Michael E. Dunn

Moderators of Stress in Parents of Children with Autism

Parents of children with autism experience more stress and are more susceptible to negative outcomes than parents of children with other disabilities. The present work examines the relationship between stressors, social support, locus of control, coping styles, and negative outcomes (depression, social isolation, and spousal relationship problems) among parents of children with autism. Fifty-eight parents completed surveys. Results indicated that several coping styles corresponded to negative outcomes. Furthermore, the relationship between stressors and negative outcomes was moderated by social support and coping style. Results are discussed in relation to applications for clinical practice.

Efficacy of relapse prevention: A meta-analytic review

Although relapse prevention (RP) has become a widely adopted cognitive-behavioral treatment intervention for alcohol, smoking, and other substance use, outcome studies have yielded an inconsistent picture of the efficacy of this approach or conditions for maximal effectiveness. A meta-analysis was performed to evaluate the overall effectiveness of RP and the extent to which certain variables may relate to treatment outcome. Twenty-six published and unpublished studies with 70 hypothesis tests representing a sample of 9,504 participants were included in the analysis. Results indicated that RP was generally effective, particularly for alcohol problems. Additionally, outcome was moderated by several variables. Specifically, RP was most effective when applied to alcohol or polysubstance use disorders, combined with the adjunctive use of medication, and when evaluated immediately following treatment using uncontrolled pre-post tests.

Changes in Activation of Alcohol Expectancies in Memory in Relation to Changes in Alcohol Use After Participation in an Expectancy Challenge Program

Memory model-based expectancy studies have shed light on the process by which expectancies may influence drinking but have not related changes in expectancy activation to drinking changes. In the present study, 38 undergraduates completed a drinking measure and factor-based and memory model-based expectancy measures, before and after an expectancy challenge intervention designed to alter expectancies. Expectancies were mapped into memory network format with individual differences scaling and likely paths of activation were modeled with preference mapping. Results indicated that exposure to the expectancy challenge led to a change in likely activation of expectancies for men, but not for women. In the 30 days after the intervention, alcohol use among men decreased significantly but did not change among women. Therefore, changes in likely activation corresponded to changes in drinking. These findings support a memory model conceptualization of expectancy influence on drinking.

Residual effects of cannabis use on neurocognitive performance after prolonged abstinence: a meta-analysis.

Cannabis is the most widely used illicit drug in the U.S., and the number of illicit and licit users is rising. Lasting neurocognitive changes or deficits as a result of use are frequently noted despite a lack of clarity in the scientific literature. In an effort to resolve inconsistencies in the evidence of lasting residual effects of cannabis use, we conducted two meta-analyses. First, we updated a previous meta-analysis on broad nonacute cognitive effects of cannabis use through inclusion of newer studies. In a second meta-analysis, we focused on evidence for lasting residual effects by including only studies that tested users after at least 25 days of abstinence. In the first meta-analysis, 33 studies met inclusion criteria. Results indicated a small negative effect for global neurocognitive performance as well for most cognitive domains assessed. Unfortunately, methodological limitations of these studies prevented the exclusion of withdrawal symptoms as an explanation for observed effects. In the second meta-analysis, 13 of the original 33 studies met inclusion criteria. Results indicated no significant effect of cannabis use on global neurocognitive performance or any effect on the eight assessed domains. Overall, these meta-analyses demonstrate that any negative residual effects on neurocognitive performance attributable to either cannabis residue or withdrawal symptoms are limited to the first 25 days of abstinence. Furthermore, there was no evidence for enduring negative effects of cannabis use.

Evaluation of a single-session expectancy challenge intervention to reduce alcohol use among college students.

In this study, the authors developed and evaluated a single-session experiential expectancy challenge (EC) intervention, seeking to reduce alcohol use by changing key positive expectancies among moderate to heavy drinking male and female college students. Participants (N=217) were randomly assigned to attend a 90- to 120-min EC session, CD-ROM alcohol education, or assessment only. Participants were assessed at pretest, posttest, and 1-month follow-up. Exposure to the EC intervention led to significant decreases in alcohol expectancies and subsequent alcohol consumption in both genders at follow-up. No significant changes were evident in either control condition. This study is the first to effectively decrease expectancies and drinking in college students with a single-session EC intervention. Further, although several studies have demonstrated the utility of the intervention with men, it is the first to do so with women. This study represents a critical step in the process of translating an innovative, theory-based intervention into a more practical format that makes it more accessible to those who seek effective drinking-reduction strategies for college campuses.

