酒后操作性认知的“近视”和“远视”效应

15名被试在摄人酒精BAL≤0．5‰前后的四个时段内接受一套简单的运算操作任务,近2／3被试的认知一操作能力显示受酒精影响发生变异：酒后30分钟操作时间延滞,至60分钟更具显著性;同时,操作错误亦大幅上升,但变化趋势不同于操作时间。酒精干扰呈现认知“近视”与“远视”的迹象。     

Primary Care Treatment Integrating Motivation and Exposure for PTSD Symptoms and Hazardous Alcohol Use: A Case Series

Symptoms of posttraumatic stress disorder (PTSD) and hazardous alcohol use are highly comorbid. Research on integrated interventions to address PTSD symptoms and hazardous alcohol use concurrently has demonstrated efficacy, yet integrated treatments are underutilized. Both patient (e.g., stigma, scheduling/logistics) and clinician (e.g., concern about symptom exacerbation and/or treatment dropout) barriers may impede utilization of integrated interventions among those with comorbid PTSD symptoms and hazardous alcohol use. Primary care behavioral health models (PCBH), in which embedded behavioral health providers deliver treatment to individuals with mild or moderate behavioral health symptoms in primary care, may help address treatment barriers by offering accessible behavioral health interventions in a destigmatizing setting. This paper presents two case examples from a randomized controlled trial testing the efficacy of an integrated intervention for PTSD symptoms and hazardous alcohol use developed for and delivered in primary care. Outcome data and session-by-session content for two participants are included, along with discussion of barriers encountered during the course of treatment. Clinician-suggested strategies for navigating barriers to facilitate utilization of integrated interventions for PTSD symptoms and hazardous alcohol use are also discussed.     

A follow-up program for suicide attempters: evaluation of effectiveness.

Suicide attempters are a high-risk group in relation to ultimately completing suicide and are usually "treated and released" with little or no follow-up care. A 4-month follow-up outreach program for suicide attempters seen in the emergency room was developed with an emphasis on continuity and quantity of "treatment" received. Suicide attempters were randomly assigned to the "follow-up outreach" or "normal" treatment programs. Measures for the evaluation of effectiveness were (a) incidence of suicide reattempts and purposive accidents and (b) prevalence of drug misuse and excessive use of alcohol. The experimental group showed a statistically significant reduction in suicide reattempts and excessive use of alcohol, while the reduction of drug abuse, although not statistically significant, did conform to a trend indicating improvement. Purposive accidents occured at a relatively equal rate among both groups.     

Aggression, alcohol dependency, and self-consciousness among high school students of divorced and nondivorced parents.

134 high school students from a small high school in north central Kansas completed the MacAndrew Alcoholism Scale, Fenigstein, et al.'s Self-consciousness Scale, and Zaks' Aggression Scale. Analyses of variance showed significant differences between boys and girls but not among grades. On the aggression and alcohol measures boys scored higher than girls, but lower on public self-consciousness. Youth of divorced parents scored significantly higher than those of nondivorced parents on aggression, private self-consciousness, and general self-consciousness. Aggression scores were significantly and positively correlated with those on the alcohol and private self-consciousness scales. When students' alcoholism scores indicate problems with alcohol, their scores on aggression indicate greater aggression and their private self-consciousness scores indicate sensitivity toward events in their environment, then having concerns about inner self can inhibit the action required for change. MacAndrew scores correlated significantly and negatively with scores on social anxiety about self-consciousness. When MacAndrew scores indicated problems with alcohol, the students' scores on social anxiety about self-consciousness suggested confidence in social settings, being at ease interacting with people. The present study involved students from a single rural district so increased understanding will require more extensive research if strategies for prevention and intervention are to be developed and utilized.     

