Sensation seeking, alcohol use, and sexual behaviors among sexually transmitted infection clinic patients in Cape Town, South Africa.

Alcohol use is associated with risks for HIV/AIDS. The association between alcohol and sexual risk may be accounted for by sensation seeking personality. However, sensation seeking in relation to substance use and HIV risk has not been examined in Africa. In this study, 292 men and 219 women receiving sexually transmitted infection (STI) diagnostic and treatment services in Cape Town, South Africa, completed anonymous behavioral surveys. Structural modeling was used to test a model of alcohol use and sensation seeking in relation to sexual risk behaviors. Results showed that sensation seeking and alcohol use in sexual contexts were related to HIV risks, controlling for gender and marital status. The association between sensation seeking and HIV risk was partly accounted for by alcohol use in proximity to sex. In contrast to studies conducted in the United States, sensation seeking was not related to alcohol-sex outcome expectancies. These findings suggest that alcohol use is an important HIV transmission risk factor for many STI clinic patients and that interventions for individuals who are characterized as sensation seekers are urgently needed in South Africa. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-regulation as a protective factor against risky drinking and sexual behavior.

Prior research suggests that high dispositional self-regulation leads to decreased levels of risky drinking and sexual behavior in adolescence and the early years of college. Self-regulation may be especially important when individuals have easy access to alcohol and freedom to pursue sexual opportunities. In the current 1-year longitudinal study, we followed a sample of N = 1,136 college students who had recently reached the legal age to purchase alcohol and enter bars and clubs to test whether self-regulation protected against heavy episodic drinking, alcohol-related problems, and unprotected sex. We tested main effects of self-regulation and interactions among self-regulation and established risk factors (e.g., sensation seeking) on risky drinking and sexual behavior. High self-regulation inversely predicted heavy episodic drinking, alcohol-related problems, and unprotected sex, even when taking into account gender and risk factors. Moreover, in predicting unprotected sex, we found three-way interactions among self-regulation, sensation seeking, and heavy episodic drinking. Self-regulation buffered against risk associated with heavy drinking but only among those low in sensation seeking. The protective effects of self-regulation for risky drinking and sexual behavior make it a promising target for intervention, with the caveat that self-regulation may be less protective among those who are more drawn to socially and emotionally rewarding stimuli. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prospective associations among alcohol use-related sexual enhancement expectancies, sex after alcohol use, and casual sex.

Higher levels of alcohol use have consistently been related to higher rates of sexual risk taking; however, it is not clear whether this relationship is causal. This study examined the concurrent and predictive associations among alcohol use-related sexual enhancement expectancies, drinking alcohol before engaging in sex, and casual sex during the transition into emerging adulthood and whether these associations differed for men and women. Data came from 590 men and women who were interviewed 3 times at 6-month intervals after high school. Growth curve analyses indicated that alcohol-related sexual enhancement expectancies were related to casual sex indirectly through drinking before sex but did not predict change in either of these behaviors. However, increases in drinking before sex predicted increases in casual sex over time. The findings provide some support for prevention programs that focus on alcohol-related sexual expectancies to reduce sexually transmitted illnesses among emerging adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality and cognitive factors influencing substance use and sexual risk for HIV infection among gay and bisexual men.

Substance use reliably predicts sexual risk behavior, and sensation-seeking personality characteristics have been found to covary with these associations. In a study of 289 gay and bisexual men attending a large gay pride event, the authors examined the role of substance use sexual outcome expectancies in explaining associations between sensation seeking, substance use, and risky sex. Consistent with previous research, alcohol and other drugs were associated with sexual behavior. However, path analyses showed that sensation seeking accounted for variance in sexual behavior over and above substance use before sex and that sensation seeking predicted substance use expectancies that in turn predicted substance use before sex. It was concluded that altering substance use outcome expectancies may be an important strategy for HIV risk reduction for individuals high in sensation seeking. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Prospective Study of Sensation Seeking and Alcohol Use as Predictors of Sexual Risk Behaviors Among Men and Women Receiving Sexually Transmitted Infection Clinic Services.

Sensation seeking, the propensity to seek optimal stimulation and engage in risk behaviors, correlates with alcohol expectancies, which are related to alcohol use in sexual situations, potentially increasing risks for sexually transmitted infections (STIs). In the current prospective study of 313 male and 140 female STI clinic patients, path analyses showed that sensation seeking predicted unprotected intercourse 6 months later. Sensation seeking also predicted alcohol outcome expectancies, which predicted alcohol use in sexual contexts 6 months later, which in turn predicted unprotected sex. Tests for mediation showed that alcohol expectancies accounted for the association between sensation seeking and alcohol use in sexual contexts. These findings replicate previous research, with the prospective design confirming directional hypotheses and supporting causal conclusions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Up Close and Personal: Temporal Variability in the Drinking of Individual College Students During Their First Year.