Alcohol expectancies, social and environmental cues as determinants of drinking and perceived reinforcement

Increasing evidence suggests that outcome expectancies and environmental cues interact to influence post-drinking behaviors. Using an experimental methodology in a simulated social drinking setting, this research tested the potential influence of expectations for the effects of drinking, environmental cues, and beverage content on ad lib consumption and post-drinking self-perception. Eighty-eight moderate to heavy-drinking males were randomly assigned to one of eight experimental conditions in which beverage content (alcohol or placebo), social environment (friendly or unfriendly), and physical environment (simulated bar or residence) were varied. Subjects were further divided into high and low groups on three outcome expectancy factors. Unaffected by environmental cues, beverage self-administration increased when subjects strongly expected behavioral impairment from drinking but received placebo beverage. Post-drinking reports of disinhibition increased in response to friendly social cues but were not affected by beverage content or amount. Results therefore suggest that individuals beliefs about the effects of drinking influence the amounts of beverage they consume, whereas social cues more greatly affect post-drinking self-perception.

Lowering risk for early alcohol use by challenging alcohol expectancies in elementary school children.

Altering alcohol expectancies has reduced alcohol use among young adults and may lead to successful prevention of early alcohol use. The authors randomly assigned 216 4th-grade children to an expectancy challenge or control condition and used individual-differences scaling to map expectancies into memory network format, with preference mapping to model likely paths of association. After expectancy intervention, children exhibited a greater likelihood to associate alcohol use with negative and sedating consequences and a decreased likelihood to associate alcohol with positive and arousing consequences. Children and adults who emphasize negative and sedating effects have been found to be less likely touse alcohol. Therefore, expectancy challenge interventions that have been successful at modifying expectancies and subsequently decreasing alcohol consumption of adults may be useful in reducing the likelihood of early alcohol use among children.

Experimental demonstration of the influence of alcohol advertising on the activation of alcohol expectancies in memory among fourth- and fifth-grade children.

Previous work has demonstrated that childrens organization and activation of alcohol expectancies in memory vary as a function of alcohol use, even among children as young as in the 3rd grade. To advance the understanding of influences on the development of alcohol expectancies in children, 551 4th- and 5th-grade children were exposed to 5 beer commercials or 5 soft drink commercials. After viewing the advertisements, all children reported their 1st associate to an alcohol prompt and completed a memory model-based measure of childrens alcohol expectancies. Multidimensional scaling was used to map expectancies into hypothetical memory network format, and preference mapping was used to derive possible paths of activation. Children who viewed beer commercials were more likely to activate positive and arousing alcohol expectancies. In view of previous findings demonstrating that this pattern of activation corresponded to higher drinking among 3rd, 6th, 9th, and 12th graders, the present findings suggested that antecedents to drinking like exposure to advertising may promote heavier drinking among children by influencing the activation of expectancies in memory.

Consumption-related differences in the organization and activation of marijuana expectancies in memory.

Using a methodology that has advanced the study of alcohol expectancies, the authors modeled a semantic network of marijuana expectancies stored in memory. They used individual-differences scaling, a form of multidimensional scaling, to map expectancies into memory network format and preference mapping to model likely paths of expectancy activation. Organization and activation of marijuana expectancies were found to vary with consumption level. Heavy marijuana consumers emphasized a relaxed-agitated dimension and were most likely to activate positive expectancies of relaxation, cognitive enhancement, and social facilitation. Nonconsumers, however, emphasized a detached-aware dimension and were more likely to activate negative expectancies of cognitive impairment and social impediment. Future efforts to alter likely activation patterns may be successful in changing use patterns.

Differences in the Marijuana Expectancies of Adolescents in Relation to Marijuana Use

Marijuana use continues to be a problem among youth. Outcome expectancies influence substance-using behavior in both children and adults. Expectancy interventions are empirically supported. Despite their success, there is a lack of information regarding marijuana expectancies in youth from which to develop these interventions. The present investigation conducted using independent resources from 2003 to 2005 surveyed 142 children and adolescents 11 to 18 years of age in the southeastern United States to develop the Marijuana Expectancy Inventory for Children and Adolescents (MEICA). The MEICA was administered to a different sample of 144 adolescents 14 to 19 years of age, and memory modeling was used to compare the expectancies of users versus never-users. Implications for marijuana prevention and intervention programs, future research, and limitations of the current investigation are discussed.