Nora E. Noel

Matching Treatment Focus to Patient Social Investment and Support: 18-Month Follow-up Results.

Patients were randomly assigned to 1 of 3 treatments: brief broad-spectrum (BBS), extended relationship enhancement (ERE), or extended cognitive-behavioral (ECB). A hierarchical latent growth model was used to analyze the data of 188 patients (82%) followed for 18 months. ERE treatment was significantly more effective in increasing abstinence of patients entering treatment with a network unsupportive of abstinence or with a low level of investment in their network, whereas BBS treatment was more effective for patients with either (a) both a social network unsupportive of abstinence and a low level of network investment or (b) high investment in a network supportive of abstinence. ECB outcomes were neither as good as those matched nor as bad as those mismatched to the different exposures of relationship enhancement. This suggests that dose of relationship enhancement should be determined after assessing patient relationships.

Determinants of Research Follow-Up Participation in an Alcohol Treatment Outcome Trial

This study examined factors associated with research attrition in a long-term follow-up study (48 months). Researchers attempted to contact all randomized participants, not just those who completed treatment. The processes by which baseline characteristics, early treatment-research experiences, and short-term outcome affected subsequent participations were examined using logistic regression. The analyses deal primarily with refusal, the main reason for attrition. Baseline characteristics had small effects on likelihood of refusal; research engagement had some impact; but treatment participation had strong effect. Short-term outcome did not predict refusal. These findings, if generalizable, have implications for the conduct and reporting of outcome studies. By directly studying bias, rather than presuming its absence on skimpy evidence, researchers can achieve a better understanding of the strengths and limitations of outcome results.

Development and Validation of Videotaped Scenarios: A Method for Targeting Specific Participant Groups

Researchers using scenarios often neglect to validate perceived content and salience of embedded stimuli specifically with intended participants, even when such meaning is integral to the study. For example, sex and aggression stimuli are heavily influenced by culture, so participants may not perceive what researchers intended in sexual aggression scenarios. Using four studies, the authors describe the method of scenario validation to produce two videos assessing alcohol-related sexual aggression. Both videos are identical except for the presence in one video of antiforce cues that are extremely salient to the young heterosexual men. Focus groups and questionnaires validate these mens perceptions that (a) the woman was sexually interested, (b) the sexual cues were salient, (c) the antiforce cues were salient (antiaggression video only), and (e) these antiforce cues inhibited acceptance of forced sex. Results show the value of carefully selecting and validating content when assessing socially volatile variables and provide a useful template for developing culturally valid scenarios.

Collateral Informant Assessment in Alcohol Use Research Involving College Students

Abstract Objective: This study examined the associations between college students’ self-reported alcohol use and corresponding collateral reports and identified factors that influence agreement between both sets of reports. Participants/Methods: Subject–collateral pairs (N = 300) were recruited from undergraduate psychology courses. Results: Data yielded moderate correlations between subject-collateral pairs for all alcohol use measures, whereas discrepancy analyses revealed a tendency for subjects to report greater alcohol use relative to collateral reports. Greater subject–collateral agreement regarding frequency of subject alcohol use was predicted by a greater frequency of shared drinking occasions between the dyads, lower subject self-reported drug use, and lower levels of collateral guessing, whereas greater correspondence for quantity of alcohol consumed was predicted by fewer subject self-reported alcohol-related negative consequences, lower levels of subject self-reported drug use, and lower levels of alcohol ingestion among collaterals. Conclusions: College students appear to provide reasonably accurate self-reports of their alcohol use.

What Do Women Want? A Qualitative Study of Dating

Many approaches to decrease unwanted sex for women emphasize enhanced risk recognition. However, women often remain in risky situations despite recognition; so we need to understand the attractions of normative dating and sex. In this focus group study, 45 young adult women discussed their attractions to men, dating, and sex. Themes emerged describing conflicts between what they wanted, dating realities, desire for “traditional” behavior from the man, alcohol use, sexual arousal (hers and his), indirect communication about sex, feeling “obligated,” and enhanced self-esteem. Results suggest improving risk-recognition programs by examining and clarifying women’s goals for dating and putting positive emphasis on “have fun, achieve your goals, but try to avoid harm in the process.”

