The relationship between coping strategies, alcohol expectancies, drinking motives and drinking behaviour

Numerous models have been proposed in an attempt to explain both alcohol use and alcohol abuse. Many of these models propose that drinking behaviour is the result of a complex interplay of cognitive and behavioural variables including coping strategies, alcohol expectancies and motives for drinking. However few studies have explored how these elements may work together to predict drinking. The current study proposed a mediational model of alcohol use in which coping strategies are related to alcohol expectancies, which in turn are related to drinking motives. Drinking motives were then viewed as proximal predictors of drinking behaviour. There were 454 participants (55.78% female) who completed self-report questionnaires assessing the above constructs. Approximately half the participants completed the questionnaires online, while the others completed the paper and pencil versions of the same measures. Findings generally supported the hypothesised model. The relationship between avoidant coping and drinking behaviour was mediated by alcohol expectancies of increased confidence and tension reduction, which in turn were related to drinking motives. As expected, drinking motives were positively related to drinking behaviour. Negative expectancies were also directly related to drinking behaviour. The results are discussed in light of cognitive models of drinking, and implications for prevention and early intervention of alcohol-use problems.     

The relationship between alcohol expectancies and drinking restraint in treatment seeking alcohol dependent patients

The allied psychological drinking constructs of alcohol expectancy and drinking restraint have shown considerable promise, both independently and in combination, in understanding problematic drinking. However, previous research examining the relationship between these two constructs has only occurred in pre-dependent, convenience samples. This study examined the role of both alcohol expectancies and drinking restraint in an alcohol dependent sample. 143 DSM-IV alcohol dependent participants (93 males, 50 females) completed measures of drinking restraint (Temptation and Restraint Inventory, TRI) and alcohol expectancy (Drinking Expectancy Profile, DEP), along with quantity and frequency of consumption and dependence severity (Alcohol Dependence Scale, ADS). The results showed that although alcohol expectancy and drinking restraint do share common underlying properties, there was unique variance attributed to the prediction of dependence severity and consumption. The results also failed to replicate the drinking restraint model observed in non-clinical samples. It was concluded that alcohol expectancy and drinking restraint models appear to show superior utility in pre-dependent populations. The implications of these findings in refining social cognitive models of alcohol misuse are discussed, with a particular focus on prevention.     

The relationship between reasons for drinking alcohol and alcohol consumption: An interactional approach

Two motives for alcohol consumption have been emphasized in the etiological and the reasons-for-drinking literature: (a) people drink alcohol to cope with stress, and (b) people drink alcohol because of social influences. There is support for both of these hypotheses, but the results are usually modest and most authors agree that more complex theories of alcohol consumption are needed. This study examined the interactional effects of reasons for drinking alcohol and situational factors on alcohol consumption. Standardized telephone interviews were conducted with 781 randomly selected Michigan drinkers. Hierarchical multiple regression analyses indicated that gender, friends' alcohol consumption, coping, and social motives for drinking were significant predictors of study participants' alcohol consumption. As predicted, there was a significant interaction between drinking to cope with stress and perceived stress, and there was also a significant interaction between drinking for social reasons and friends' alcohol consumption. Similarities and differences in the results for women, men, Blacks, and Whites are described.     

Drinking identity as a mediator of the relationship between drinking motives and weekly alcohol consumption among heavy drinking undergraduate students

Objectives

The present study assessed relationships among social, coping, enhancement, and conformity drinking motives and weekly alcohol consumption by considering drinking identity as a mediator of this relationship.

Methods

Participants were 260 heavy drinking undergraduate students (81% female; M_age = 23.45; SD = 5.39) who completed a web-based survey.

Results

Consistent with expectations, findings revealed significant direct effects of motives on drinking identity for all four models. Further, significant direct effects emerged for drinking identity on weekly drinking. Results partially supported predictions that motives would have direct effects on drinks per week; total effects of motives on drinking emerged for all models but direct effects of motives on weekly drinking emerged for only enhancement motives. There were significant indirect effects of motives on weekly drinking through drinking identity for all four models.

Conclusions

The findings supported the hypotheses that drinking identity would mediate the relationship between drinking motives and alcohol consumption. These examinations have practical utility and may inform development and implementation of interventions and programs targeting alcohol misuse among heavy drinking undergraduate students.     

