 18.5 years; 51% with family history of alcoholism) assessed 5 times over 7 years. The ST model demonstrated superior fit over a first-order autoregressive model. The tendency to diagnose with AUD and TD was partially explained by family history of alcoholism; this relationship was mediated by childhood stressors, alcohol expectancies, and behavioral undercontrol. Results supported a common third-variable influence (vs. directional) model of comorbidity. The ST model is an important conceptual and methodological approach to the prospective study of comorbidity in general.     

Correlates of adult and child perceptions of social competency

In this study, the relationship between two commonly used measures of social competency, peer ratings of perceived status and adult ratings of assertiveness, were examined. In Phase I, high and low sociometric status children were videotaped responding to a series of role-play scenes; performance on these scenes was then rated retrospectively by adults for overall assertiveness. In Phase II, a second group of children who were unfamiliar with the videotaped children observed the taped scenes and provided ratings of likability, intelligence, working together, and attractiveness. In general, results revealed that children and adults differed in their ratings of the videotaped children. Further, boys used different cues in their ratings than did girls. More specifically, the sociometric status of girls was related to perceived attractiveness, whereas the sociometric status of boys was more closely related to perceived intelligence. Such findings suggest that children and adults look for and use different cues in their judgments. Given these differences, it is concluded that child and adult ratings should not be used interchangeably in the assessment of, and evaluation of, social competency in children.Portions of this research were supported by a grant from the Virginia Department of Criminal Justice Services.     

Examining a brief suicide screening tool in older adults engaging in risky alcohol use

Alcohol misuse increases risk of suicidal behavior in older adults. The Depressive Symptom Inventory‐Suicidality Subscale (DSI‐SS; Metalsky & Joiner, 1997) and its relation to suicide attempt history was examined to see if it differed for older adults as a function of their alcohol use. Structural equation modeling was used in a sample (N = 1,061) of older adult outpatients to examine the scale’s measurement invariance and population heterogeneity and its relation to suicide attempt history. Analyses supported the equivalence of the DSI‐SS in risky and nonrisky drinkers. The DSI‐SS significantly predicted past suicide attempts. Findings support the viability of the DSI‐SS as suicide screening tool for older adults.     

Alcohol use disorders and psychological distress: a prospective state-trait analysis

The present study examined the association between alcohol use disorders (AUDs) and psychological distress over an 11-year period using a sample of 378 young adults (46% men, 54% women: baseline age = 18.5; 51% with paternal history of alcoholism). The authors examined this relation using a state-trait model, which decomposes variance in a given construct into a general traitlike factor that spans measurement occasion and more situational, occasion-specific variability. Trait AUD and trait distress were correlated (r =.43), suggesting that the tendency to meet criteria for an AUD is associated with the tendency to experience psychological distress. Much of this association was due to 3rd variables (primarily neuroticism but also childhood stressors and behavioral undercontrol), supporting a common 3rd-variable influence model of comorbidity.     

The relation of personality to alcohol abuse/dependence in a high-risk sample

The current study had two goals. The first goal was to test the mediational role of young adult personality in the relation between parental alcoholism and young adult alcoholism. The second was to examine the associations between personality and alcohol use motives and reasons to limit drinking in order to explore possible mechanisms by which personality may influence alcohol abuse/dependence. Multilevel modeling techniques were used to analyze data obtained from a community sample of young adult children of alcoholics and demographically matched controls. Results revealed that young adult neuroticism and agreeableness each, in part, mediated the effect of parental alcoholism on young adult alcoholism. Moreover, individuals high in neuloticism reported stronger coping motives to use alcohol, individuals low in agreeableness reported stronger coping motives and weaker upbringing reasons to limit drinking, and individuals low in conscientiousness reported stronger coping and enhancement motives to use alcohol, and weaker performance reasons to limit drinking.     

Self-Reported Use of Alcohol,Marijuana, and Hard Drugs and Aggression: A Structural Equation Modeling Analysis of an Internet Survey of Long-Term Marijuana Users

In the largest study to date investigating aggressive behavior among long-time adult concomitant marijuana and alcohol users, respondents completed an Internet survey on substance use and aggressive behavior. Aggressive acts following alcohol consumption were more frequent than aggressive acts following marijuana consumption. Structural equation modeling demonstrated that there was no relationship between marijuana and aggression once recent alcohol use, hard drug history, gender, and age were taken into account. Alcohol use and history of hard drug use were associated with increased aggression. It also appears that increased aggression among males is partially mediated by alcohol use. This model fit the data better than plausible alternative models. Although the sample characteristics limit the generalizability of these findings, our data suggest that marijuana use does not lead to aggressive behavior in adults, even among frequent, long-time users.     