Surveys have documented excessive drinking among college students and tracked annual changes in consumption over time. This study extended previous work by examining drinking changes during the freshman year, using latent growth curve (LGC) analysis to model individual change, and relating risk factors for heavy drinking to growth factors in the model. Retrospective monthly assessments of daily drinking were used to generate weekly estimates. Drinking varied considerably by week, apparently as a function of academic requirements and holidays. A 4-factor LGC model adequately fit the data. In univariate analyses, gender, race/ethnicity, alcohol expectancies, sensation seeking, residence, and data completeness predicted growth factors (ps     

Risk factors for elementary school drinking: Pubertal status, personality, and alcohol expectancies concurrently predict fifth grade alcohol consumption.

Little is known about the correlates and potential causes of very early drinking. The authors proposed this risk theory: (a) pubertal onset is associated with increased levels of positive urgency (the tendency to act rashly when experiencing intensely positive mood), negative urgency (the tendency to act rashly when distressed), and sensation seeking; (b) those traits predict increased endorsement of high-risk alcohol expectancies; (c) the expectancies predict drinker status among fifth graders; and (d) the apparent influence of positive urgency, negative urgency, and sensation seeking on drinker status is mediated by alcohol expectancies. The authors conducted a concurrent test of whether the relationships among these variables were consistent with the theory in a sample of 1,843 fifth grade students. In a well-fitting structural model, their hypotheses were supported. Drinker status among fifth graders is not just a function of context and factors external to children: it is predictable from a combination of pubertal status, personality characteristics, and learned alcohol expectancies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influences of sexual sensation seeking, alcohol consumption, and sexual arousal on women's behavioral intentions related to having unprotected sex.

This experimental study examined effects of alcohol consumption and sexual sensation seeking on unprotected sex intentions, taking into account sexual arousal, indirectly discouraging sex, and condom insistence. Women (N = 173; mean age = 25.02) were randomly assigned to a control, placebo, low-dose beverage (target blood alcohol level = .04), or high- dose beverage (target blood alcohol level = .08) condition. Participants projected themselves into a hypothetical sexual interaction with a man in which no condom was available. Structural equation modeling demonstrated that both sexual sensation seeking and alcohol dose directly increased sexual arousal early in the interaction, but later sexual arousal indirectly increased unprotected sex intentions by decreasing endorsement of indirect discouragement and, in turn, condom insistence. These findings help to clarify the role of alcohol consumption and sensation seeking in women's sexual decision making and point to the importance of examining it as a multistage process. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does drinking lead to sex? Daily alcohol–sex behaviors and expectancies among college students.

A within-person multilevel approach was used to model the links between alcohol use and sexual behavior among first-year college students, using up to 14 days of data for each person with occasions (Level 1, N = 2879 days) nested within people (Level 2, N = 218 people; 51.4% male). Between-persons (Level 2) effects were gender, relationship status, person means of alcohol use, and alcohol-sex expectancies for sexual affect and sexual drive. Within-person (Level 1) effects were weekend days, number of drinks consumed, and the interaction between drinks consumed and alcohol-sex expectancies. Independent of average alcohol use, consuming more drinks on a given day was associated with a greater likelihood of oral sex and with experiencing more positive consequences of sex that day. Significant Alcohol Use × Alcohol-Sex Expectancies interactions were found for oral sex and total sex behaviors, indicating that individuals with more positive expectancies were more likely to have sex after drinking. The negative association between drinks and condom use was at a trend level of significance. Results support the potential for promoting sexual health by focusing on cross-behavior expectancies among late adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social environmental selection as a mediator of gender, ethnic, and personality effects on college student drinking.

Structural equation modeling was used to test the mediational role of social environmental selection on alcohol use in cross-sectional samples of 447 students from a rural state university and 421 students from an urban private university. Results showed that male gender, White ethnicity, and sensation seeking were uniquely associated with greater alcohol use. Mediational analyses indicated that socioenvironmental factors (i.e., Greek involvement, friends' approval of drinking/getting drunk) were positively associated with alcohol use and significantly accounted for parts of the effects of ethnicity and sensation seeking, but not gender, on alcohol use. Results suggest that White students and those high on sensation seeking may drink more heavily in college, in part because they select social environments in which alcohol use is encouraged. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender, Alcohol Consumption, and Differing Alcohol Expectancy Dimensions in College Drinkers.

