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

2. 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

3. 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

4. What comes first, the drinking or the expectancies?
N=461 adolescents from 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)

5. 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)

6. 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

7. 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)

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

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