Replication and extension analyzing the factor structure of Locus of Control scales for substance-abusing behaviors

Two research questions were addressed in this study. First, what are the dimensions of the concept of control orientation with respect to substance-abusing behaviors as measured by Keyson and Janda's 1972 Drinking-related Locus of Control Scale and by an adaptation of that scale developed for users of other drugs. Second, utilizing a large sample of both male and female clients who abused both alcohol and other drugs, how does that dimensional structure differ from the one presented by Donovan and O'Leary in 1978 for male alcoholics at a VA hospital. Since the present sample was a large (N = 542) representative sample of publicly subsidized clients in Missouri, it provided an opportunity to extend earlier work across type of drug abused and sex. Like Donovan and O'Leary we used a principal components analysis with a varimax rotation to examine the dimensions of the 25-item locus of control scales. Like those authors, the analysis for male alcohol users produced a three-factor solution with interpretations resembling their "intrapersonal" and "interpersonal" factors but with a more fully developed third factor interpretable as a fate or luck dimension. These dimensions were apparent for the other groups as well, although the first two factors were reversed for male users of other drugs and the analysis for female alcohol abusers showed a more consistent sociability dimension than for males. While the derived structures are therefore similar to Donovan and O'Leary's results and consistent with the theoretical uses of control orientation in discussion of alcohol and other drug abuse, they also show some differences for type of drug abused and by sex. These are necessary but not sufficient conditions for including such measures in more specific models relating clients' motivation and propensity for change to outcomes.     

Affective Priming of Alcohol Schema in Coping and Enhancement Motivated Drinkers

This study investigated whether Coping Motivated and Enhancement Motivated drinkers differ in their degree of semantic activation of alcohol concepts on a primed Stroop colour-naming task following exposure to negative and positive affect primes, respectively. Participants were 48 undergraduates (not necessarily problem drinkers) who had elevated scores on the Coping Motivated or Enhancement Motivated subscale of the Drinking Motives Questionnaire - Revised. The Stroop task involved negative, positive and neutral primes that preceded alcohol and no-alcohol target words. As hypothesized, Coping Motivated drinkers showed semantic activation of alcohol concepts following exposure to negative but not neutral primes. Also as hypothesized, Enhancement Motivated drinkers showed semantic activation of alcohol concepts following exposure to positive but not negative primes. Unexpectedly, semantic activation of alcohol concepts was also observed among Coping Motivated drinkers following positive primes and among Enhancement Motivated drinkers following neutral primes. Theoretical implications are discussed, as are implications for improving cognitive behavioral interventions for problem drinkers.     

A Review of REBT Research in Alcohol Abuse Treatment

Clinical outcome studies have shown that cognitive-behavioral approaches to alcohol abuse are efficacious. As the research continues to be refined, practitioners can work with clients based on better science. REBT practitioners have developed a number of theoretical and treatment manuals to promote better practice. The empirical literature on REBT treatment for alcohol abuse does not provide strong evidence of its effectiveness. The present article comprehensively reviews the REBT outcome literature and identified six studies. Of these, three met the inclusionary criteria. The findings demonstrated change in endorsement of irrational thinking, with limited behavioral change. Limitations of the present research base for alcohol abuse are discussed and suggestions offered for conducting and reporting REBT research on alcohol abuse.     

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.     

The skin-flushing response: autonomic, self-report, and conditioned responses to repeated administrations of alcohol in Asian men

This study examined the skin-flushing response in Asian men, which is a low-risk factor for alcoholism. Asian men who did and did not flush to alcohol consumed 0.5 g/kg ethanol during three sessions with alcohol, and placebo in a fourth session. The results indicated that: (a) Asian men who flushed to alcohol showed pronounced cardiovascular changes that did not exhibit differential tolerance over 3 sessions, (b) there were surprisingly few self-reported mood differences in response to alcohol between those who did and did not flush, and (c) finger-pulse amplitude decreased and self-ratings of "boastful" increased significantly in response to placebo challenge in those men who did not flush. These results raise questions about the psychological mechanisms by which the skin-flushing response inhibits the development and expression of alcoholism.     

Effects of alcohol and extended practice on divided-attention performance

The effects of alcohol and extended practice on divided attention were investigated using a visual tracking task and an auditory detection task. Subjects performed the tasks with and without alcohol, under single-task (S) and dual-task (D) conditions, both before and after they had received extended practice under single-task conditions without alcohol. Tracking accuracy improved with practice and was impaired under divided-attention conditions but was not affected by alcohol. Speed of detection was impaired by alcohol, improved by practice, and impaired by divided attention. Extended practice did not reduce the influence of alcohol. The effects of both alcohol and practice on speed of detection were significantly greater under dual-task conditions than under single-task conditions. Analysis of detection-task reaction times in terms of relative divided-attention costs, (D-S)/S, showed no effect of alcohol, but a highly significant reduction in costs with extended practice. It is concluded that (1) alcohol and practice can have quantitatively, but not qualitatively, similar effects on speeded performance, and (2) the effect of alcohol is not influenced by the attentional requirements of the task.     

