Amanda K. Gilmore

Underestimating protection and overestimating risk: examining descriptive normative perceptions and their association with drinking and sexual behaviors

Individuals who engage in risky sexual behavior face the possibility of experiencing negative consequences. One tenet of social learning theory is that individuals engage in behaviors partly based on observations or perceptions of others’ engagement in those behaviors. The present study aimed to document these norms–behavior relationships for both risky and protective sexual behaviors, including alcohol-related sexual behavior. Gender was also examined as a possible moderator of the norms–behavior relationship. Undergraduate students (n = 759; 58.0% female) completed a Web-based survey, including various measures of drinking and sexual behavior. Results indicated that students underestimate sexual health-protective behaviors (e.g., condom use and birth control use) and overestimate the risky behaviors (e.g., frequency of drinking prior to sex, typical number of drinks prior to sex, and frequency of casual sex) of their same-sex peers. All norms were positively associated with behavior, with the exception of condom use. Furthermore, no gender differences were found when examining the relationship between normative perceptions and behavior. The present study adds to the existing literature on normative misperceptions as it indicates that college students overestimate risky sexual behavior while underestimating sexual health-protective behaviors. Implications for interventions using the social norm approach and future directions are discussed.

Influences of Situational Factors and Alcohol Expectancies on Sexual Desire and Arousal Among Heavy-Episodic Drinking Women: Acute Alcohol Intoxication and Condom Availability

Although studies suggest that alcohol increases women’s sexual desire, no studies to our knowledge have examined the effects of acute alcohol intoxication on women’s sexual desire. The majority of research examining alcohol’s effects on sexual arousal in women suggests that alcohol increases self-reported arousal. In an alcohol administration study in which women projected themselves into an eroticized scenario depicting a consensual sexual encounter with a new male partner, we examined the effects of alcohol and condom condition on women’s sexual desire and arousal. The moderating effects of sex-related alcohol expectancies were also examined. Results revealed that alcohol intoxication was related to less desire to engage in sex with a new partner and condom presence was related to more desire. Alcohol interacted with sexual disinhibition alcohol expectancies, indicating that more expectancy endorsement was associated with greater sexual desire and self-reported arousal in the alcohol condition, but not the control condition. Condom condition had no effect on self-reported sexual arousal. The present research suggests that sexual desire merits research attention in non-clinical samples, and experimental methodology can provide valuable information about alcohol’s influence on women’s sexual desire, thus advancing our understanding of this relationship beyond cross-sectional correlations. The current findings also provide evidence that sex-related alcohol expectancies may play an important role in alcohol-involved sexual experiences including desire and arousal.

Balanced placebo design: Revolutionary impact on addictions research and theory

Prior to the publication of Marlatt, Demming, and Reids (1973, Journal of Abnormal Psychology, 81, 233–241) manuscript entitled “Loss of control drinking in alcoholics: An experimental analogue,” the disease model of alcoholism prevailed. Central to the model was the belief that alcoholics suffer from a loss-of-control such that any drinking resulted in unregulated consumption and intoxication. In a masterfully crafted experimental investigation that represented an early use of the balanced placebo design (BPD), G. Alan Marlatt and his colleagues demonstrated that a priming drink of alcohol had no effect on how much alcoholics consumed during an ad libitum assessment of alcohol consumption. Marlatts publication reflected a departure from conventional wisdom by challenging the strict adherence to the disease model of alcoholism and contributed to advancements in both addictions research and theory. This article is dedicated to describing these advancements including: (1) a revised understanding of the symptomatology and etiology of alcoholism; (2) the development of cognitive-behaviorally oriented alcohol interventions; (3) the effects of alcohol on behavior and the role of alcohol expectancies; (4) the use of the BPD; and (5) the development of behavioral assessment strategies for addictions by innovating in vitro procedures for measuring ad libitum alcohol consumption unobtrusively. In the 40 years since its publication, Marlatt et al. (1973, Journal of Abnormal Psychology, 81, 233–241) continues to have a profound impact on research and theory and is a testament to G. Alan Marlatts status as a visionary and pioneer in the field of addictions research.

Assessing women's sexual arousal in the context of sexual assault history and acute alcohol intoxication.

INTRODUCTION Few studies have examined differences in womens sexual arousal based on sexual assault history (SAH) or in-the-moment alcohol intoxication. Only one has examined combined effects. Findings regarding the relationship between SAH and arousal are contradictory. AIM We aimed to determine the relationship between SAH, alcohol intoxication, and sexual arousal. METHODS Women were randomly assigned to an alcohol (target blood alcohol level = 0.10%) or control condition and categorized as having an SAH or not. After beverage administration, all women watched erotic films while genital arousal (vaginal pulse amplitude; VPA) was measured. Afterward, self-reported sexual arousal was measured. MAIN OUTCOME MEASURES Genital response was measured by VPA using vaginal photoplethysmography while watching erotic films. Self-reported sexual arousal was assessed after watching erotic films. RESULTS Women with an SAH had smaller increases in genital arousal in response to the films than women without an SAH. Intoxicated women had smaller increases in genital arousal than sober women. However, no differences for SAH or intoxication were found in self-reported arousal. CONCLUSION SAH and alcohol intoxication are associated with smaller increases in genital arousal compared to women without an SAH and sober women, suggesting that these co-occurring factors impact sexual arousal.

