Amy L. Stamates

Alcohol Expectancies Mediate the Relationship Between Age of First Intoxication and Drinking Outcomes in College Binge Drinkers

ABSTRACT Background: While prior research has shown that age of first intoxication (AI) is associated with negative alcohol outcomes, limited research has examined factors accounting for this relationship. Alcohol expectancies, or beliefs about the effects of alcohol, may explain such associations as both positive and negative expectancies have been shown to be key predictors of drinking outcomes. Objective: The present study examined expectancies as mediators between early AI and alcohol-related outcomes. Method: Data collection occurred in 2012 and 2013. Participants were college students (N = 562, 65.8% women) who completed an online survey including measures of alcohol use history, alcohol expectancies, typical alcohol consumption, and alcohol-related problems. Structural equation modeling was used to test the hypothesized model. Results: Our findings support a model whereby AI is associated with drinking through its influence on both positive and negative expectancies. Specifically, an earlier AI was associated with stronger alcohol expectancies, which in turn, was associated with heavier alcohol use and alcohol-related problems. Conclusions/Importance: These findings are consistent with expectancy theory and previous research suggesting that more experienced drinkers hold stronger drinking-related beliefs, be it positive or negative, and these expectancies ultimately explain variability in alcohol use and problems. Our findings further support that expectancies play an important role in the initiation of drinking behavior.

Alcohol use variability in a community-based sample of nonstudent emerging adult heavy drinkers

ABSTRACT Background: While nonstudent emerging adults are at elevated risk for experiencing alcohol-related problems, there remains a paucity of research devoted specifically to addressing drinking in this group. Objectives: The present study sought to offer unique insights into nonstudent drinking by examining drinking variability across 30 days using a retrospective diary method. Specific aims were to: (1) compare within- and between-person variability in alcohol use across 30 days, and (2) determine the extent to which central social-cognitive between-person factors (i.e., social expectancies, perceived drinking norms, social drinking motivations) predict between-person alcohol use as well as within-person variability in drinking. Methods: Participants were 195 (65.1% men) nonstudent emerging adults recruited from the community with a mean age of 21.9 (SD = 2.1) years. Results: Findings showed that a substantial portion of variation in daily alcohol consumption was attributable to the within-person (83%) rather than between-person (17.2%) level. Social expectancies, perceived drinking norms, and social motives were found to influence variability in daily alcohol consumption. Conclusion: Our findings contribute to knowledge that could guide efforts to design and tailor intervention strategies to minimize the harms experienced by an understudied and at-risk population of drinkers.

The dimensionality of impulsivity: Perspectives and implications for emerging adult drinking.

Heightened impulsivity is a risk factor for problematic alcohol use among emerging adults. However, recent literature suggests that impulsivity is comprised of several facets that have shown differential relationships with alcohol use versus alcohol-related problems. Previous reviews have noted the bivariate associations between facets and alcohol use outcomes, but have not honed in on which facets may explain more variance in alcohol-related outcomes once other facets are accounted for. As such, certain facets may be more relevant than others in predicting alcohol-related harms among emerging adults. Consequently, the purpose of this review was to support the validity of discrete impulsivity facets and to identify specific facets that may pose most risk for alcohol-related harms. Based on previous research, the present review focused on five facets from the self-report impulsivity literature (i.e., sensation seeking, negative urgency, positive urgency, premeditation, and perseverance) and two facets from the behavioral impulsivity literature (i.e., impulsive action and impulsive choice). Conceptual and empirical evidence were provided to support the distinction of these self-report and behavioral facets, and literature comparing each of their relative contributions to alcohol use and alcohol-related problems, while controlling for the influence of other facets, is summarized. Overall, it is suggested that among emerging adults, sensation seeking is the strongest predictor of alcohol use whereas positive and negative urgency are the strongest predictors of alcohol-related problems. Implications and directions for future research were proposed.

