Voucher-based reinforcement for alcohol abstinence using the ethyl-glucuronide alcohol biomarker

This study assessed the effects of a contingency management (CM) intervention for alcohol consumption in 10 alcohol-dependent participants. An ABCA design was used. Vouchers were provided contingent on results of ethyl glucuronide (EtG) urine tests (an alcohol biomarker with a 2-day detection period) and alcohol breath tests during the C phase. The percentage of negative urines was 35% during the first baseline phase, 69% during the C phase, and 20% during the return-to-baseline phase. Results suggest that EtG urine tests may be a feasible method to deliver CM to promote alcohol abstinence.     

Personality and alcohol dependence

In this study, groups of ‘alcoholic’ subjects were independently rated as to their degree of dependence by a technique previously validated. The two groups of moderately and severely dependent subjects were then given the 101-item EPQ. In keeping with other similar studies, the data suggested that high N, high P and low E in men were related to the Clinical Alcohol Personality. Further analysis of these and other data suggest that whilst raised N scores may be a spurious artefact which is a consequence of heavy alcohol consumption, the E and P findings may reflect stable predispositions. There were no sex differences, but there was a major group difference on P, with both severely dependent men and women scoring significantly higher than their less dependent counterparts.     

Belligerence in alcohol dependence

Alcohol intoxication is frequently associated with acts of interpersonal violence. The present study indicates that a substantial proportion of patients with a primary diagnosis of alcohol dependence do not become violent while drinking. Those who did evidenced a clearly different personality profile, exhibited more problems related to alcohol use, and greater impairment of various cognitive neuropsychological functions. They also tended to have established a pattern of excessive alcohol use at an earlier age. The findings may be explained by a pre-alcoholic vulnerability of a nature which increases the probability of belligerent behavior during intoxication.     

Five-Factor Model and alcohol outcomes: Mediating and moderating role of alcohol expectancies

The aim of the present study was to examine the relationship between the Five-Factor Model of personality and alcohol expectancies (AEs) with different alcohol outcomes. The sample was composed of 738 participants (63.7% females). Path and regression analyses were performed to test the mediation and moderation effects. The results indicated that Neuroticism was related to alcohol consumption through Positive Alcohol Expectancies, and that Negative Alcohol Expectancies, but also Positive Alcohol Expectancies, partially mediated the relationship of Neuroticism to alcohol-related problems. In addition, Positive Alcohol Expectancies partially mediated the associations of extraversion and low conscientiousness with weekend Standard Drink Units (SDUs), and they completely mediated the associations of these personality variables with alcohol-related problems. Additional direct paths were found from low agreeableness to weekly SDUs and alcohol-related problems; and from low openness to weekend SDUs. Moderation effects of alcohol expectancies on personality and both alcohol use and alcohol-related problems were also found. The present research contributes new evidence on the influence of the five factors of personality on alcohol outcomes, and the mediation/moderation role of alcohol expectancies. These findings can be useful to develop prevention/intervention programmes.     

The influence of alcohol expectancy priming and mood manipulation on subsequent alcohol consumption

Studies showing that verbal priming can implicitly affect alcohol consumption have been used to support cognitive models of expectancies. However, because expectancy words reflect affective states as well as drinking outcomes, mediation through an affective pathway remains theoretically plausible (i.e., such words inadvertently may affect mood, which in turn influences drinking). The primary pathway was identified (and expectancy theory was tested) by comparing memory priming (using alcohol expectancy or neutral words) with mood induction (using positive or neutral music); an unrelated experiment paradigm allowed the priming manipulation to implicitly affect drinking. Men in the alcohol priming group drank significantly more than men in each of the other conditions, and, consistent with theory, men with histories of heavier drinking drank the most when primed with alcohol expectancies, indicating that expectancies can function as automatic memory processes.     

Racial/ethnic differences in the influence of cultural values, alcohol resistance self-efficacy, and alcohol expectancies on risk for alcohol initiation

Prior research has reported racial/ethnic differences in the early initiation of alcohol use, suggesting that cultural values that are central to specific racial/ethnic groups may be influencing these differences. This 1-year longitudinal study examines associations between two types of cultural values, parental respect (honor for one's parents) and familism (connectedness with family), both measured at baseline, and subsequent alcohol initiation in a sample of 6,054 (approximately 49% male, 57% Hispanic, 22% Asian, 18% non-Hispanic White, and 4% non-Hispanic Black) middle school students in Southern California. We tested whether the associations of cultural values with alcohol initiation could be explained by baseline measures of alcohol resistance self-efficacy (RSE) and alcohol expectancies. We also explored whether these pathways differed by race/ethnicity. In the full sample, adolescents with higher parental respect were less likely to initiate alcohol use, an association that was partially explained by higher RSE and fewer positive alcohol expectancies. Familism was not significantly related to alcohol initiation. Comparing racial/ethnic groups, higher parental respect was protective against alcohol initiation for Whites and Asians, but not Blacks or Hispanics. There were no racial/ethnic differences in the association between familism and alcohol initiation. Results suggest that cultural values are important factors in the decision to use alcohol and these values appear to operate in part, by influencing alcohol positive expectancies and RSE. Interventions that focus on maintaining strong cultural values and building strong bonds between adolescents and their families may help reduce the risk of alcohol initiation. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Effects of alcohol sensitivity on P3 event-related potential reactivity to alcohol cues.

