PHP 1540: Alcohol Use and Misuse 9/26/12 Psychological Predictors of Use/Misuse

Two reliable cognitive predictors of drinking: Expectancies Beliefs about the effects/outcomes of drinking May be positive or negative Learned directly and indirectly Motives = people drink to achieve certain valued outcomes Relationship? Have to hold expectancy of a desired effect in order to drink to obtain that effect

What are the effects of “a few drinks”? Common categories of alcohol outcome expectancies = Global positive change Physical/social pleasure Increased social assertiveness Sexual enhancement Relaxation/tension reduction Arousal/aggression Cognitive-motor impairment Brown et al (1987) identified 6 positive dimensions / expected outcomes of drinking These have been supplemented by measures of negative expectancies Per Lee et al. (1999), neg expect correlate with frequency and pos expect correlate with quantity

What comes first, the drinking or the expectancies? N=461 adolescents from 12-14 years old, followed for two years. . . . Time 1 drinking Time 2 drinking Expectancies develop early (middle school years for most; earlier for kids in families where lots of drinking takes place) Expectancies and drinking behavior influence each other in reciprocal fashion: Smith et al (1995) studied early adolescents NOTE: the explanation in the book is a little confusing; not entirely accurate Time 1, 23% drank alcohol; Time 2 44% drank; Time 3 62% drank Strength of expectancies (for social facilitation) grew over time the greater the expectancy endorsement, the higher the subsequent drinking levels; teens with low expectancies either did not begin drinking or increased only gradually the higher the drinking levels, the greater the subsequent expectancy endorsement (weaker relationship) Time 1 expectancies Time 2 expectancies Smith, Goldman, Greenbaum, & Christiansen (1995)

Who develops strong expectancies? High-risk personality : impulsive + aggressive + poor school performance + male Especially if family history positive Mann, Chassin, & Sher (JCCP 1987) HS students with higher personality risk scores endorse stronger expectancies for positive effects from alcohol WHY?? Strongest alcohol-related expectancies if both FHP and high-risk personalities Mann, Chassin, & Sher (1987)

Two reliable cognitive predictors of drinking: Expectancies Beliefs about the effects of drinking May be positive or negative Learned directly and indirectly Motives Reasons why a person drinks We drink to achieve valued outcomes Influenced by outcome expectancies Motives = people drink to achieve certain valued outcomes Relationship? Have to hold expectancy of a desired effect in order to drink to obtain that effect Expectancies  Motives  Drinking  Outcomes

Cooper’s (1994) model of Motives for Drinking Source of reinforcement: External/Social Internal/Emotional Motives = reasons for drinking Source of reinforcement = focus on effects that are external (social) or internal (emotional)

Cooper’s (1994) model of Motives for Drinking Source of reinforcement: Type of reinforcement: External/Social Internal/Emotional Positive Negative Positive consequences increase likelihood of repeating a behavior Type of reinforcement: according to learning theory, there are 2 ways of increasing the rate of a behavior: pos + neg reinforcement IN SUBSTANCE USE AND ADDICTION STUDIES, THE CONCEPT OF REINFORCEMENT IS VERY IMPORTANT!! POSITIVE REINFORCMENT = NEGATIVE REINFORCEMENT = Who can distinguish between neg reinf and punishment? Removal of unpleasant state increases likelihood of repeating a behavior

Cooper’s (1994) model of Motives for Drinking Source of reinforcement: Type of reinforcement: External/Social Internal/Emotional Positive Social Enhancement Negative Conformity Coping Social motives = achieving positive social rewards; being accepted as part of a peer group that approves of drinking Enhancement motives = enhancing positive mood states; celebrating positive events Conformity motives = avoiding social sanctions for not drinking Coping motives = drinking to cope with or avoid negative affect; WHAT DO WE KNOW: Motives for drinking make a difference (Kuntsche, Knibbe, Gmel & Engels, 2005) -Most people drink for multiple motives. -Strong social motives are associated with moderate drinking, and are most common -Enhancement motives predict heavy drinking, esp. if operationalized as “drinking to get drunk” -Relying on drinking to help regulate negative mood states predicts negative consequences (coping motives = special kind of utilitarian use) Critiques of motive literature? -measured in inconsistent ways -most cross-sectional -motives may be most relevant to starting drinking, not maintenance phase

Initiation of drinking behavior, from a learning perspective availability of alcohol lack of reinforcement for alternative behaviors lack of punishment for experimenting with alcohol or drugs Importance of learning from the consequences of our behavior; what is necessary from a conditioning perspective? Initiation of drinking behavior: 1. availability of alcohol 2. lack of reinforcement for alternative behaviors 3. lack of punishment for experimenting with A/D

Maintaining drinking behavior, from a learning perspective continued availability of alcohol positive reinforcement for drinking negative reinforcement for drinking lack of punishment for continuing to drink lack of reinforcement for competing behaviors Maintaining/increasing drinking: 1. availability of alcohol 2. positive reinforcement for drinking 3. negative reinforcement for drinking 4. lack of punishment for continuing to drink 5. lack of reinforcement for competing behaviors

Key Concepts in Behavioral Economics Reinforcement from alcohol use is considered in light of reinforcement from alternative activities Change the relative reinforcement ratio and you change the “demand” for alcohol, i.e., the rate of drinking Delayed outcomes tend to be devalued relative to immediate outcomes Matching law = Matching law holds that the relative response rate R1 / (R1 + R2) matches, that is, equals, the relative reinforcement rate Rf1 / (Rf1 + Rf2) Substance use is relatively elastic = rates respond to changes in cost

Summary of Behavioral Economics as applied to the onset and maintenance of drinking Alcohol use is more likely when Cost is low; availability is high Alternate substance-free reinforcers are limited Alcohol use is constrained to the extent that It is costly in money/time/social capital One has access to competing reinforcers Substance use is relatively elastic = rates respond to changes in cost

How can the environment be altered to change drinking behavior? reduce the reinforcement obtained from drinking increase the reinforcement derived from alternative, competing behaviors ?