Treatment of esophageal varices

The pathophysiology and treatment of esophageal varices are reviewed. The cause of esophageal varices is generally thought to be portal hypertension. The most common cause of portal hypertension in the United States is alcoholic liver disease. Other etiologies of portal hypertension include portal vein thrombosis, schistosomiasis, and inferior vena caval obstruction by tumor or thrombus. Although short-term balloon tamponade and vasopressin infusion will control acute variceal hemorrhage, they do not affect the underlying problem and are not indicated for long-term treatment of esophageal varices. Surgical procedures either ablate varices or lower portal vein pressure. Portal-systemic shunts have emerged as the preferred surgical technique, but the superiority of total versus selective shunts is unclear. Pharmacological management can include administration of vasopressin, somatostatin, verapamil, or isosorbide dinitrate for short-term treatment or verapamil, isosorbide dinitrate, or propranolol for prolonged treatment. Use of sclerotherapy for treatment and prevention of hemorrhage from esophageal varices has grown recently. Because there are several sclerosing agents and combinations of agents available for use, assessing their relative safety and efficacy is difficult. Innovative approaches to management of varices include a shunt procedure involving the left lung, use of a tissue adhesive, and laser treatment. Because of its effectiveness and ease of administration, sclerotherapy appears to be a rational method of treatment for acute hemorrhage from esophageal varices.     

An association between plasma levels of 8-isoprostane and alcohol drinking habits in Japanese volunteers]

Lipid peroxidation and oxidative stress may play a certain role in the pathogenesis of pressure-induced atherosclerosis, and alcohol related diseases. Recently, 8-isoprostane in biological fluids has been reported to be a reliable marker for lipid peroxidation and oxidative stress in vivo. In the present study, we developed an ELISA method for 8-isoprostane which has high sensitivity, intra- and inter-assay reproducibility and wide dynamic assay range. Using this method, we examined the effects of drinking and smoking habits on plasma levels of 8-isoprostane in healthy subjects. A total of 157 apparently healthy volunteers was assayed for plasma 8-isoprostane. Subjects were divided into three groups according to their alcohol consumption. Group I is non- or few-drinkers, Group II includes subjects who drink once or twice a week, and subjects of Group III intake 3 to 5 times a week or almost every day. In addition, the same population was divided into two groups, 96 non-smokers and 61 smokers. Plasma 8-isoprostane was extracted with ODS gel followed by NH2 Sep-Pak column. The 8-isoprostane fractions thus separated were assayed by a commercial ELISA kit (Cayman Chemical). The plasma 8-isoprostane was estimated to be 20.9 +/- 93 pg/ml in a total of 157 volunteers (83 male, 74 female). The plasma 8-isoprostane levels were elevated in the Group III (26.6 +/- 9.5 pg/ml) compared with Group I (20.3 +/- 6.1 pg/mL, p<0.0001) and Group II (20.9 +/- 5.7 pg/ml, p<0.001). Significant increase of the plasma 8-isoprostane was observed only in habitual drinkers of females, but not in those of males. On the other hand, no significant difference of the plasma 8-isoprostane levels were observed between non-smokers (21.5 +/- 7.3 pg/ml) and smokers (22.8 +/- 7.4 pg/ml, p>0.05). We suppose that plasma 8-isoprostane may increase in the habitual drinkers due to the oxidization stress induced by alcohol intake, and it may become a useful marker to estimate drinking habit     

I can play all night: examining the relationship between perceived tolerance and drinking game alcohol consumption

The present study examined the impact of perceived tolerance to alcohol on maximum alcohol consumption while playing drinking games. Participants were student drinkers (N=3,546) from two west coast universities. Among these students, 69.2% (n=2,290) reported playing a drinking game in the past month. Analyses demonstrated game players had higher perceived tolerances, and consumed more alcohol than non-game players. A regression model revealed that higher levels of perceived tolerance were related to increased maximal alcohol consumption while playing drinking games. Study limitations and implications for future research are discussed.     

