Roisin M. O'Connor

Structural, concurrent, and predictive validity of the Substance Use Risk Profile Scale in early adolescence

A brief personality risk profile (23 items), the Substance Use Risk Profile Scale was tested for concurrent and predictive validity for substance use in 1139 adolescents (grades 8-10) from a mid-sized city in western Canada. The SURPS was administered in two waves of a longitudinal study separated by 12 months (2003-04). As expected, four subscales were supported by confirmatory factor and metric invariance analysis. In regression analysis, three subscales, hopelessness, impulsivity, and sensation seeking, were positively related to current and future use; while one, anxiety sensitivity, was negatively related. Findings suggest clinical utility for screening adolescents at risk for substance use.

Attention bias and disinhibited behavior as predictors of alcohol use and enhancement reasons for drinking.

Disinhibition is a risk factor for alcohol use that may be specifically linked to drinking to enhance positive affect (enhancement motives). In this study individual differences germane to disinhibition were assessed, and their relation to alcohol use and reasons for drinking was examined. Laboratory tasks assessed attentional biases for reward and punishment cues and disinhibited behavior. Self-reported personality, alcohol use, and reasons for drinking were included. Frequent alcohol use and frequent drinking for enhancement, but not for coping or social reasons, were associated with a bias to attend to reward cues and disinhibited behavior. Poor inhibitory control assessed by self-reports was also associated with alcohol use and enhancement reasons for drinking. Results support a positive reinforcement mechanism of alcohol use.

Context counts: Solitary drinking explains the association between depressive symptoms and alcohol-related problems in undergraduates

INTRODUCTION According to theory, depressed individuals self-medicate their negative affect with alcohol. Due to isolation and interpersonal difficulties, undergraduates with elevated depressive symptoms may do much of their drinking alone and/or in intimate contexts (e.g., with family or romantic partners) rather than at normative social events (e.g., parties). Evidence suggests drinking in these contexts leads to heavy use and alcohol-related problems. Accordingly, context may be an explanatory mechanism linking depressive symptoms to problematic drinking. This pathway remains understudied in the literature. Our study aimed to examine solitary and intimate drinking as distinct mediators of the depression-problematic drinking association. We hypothesized that depressive symptoms would be positively associated with solitary and intimate drinking which in turn would be associated with elevated alcohol use and related problems. METHODS Undergraduates (N=295; 72% women) completed online self-reports. RESULTS Consistent with hypotheses, path analyses supported depressive symptoms as a positive predictor of solitary drinking, which in turn was a positive predictor of alcohol-related problems, but not of alcohol use. Counter to hypotheses, depressive symptoms were unrelated to intimate drinking. Interestingly, depressive symptoms were negatively associated with drinking at parties, which in turn led to reduced risk for elevated alcohol use and related problems. CONCLUSIONS Our results shed new light on the depression pathway to problematic drinking in undergraduates by considering the role of drinking context. Our findings suggest undergraduates with elevated depressive symptoms are at risk for potentially problematic drinking because they are drinking alone. Solitary drinking represents a malleable target for clinical interventions aimed at reducing risky depression-related alcohol use.

Clarifying the measurement and the role of the behavioral inhibition system in alcohol misuse

BACKGROUND In response to conflicting reward (Behavioral Approach System [BAS]) and/or punishment cues (Fight-Flight-Freeze System [FFFS]) the Behavioral Inhibition System (BIS) inhibits behavior, leading to increased attention to threat, high anxiety, and behavioral ambivalence. The role of BIS in alcohol misuse is complex, as anxiety promotes self-medication drinking, while attention to threat (e.g., negative outcomes of heavy drinking) may reduce risk. Theory suggests that a concurrent strong BAS may bias BIS-conflict in favor of alcohol approach, while a concurrent strong FFFS may increase the likelihood of alcohol avoidance. However, few studies measure BIS as a conflict system, and no studies incorporate such a measure into examinations of alcohol misuse. Our study goals were to (i) test the Motivational Flanker Task (MFT) as a new laboratory measure of the BIS, BAS, and FFFS; and (ii) use the MFT, in conjunction with self-report measures, to test BAS and FFFS as moderators of the BIS-alcohol misuse relation. We hypothesized that an elevated BIS would predict heavy drinking and alcohol-related problems, but only when BAS was high. Further, we expected an elevated BIS to be associated with reduced alcohol misuse, but only when FFFS was high. METHODS Students (N = 198) completed self-reports of BIS/BAS/FFFS and drinking behavior, and 2 reaction time tasks: MFT and Point Scoring Reaction Time Task (PSRTT). The PSRTT is a published measure of the revised BIS. RESULTS MFT BIS conflict was associated with self-report and PSRTT measures. MFT BAS, but not FFFS, was associated with self-reports. As expected, elevated BIS was associated with heavy drinking, but only when BAS-Drive and BAS-Fun Seeking was also high. FFFS was not supported as a moderator of the BIS-alcohol misuse association. CONCLUSIONS Results support the MFT as a promising measure of the revised BIS. Considering the joint effects of BIS and BAS clarified risk for alcohol misuse.