Although alcoholics and individuals at risk for alcoholism often show smaller amplitude of the P3 event-related brain potential (ERP), recent data (K. Namkoong, E. Lee, C. H. Lee, B. O. Lee, & S. K. An, 2004) indicate that alcohol-related cues elicit larger P3 amplitude in alcoholics than in controls. Little is known concerning the ERP profiles or alcohol cue reactivity of social drinkers at risk for alcoholism due to low sensitivity to alcohol's effects. Participants differing in alcohol sensitivity viewed images of alcoholic and nonalcoholic beverages while ERPs were recorded and provided information about their alcohol use patterns at baseline and 4 months later. Compared to high-sensitivity participants, those low in sensitivity showed larger P3s to alcohol cues, even when recent alcohol use was statistically controlled for. Moreover, the P3 elicited by alcohol cues predicted alcohol use at follow-up, a finding supporting the idea that P3 amplitude reflects the motivational significance of substance-related cues. These findings point to risk status, not consumption history, as an important predictor of cue reactivity effects.     

Expectancy models of alcohol use

The primary goal of the present article is to compare expectancy models with competing attitude models of alcohol use. First, several methodological issues in expectancy research were addressed, to more adequately compare the theoretical models. Study 1 examined the effect of possible self-report biases on associations among expectancy constructs and alcohol use. In Studies 2 and 3, the basic distinction between general factors of positive and negative alcohol expectancies was investigated in both cross-sectional and prospective models. Alternative predictions that were based on competing expectancy and attitude theories were evaluated primarily in Study 3. Results from these studies supported the validity of the expectancy constructs and the proposed distinctions among expectancy and attitude constructs-in terms of strong discriminant validity, absence of self-report bias, and differential prediction of alcohol use. Furthermore, the findings favored certain expectancy models over alternative attitude models of alcohol use, reaffirming the usefulness of the expectancy framework.     

Learning techniques for alcohol abuse

Eighteen month follow-up data are presented for two projects evaluating the effectiveness of learning techniques for treating alcohol abuse and achieving moderation using three groups of subjects-inpatient alcoholics, outpatient alcoholics and problem drinkers. Subjects received various combinations of the following procedures: videotape self-confrontation of drunken comportment, blood alcohol concentration discriminating training, aversion training for overconsumption, avoidance practice, behavior counseling and alternatives training, and alcohol education. While the loss of subjects was considerable between 12 and 18 months follow-up, the data were very similar. Subjects in all groups improved in terms of reductions in alcohol intake and on drinking-related variables. Significant between-groups differences in favor of subjects whose training included actual experience in drinking moderately were found only for the inpatient alcoholics. In this research, the best candidate for moderation was the less chronic. younger drinker with a relatively lower alcohol intake, a more stable vocational record and no history of hospitalization for alcohol abuse or physical deterioration from drinking. We believe that the techniques with the greatest potential for the prevention and treatment of alcohol abuse are videotape self-confrontation, blood alcohol discrimination training, and alcohol education/alternatives training.     

Preattentive processing of alcohol stimuli

An experiment was conducted to test the automatic analysis of briefly presented alcohol stimuli in alcohol-dependent individuals. Alcoholics and controls were exposed to four different conditions: two brief (30 ms) and two long (130 ms) exposure conditions, each containing alcoholic and non-alcoholic pictures. Heart rate (HR) interbeat intervals were recorded and phasic cardiac responses assessed. Alcoholics had a stronger initial HR deceleration after exposure to masked alcohol slides compared with masked control slides, indicating a preattentive analysis of alcohol stimuli. This initial HR deceleration in the masked condition suggests an automatic attentional focusing to degraded alcohol cues. No such attentional effect was found when the pictures were presented unmasked and were clearly perceived. The implication of these results for the understanding of relapse in addictive behavior is discussed.     

Clinical management of alcohol withdrawal

It has been well known for a number of years that abrupt withdrawal from alcohol following chronic use is associated with adverse consequences, ranging from mild tremors to withdrawal seizures. The overall purposes of treating alcohol withdrawal (AW) are to relieve patient discomfort, to prevent the development of more serious withdrawal symptoms, and to initiate long-term alcohol rehabilitation. Several areas of controversy exist in the clinical management of AW, including the optimal treatment setting, the need for pharmacologic management, and the most appropriate agent to prescribe when medication is deemed necessary. This article reviews the clinical features, general management, and treatment of AW.     

