Evaluación del Modelo de Predisposición Adquirida para consumo de alcohol en adolescentes / Evaluation of the Acquired Preparedness Model for Alcohol Use in Adolescents / Avaliação do Modelo de Predisposição Adquirida para o consumo de álcool em adolescentes

Durante la adolescencia se observan altas tasas de consumo elevado de alcohol. El Modelo de Predisposición Adquirida (mpa) postula que la confluencia de factores de personalidad (como la impulsividad) y factores psicosociales (como las expectativas hacia el alcohol [ea]) predice el consumo de sustancias. Algunos resultados previos respaldan el mpa para explicar el uso de alcohol en adolescentes argentinos; sin embargo, no queda claro el modo en que distintas dimensiones de impulsividad se asocian con el uso de alcohol en esta etapa del desarrollo. El objetivo de este trabajo fue examinar, en una muestra de adolescentes argentinos, el rol mediador de las ea en la relación entre cinco dimensiones de impulsividad rasgo, medidas con la escala upps-p y la frecuencia de Consumo Episódico Elevado de Alcohol (ceea). Materiales y métodos: participaron 427 adolescentes de 13 a 18 años (58 % mujeres; M edad = 15.72, de = 1.48), escolarizados en el nivel medio (91.1 % en gestión privada). Resultados: apoyando el mpa, la tendencia a actuar precipitadamente bajo estados emocionales intensos (tanto positivos como negativos) se asoció a una mayor frecuencia de ceea vía una mayor anticipación de efectos positivos del consumo de alcohol. Urgencia positiva tuvo, además, un efecto directo sobre la frecuencia de ceea. Conclusiones: esta información puede ser de utilidad para el desarrollo de intervenciones destinadas a disminuir el desarrollo o mantenimiento de las positivas y, de esta manera, reducir el consumo de alcohol en los adolescentes.

High rates of heavy alcohol use are observed among adolescents. The Acquired Preparedness Model (apm) posits that the confluence of personality factors (e.g., impulsivity) and psychosocial factors (e.g., alcohol expectancies [aes]) predicts substance use. Research supports the use of the apmto explain alcohol use in Argentinean adolescents; however, how different dimensions of impulsivity are associ-ated with alcohol use at this developmental stage is unclear. This study was designed to examine the mediational role of aes in the relationship between multiple dimensions of trait-like impulsivity using the upps-p scale and the frequency of heavy episodic drinking (hed) in Argentinean adolescents. Materials and Methods: In this study, 427 adolescents (58% were women) with a mean age of 15.72 ± 1.48 years (range, 13­18 years) were enrolled. Results: In line with the associations proposed by the apm, this study showed that the tendency to act rashly under intense negative and positive emotions was positively associated with the frequency of hed, via the anticipation of more positive effects of alcohol use. Positive urgency also had a direct effect on the frequency of hed. This information may be useful in developing interventions to reduce positive aes to decrease adolescent alcohol use.

na adolescência observam-se altas taxas de consumo de álcool. O Modelo de Predisposição Adquirida (mpa) postula que a confluência de fatores de personalidade (como a impulsividade) e fatores psicossociais (como expectativas em relação ao álcool [ea]) prediz o uso de substâncias. Alguns resul-tados anteriores corroboram o mpa para explicar o consumo de álcool em adolescentes argentinos; no entanto, não está claro como as diferentes dimensões da impulsividade estão associadas ao consumo de álcool nesta fase do desenvolvimento. O objetivo deste trabalho foi examinar, em uma amostra de adolescentes argentinos, o papel mediador da ea na relação entre cinco dimensões do traço de impul-sividade, medidas com a escala upps-p e a frequência de Consumo Episódico Elevado de Álcool (ceea). Materiais e métodos: participaram 427 adolescentes de 13 a 18 anos (58% mulheres; M idade = 15,72; dp = 1,48), matriculados no ensino médio (91,1% em escola particular). Resultados: apoiando o mpa, mostra-se que a tendência a agir precipitadamente sob estados emocionais intensos ­tanto positivos quanto negativos­ foi associada a uma maior frequência de ceea por meio de uma maior antecipação dos efeitos positivos do consumo de álcool. A urgência positiva também teve efeito direto na frequência de ceea. Conclusões: esta informação pode ser útil para o desenvolvimento de intervenções que visem reduzir o desenvolvimento ou manutenção de ea positivas e, desta forma, reduzir o consumo de álcool em adolescentes.

