Personality and Defense Styles: Clinical Specificities and Predictive Factors of Alcohol Use Disorder in Women

This study investigated personality traits and defense styles in order to determine clinical specificities and predictive factors of alcohol use disorders (AUDs) in women. A female sample, composed of AUD outpatients (n = 48) and a control group (n = 50), completed a sociodemographic self-report and questionnaires assessing personality traits (BFI), defense mechanisms and defense styles (DSQ-40). Comparative and correlational analyses, as well as univariate and multivariate logistic regressions, were performed. AUD women presented with higher neuroticism and lower extraversion and conscientiousness. They used less mature and more neurotic and immature defense styles than the control group. Concerning personality traits, high neuroticism and lower conscientiousness were predictive of AUD, as well as low mature, high neurotic, and immature defense styles. Including personality traits and defense styles in a logistic model, high neuroticism was the only AUD predictive factor. AUD women presented clinical specificities and predictive factors in personality traits and defense styles that must be taken into account in AUD studies. Implications for specific treatment for women are discussed.     

Personality Traits Moderate Connections from Drinking Attitudes to Alcohol Use and Myopic Relief,Self-inflation,and Excess

Background: Alcohol myopia theory postulates that the level of alcohol use in conjunction with personal cues, such as alcohol attitudes and personality traits help to understand the types of consequences manifested. Objectives: This study examined and identified the personality traits that served as predictors and moderators of the risk connections from drinking attitudes to alcohol use to myopia outcomes. Methods: College students (N?=?433) completed self-report measures. In a path analysis using structural equation modeling, personality traits (extraversion, agreeableness, conscientiousness, openness, and neuroticism), drinking attitudes, and personality?×?drinking attitudes interactions simultaneously served as predictors on the outcomes of alcohol use and myopic relief, self-inflation, and excess. Results: Alcohol attitudes and use consistently emerged as unique predictors of all three myopia outcomes. Extraversion and neuroticism were identified as statistical moderators, but results varied depending on the myopia outcome interpreted. Specifically, extraversion moderated the pathways from attitudes to usage and from attitudes to myopic relief. Neuroticism, however, moderated the relations from attitudes to myopic self-inflation and from attitudes to myopic excess. Conclusions/Importance: Extraverted and neurotic dispositions could exacerbate or attenuate the risk connections from alcohol attitudes to outcomes. Findings offer implications for alcohol prevention efforts designed to simultaneously target drinking attitudes, personality traits, and alcohol myopia.     

A personality-based description of maturing out of alcohol problems: Extension with a Five-Factor model and robustness to modeling challenges

Aim

To examine the relation of changes in Five-Factor personality traits (i.e., extraversion, agreeableness, conscientiousness, neuroticism, and openness to experience; Costa & McCrae, 1985), drinking motives, and problematic alcohol involvement in a cohort of college students (N = 467) at varying risk for alcohol use disorders from ages 21 to 35.

Method

Parallel process latent growth models were estimated to determine the extent that prospective changes in personality and alcohol problems covaried as well as the extent to which drinking motives appeared to mediate these relations.

Results

Changes in neuroticism and conscientiousness covaried with changes in problematic alcohol involvement. Specifically, increases in conscientiousness and decreases in neuroticism were related to decreases in alcohol from ages 21 to 35, even after accounting for marriage and/or parenthood. Change in coping (but not enhancement) motives specifically mediated the relation between changes in conscientiousness and alcohol problems in addition to the relation between changes in neuroticism and alcohol problems.

Discussion

Personality changes, as assessed by a Five-Factor model of personality, are associated with “maturing out” of alcohol problems. Of equal importance, change in coping motives may be an important mediator of the relation between personality change and the "maturing out" of alcohol problems.     