Mixing alcohol with artificially sweetened beverages: prevalence and correlates among college students

Mixing alcohol with diet beverages, as compared to mixing the same amount of alcohol with a regular beverage, is associated with greater intoxication. This may occur because diet mixers increase alcohol absorption rates. Thus, it is plausible that the use of diet mixers may increase the risk of alcohol-related harms. The current study sought to (1) determine the rate/frequency of use in among college students, (2) examine the relationship between mixing alcohol with diet beverages and alcohol-related problems, above typical alcohol use and sensation seeking, and (3) explore key traits (gender, restricting food while drinking, and body mass index [BMI]) that may characterize users. Participants were 686 (73% female) undergraduate students who completed self-reports of alcohol use (including diet mixer use), alcohol-related problems, eating behaviors while drinking, sensation seeking, and demographic information. Results revealed that about 36% of the sample reported consuming alcohol with diet mixers, and users typically consumed this beverage at least once a month. Students who reported mixing alcohol with diet beverages experienced more alcohol-related problems. And, the more frequently one consumed this beverage, the more problems were reported. These associations were found after controlling for typical level of alcohol use and sensation seeking. No differences were observed between user-status on gender, eating behaviors while drinking, and BMI. Our findings suggest that mixing alcohol with diet beverages could be a risk factor for experiencing more alcohol-related harms. Further research is needed to understand this relationship, as it may help guide intervening efforts aimed to reduce alcohol-related risks.

Testing a model of caffeinated alcohol-specific expectancies

INTRODUCTION The present study sought to further understand the association between caffeinated alcoholic beverage (CAB) use and alcohol-related risks. In particular, we focused on the role of two identified expectancies specific to CAB use: intoxication enhancement and avoidance of negative consequences. Although outcome expectancies are consistent predictors of substance use, limited research has examined expectancies related to CAB use and their association with alcohol-related behaviors, such as protecting themselves from alcohol-related harms. Consequently, the present study examined CAB-specific expectancies and protective behavioral strategies (PBS) as mediators of CAB use and negative consequences. METHODS Participants were 322 (219 women) college drinkers who completed self-report measures of typical CAB and alcohol use, CAB-specific expectancies, PBS use, and alcohol-related harms. RESULTS Structural equation modeling revealed, after controlling for typical non-CAB heavy alcohol use, a significant indirect effect of CAB use to alcohol-related problems through avoidance of negative consequences CAB expectancies and PBS use. However, intoxication enhancement expectancies did not mediate this association. CONCLUSIONS Our findings indicate that heavier CAB use was associated with stronger expectations that drinking CABs can help avoid negative consequences. These beliefs were related to using fewer PBS when drinking and a greater likelihood of experiencing problems. Given that these expectancies may be underlying mechanisms of CAB use, their inclusion in existing alcohol interventions may be beneficial.

Impulsivity and risk-taking as predictors of alcohol use patterns and alcohol related-problems

Abstract This study examined the predictive utility of self-report measures of impulsivity and risk-taking in alcohol use outcomes (i.e. quantity, frequency, binge frequency, and alcohol-related problems). Participants were 370 (265 women) college student drinkers between ages 18 and 25 years from a mid-size east coast university. Participants completed measures of impulsivity, risk-taking, alcohol use, and alcohol-related problems. Impulsivity and risk-taking contributed uniquely to approximately 12% in quantity, 4% in frequency, 12% in binge frequency, and 7% in alcohol-related problems, after controlling for age and gender. When controlling for risk-taking, impulsivity accounted for more incremental variance in alcohol use outcomes (9% in quantity, 4% in frequency, 6% in binge frequency, and 5% in problems). Regarding specific impulsivity subscales, motor impulsiveness was more predictive of alcohol use variables whereas attentional and non-planning impulsiveness were predictive of alcohol-related problems. Although the risk behaviors subscale predicted some drinking indices and problems, risk assessment was not associated with any alcohol use outcome. Overall, the findings provide support for the predictive utility of both impulsivity and risk-taking in accounting for variability in various alcohol use behaviors and alcohol-related problems; however, findings suggest that impulsivity may have a stronger and more consistent association with alcohol use patterns and problems. The inclusion of both constructs in theoretical frameworks may aid our conceptualization of the role disinhibition has in college drinking and provide information for intervening efforts aimed at reducing risky alcohol behaviors.