Transitioning into and out of large-effect drinking in young adulthood

As individuals age beyond the college years into young adulthood, many exhibit a tendency to moderate or "mature out of" alcohol involvement. The current study classified effect-drinking statuses in young adults and examined transitions among statuses using latent transition analysis, a latent variable state-sequential model for longitudinal data. At 3 occasions over 7 years (Years 1, 4, and 7), 443 men (47%) and women (mean age of both at baseline = 18.5 years; 51% with family history of alcoholism) responded to 3 past-30-day items assessing drinking and subjective effects of drinking: whether the respondent drank alcohol, felt high, and felt drunk. Latent statuses included abstainers (14% at Year 1), limited-effect drinkers (8%), moderate-effect drinkers (23%), and large-effect drinkers (54%). Respondents with family history of alcoholism were less likely to transition out of large-effect drinking than those without family history. Men exhibited more severe initial effect-drinking statuses and lower transition probabilities into less severe effect-drinking statuses than women.     

Effects of alcohol abuse and familial alcoholism on physical health in men and women

Detoxified alcoholic men (n = 76) and women (n = 72) and nonalcoholic control men (n = 50) and women (n = 51) were given a structured interview that assessed five categories of physical health: medical history, alcohol-related disorders, trauma history, drug use history, and, for females, female-related disorders. Approximately half the subjects in each group were family history positive for alcoholism. Significant differences between alcoholics and controls were found for all five categories; family history effects were significant for four of the five categories, and sex differences were present in two categories. The results indicate that (a) alcoholics suffer pervasive physical health difficulties, (b) a family history of alcoholism is predictive of health problems in both alcoholics and controls, (c) the effects of alcohol abuse and family history of alcoholism on health appear to be independent and additive, and (d) women may be more "illness prone" than men and exhibit an increased vulnerability to the adverse effects of alcoholism.     

Effect of Cheating Experience on Attitudes toward Infidelity

The present study investigated how cheating experience influences perception of others’ infidelity. Using vignette characters, we explored the hypothesis that a participant’s experience cheating on a partner and gender of vignette character moderate gender-differentiated perceptions of infidelity (i.e., men reporting more accepting attitudes toward infidelity than women). Participants (N = 320) were asked a series of questions evaluating both how ‘acceptable’ and ‘forgivable’ was a vignette character’s infidelity. Men and women with prior experience cheating found the cheating vignette character of their same gender significantly more acceptable and forgivable than the unfaithful character of the other gender. Participants who reported no history of infidelity found infidelity as generally unacceptable, regardless of character gender.     

Characteristics of children of alcoholics: putative risk factors, substance use and abuse, and psychopathology.

A sample of 253 children of alcoholics (COAs) and 237 children of nonalcoholics (non-COAs) were compared on alcohol and drug use, psychopathology, cognitive ability, and personality. COAs reported more alcohol and drug problems, stronger alcohol expectancies, higher levels of behavioral undercontrol and neuroticism, and more psychiatric distress in relation to non-COAs. They also evidenced lower academic achievement and less verbal ability than non-COAs. COAs were given Diagnostic Interview Schedule alcohol diagnoses more frequently than non-COAs. The relation between paternal alcoholism and offspring alcohol involvement was mediated by behavioral undercontrol and alcohol expectancies. Although gender differences were found, there were few Gender X Family History interactions; the effects of family history of alcoholism were similar for men and women. When gender effects were found, they showed greater family history effects for women.     

A longitudinal study of children of alcoholics: predicting young adult substance use disorders, anxiety, and depression

This study tested the specificity of parent alcoholism effects on young adult alcohol and drug abuse/dependence, anxiety, and depression, and tested whether adolescent symptomatology and substance use mediated parent alcoholism effects. Participants were from a longitudinal study in which a target child was assessed in adolescence and young adulthood with structured interview measures (N = 454 families at Time 1). Results showed unique effects of parent alcoholism on young adult substance abuse/dependence diagnoses over and above the effects of other parental psychopathology. There was some evidence of parent alcoholism effects on young adult depression and of maternal alcoholism effects on young adult anxiety, although these were not found consistently across subsamples. Mediational models suggested that parent alcoholism effects could be partially (but not totally) explained by adolescent externalizing symptoms.     

Predicting Substance Use Patterns Among Rural Adults: The Roles of Mothers,Fathers, and Parenthood

This study examined the role of parenthood and parental influences on substance use patterns for 710 stimulant users age 18–61 living in the rural Midwest and Mid‐south U.S. Longitudinal growth analyses showed that a maternal history of drug use was associated with increased baseline drug use severity, lesser declines in severity, and greater plateau of drug use severity over time. Parental conflict was associated with lesser declines in drug use severity, and drug use severity declined more steeply for participants who were themselves parents. Participants with two parents having a history of alcohol use had a greater baseline severity of alcohol use, with paternal history of drug use associated with lower baseline alcohol use severity. These findings demonstrate the importance of identifying parental influences in evaluating adult substance use, and point to the inclusion of parents in efforts to prevent and treat substance use disorders.     