The Relationship Between the Big Five Personality Traits,Impulsivity, and Anabolic Steroid Use

Background: The increase in the prevalence of anabolic-androgenic steroids (AAS) use has been the subject of study in the last decades. Several studies indicated a strong association between the use of AAS and the performance of risky behaviors mediated by factors such as aggression, impulsivity, depression, and anxiety. Objective: This study aimed to identify differences in personality trait, impulsivity, and the ability to delay gratification between AAS users and non-users that predispose or serve as a buffering mechanism against its usage and whether it is related to an increased likelihood of engaging in infidelity. Methods: Two hundred and twelve male volunteers (88 AAS users), aged between 21 and 36?years (M = 28.22), completed self-report measures of personality, impulsivity, delayed gratification, and attitudes toward infidelity. Multivariate analysis of variance and logistic regression were conducted to establish differences between AAS users and non-users. Results: The results showed that AAS users displayed an inability to delay gratification, a greater impulsivity, and a more benevolent attitude toward infidelity. AAS users obtained higher scores on openness and neuroticism, which was larger “off-cycle,” although they presented lower scores on extraversion compared to the non-users group. Regression analysis revealed that neuroticism, impulsivity, and delaying gratification scores were significant predictors of AAS usage. In addition, impulsivity functioned as a partial mediator in the relationship between neuroticism and AAS use. Conclusion: The results of this research highlight a pivotal implication of impulsivity in AAS use in conjunction with neuroticism, openness, and extraversion traits.     

Food Addiction is Associated with Higher Neuroticism,Lower Conscientiousness,Higher Impulsivity,but Lower Extraversion in Obese Patient Candidates for Bariatric Surgery

Background: The “food addiction” phenotype identifies a subpopulation of individuals experiencing substance-dependence symptoms toward specific foods. In the current debate on whether the “food addiction” phenotype should be considered as an addictive disorder, assessment of the personality traits associated with this phenotype would provide arguments for or against the “food addiction” phenotype and its inclusion in the “substance-related and addictive disorder” category. Objectives: To assess the personality characteristics associated with the “food addiction” phenotype in obesity surgery candidates (i.e., big five personality dimensions, alexithymia and impulsivity). Methods: We assessed food addiction (Yale Food Addiction Scale), personality dimensions (Big Fig Inventory), impulsivity (Barratt Impulsiveness Scale-11^th version) and alexithymia (Toronto Alexithymia Scale-20 items) in 188 bariatric surgery candidates recruited between July 2013 and November 2015 in the Nutrition Department of the University Hospital of Tours. We used chi-squared tests and Student's tests or Mann-Whitney-U-tests to determine the factors associated with food addiction. Results: Prevalence of current food addiction was 16.5%. Patients with (vs. without) food addiction had lower conscientiousness (p = .047), higher neuroticism and lower extraversion (p_s < 0.001), but there was no difference in terms of agreeableness (p = 0.42) or openness (p = 0.16). They were more frequently single (p = .021) and reported higher alexithymia (p_s < .001) and higher impulsivity sub-scores (p_s<.05). Conclusions/Importance: Food addiction shares personality traits with substance-related disorders (regarding neuroticism, conscientiousness, impulsivity, alexithymia), and one distinctive trait (low extraversion). This study provides additional data that enrich the discussion on whether the “food addiction” phenotype should be included or not in the “substance-related and addictive disorder” category.     

Coping and violence perpetration in a residential substance use disorder treatment sample

Background: Individuals in substance use disorder treatment report high rates of violence against partners and non-partners. There is growing interest in integrated coping-oriented treatment approaches for violence and substance use concerns, yet little is known about the relationship between specific coping responses and perpetration of partner and non-partner violence. Objective: This cross-sectional study evaluated relationships between coping responses and partner and non-partner physical assault perpetration in a substance use disorder treatment sample. Methods: Participants included 343 men (76%) and women (24%) who completed self-report survey measures of coping responses, violence perpetration, and substance use as part of screening for a randomized trial. Negative binomial regression was used to examine relationships between coping strategies and partner and non-partner violence perpetration, when accounting for substance use and demographic factors. Results: About one-third of participants reported partner violence perpetration (30%) and non-partner violence perpetration (34%). Frequency of partner violence and non-partner violence were both associated with more use of avoidant and emotion-focused strategies and less use of problem-focused coping in adjusted models. Discussion: Continued research is warranted to determine whether coping-oriented interventions decrease violence among people in substance use disorder treatment.     