Poor adjustment to college life mediates the relationship between drinking motives and alcohol consequences: a look at college adjustment, drinking motives, and drinking outcomes

The current study examined whether the relationship between drinking motives and alcohol-related outcomes was mediated by college adjustment. Participants (N=253) completed an online survey that assessed drinking motives, degree of both positive and negative college adjustment, typical weekly drinking, and past month negative alcohol-related consequences. Structural equation modeling examined negative alcohol consequences as a function of college adjustment, drinking motives, and weekly drinking behavior in college students. Negative college adjustment mediated the relationship between coping drinking motives and drinking consequences. Positive college adjustment was not related to alcohol consumption or consequences. Positive reinforcement drinking motives (i.e. social and enhancement) not only directly predicted consequences, but were partially mediated by weekly drinking and degree of negative college adjustment. Gender specific models revealed that males exhibited more variability in drinking and their positive reinforcement drinking motives were more strongly associated with weekly drinking. Uniquely for females, coping motives were directly and indirectly (via negative adjustment) related to consequences. These findings suggest that interventions which seek to decrease alcohol-related risk may wish to incorporate discussions about strategies for decreasing stress and increasing other factors associated with better college adjustment.     

Nationwide survey of alcohol drinking and alcoholism among Japanese adults]

PURPOSE: To investigate the characteristics of alcohol use among Japanese adults and prevalence of alcohol dependence in Japan, we conducted a nationwide survey on alcohol drinking behavior and alcohol dependence among Japanese adults using a representative sampling method. METHODS: We sampled 3500 adults from throughout the entire country using a stratified random sampling method with two-step stratification, and carried out a home visit interview survey. A total of 2547 people (72.8%) responded to the survey. The survey period was June, 2003. The questionnaire contained questions about the frequency and quantity of alcohol use, 'hazardous use of alcohol' and 'alcohol dependence' according to the ICD-10 definition, several screening scales on problem use of alcohol (CAGE, KAST, AUDIT), life-time prevalence of 24 alcohol related diseases, smoking status, dysgryphia, and nightcap drinking. RESULTS: The number of respondents was, 1184 males, and 1363 females. Lifetime alcohol drinking, and weekly drinking, and daily drinking rates were 95.1%, 64.4%, and 36.2% for males, 79.0%, 27.5%, and 7.5% for females, respectively. Average daily alcohol consumption was 3.7 units for males, and 2.0 units for females (1 unit = 10 g pure alcohol). The proportion of drinkers who drank alcohol 4 units or more daily was 28.9% for males, and 7.6% for females, and that for 6 units or more was 12.7% for males, and 3.4% for females. The proportion of flasher was 41.2% for males, and 35.0% for females. Among screening questions, problem drinking was most frequently identified using AUDIT (score 12 points or more, 150 persons), followed by KAST (2 points or more, 100 persons) and CAGE (2 points or more, 98 persons). The number of subjects who met the ICD-10 criteria for alcohol dependence was 24, while the number who engaged in hazardous alcohol use was 64. CONCLUSIONS: This study revealed that problem drinking and alcohol dependence are a serious problem in Japanese general population. The problem of females drinking may be growing. The government should emphasize the prevention of alcohol drinking problems in adults and continue the conduct of nationwide prevalence surveys to monitor the problem.     

Longitudinal relationship between the alcohol warning label and alcohol consumption

OBJECTIVE: The present study reports the longitudinal relationship between alcohol warning label exposure and alcohol consumption among adolescents. METHOD: In-school surveys assessed adolescents at three annual time points beginning in tenth grade. There were 649 participants measured at all three time points; 51% were female. Four effects were the focus of the covariance structure, latent growth analysis of these data: (1) an exposure effect, whereby earlier alcohol use leads to more exposure to the warning label; (2) a deterrent effect, whereby earlier alcohol warning label exposure reduces subsequent alcohol consumption; (3) a harmful effect, corresponding to a positive relationship between early exposure and subsequent consumption; and (4) both exposure and deterrent effects operating at the same time. RESULTS: There was a statistically significant exposure effect such that earlier alcohol use was associated with later exposure to the warning. The association between earlier alcohol warning label exposure and subsequent alcohol use was generally negative but not statistically significant, suggesting that the warning did not affect alcohol consumption. CONCLUSIONS: These results suggest that the alcohol warning label is having the intended effect as described in the law requiring the warning. That is, it is informing and reminding persons of the risks associated with alcohol use. The warning does not appear to significantly increase or decrease alcohol consumption.     