Influence of alcohol use experience and motivational drive on college students' alcohol-related cognition.

BACKGROUND Cognitive processes are thought to be pivotal to risk for heavy drinking. However, few studies have examined the alcohol cue-activated positive and negative semantic memory networks that may be pivotal to drinking behavior. Moreover, much is to be understood about the influences of cognitive processes, particularly in high-risk drinking samples such as college students. The current study examines the sequential process of alcohol cues activating valenced semantic memory networks, and the influences of prior drinking experience and individual differences in motivational drive on this automatic (implicit) cognitive process. METHODS Participants (N = 138, 52% women) were college freshmen prescreened to represent the full range of drinking experience (i.e., current abstainers, light and heavy drinkers). Participants completed self-reports of past month alcohol use, and individual differences in behavioral inhibition system (BIS) and behavioral approach/activation system (BAS). Alcohol cue-elicited positive and negative semantic memory networks were assessed using a priming task. RESULTS Results from the priming task revealed that for light drinkers alcohol cues were equally as likely to activate positive and negative semantic memory networks, suggesting relatively neutral cue-elicited alcohol attitudes. Conversely, for heavy drinkers, alcohol cues more readily activated positive relative to negative semantic memory networks, suggesting relatively positive cue-elicited alcohol attitudes. Furthermore, positive alcohol cue-elicited semantic memory networks (positive attitudes) were evident for individuals characterized by a strong BAS and weak BIS (as hypothesized) and those characterized by a weak BAS and weak BIS. CONCLUSIONS The findings suggest that alcohol-cue elicited positive semantic memory networks may be pivotal to risk for heavy drinking. Specifically, it is via the influence on this cognitive process that prior drinking experience and individual differences in motivational drive, respectively, may maintain and predispose individuals to risk for heavy alcohol use.

Getting the party started — Alone: Solitary predrinking mediates the effect of social anxiety on alcohol-related problems ☆

Predrinking (or pregaming) is common among undergraduates and has been linked with problem alcohol use. While many students predrink to save money, evidence suggests that some students predrink to cope with social anxiety (SA). Tension reduction and cognitive theories predict that those high in SA may predrink to reduce anticipatory anxiety before attending social events and their predrinking may be done alone rather than in normative social contexts. Available data suggest that, relative to social drinking, solitary drinking elevates risk for alcohol use and related problems. Informed by this evidence, we speculated that context for predrinking may be an important mechanism by which SA-risk for alcohol use unfolds. Specifically, we offered the novel hypothesis that those high in SA would engage frequently in solitary predrinking and this in turn would be associated with elevated alcohol use and related problems. Undergraduate drinkers (N=293; 70% women) completed self-reports of social anxiety, predrinking context (social, solitary), alcohol use, and alcohol-related problems. In partial support of our hypotheses, SA was a positive predictor of solitary predrinking, which in turn predicted elevated alcohol-related problems, but not alcohol use. While not hypothesized, we also found that SA was a negative predictor of social predrinking, which in turn reduced risk for alcohol use and related problems. Our study is the first in the literature to show that solitary predrinking helps explain the well-documented association between SA and alcohol-related problems. These findings may inform etiological models and clinical interventions, suggesting that SA-risk for problem drinking begins even before the party starts.