Examinations of gender differences in alcohol expectancies among college drinkers typically have used self-report measures to assess single expectancy dimensions and often have been confounded by drinking level. This study examined gender differences in alcohol expectancies using 2 assessment methods. College students (N = 88) completed self-report questionnaires, including expectancy likelihood and subjective evaluation endorsements of expectancies, and a computerized expectancy accessibility task. Expectancy accessibility and endorsement were modestly correlated, with higher alcohol consumption and female gender linked to greater accessibility and endorsement of social enhancement expectancies. Gender moderated the relation between consumption and sociability expectancy accessibility; among men, heavier drinking was associated with more rapid activation of expectancies. Findings suggest complexity in associations among these variables and underscore the need to capture the multidimensionality of the expectancy construct and its relationship to alcohol use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex-related alcohol expectancies predict sexual risk behavior among severely and persistently mentally ill adults.

Three hundred three adults (57% male, average age 42 years) with severe and persistent mental illness receiving treatment at community mental health clinics completed a survey, which included B. C. Leigh's (1990) sex-related alcohol expectancy scale and measures of alcohol use and sexual risk behavior. Hierarchical logistic regression analyses, controlling for drinking behavior, revealed that participants with stronger expectancies that drinking would lead to enhanced sexual experience were more likely to have drank prior to intercourse and that, among participants who drank prior to intercourse, those with stronger expectancies that alcohol would lead to riskier sexual behavior were more likely to have engaged in sexual risk behavior. Implications for preventing HIV infection among people with severe mental illness are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An alcohol expectancy-challenge prevention program for at risk college women.

Alcohol expectancy-challenge programs are effective in changing expectancies and reducing drinking in college men (J. Darker & M. S. Goldman. 1993. 1998); however, recent evidence suggests this protocol might not be effective for women (M. E. Dunn, C. Lau, & I. Y. Cruz, 2000). This study was designed to reevaluate the effectiveness of a social/sexual expectancy-challenge intervention in college women reporting moderate to heavy alcohol use. Forty-six undergraduate women were randomly assigned to the prevention or control condition. Participants reported alcohol expectancies at pre- and posttest and monitored their drinking patterns daily for 6 weeks. The program was effective in changing some expectancies but did not reduce drinking. This further confirms differences in the mechanisms by which expectancy-challenge programs function for men and women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Associations of marijuana use and sex-related marijuana expectancies with HIV/STD risk behavior in high-risk adolescents.

Multiple studies suggest an association of marijuana use with increased rates of sexual risk behavior and sexually transmitted diseases (STDs). Most studies have focused on global associations of marijuana use with sexual risk outcomes and few have examined relevant cognitive variables. Adolescents in the juvenile justice system are at elevated risk for HIV/STDs and preliminary evidence suggests that marijuana is a potentially important cofactor for sexual risk behavior in this population. This study evaluated global, situational and event-level associations of marijuana use and sex-related marijuana expectancies with sexual risk outcomes in a large, racially diverse sample of adjudicated youth (n = 656, 66% male, mean age = 16.7 years). Cross-sectional and prospective analyses identified associations of marijuana use and dependence symptoms with sexual risk outcomes, including lower frequency of condom use and higher STD incidence. Stronger sex-related marijuana expectancies predicted greater intentions for and frequency of marijuana use in sexual situations. In event-level analyses that controlled for alcohol, marijuana use predicted a significantly decreased likelihood of condom use; this association was moderated by sex-related marijuana expectancies. Mediation analyses suggested that behavioral intentions partly accounted for the prospective association of expectancies with marijuana use before sex. These results provide further evidence that marijuana use is a potentially important cofactor for HIV/STD transmission in high-risk adolescents and suggest that cognitive factors could be important for characterizing this association. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Analysis of item response and differential item functioning of alcohol expectancies in middle school youths.

Drinking behavior in preadolescence is a significant predictor of both short- and long-term negative consequences. This study examined the psychometric properties of 1 known risk factor for drinking in this age group, alcohol expectancies, within an item response theory framework. In a sample of middle school youths (N = 1,273), the authors tested differential item functioning (DIF) in positive and negative alcohol expectancies across grade, gender, and ethnicity. Multiple-indicator multiple-cause model analyses tested differences in alcohol use as a potential explanation for observed DIF across groups. Results showed that most expectancy items did not exhibit DIF. For items where DIF was indicated, differences in alcohol use did not explain differences in item parameters. Positive and negative expectancies also systematically differed in the location parameter. Latent variable scale scores of both positive and negative expectancies were associated with drinking behavior cross-sectionally, while only positive expectancies predicted drinking prospectively. Improving the measurement of alcohol expectancies can help researchers better assess this important risk factor for drinking in this population, particularly the identification of those with either very high positive or very low negative alcohol expectancies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Positive alcohol expectancies partially mediate the relation between delinquent behavior and alcohol use: Generalizability across age, sex, and race in a cohort of 85,000 Iowa schoolchildren.