Race,Coping Style,and Substance Use Disorder Among Non-Hispanic African American and White Young Adults in South Florida

Background: Despite their higher rates of stress, African American young adults tend toward similar or lower rates of substance misuse than their White counterparts. Arguably, such patterns derive from: (1) racial variations in the availability of coping strategies that mitigate stress; and/or (2) racial differences in the efficacy of available coping styles for reducing substance misuse. Objectives: We assessed whether two coping style types—problem-focused and avoidance-oriented—varied by race (non-Hispanic African American vs. non-Hispanic White) and whether the effects of coping styles on substance misuse were moderated by race. Methods: Using data from a community sample of South Florida young adults, we employed logistic regression analyses to examine racial differences in coping style and to test if race by coping style interactions (race × problem-focused coping and race × avoidance-oriented coping) influenced the odds of qualifying for a DSM-IV substance use disorder, net of lifetime stressful events and sociodemographic controls. Results: We found that African American young adults displayed lower problem-focused coping, and higher avoidance-oriented coping, than did White young adults. Among both African American and White respondents, problem-focused coping was associated with reduced odds of illicit drug use disorder (excluding marijuana), and among Whites, avoidance-oriented coping was associated with increased odds of an aggregate measure of alcohol, marijuana, and other illicit drug use disorders. Among African Americans, however, avoidance-oriented coping was associated with lower odds of marijuana use disorder. Conclusion: Substance misuse policies and practices that consider the sociocultural contexts of stress and coping are recommended.     

Relationship of PTSD With impulsivity Dimensions While Controlling the Effect of Anxiety and Depression in a Sample of Inpatients With Alcohol Use Disorder

Objective: The aim of the present study was to evaluate the relationship of posttraumatic stress disorder (PTSD) with impulsivity dimensions while controlling the effect of anxiety and depression in a sample of inpatients with alcohol use disorder (AUD). Methods: Participants were 190 male patients admitted to a specialized center for substance use disorders within a six month period. Participants were evaluated with the State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), the Short Form Barratt Impulsiveness Scale (BIS-11-SF), the Traumatic Experiences Checklist, and PTSD Checklist-Civilian version. Results: Age was lower in the group with PTSD (n = 63, 33.2%) than the group without PTSD (n = 127, 66.8%). Duration of education, marital, and employment status did not differ between the groups. STAI, BDI, and BIS-11-SF scores were higher in the group with PTSD. Trait anxiety, depression, and impulsivity predicted high PTSD risk in a logistic regression model. Same variables predicted the severity of PTSD symptoms in a linear regression. Among dimensions of impulsivity attentional component was the only predictor of PTSD symptoms severity, not motor or nonplanning impulsivity. Conclusions: These findings suggest that the PTSD may be related to impulsivity, particularly attentional impulsivity, even after controlling anxiety and depression among inpatients with AUD.     

Psychosocial differences between smokers and non-smokers during pregnancy

Despite the well-established adverse birth and childhood health outcomes associated with maternal smoking, smoking rates among pregnant women remain high. Psychosocial health attributes, including anxiety, depression, perceived stress, self-efficacy, and personality characteristics, have especially important roles in smoking behavior. Understanding who smokes during pregnancy and what factors influence this behavior choice may be key to improving the effectiveness of smoking cessation intervention programs. We use data from a prospective cohort study of pregnant women to understand the psychosocial health profiles of women who choose to smoke during pregnancy compared to the profiles of women who do not smoke or successfully quit smoking during pregnancy. Multinomial logistic regression analyses on 1518 non-Hispanic black and non-Hispanic white women assessed the association between smoking status and psychosocial health while controlling for demographic characteristics. Higher levels of perceived stress, depression, neuroticism, negative paternal support, and perceived racism among non-Hispanic blacks were associated with higher odds of being a smoker than a non-smoker (p < 0.05). Higher levels of self-efficacy, extraversion, agreeableness, conscientiousness, interpersonal support, positive paternal support, and perceived social standing were associated with lower odds of being a smoker than a non-smoker (p < 0.05). Our analysis indicates that women who smoked during pregnancy experienced a more negative constellation of psychosocial adversities than women who did not smoke. Given the psychosocial needs and personality profiles experienced by smokers, more attention to the psychosocial strengths and weaknesses of these women may allow for more tailored smoking cessation programs, enhancing both the short- and long-term effectiveness of such interventions.     

Personality Traits of Hospital Pharmacists: Toward a Better Understanding of Factors Influencing Pharmacy Practice Change

Background

The profession of pharmacy has adopted a mandate to become more patient-centred; however, significant change in this direction has not been achieved.

Objective:

To characterize the personality traits of hospital pharmacists in one Canadian province, to provide insights into potential barriers to practice change.