Modelo de predisposición adquirida para el uso de alcohol en adolescentes argentinos / The acquired preparedness model for alcohol use in Argentinian adolescents

Se analizó, en una muestra de adolescentes argentinos, el modelo de predisposición adquirida. El modelo propone que el rasgo desinhibición influye de manera indirecta, a través de variables cognitivas, sobre el consumo de alcohol. La exposición a modelos de consumo del grupo de pares influye directa e indirectamente (mediante las expectativas hacia el alcohol) sobre el uso de alcohol. Participaron 343 adolescentes asistentes a colegios públicos de educación media de la ciudad de Córdoba (Argentina). Se midió impulsividad, expectativas hacia el alcohol, motivos de consumo de alcohol, normas sociales de consumo y consumo de alcohol de los adolescentes. Para determinar el efecto de las variables señaladas como antecedentes del consumo se aplicó un análisis de senderos. Se propusieron dos modelos teóricos que diferían en la inclusión, o no, de las normas sociales del consumo de alcohol. Los resultados apoyan el modelo de predisposición adquirida e indican que el efecto de impulsividad sobre el consumo de alcohol es indirecto mediado por las expectativas hacia el alcohol. Aunque ambos modelos presentan adecuado ajuste a los datos, el modelo que incorpora el efecto de las normas sociales de consumo presenta un ajuste excelente. Los resultados de este trabajo, el primero de nuestro medio en evaluar el modelo de predisposición adquirida sobre el consumo de alcohol, destacan la utilidad de diagramar esfuerzos preventivos focalizados en el control de los impulsos, en las expectativas positivas hacia el alcohol y en la reducción de la percepción del consumo de los pares.

The acquired preparedness model was examined in a sample of Argentinian adolescents. This model suggests that disinhibition has an indirect effect, through cognitive variables, on alcohol consumption. Asample of 343 adolescents from the city of Cordoba (Argentina) from public secondary education schools took part in the study. Standardised measurements were used to assess impulsivity, alcohol expectancies, social norms of alcohol drinking, and drinking patterns. A path analysis was conducted to determine the effect of these variables on quantity of alcohol consumption. Two theoretical models, that differed in the inclusion - or not - of social norms of alcohol drinking, were evaluated. The results, according to the acquired preparedness model, indicate that impulsivity influences alcohol consumption through alcohol expectancies. The model that incorporates the effect of social norms of alcohol drinking showed an excellent fit to the data. This study - the first in Argentina that evaluates this model - emphasises the usefulness of addressing impulse control and alcohol expectancies when developing interventions aimed at reducing alcohol consumption.

Diferenças de gênero sobre expectativas do uso de álcool / Gender differences in alcohol expectancies

CONTEXTO: Estudos indicam que expectativas sobre o uso de álcool podem contribuir para o início e a manutenção do consumo da droga e modular de forma diferente o comportamento do beber de homens e de mulheres. OBJETIVOS: Descrever e analisar diferenças de gênero sobre expectativas relacionadas ao uso de álcool em artigos da literatura indexada. MÉTODOS: Foram pesquisados artigos empíricos originais no período de 2000 a 2011 nos indexadores PubMed, SciELO, Lilacs e PsycInfo. RESULTADOS: Foram selecionados 32 estudos, sendo apenas dois de origem latino-americana. Expectativa de facilitação social foi a mais observada para ambos os gêneros. Homens apresentaram maior diversidade de expectativas sobre os efeitos do uso de álcool. Intervenções baseadas na redução de expectativas positivas parecem mais eficazes entre os homens. CONCLUSÃO: Expectativas são um importante fator de risco para o uso de álcool, independentemente do gênero. A consideração das diferenças de gênero sobre expectativas pode beneficiar o manejo clínico de problemas associados ao consumo de álcool e direcionar ações preventivas para o risco de abuso e dependência.

BACKGROUND: Previous studies have shown, that expectancies about the consumption of alcohol can contribute to the onset and maintenance of alcohol use and modulate in different ways the drinking behaviour of men and women. OBJECTIVES: To describe and analyse gender differences in alcohol expectancies based on indexed literature. METHODS: The research was conducted via the electronic databases PubMed, SciELO, Lilacs and PsycInfo, considering original articles published between 2000 and 2011. RESULTS: Thirty two studies were found, whereby only 2 were from Latin America. Social facilitation was the most frequent expectancy in both genders. Men showed more variety of expectancies associated to alcohol use. Preventive measures with the aim to reduce positive expectancies were more effective in male. DISCUSSION: Regardless of gender, alcohol expectancies are an important risk factor for alcohol use. The consideration of gender differences in alcohol expectancies can enhance clinical monitoring of problems associated with alcohol use and direct preventive efforts against the risk of abuse and dependence.