Alcohol and vigilance performance: effect of small doses of alcohol on simple auditory reaction time

This study explored whether a small dose of alcohol (0.67 ml/kg) would affect simple auditory RT as developed with time on task in a vigilance setting. Analysis indicated that absolute levels were not affected and no interaction with time on task was evident. Alcohol did, however, increase both number and mean duration of the extreme long reactions but this effect was not related to time on task. It was concluded that in many applied situations this effect of small alcohol doses may be critical.     

Suppression-induced hyperaccessibility of thoughts in abstinent alcoholics: a preliminary investigation

Abstinent alcoholics were compared to a non-alcoholic control group on a modified Stroop color-naming task. Alcoholics took significantly longer to name the color of the word "alcohol" than to name the color of non-alcohol words (i.e., they showed an interference effect) after they had first tried to suppress thoughts of alcohol. Alcoholics who had freely expressed thoughts about alcohol prior to the Stroop did not show such interference. Control participants who had suppressed thoughts of alcohol showed no interference effect. The results overall suggest that when alcoholics try to suppress thoughts of alcohol, these thoughts may become hyperaccessible immediately afterward.     

The variable nature of cognitive control in a university sample of young adult drinkers

The current study investigates the effect of task‐irrelevant alcohol distractors on cognitive control and its interaction with heavy/light drinking in a group of young adult drinkers. It was hypothesised that alcohol distractors would result in a reduction of proactive control (reduced conflict adaptation) especially in heavy drinkers. 60 participants took part in a face‐word version of the Stroop task preceded by an alcohol or neutral image. Light drinkers only showed a congruency effect which indicated a greater level of proactive control. Heavy drinkers showed a greater level of reactive control in which the conflict adaptation effect occurred with neutral images but not with alcohol images. Possible explanations are discussed.     

Trajectories of alcohol and drug use and dependence from adolescence to adulthood: the effects of familial alcoholism and personality

This study describes trajectories of substance use and dependence from adolescence to adulthood. Identified consumption groups include heavy drinking/heavy drug use, moderate drinking/experimental drug use, and light drinking/rare drug use. Dependence groups include alcohol only, drug only, and comorbid groups. The heavy drinking/heavy drug use group was at risk for alcohol and drug dependence and persistent dependence and showed more familial alcoholism, negative emotionality, and low constraint. The moderate drinking/experimental drug use group was at risk for alcohol dependence but not comorbid or persistent dependence and showed less negative emotionality and higher constraint. Familial alcoholism raised risk for alcohol and drug use and dependence in part because children from alcoholic families were more impulsive and lower in agreeableness.     

Impact of pre-existing levels of hostility and aggression on substance abuse treatment outcome

The impact of the change in level of hostility and aggression on subsequent substance abuse (drug, alcohol, or combined) recovery was investigated. One hundred and thirty-two dually diagnosed veterans completed an inpatient treatment programme at a large DVA Medical Centre. Results showed significant decreases in addiction severity over 3 month and 12 month following-up. At 3 months, pretreatment severity was predictive of drug, alcohol, and drug/alcohol severity whereas change in hostility and aggression scores were not. At 12 months, however, pretreatment severity was predictive only of drug severity whereas change in hostility and aggression were predictive of alcohol and combined drug/alcohol severity. Implications for changes in substance abuse correlates over time are discussed.     

Personality traits and alcohol consumption in a sample of non-alcoholic women

Many studies have shown the importance of personality traits as factors related to alcohol use and misuse. The relationship between personality traits and alcohol consumption was studied in a sample of 149 non-alcoholic women using the Karolinska Scales of Personality (KSP) and the Eysenck Personality Questionnaire-Revised (EPQ-R). The results showed positive correlations between alcohol consumption and disinhibitory personality traits (sensation seeking, impulsivity, psychopathy, nonconformity) and dimensions (psychoticism and extraversion). Sensation seeking combined with impulsivity were the strongest predictors of alcohol consumption. Anxiety-related traits and neuroticism were not related to alcohol frequency/amount of alcohol use.     