Specificity of Childhood Learning Experiences in Relation to Anxiety Sensitivity and Illness/Injury Sensitivity: Implications for Health Anxiety and Pain

Health anxiety refers to the preoccupation with and fear of bodily sensations arising from catastrophic misinterpretations about the significance of these sensations (Hadjistavropoulos, Asmundson, & Kowalyk, 2004). Constructs theoretically relevant to the development of both health anxiety and chronic pain are two of the putative “fundamental fears” identified by Reiss (1991)—anxiety sensitivity (AS) and illness/injury sensitivity (IS) (Cox, Borger, & Enns, 1999; Vancleef, Peters, Roelofs, & Asmundson, 2006). The learning history origins of AS have been examined in a series of studies (Stewart et al., 2001; Watt & Stewart, 2000; Watt, Stewart, & Cox, 1998); however, no studies have examined the learning history antecedents of IS. The present retrospective study compared the relative specificity of learning experiences related to the development of AS and IS in a sample of 192 undergraduates (143 women and 49 men). Structural equation modeling supported nonspecific paths from both anxiety-related and aches/pains-related childhood learning experiences to AS and a more specific path from aches/pain-related childhood learning experiences to IS. Results suggest that the developmental antecedents of IS are more specific to learning experiences around aches and pains, whereas the developmental origins of AS are more broadly related to learning experiences around bodily sensations.

Growth trajectories of alcohol information processing and associations with escalation of drinking in early adolescence.

This longitudinal study provided a comprehensive examination of age-related changes in alcohol outcome expectancies, subjective evaluation of alcohol outcomes, and automatic alcohol associations in early adolescence. A community sample (52% female, 75% White/non-Hispanic) was assessed annually for 3 years (mean age at the first assessment = 11.6 years). Results from growth modeling suggested that perceived likelihood of positive outcomes increased and that subjective evaluations of these outcomes were more positive with age. Perceived likelihood of negative outcomes declined with age. Automatic alcohol associations were assessed with an Implicit Association Task (IAT), and were predominantly negative, but these negative associations weakened with age. High initial levels of perceived likelihood of positive outcomes at age 11 were associated with escalation of drinking. Perceived likelihood of negative outcomes was associated with low risk for drinking at age 11, but not with changes in drinking. Increases in positive evaluations of positive outcomes were associated with increases in alcohol use. Overall, findings suggest that at age 11, youth maintain largely negative attitudes and perceptions about alcohol, but with the transition into adolescence, there is a shift toward a more neutral or ambivalent view of alcohol. Some features of this shift are associated with escalation of drinking. Our findings point to the importance of delineating multiple aspects of alcohol information processing for extending cognitive models of alcohol use to the early stages of drinking.

Impulsivity increases risk for coping-motivated drinking in undergraduates with elevated social anxiety☆

According to theory, those high in social anxiety (SA) are at risk for drinking alcohol for coping and conformity motives, which in turn lead to alcohol use and related problems. Empirical tests of this risk pathway in non-clinical samples have produced mixed results. Although those high on SA may drink to cope with anxiety and to reduce the likelihood of social rejection, they may also avoid drinking for fear of embarrassing themselves when intoxicated. Central to alcohol use by those high in SA is a temporary disregard of alcohols potentially negative consequences. Accordingly, we hypothesized that SA would positively predict alcohol use and problems, but only at high levels of impulsivity (IMP). We expected these interactive effects to be mediated by coping and conformity motives. Undergraduates (N = 461) completed self-reports. Partially supporting hypotheses, IMP moderated the association between SA and alcohol-related problems (but not use), such that SA predicted problems only at high IMP. This interactive effect was mediated by coping (but not conformity) motives, such that SA positively predicted coping motives (especially at high IMP), which in turn predicted problems. Results suggest that IMP and coping motives clarify SA-related drinking. Clinical interventions may consider targeting IMP.

Interactive Effects of the BIS and the BAS on Trajectories of Alcohol Misuse after University Graduation.

Reinforcement Sensitivity Theory predicts that those with a strong behavioral inhibition system (BIS) likely experience considerable anxiety and uncertainty during the transition out of university. Accordingly, they may continue to drink heavily to cope during this time (a period associated with normative reductions in heavy drinking), but only if they also have a strong behavioral approach system (BAS) to enhance the anxiolytic effects of drinking. The purpose of this study was to test this hypothesis. Participants completed online measures prior to and at 3-month intervals over the course of the year following graduation. As hypothesized, results showed that an elevated BIS predicted impeded maturing out, but only when the impulsivity facet of BAS was also elevated. In contrast, a strong BIS predicted rapid maturing out if BAS impulsivity was weak. Study findings advance our understanding of BIS-related alcohol misuse trajectories in young adulthood and provide direction for clinical interventions.