Sexual assault, drinking norms, and drinking behavior among a national sample of lesbian and bisexual women

Childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) are strongly associated with womens alcohol use and the rates of both alcohol use and sexual assault history are higher among lesbian and bisexual women than heterosexual women. Although descriptive drinking norms are one of the highest predictors of alcohol use in emerging adults, this is the first study to examine the relationship between sexual assault history, drinking norms, and alcohol use in lesbian and bisexual women. We found that CSA severity was associated with a higher likelihood of experiencing more severe alcohol-involved ASA, more severe physically forced ASA, and was indirectly associated with more drinking behavior and higher drinking norms. Additionally, more severe alcohol-involved ASA was associated with higher drinking norms and more drinking behavior, but physically forced ASA was not. These findings help explain previous contradictory findings and provide information for interventions.

The role of social drinking factors in the relationship between incapacitated sexual assault and drinking before sexual activity

White House Council on Women and Girls (2014) highlighted sexual assault prevention as a high priority issue in need of immediate attention. A risk factor associated with sexual assault victimization and revictimization is drinking before sexual activity. The current study examined the relationship between incapacitated sexual assault (ISA) and drinking before sexual activity. Given the typical social context of both drinking before sexual activity and sexual assault in college settings, social-related drinking factors including drinking to conform motives, social drinking motives, and perceived drinking norms were examined. Six hundred and three undergraduate college women completed a survey online assessing history of ISA, social factors associated with drinking, and frequency of drinking before sexual activity. Path analysis indicated that both ISA before college and since entering college were associated with higher perceived drinking norms, more social drinking motive endorsement, and more drinking to conform. However, only higher perceived drinking norms and more social drinking motive endorsement were associated with both more severe ISA histories and more frequent drinking before sexual activity. Thus, a more severe ISA history was indeed associated with more frequent drinking before sexual activity and social factors related to drinking played a significant role in this relationship. Social factors can be easily targeted through brief interventions and these findings can inform future programming to promote more careful use of alcohol in social and sexual situations.

Minority stress is longitudinally associated with alcohol-related problems among sexual minority women

Compared to sexual minority men and heterosexual women, sexual minority women report elevated alcohol use in young adulthood. Heavy alcohol use and alcohol use disorders disproportionately affect sexual minority women across the lifespan, yet there is limited research investigating reasons for such associations. The present study investigates longitudinal associations between minority stress and both alcohol use as well as self-rated drinking consequences. Participants (N=1057) were self-identified lesbian (40.5%) and bisexual (59.5%) women between the ages of 18 to 25 recruited from across the U.S. using online advertisements. Participants completed four annual surveys. Hurdle mixed effects models were used to assess associations between minority stress and typical weekly drinking and drinking consequences one year later. Minority stress was not significantly associated with subsequent typical drinking. However, minority stress was significantly associated with having any alcohol consequences as well as the count of alcohol consequences one year later after controlling for covariates. Consistent with extant literature, this study provides evidence for a prospective association between minority stress experienced by sexual minority women and drinking consequences. This study also provides support for the potential impact of efforts to reduce minority stress faced by sexual minority women.

The Use of Drinking and Condom-Related Protective Strategies in Association with Condom Use and Sex-Related Alcohol Use

Approximately 40% of American college students engage in heavy drinking, and heavy drinking is associated with sexual risk behaviors. It is imperative to gain a better understanding of the relationship between alcohol and sexual risk behaviors for prevention efforts. This article examined the use of drinking and condom-related protective behavioral strategies (PBS) in relation to drinking and condom-use outcomes in 436 college students. Drinking PBS are related to drinking and negative alcohol-related consequences. Furthermore, condom-related PBS are related to condom use; however, it is unclear if drinking PBS are related to condom use, particularly condom use when drinking. It was hypothesized that the use of drinking PBS would be related to less alcohol-related sexual activity, that the use of condom-related PBS would be related to greater condom use and condom use while drinking, and that drinking PBS would be related to greater condom use, especially condom use when drinking. It was found that condom-related PBS were associated with condom behavior and drinking PBS were related to drinking behavior, but we did not find support for a relationship between drinking PBS and condom use. This suggests that condom-related PBS may be a more effective target for increasing condom use than drinking PBS alone.

Verbal Sexual Coercion Experiences, Sexual Risk, and Substance Use in Women

Research has linked sexual assault, substance use, and sexually transmitted infection (STI) risk in women. Sexual assault by means of verbal sexual coercion (VSC) is more common than sexual assault by means of physical tactics, but VSC is rarely assessed independently. In addition, past work has established global connections among substance use, sexual assault history, and STI risk; however, assessing substance use during sexual behavior is less common. This study examined the relations among VSC, STI risk behavior, and substance use and attitudes. We hypothesized that women with larger numbers of VSC experiences would report more frequent sexual risk behaviors and substance use and attitudes. Participants with larger numbers of VSC experiences reported larger numbers of anal sex partners, more frequent penile–vaginal sex and sexual activity after substance use, and stronger sex-related alcohol expectancies. These findings suggest that VSC is associated with higher levels of STI risk in women.

The Use of Drinking and Sexual Assault Protective Behavioral Strategies Associations With Sexual Victimization and Revictimization Among College Women

Despite consistent high rates of campus sexual assault, little research has examined effective strategies to decrease sexual assault victimization. Sexual assault and drinking protective behavioral strategies (PBS) may be important means of reducing sexual assault victimization risk on college campuses but need further examination. The current study examined the relationship among sexual assault in childhood, before college, and since college to evaluate the mitigating roles of both sexual assault PBS and drinking PBS on sexual assault victimization. Participants (n = 620) were undergraduate women, 18 to 20 years old. The current study was a cross-sectional online survey assessing participants’ sexual assault PBS and sexual assault history. Sexual assault history was positively associated with future sexual assault experiences. Pre-college sexual assault was associated with increased since-college sexual assault and increased drinks per week. Since-college adolescent/adult sexual assault was associated with less use of sexual assault PBS. These findings suggest that PBS may have an important role in sexual assault victimization and future research should examine their usefulness in risk reduction programs for college women.