Alcohol intoxication alters cognitive skills mediated by frontal and temporal brain regions

Alcohol intoxication affects frontal and temporal brain areas and may functionally impair cognitive processes mediated by these regions. This study examined this hypothesis by testing the effects of alcohol on sustained attention, impulsivity, and verbal memory. Sober and placebo control groups were used to distinguish pharmacological from expectancy effects of alcohol. One hundred nine university students were assigned to an alcohol (low, medium, or high dose), placebo or sober group. Moderate and high doses of alcohol impaired all cognitive measures. A gender effect was revealed in that alcohol impaired sustained attention in males, but not females. Both sustained attention and verbal memory exhibited a U-shaped pattern, in that the medium-dose alcohol group showed the greatest impairment. This study adds to knowledge about the effects of alcohol intoxication on frontally- and temporally-mediated cognitive function. These findings have specific relevance for heavy-drinking undergraduate populations, particularly in light of the fact that repeated alcohol administration produces persistent changes in brain neurocircuitry.     

Locus of control and perceived alcohol ingestion in performance of a fine motor skill

To investigate the influence of locus of control on a fine motor corrdination task where subjects had ingested or believed that they had ingested alcohol, 60 men who were enrolled in introductory psychology and scored in the upper or lower thirds of the population on Rotter's I-E Scale (30 external and 30 internal scorers) were randomly assigned to one of three treatment conditions: a control group (no alcohol expected/no alcohol received), an alcohol group (alcohol expected/alcohol received), and a placebo group (alcohol expected/no alcohol received). Pretest and posttest measures of performance on the Purdue Pegboard Test were obtained from all subjects. Subjects in the control groups were given three 6-oz. (177.4-ml) glasses of fruit punch over a 35-min. waiting period between pretest and posttest on the Purdue Pegboard. The alcohol groups drank a sufficient number of similar glasses (usually three) to produce a 0.1% measure on a breathalyzer before completing the posttest on the Purdue. Pegboard. The placebo groups were told that they were drinking an alcohol-based drink but were served three glasses of a nonalcoholic, rum-flavored fruit drink. These groups were also told that they measured 0.1% on a breathalyzer. Control groups, both internal and external scorers, showed essentially no change from pre- to posttest on the Purdue Pegboard. The alcohol groups, on the other hand, both internal and external scorers, showed a significant decrement in performance. The internal-placebo group did not differ from the two control groups and showed no decrement in performance.(ABSTRACT TRUNCATED AT 250 WORDS)     

Affect and alcohol use: an ecological momentary assessment study of outpatients with borderline personality disorder

Alcohol use may be viewed as an attempt (albeit maladaptive) to regulate negative emotional states. We examined associations between both negative and positive affects and alcohol use in outpatient women diagnosed with borderline personality disorder (BPD; n=74), a prototype of emotional dysregulation, as well as a psychiatric control group of women with current depressive disorder (major depressive disorder/dysthymic disorder [MDD\DYS]; n=50). Participants completed randomly prompted reports of mood and alcohol use up to six times a day over a 28-day period using electronic diaries. Mean levels of either positive or negative affects did not distinguish between drinkers and nondrinkers in either diagnostic group. However, levels of both negative and positive affects were positively associated with alcohol use at the momentary level in BPD drinkers. More robust findings were obtained with respect to within-person affective variability, which was related to alcohol use in multiple ways. BPD drinkers showed higher within-person variability for most negative affects than BPD nondrinkers; MDD\DYS drinkers in general showed less within-person variability than MDD\DYS nondrinkers for negative affects. Multilevel lagged analyses for BPD drinkers indicated that alcohol use was positively related to variability in all affects, concurrently, but fewer significant effects of affect variability on the next day's drinking or significant effects of alcohol use on the next day's affect variability were observed. Among MDD\DYS drinkers, we observed more significant associations between affect variability on next day's alcohol use and of alcohol use on next day's affect variability. We discuss theoretical and methodological issues relevant to these findings as well as implications for future research.