Effects of alcohol consumption on the prevention and alleviation of stress-reactions

Alcohols Stress-Response-Dampening (SRD) effect has been the subject of much research, but little has been done to examine the effects of drinking alcohol after experiencing a stressor (Stress-Response-Recovery; SRR). In this study, 65 male and 65 female moderate or heavy drinking undergraduates were randomly assigned (with equal numbers of each sex per group) to 1 of 13 groups. Six experimental conditions were used to compare alcohols SRD and SRR effects with two doses (moderate: .75 ml/kg; low: .33 ml/kg) and a placebo, and seven control conditions were used to measure the effects of the stressor (uncontrollable aversive noise) and the alcohol doses alone on the dependent measures. The major dependent variable was escape learning in a human shuttle box. In the SRD conditions, subjects who drank a moderate dose of alcohol learned to escape faster than those drinking the low dose or placebo. However, in the SRR conditions, subjects in the placebo group did not show escape learning deficits, in contrast to the impaired performance of subjects in the two alcohol groups. These results suggest a complex alcohol-stress relationship in which timing, dose, and expectations about alcohol lead to differential SRD and SRR effects.

Assessing Acceptance of Violence Toward Women: A Factor Analysis of Burt's Acceptance of Interpersonal Violence Scale

The Acceptance of Interpersonal Violence Scale (AIV) is a self-report inventory assessing beliefs about violence toward women. This studys purpose was to test the multidimensionality of the AIV. Exploratory factor analysis (EFA) was conducted on half a sample of 772 male participants and confirmatory factor analysis (CFA) on the other half. EFA indicated a two-factor solution. Factors were labeled Intimate Partner Violence and Sexual Violence. The CFA showed this model provided a good fit and was superior to the original one-factor model. Potential problems when using the single sum score and the applicability of the derived factor structure to violence research are discussed.

Evidence-Based Treatment Planning for Substance AbuseTherapy

Publisher Summary Treatment planning is a process in which the therapist tailors, to the greatest extent possible, the application of available treatment resources to each clients individual goals and needs. A thorough multidimensional assessment is essential to individualized treatment planning. In addition, a carefully kept accurate record of each clients assessment, ongoing treatment, and outcome evaluation is necessary for planning and fine-tuning each clients program. Carefully collected data can be aggregated to provide program evaluation, leading to eventual improvement in client-treatment-matching knowledge. The guidelines for treatment planning presented here can be adapted for use at any level of treatment, but probably are most flexible at the outpatient level. Treatment planning should be integrated in the clients therapeutic process from the first meeting. Setting goals and specifying methods of achieving those goals provide a blueprint for treatment and a therapeutic structure for the client. Substance abuse clients often feel over-whelmed by their problems and not in control of the most important aspects of their lives. Providing the structure of a set of goals and procedures can help relieve anxiety and enhance the clients self-efficacy.

Women's drinking decisions in heterosocial situations: development and validation of scenarios to assess influence of attraction and risk-awareness

These three related studies created a set of ecologically valid scenarios for assessing relative associations of both attraction and sexual coercion risk-recognition in college women’s heterosocial situational drinking decisions. The first study constructed nine scenarios using input from heterosexual drinking women in the age cohort (18-30) most likely to experience alcohol-related sexual coercion. In the second study, 50 female undergraduates (ages 18-25) assessed the salience of three important dimensions (attraction, risk, and realism) in these scenarios. The third study was a factor analysis (and a follow-up confirmatory factor analysis) of the elements of coercion-risk as perceived by the target group with two female samples recruited 1 year apart (Sample 1: N = 157, ages 18-29); Sample 2: N = 157, ages 18-30). Results confirmed that the scenarios could be a useful vehicle for assessing how women balance out risk and attraction to make in-the moment heterosocial drinking decisions. The factor analysis showed participants perceived two types of situations, based on whether the male character was “Familiar” or “Just Met” and perceived themselves as happier and more excited with Familiar males. However, in contrast to HIV risk studies, Familiar males were perceived as higher risk for unwanted sex. Future research will use the six scenarios that emerged from the factor analysis to study how attraction and risk perception differentially affect young adult women’s social drinking decisions.