Exposure to drinking mediates the association between parental alcohol use and preteen alcohol use

ObjectiveThe aim of the present study was to test the link between exposure to parental alcohol use (i.e., preteens seeing their parents drinking) and preteen's alcohol use. Specifically, this study aimed to (a) replicate the association between parental alcohol use and preteen alcohol use and (b) test whether alcohol use exposure mediated this association.MethodFamilies were recruited from five regions in the Netherlands from 104 schools that agreed to participate. Preteens (N = 755, M_age = 11.27, SD = 0.56, 45.8% boys) and their mothers (N = 755) participated in the study. Preteens reported lifetime alcohol use and parental alcohol use exposure. Mothers reported on alcohol use for both parents. Structural Equation Modelling was used to assess direct and mediated paths between parental alcohol use, preteen's exposure to alcohol use and preteen alcohol use in one model.ResultsUnexpectedly, father's alcohol use was negatively associated (β = −0.121, p = .012) and mother's alcohol use was not associated (β = 0.056, p = .215) with preteen's alcohol use. A positive indirect effect emerged through alcohol use exposure, showing that exposure to father's alcohol use mediated the association between parent's and preteen's alcohol use (β = 0.064, p = .001). This effect was absent for mother's alcohol use (β = 0.026, p = .264). Gender differences were non-significant.ConclusionsParental alcohol exposure positively mediated the association of parental alcohol use with preteen's alcohol use. These effects were found for both boys and girls and were most robust for father's drinking. The findings might provide clues for preventive action, for example, by emphasizing that exposure should be restricted to prevent preteen's alcohol use.     

Event time-series relationship between cigarette smoking and coffee drinking

Eight subjects resided in a programmed laboratory environment for seven to twelve successive days during which time cigarettes and coffee were freely available. An event time-series analysis based upon instances in time of each substance's use revealed a relationship between cigarette smoking and coffee drinking: a coffee-drinking event tended to occur late in the inter-cigarette interval, and a cigarette-smoking event was most probable during the twenty minutes immediately following a coffee-drinking event.     

The relationship between situational determinants of use and drinking motives

Objective: Recent research has focused on motives as proximal factors of alcohol use that relate to problematic outcomes. High-risk situations for use are also salient predictors of use and negative consequences, and there is some evidence to suggest that situations of use align with motives for alcohol use. The goal of the current study was to examine whether situational use variables can potentially be a proxy for motives for use by evaluating the relationships between motives, rates of alcohol use, and situational use variables (situations of use, locations of use, use companions).

Methods: We utilized data from a randomized controlled treatment trial of a brief personalized feedback intervention and subsequent online assessments that focused on motives for alcohol use among 303 college students (77.9% female, mean age?=?19.8 years).

Results: Results substantiated several theoretical relationships between Social motives and drinking in positive affect situations with others, Coping motives and drinking alone in negative affect-driven situations, Enhancement and use in positive affective situations, and Conformity and drinking in situations that are not indicative of pleasant emotions. However, we failed to find significant relationships with overall rates of use except for among Enhancement-oriented drinkers.

Conclusion: Results provide insight into the relationships between motives and situations of use. Findings broadly support the use of situational measures as an indicator of motives and suggest future avenues of research and intervention.     

Racial differences in the link between alcohol expectancies and adolescent drinking

IntroductionAlcohol expectancies are important determinants and predictors of adolescent alcohol use. Research with African Americans has shown that the endorsement of positive alcohol expectancies differs from that of Whites during childhood and predicts different alcohol outcomes during young adulthood. However, limited research has explored racial differences in the relationship between expectancy endorsement and alcohol use in school-aged adolescents. The current study examines the effect of White or African American race on the relationship between positive alcohol expectancies and alcohol use.MethodsParticipants were 104 adolescents ages 12–18 who identified as either non-Hispanic White or non-Hispanic African American. Participants completed self-report measures of alcohol consumption and positive social alcohol expectancies.ResultsPreliminary analyses revealed no racial differences in alcohol expectancies or consumption. However, race moderated the relationship between alcohol expectancies and alcohol use such that more positive expectancies predicted alcohol use among White youth, but not African American youth.ConclusionsThese results suggest that alcohol expectancies, which were thought to be important mediators of the relationship between social and personality factors and adolescent alcohol use may not be as impactful for African Americans. Future research should focus on identifying factors posing unique risk for alcohol consumption in this population.