Methods:

A cross-sectional survey of hospital pharmacists was conducted in Alberta, Canada. An invitation to participate was sent to all 766 hospital pharmacists practising in the province’s 2 health service organizations. The survey was based on the Big Five Inventory, a validated, reliable instrument that uses a 5-point Likert scale to measure the traits of extraversion, agreeableness, conscientiousness, neuroticism, and openness.

Results:

Of the 347 pharmacists who completed the survey (45% response rate), the majority (297 [86%]) were staff pharmacists working full time in an urban setting. The average age of respondents was 41 years (standard deviation [SD] 11 years), and the average period in practice was 17 years (SD 11 years). Respondents’ mean scores were 3.2 (SD 0.7) on extraversion, 3.8 (SD 0.4) on agreeableness, 4.0 (SD 0.4) on conscientiousness, 2.5 (SD 0.7) on neuroticism, and 3.5 (SD 0.6) on openness. Total frequency counts revealed that respondents tended toward stronger expression of extraversion, agreeableness, conscientiousness, and openness and low levels of neuroticism (with the latter indicating stability).

Conclusion:

The Big Five Inventory represents a novel approach to examining pharmacists’ change-related behaviours. Improving understanding of hospital pharmacists’ personality traits will provide insights for the development of training and support programs tailored specifically to this group.     

Protective behavioral strategies mediate problem-focused coping and alcohol use in college students

Objective

Protective behavioral strategies have emerged as a construct protective against alcohol use. The current study examines the theoretical associations among general coping styles, protective behavioral strategies, drinking to cope motives, and alcohol use in college students.

Method

Analyses of fully latent variables were conducted using structural equation modeling in a sample of 327 college students.

Results

Protective behavioral strategies partially mediated the association between problem-focused coping and alcohol use. Behaviorally oriented problem-focused coping strategies accounted for the positive relationship between problem-focused coping and protective behavioral strategies whereas cognitively oriented problem-focused coping strategies were associated with less use of protective behavioral strategies and increased alcohol use.

Conclusions

This is the first study to find that protective behavioral strategies are more likely to be used by college students who endorse using a problem-focused coping style, especially if they tend to use behaviorally oriented problem-focused coping strategies. These findings extend the literature on protective behavioral strategies and indicate that students less likely to use problem-focused coping skills to deal with stress in general may need additional interventions to increase their use of protective behavioral strategies.     

Hoarding Behaviors and Alcohol Use: The Mediating Role of Emotion Dysregulation

Background: Despite recent research establishing high rates of comorbidity between hoarding disorder and alcohol use disorders (AUD), no studies have systemically examined the associations between symptoms of hoarding and alcohol use. Moreover, no studies have explored potential mechanisms that may help to explain these relations. Objectives: Thus, the current study was designed to examine the associations between hoarding and AUD symptoms, as well as the mediating role of emotion dysregulation. Methods: Self-report measures of hoarding, depression, anxiety, alcohol use, and emotion regulation were collected in a sample of 574 adults (M age = 35.43, SD = 12.57; 62% female). Results: Even when controlling for depression and anxiety, AUD symptoms were associated with overall hoarding severity (β =.23, p <.001) as well as acquiring symptoms (β =.16, p =.03). Further, the relation between hoarding symptoms and AUD symptoms was mediated by difficulties regulating emotions (B =.04, 95% CI [.02,.06]). Conclusions/Importance: Results of the current study suggest that increased alcohol use may be one way in which individuals with hoarding symptoms attempt to regulate their emotions.     

Neurotic Personality Traits and Risk for Adverse Alcohol Outcomes: Chained Mediation through Emotional Disorder Symptoms and Drinking to Cope

Background: Rates of alcohol abuse are high on Canadian postsecondary campuses. Individual trait differences have been linked to indices of alcohol use/misuse, including neurotic traits like anxiety sensitivity (AS) and hopelessness (HOP). We know little, though, about how these traits confer vulnerability. AS and HOP are related to anxiety and depression, respectively, and to drinking to cope with symptoms of those disorders. Neurotic personality may therefore increase risk of alcohol use/abuse via (1) emotional disorder symptoms and/or (2) coping drinking motives. Objectives: Allan and colleagues (2014) found chained mediation through AS-generalized anxiety-coping motives-alcohol problems and AS-depression-coping motives-alcohol problems. We sought to expand their research by investigating how emotional disorder symptoms (anxiety, depression) and specific coping motives (drinking to cope with anxiety, depression) may sequentially mediate the AS/HOP-to-hazardous alcohol use/drinking harms relationships among university students. Methods: This study used cross-sectional data collected in Fall 2014 as part of the Movember-funded Caring Campus Project (N = 1,883). The survey included the SURPS, adapted DMQ-R SF, and AUDIT-3. Results: AS and HOP were both related to hazardous alcohol and drinking harms via emotional disorder symptoms and, in turn, coping drinking motives. All indirect pathways incorporating both mediators were statistically significant, and additional evidence of partial specificity was found. Conclusions/Importance: The study's results have important implications for personality-matched interventions for addictive disorders.     