The effects of familial risk, personality, and expectancies on alcohol use and abuse

This study tested a structural model of the association between familial risk, personality risk, alcohol expectancies, and alcohol abuse in a sample of 224 young adult offspring of alcoholics and 209 offspring of nonalcoholics. The results provided support for 2 personality-risk pathways, a social deviance proneness and an excitement/pleasure seeking path, that accounted for a significant portion of the association between a familial alcoholism and alcohol abuse. The path from familial alcoholism to social deviance proneness lead directly to alcohol problems. The path from familial alcoholism to excitement/pleasure seeking was associated with increased drinking, which, in turn, was associated with alcohol problems. Positive alcohol expectancies accounted for part of the association between excitement seeking and alcohol use. The results suggest 2 different biopsychosocial mechanisms that elevate risk for abuse in the offspring of alcoholics.     

Hangover frequency and risk for alcohol use disorders: evidence from a longitudinal high-risk study

Data from a prospective high-risk study (N=489; 51% with a family history of alcoholism) were used to test whether family history is associated with greater hangover proneness and whether hangover is a risk factor for alcohol use disorders. Hangover was more frequent in family-history-positive participants during the college years. Persons with an alcohol diagnosis showed excess hangover before earning a diagnosis. Year 1 hangover predicted alcohol use disorders at Years 7 and 11, even when family history, sex, Year 1 diagnoses, and Year 1 drinking were statistically controlled. Several nonhangover drinking symptoms failed to predict later diagnoses. Taken together, the findings suggest a need for further research and theory on the role of hangover in the etiology of drinking problems.     

The cycle of schizoaffective disorder, cognitive ability, alcoholism, and suicidality

In this study we investigated the putative role of cognitive dysfunction, diagnosis (schizoaffective versus schizophrenia disorder), and alcoholism as risk factors for suicidal behavior among individuals with DSM-TV schizophrenia or schizoaffective disorders. Subjects received cognitive tests and medical records were reviewed for evidence of a history of suicide attempts or suicidal ideation. Discriminant analysis was used to identify cognitive test performance measures that distinguished those with versus those without suicidal behavior. None of the cognitive measures discriminated between the two groups. The rates of suicidal behavior (suicidal ideation and suicide attempts) did not differ between participants with versus those without comorbid alcohol use. An association was found between suicidal behavior and the diagnosis of schizoaffective disorder. It was concluded that the history of prominent mood syndromes characteristic of schizoaffective disorder contributes to increased risk of suicidal behaviors. Cognitive dysfunction and/or alcoholism did not contribute additionally to risk in this study.     

FEMALE AGGRESSION TOWARD MALE INTIMATE PARTNERS: AN EXAMINATION OF SOCIAL NORMS IN A COMMUNITY-BASED SAMPLE

We investigated the effect of assailant gender on injunctive social norms (i.e., beliefs about what ought to happen) regarding violence toward an intimate heterosexual partner. In a random-digit-dialed survey conducted in four languages, 3,769 community-residing adults were presented with five vignettes in which we experimentally manipulated characteristics of the assailant, victim, and incident. We examined the vignette variables and measured respondent characteristics using multivariate logistic regressions. Judgments about women's violence against male intimates (vs. men's violence against female intimates) were less harsh and took contextual factors more fully into account. The type of violence and the presence of a weapon played a central role in respondent judgments. Respondent demographic characteristics were largely unrelated to their judgments.     

Sex Bias at Work: The Effects of Attentional and Memory Demands on Performance Ratings of Men and Women1

The present study examined the impact of attentional and memory demands on work performance ratings accorded men and women in traditionally male jobs. Of interest was whether sex discrimination would abate in the face of individuating and job-relevant work behavior even when the demands likely to be faced in actual work settings were taken into account. Two hundred and two subjects read a vignette depicting the work behavior of a male or female police officer and then rated the individual's work performance. The attentional demands imposed on subjects while reading the vignette and the amount of time elapsed prior to issuing the performance ratings were systematically varied. As predicted, men were evaluated more favorably than women when raters were faced with an additional task requiring attention and time pressures were made salient. Only when subjects were able to carefully allocate all of their attentional resources did sex bias in work performance ratings abate. Memory demands had no effects on work performance ratings. Gender-related work characterizations paralleled the performance ratings, providing support for the idea that sex stereotypes mediate discrimination in performance appraisal judgments. The theoretical and practical implications of these findings, as well as suggestions for future research, are discussed.     

INCREASING TREATMENT ACCEPTABILITY THROUGH VIDEO

The effects of a video vignette on the treatment acceptability ratings of four behavioral interventions were evaluated. Two interventions involved positive reinforcement (DRO and DRI) and two negative consequences (contingent physical restraint and contingent electric shock). Seventy-four undergraduate psychology students were randomly assigned into two groups. The experimental group (n=36) viewed a video vignette of a self-abusive individual whereas the control group (n=38) did not. Acceptability ratings prior to the video showed no differences between the experimental and control groups. The post video ratings indicated significant acceptability increases for physical restraint for the experimental group. There also was a significant group by testing effect because the means for the experimental group rose whereas the control group's means were stable. These results replicated and extended Foxx, McHenry and Bremer (in press) who showed that treatment acceptability is alterable through video.