The extent to which positive alcohol expectancies mediated the association between delinquency and alcohol use, as well as whether age, sex, or race moderated this mediational relation, was examined in a population-based sample of Iowa schoolchildren (N = 85,301) from the 6th, 8th, and 11th grades. Positive alcohol expectancies were found to partially mediate the association between delinquency and alcohol use (alcohol use initiation, past-month drinking, and past-month binge drinking) across the full sample and in each age, sex, and racial subgroup. Evidence for moderated mediation was found for age and race but not for sex, which suggests that the magnitude of the relations among delinquency, positive alcohol expectancies, and alcohol involvement is different in younger versus older children and White, African American, Native American, Asian, and Hispanic youths but is similar in boys versus girls. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Women HIV sexual risk takers: related behaviors, interpersonal issues, and attitudes

HIV and AIDS is a growing health risk for heterosexual women, particularly women of color (Centers for Disease Control and Prevention, 1997). Our research identified 5 types of HIV sexual risk taking in 3 independent samples of adult women from a New England Community: Group A women were noted by low to moderate levels of the 4 risk markers (i.e., unprotected vaginal sex, perceived partner-related risk, number of sexual partners, and unprotected anal sex); Group B women reported very high frequency of unprotected vaginal sex; Group C women were characterized by unprotected anal sex; Group D women had high perceived partner risk; and Group E women reported extremely high levels on all 4 HIV risk markers. Sexual risk groups were validated by demonstrating significant differences among groups on relevant behaviors, interpersonal experiences, and attitudes. Compared to other women, higher risk types reported greater behavioral risk practices (substance use, prostitution, diverse sexual experience), interpersonal risk experiences (sexual abuse, violence), initiation sexual assertiveness, and attitudinal risks (psychosocial distress). They reported less interpersonal assurance (surety of own and partner's HIV status), sexual assertiveness (for condom use and partner communication), psychosocial strengths (sexual self-acceptance), and transtheoretical readiness for change (condom use efficacy, readiness to consider condoms). Results provide additional support for the multifaceted model of HIV risk and the transtheoretical model. Suggestions for specifically focused interventions are given, depending on the pattern of sexual risk taking.     

Use of drinking protective behavioral strategies in association to sex-related alcohol negative consequences: The mediating role of alcohol consumption.

Alcohol use has been implicated as a risk factor for sexual negative consequences, such as unprotected sexual intercourse. The present research was conducted to examine the relationship between drinking protective behavioral strategies and consensual sex-related alcohol negative consequences, and whether this relationship varied by gender. Additionally, typical number of drinks during sexual behavior was evaluated as a potential mediator of this association. Heavy drinking, sexually active college students (N = 297, 50.2% women) completed self-report measures of drinking protective behavioral strategies, alcohol consumption, and sex-related alcohol negative consequences. Findings indicated that women who used drinking protective behavioral strategies more frequently were less likely to experience sex-related alcohol negative consequences whereas this relationship was not significant for men. For women, this relationship was mediated by the typical number of drinks consumed during sexual behavior. The current research demonstrates that use of drinking protective behavioral strategies is related to a reduction in women's sex-related risks when drinking. Findings are discussed in terms of alcohol myopia theory. Implications for interventions aimed to reduce higher risk sexual behavior among college students are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reactivity to Alcohol-Related Cues: Relationship Among Cue Type, Motivational Processes, and Personality.

This study examined the relationship between personality traits implicated in the drinking literature (i.e., sensation seeking and anxiety) and reactivity to 2 different alcohol cues. The opportunity to consume alcohol was manipulated, and differences in urge and affective reactivity were assessed. Gray's (1987) model of impulsive sensation seeking and anxiety was adopted to investigate relationships between personality and responses to the appetitive (consumption) and aversive (no consumption, nonrewarding) alcohol cues in 40 regular social drinkers. The consumption cue produced increases in appetitive motivation and positive correlations with sensation-seeking traits. The no-consumption cue produced increases in aversive motivation and positive correlations with anxiety-related traits. It was concluded that Gray's model of impulsive sensation seeking and anxiety may provide a useful framework for examining the personality correlates of cue reactivity to different cues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)