Neuroticism and Negative Urgency in Problematic Alcohol Use: A Pilot Study

Background: Problematic alcohol use is common among university students and personality might account for individual differences in developing this maladaptive behavior. Two personality dispositions implicated in problematic alcohol use are negative urgency and neuroticism. However, the relationship of these traits to problematic alcohol use is unclear. In college students high neuroticism is not directly linked to problematic alcohol use. On the other hand, the experience of emotional distress in people high in neuroticism could impair the capacity for impulse control. Loss of impulse control under conditions of negative affect could trigger impulsive drinking and problematic alcohol use in the long run. Objectives: We investigated this idea by testing whether negative urgency mediates the relationship of neuroticism to problematic alcohol use. Methods: Participants were 60 undergraduate university students who completed the Urgency subscale of the Urgency, (lack of) Premeditation, (lack of) Perseverance, Sensation Seeking, and Positive Urgency Impulsive Behaviour scale (UPPS-P), the Alcohol Use Disorders Identification Test (AUDIT), and the Neuroticism subscale of the Eysenck Personality Questionnaire Revised short form (EPQ-RSS). Results: The results confirmed our hypothesis as we found an indirect effect of negative urgency on the relationship between neuroticism and problematic alcohol use. Conclusions/Importance: It appears that it is not distress but the tendency to act rashly when distressed that is important in developing problematic alcohol drinking in university students.     

Depressive Symptoms and Associated Clinical Characteristics in Outpatients Seeking Community-Based Treatment for Alcohol and Drug Problems

Background: Comorbid psychiatric and substance use disorders are common and associated with poorer treatment engagement, retention, and outcomes. This study examines the presence of depressive symptoms and the demographic and clinical correlates in a diverse sample of substance abuse treatment seekers to better characterize patients with co-occurring depressive symptoms and substance use disorders and understand potential treatment needs. Methods: Baseline data from a randomized clinical effectiveness trial of a computer-assisted, Web-delivered psychosocial intervention were analyzed. Participants (N = 507) were recruited from 10 geographically diverse outpatient drug treatment programs. Assessments included the self-report Patient Health Questionnaire, and measures of coping strategies, social functioning, physical health status, and substance use. Results: One fifth (21%; n = 106) of the sample screened positive for depression; those screening positive for depression were significantly more likely to screen positive for anxiety (66.9%) and posttraumatic stress disorder (PTSD; 42.9%). After controlling for anxiety and PTSD symptoms, presence of depressive symptoms remained significantly associated with fewer coping strategies (P = .001), greater impairment in social adjustment (P < .001), and poorer health status (P < .001), but not to days of drug use in the last 90 days (P = .14). Conclusions: Depression is a clinically significant problem among substance abusers, and, in this study, patients who screened positive for depression were more likely to have co-occurring symptoms of anxiety and PTSD. Additionally, the presence of depressive symptoms was associated with fewer coping strategies and poorer social adjustment. Coping skills are a significant predictor of addiction outcomes, and it may be especially important to screen for and enhance coping among depressed patients. Evidence-based interventions that target coping skills and global functioning among substance abusers with depressive symptoms may be important adjuncts to usual treatment.     

Personality risk profile for conduct disorder and substance use disorders in youth

The five factor model of personality is a useful metric to describe personality profiles associated with maladaptive functioning. Using the NEO-Five Factor Inventory (NEO-FFI), we examined a conceptually based profile of high neuroticism, low agreeableness and low conscientiousness among 243 youth (aged 13-18 years) with varying degrees of conduct disorder (CD) and substance use disorders (SUD). Comparisons of the NEO-FFI personality dimensions between CD/SUD youth and adolescent siblings (N=173), and relations between the personality dimensions and behavioral indicators of conduct disorder and substance involvement were examined. Youth with CD and SUD had greater neuroticism, lower agreeableness, and lower conscientiousness than siblings of a similar age. The NEO-FFI scales predicted aggression and substance involvement for both probands and siblings in this cross-sectional investigation. These findings support the role for personality in models of the etiology and persistence of conduct disorder and substance use disorders.     