Lasting effects of alcohol: Subliminal alcohol cues,impairment expectancies,and math performance

Many people believe that drinking alcohol reduces cognitive performance, and prior research has shown such expectancy‐related impairment even when people merely thought that the (non‐alcoholic) drink they consumed contained alcohol. This study tested whether subliminal priming with alcohol‐related cues would similarly result in expectancy‐consistent cognitive performance decrements. Additionally, the moderating role of alcohol use was examined. After assessing participants' baseline math performance, participants were primed with alcohol‐related or neutral words and then completed a post‐treatment math task. Whereas impairment expectancies had no influence on math performance in control participants, expectancies predicted math performance for participants primed with alcohol‐related words. As hypothesized, expectancy‐consistent impairment in performance was only observed among high alcohol users. The current findings suggest that, in the presence of alcohol‐related cues in the environment, some people may perform less on cognitive tasks even in the absence of actual or assumed alcohol consumption and without being aware of it. Copyright © 2011 John Wiley & Sons, Ltd.     

Genetic associations of alcohol dehydrogenase with alcohol use disorders and endophenotypes in white college students

Associations of alcohol dehydrogenase (ADH) gene polymorphisms (ADH1B*2 and ADH1C*1) with a lifetime alcohol use disorder (AUD) were examined in White college students. Alcohol-related endophenotypes likely to be influenced by elevations in acetaldehyde were also assessed. Individuals with an ADH1B*2 allele had lower rates of AUDs, consumed a lower maximum number of drinks in a 24-hr period, reported a greater level of response to alcohol, were more likely to have experienced alcohol-induced headaches following 1 or 2 drinks, and reported more severe hangovers than those lacking this allele. These findings are consistent with the hypothesis that enhanced sensitivity to alcohol and lower levels of alcohol use reflect the mechanism by which ADH1B*2 protects against developing an AUD.     

Stress and alcohol use: moderating effects of gender, coping, and alcohol expectancies.

A stressor vulnerability model of stress-induced drinking was tested in a stratified random sample of 1,316 Black and White adult drinkers. Stressors were highly predictive of both alcohol use and drinking problems among men who relied on avoidant forms of emotion coping or held strong positive expectancies for alcohol's effects and accounted for more than 35% of the variance in alcohol use among the subgroup of men who were high in both vulnerability factors. In contrast, stressors were negatively related among men who were low in both and were unrelated among women regardless of their coping or expectancies. These findings suggest that tension reduction theories of alcohol use are overly broad and that individual characteristics must be considered to account for stress-related effects on alcohol use and abuse.     

Drinking without thinking: an implicit measure of alcohol motivation predicts failure to control alcohol use

Addiction is characterized by dyscontrol - substance use despite intentions to restrain. Using a sample of at-risk drinkers, the present study examined whether an implicit measure of alcohol motivation (the Implicit Association Test [IAT]; Greenwald, A.G., McGhee, D.E., & Schwartz, J.L.K. (1998). Measuring individual differences in implicit cognition: the Implicit Association Test. Journal of Personality and Social Psychology, 74, 1464-1480) would predict dyscontrol of alcohol use. Participants completed an IAT and, to elicit motivation to restrain alcohol use, were instructed that greater consumption in a taste test would impair performance on a later task for which they could win a prize. All participants viewed aversive slides and then completed a thought-listing task. Participants either exerted self-control by suppressing negative affect and thoughts regarding the slides or did not exert self-control. Post-manipulation, the groups did not differ in mood, urge to drink or motivation to restrain consumption. During the subsequent taste test, participants whose self-control resources were depleted consumed more alcohol than did those in the control group. Additionally, the IAT, but not an explicit measure of alcohol motivation, more strongly predicted alcohol use when self-control resources were depleted. The results indicate that the IAT may have utility in predicting dyscontrolled alcohol use.     

Electrophysiologic studies of alcohol dependent patients

Electrophysiological methods were used to examine 52 ward patients with a long history of alcohol abuse. Alertness fluctuations were much more common in the EEG than among the healthy control subjects. 86.5% of the ENG findings were abnormal and indicated demyelinisation in most cases. The latence times of the brain stem potentials were longer than normal in about half of the patients and were definitely pathological in 13.5%. There was no statistical correlation between drinking habits and the results of the examination. Unknown pathogenetic factors are therefore suspected. The polytopic pattern of damage necessitates the use of a broad range of signostic techniques.     

Neurophysiologic findings in chronic alcohol abuse

Neurophysiological examinations of 100 long term alcohol dependent patients who were having neuropsychiatric treatment, showed symptoms of polytopic damage of the peripheral and central nervous system. The results show that for recognition of the damage an extensive diagnostic programme must be used.     

Legal drinking age and alcohol consumption

Utilizing samples from two states, one where the legal age for the possession and consumption of alcohol was 18 (Louisiana) and one where the legal age was 21 (North Carolina), we examine the assumption that restricting access to alcohol results in lower alcohol consumption rates for the target population (age 18–20). We find little support for this assumption, but considerable evidence that restrictive legislation drives younger drinkers underground, resulting in overall higher consumption rates for the target population.