Expectativas relacionadas con el alcohol en la predicción del abuso en el consumo en jóvenes

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Abstract: In México, addictions among the middle- and high-school student population have been widely studied, which has shed light on certain risks associated with alcohol abuse, including a higher probability of expriencing with other drugs -particularly in the case of males-, engaging in risky sexual practices and attempting suicide, a situation that is twice as common among those who drink and drive. Nevertheless, research on alcohol abuse among the university population has been less explored, particularly as regards the identification of the variables that predict excessive alcohol consumption. A review of the international literature on factors associated with alcohol abuse in this type of population indicates that it is among university students that high or explosive consumption tends to be largest, even among young people who do not attend school, and that the period of higher consumption is between 17 and 21 years of age. Other factors that have been identified include exposure to negative life events, inappropriate coping styles, personality variables, resorting to alcohol to reduce tension, and environmental and socio-cognitive variables, foremost among which are expectations of the positive effects of alcohol. These expectations not only predict alcohol consumption but also differentiate between problem and non-problem drinking. For example, while social drinkers tend to harbor more social expectations when drinking alcohol, excessive drinkers expect alcohol to increase their aggressive and social behavior, while reducing stress or tension. This paper seeks to evaluate the impact of expectations regarding alcohol, in predicting alcohol abuse among students at public and private universities in Mexico City. Indicators of alcohol abuse include consumption of five or more drinks on each occasion, drunkenness during the past month and year as well as associated problems. The study also seeks to determine the way in which sub-scales of expectations interact with each other. An ex post facto transversal study was carried out on a sample of 678 university male and female students aged 17 to 25, with an average age of 20 (s.d. = 1.80). Participants were asked to complete a self-report which included the following areas: a) Sociodemographic data, b) Questionnaire on Expectations regarding Alcohol (AEQ), in a version adapted to this population and c) Alcohol consumption habits over the past month and year. As regards drinking habits, a comparative analysis was carried out by sex and age. Consumption of 5 or more drinks per occasions tends to be more common among men, while the consumption of 5 drinks or less is more frequent in women. At the same time, a higher proportion of heavy drinkers was concentrated in the 20 to 22 age range. Consumers of over 5 glasses of alcohol began drinking at an average age of 14 (s.d. = 2.55) whereas consumers of fewer than 5 drinks began drinking at the age of 15 (t= 4.79 , p < .001). In both cases, the means obtained from the indicators of abuse were highest among consumers of five or more drinks. Males take more drinks than women when they get drunk, consuming an average of 9 glasses (s.d. = 4.7) whereas women get drunk after an average of 5 glasses (s.d. = 3.2) (t= -10.80, p < .001). Out of a total of 26% of young people who mentioned having problems associated with their drinking, most were men (17.9%) as opposed to women (8.2%). The multiple regression analysis carried out to determine the impact of the sub-scales of AEQ expectations on alcohol abuse found that expectations regarding alcohol as a "facilitator of group interaction" and the sub-scale of "reduction of psychological tension" were the main predictors of abuse. This model explained 20% of the variance (F=19.35, p < .001). A logistic regression analysis found that the sub-scale of expectations regarding "increase of power and aggression" as well as alcohol abuse predicted problems associated with drinking. A model was subsequently designed to integrate the expectations that predicted alcohol abu se and associated problems. A structural equations model was used which found that expectations regarding "reduction of psychological tension" and alcohol as a jacilitator of group interaction predicted 30% and 24% of abuse, respectively (X2sb = 33.52, p >0.00, CFI = 0.99 and RMSEA = 0.01). The rest of the sub-scales concerning expectations were regarded as mediating varia bles to see how they interacted with each other. As one can see, although the sub-scales of expectations are inter-related, group expectations were specifically associated with the sub-scales of "increase in sexuality," "physical tension" and "increase in power and aggression." At the same time, expectations regarding "reduction of psychological tension" are closely linked to the social sphere, specifically the expectations regarding "verbal expressiveness" and "lack of inhibition." Along these same lines, alcohol abuse and the expectations regarding alcohol as an agent that increases feelings of power and aggression predicted 26% and 28% of alcohol-related problems. One of the contributions of this research is that it considered the inter-relationship of sub-scales of expectations to explain alcohol abuse. Psychological tension, for example, appears to be linked to social aspects, specifically to verbal expressiveness and lack of inhibition, while group expectations refer to sexuality, the reduction of psychological tension and the increase of aggressiveness and feelings of power. Likewise, it is interesting to note that in addition to alcohol abuse, expectations regarding an increase in power and feelings of aggression are the best predictors of problems associated with alcohol use. The results have implications at the intervention level for developing programs specifically aimed at this population. The fact that expectations regarding alcohol as a "facilitator of social interaction" is one of the main predictors of abuse indicates the importance of considering environmental factors in the development of prevention programs. This involves including not only young people but also parents, schools, and other adults in order to question the cultural norms that promote beliefs regarding alcohol consumption, as a way of enjoying social interaction with positive, pleasurable states, and as a socially appropriate response for coping with negative events that arise in everyday life, such as drinking to relieve tension, handle crises and as an escape from chronic stress, by providing information on the negative consequences of use and promoting healthier lifestyles. At the intervention level, it is essential to target university students through programs specially designed for young people who engage in high-risk drinking. As regards expectations, actions must be carried out to resignify the positive beliefs surrounding alcohol, by providing information on the high health costs of heavy drinking and offering alternative resources oriented towards other means of responding to stress that do not involve excessive alcohol consumption.