Temporal sequence of comorbid alcohol use disorder and anorexia nervosa

Women with eating disorders have a significantly higher prevalence of substance use disorders than the general population. The goal of the current study was to assess the temporal pattern of comorbid anorexia nervosa (AN) and alcohol use disorder (AUD) and the impact this ordering has on symptomatology and associated features. Women were placed into one of three groups based on the presence or absence of comorbid AUD and the order of AN and AUD onset in those with both disorders: (1) AN Only, (2) AN First, and (3) AUD First. The groups were compared on psychological symptoms and personality characteristics often associated with AN, AUD, or both using general linear models. Twenty-one percent of women (n = 161) with AN reported a history of AUD with 115 reporting AN onset first and 35 reporting AUD onset first. Women with binge-eating and/or purging type AN were significantly more likely to have AUD. In general, differences were found only between women with AN Only and women with AN and AUD regardless of order of emergence. Women with AN and AUD had higher impulsivity scores and higher prevalence of depression and borderline personality disorder than women with AN Only. Women with AN First scored higher on traits commonly associated with AN, whereas women with comorbid AN and AUD displayed elevations in traits more commonly associated with AUD. Results do not indicate a distinct pattern of symptomatology in comorbid AN and AUD based on the temporal sequence of the disorders.     

Coping strategies,illness perception,anxiety and depression of patients with idiopathic constipation: a population-based study

BACKGROUND: Functional constipation has important psychological elements. AIM: To investigate the prevalence of functional constipation in an Asian population, and the interplay among functional constipation, anxiety/depression, perception and coping strategies. METHODS: An interview of 3282 patients was made by telephone survey. Constipation was diagnosed by Rome II criteria. Coping ability and anxiety/depression were assessed by validated questionnaires. RESULTS: Fourteen percent of the interviewees had constipation. Anxiety and depression scores were higher in constipated than in healthy subjects (P < 0.0001 and < 0.0001), and in female than male patients (P = 0.02 and < 0.0001). Patients who were aware of their symptoms perceived greater impact on their lives (P < 0.001). Frequent use of coping strategies associated with lower anxiety scores (P < 0.0001). Female were more frequently aware of the symptoms (P = 0.004), less frequently used coping strategies (P = 0.008). Regression analysis showed that female and high anxiety level were the independent factors for predicting the perception of constipation, whereas anxiety was the only independent factor for predicting the use of coping strategies. CONCLUSION: Constipation associated with anxiety and depression is prevalent in the general Asian population. Female sex and anxiety are important aetiological factors in constipation, affecting perception and the use of coping strategies.     

High- and low-dose expectancies as mediators of personality dimensions and alcohol involvement

OBJECTIVE: The present study examined the influences of personality dimensions (extraversion, neuroticism) on college alcohol involvement both (1) directly and (2) mediated by positive and negative alcohol expectancies across two imagined (high and low) alcohol doses. METHOD: Participants (N = 339; 176 women) were regularly drinking college students who completed a questionnaire battery on demographic characteristics, personality, expectancies, and alcohol use and problems. RESULTS: Structural equation modeling analysis of low- and high-dose models revealed partial support for the Social Learning Theory conceptualization of expectancies as mediators of more distal (personality) influences. Interestingly, patterns of association differed by dose. At high-expectancy doses, positive alcohol expectancies fully mediated the extraversion-use association. At low doses, positive expectancies did not play a critical role. Two distinct pathways from neuroticism to alcohol use were observed: a direct pathway, whereby neuroticism is a protective factor for alcohol use, and an indirect pathway, through positive expectancies, whereby neuroticism is a risk factor. The protective pathway was evident regardless of expectancy doses, whereas the risk pathway was evident only at high doses. Negative expectancies partially mediated the association between neuroticism and alcohol problems at both high- and low-expectancy doses. CONCLUSIONS: These data underscore the unique role of both positive and negative expectancies in the association between personality and drinking behavior and point to the importance of considering alcohol dose when assessing expectancies. Findings suggest that it may be beliefs about the effects resulting from heavy (rather than moderate) drinking that may be the active mechanism underlying drinking behavior.