Identifying patterns of situational antecedents to heavy drinking among college students

Abstract Background: Emerging adults have the highest prevalence of heavy drinking as compared to all other age groups. Given the negative consequences associated with such drinking, additional research efforts focused on at-risk consumption are warranted. The current study sought to identify patterns of situational antecedents to drinking and to examine their associations with drinking motivations, alcohol involvement, and mental health functioning in a sample of heavy drinking college students. Method: Participants were 549 (65.8% women) college student drinkers. Results: Latent profile analysis identified three classes based on likelihood of heavy drinking across eight situational precipitants. The ‘High Situational Endorsement’ group reported the greatest likelihood of heavy drinking in most situations assessed. This class experienced the greatest level of alcohol-related harms as compared to the ‘Low Situational Endorsement’ and ‘Moderate Situational Endorsement’ groups. The Low Situational Endorsement class was characterized by the lowest likelihood of heavy drinking across all situational antecedents and they experienced the fewest alcohol-related harms, relative to the other classes. Class membership was related to drinking motivations with the ‘High Situational Endorsement’ class endorsing the highest coping- and conformity-motivated drinking. The ‘High Situational Endorsement’ class also reported experiencing more mental health symptoms than other groups. Conclusions: The current study contributed to the larger drinking literature by identifying profiles that may signify a particularly risky drinking style. Findings may help guide intervention work with college heavy drinkers.

Mixing alcohol and energy drinks in daily life: A Commentary on Verster and Colleagues (2018)

Consuming alcohol mixed with energy drinks (AmEDs) is linked with heavy alcohol use and a wide range of negative consequences from drinking such as risk for injury, driving while under the influence, and sexual risk behavior (e.g., Linden & Lau‐Barraco, 2014; Marczinski & Fillmore, 2014; Roemer & Stockwell, 2017). The majority of the research on AmED use has been restricted to between‐person comparisons, limiting our understanding of whether drinking AmEDs increases the risk for alcohol‐related harm versus riskier drinkers are more likely to consume AmEDs. Verster, Benson, Johnson, Alford, Godefroy, and Scholey (2018) conducted a meta‐analysis of between‐ and within‐person studies examining AmED and alcohol‐only use. They concluded that, on average, AmED consumers drink more than alcohol‐only consumers (a between‐person difference), but within AmED consumers, individuals drink equal amounts and experience fewer consequences on AmED occasions relative to alcohol‐only occasions (a within‐person difference). Within‐person comparisons are essential for understanding the unique risks associated with drinking AmEDs; however, the studies from which these findings are based have important methodological limitations that should be illuminated. In light of recent daily diary evidence published after Verster and colleagues completed their literature review (Linden‐Carmichael & Lau‐ Barraco, 2017a), we strongly caution readers from prematurely

Testing daily associations between impulsivity, affect, and alcohol outcomes: a pilot study

Abstract Background: Considerable research has examined impulsivity between individuals, but less research has focused on whether impulsivity fluctuates within a person. Although previous research supports trait levels of impulsivity as a risk factor for increased alcohol involvement, it is unclear whether daily (i.e., state) fluctuations in impulsivity coincide with same-day drinking behaviors. The present pilot study tested (1) the extent to which impulsivity fluctuates within-person; (2) the influence of daily impulsivity on alcohol use outcomes across all days (i.e., whether drinking occurred, the number of drinks consumed, and intentions to drink) and on drinking days only (i.e., whether heavy episodic drinking occurred and the number of problems experienced); and (3) daily affect as moderators of these relationships. Method: Participants were 24 young adult drinkers without postsecondary education who completed a baseline plus 14 follow-up daily surveys. Each day, participants reported their impulsivity, affect, and drinking behavior. Results: Multilevel modeling revealed that 42.5% of the variability in daily impulsivity was due to within-person differences. Impulsivity was related to greater odds of heavy episodic drinking and more alcohol-related problems on drinking days. Positive affect moderated the relationship between impulsivity and alcohol-related problems, and the relationship between impulsivity and drinking intentions. Conclusions: Findings suggest that changes in positive affect and impulsivity may be a risk factor for alcohol problems in a daily context. Future research examining within-person impulsivity and negative outcomes may benefit from considering positive affect.

An Examination of the Most Recent Episode of Molly Use among College Students

The current study examined event-level characteristics (e.g., contextual factors, risk behaviors) during the most recent episode of Molly use among a sample of college students who reported previously using Molly. Participants (N = 151; 66.7% female) were drinkers aged 18 to 25 years. Data were collected from October to November 2014, February to April 2015, and September to November 2015. Participants completed measures regarding typical Molly use and items related to context and behaviors during their most recent episode of Molly use. Findings revealed that our sample most commonly reported using Molly earlier in the evening while hanging out with friends or at a party. In addition, sexual and other drug use behaviors commonly occurred when using Molly. Findings provide preliminary information in guiding future work exploring Molly use and potential substance-related issues associated with the context of when and how Molly is consumed.