Neural underpinnings of expecting alcohol: Placebo alcohol administration alters nucleus accumbens resting state functional connectivity.

BACKGROUND: Using balanced placebo designs, seminal alcohol administration research has shown individuals' beliefs about whether they have consumed alcohol, irrespective of the actual presence of alcohol, can determine level of alcohol consumption and impact social behavior. Despite the known effect of expecting alcohol on drinking behavior, few studies have used the placebo manipulation to directly investigate the neural underpinnings of the expectancy-related effects that occur following perceived alcohol consumption in humans. The present paper examined placebo responses in the laboratory to better understand the neural basis for the psychological phenomenon of expectancies. METHODS: As part of a larger within-subjects study design, healthy young adults (N = 22, agemean+SD=23 +1) completed resting state fMRI scans and measures of subjective response before and after consuming placebo beverages. Effect of placebo beverage consumption (pre- versus post-beverage consumption) on functional connectivity within prefrontal cortical networks was examined using the CONN Toolbox. Relations between perceived subjective response to alcohol with functional connectivity response following placebo beverage consumption were examined. RESULTS: Compared to pre-beverage scan, placebo beverage consumption was associated with increased positive functional connectivity between right nucleus accumbens - ventromedial prefrontal cortex and subcallosal cingulate cortex (pFDR<0.05). Subjective ratings of intoxication (i.e., feeling 'drunk') positively correlated with placebo beverage-related increases in nucleus accumbens - subcallosal cingulate cortex functional connectivity. CONCLUSION: Results suggest placebo response to alcohol is associated with increased functional connectivity within a key reward network (nucleus accumbens - ventromedial prefrontal cortex and subcallosal cingulate cortex) and put forth a mechanism by which alcohol expectancies may contribute to the subjective experience of intoxication.

Maximal constant heart rate--a heart rate based method to estimate maximal lactate steady state in running.

The aim of the present study was to investigate the accuracy of the maximal constant heart rate method for predicting anaerobic threshold (AnT) in running. This method only requires a common heart rate (HR) monitor and is based on the identification of the maximal constant HR maintainable for 30 min (HRMC). HRMC, 4-mmol threshold, and maximal lactate steady state (MLSS) were determined in 31 probands. 17 probands underwent an additional MLSS retest within 2 weeks. The correlation between HR at MLSS and at MLSS retest was very close (r = 0.807; SEE = 5.25 beats x min(-1); p < 0.001). So were the correlations between HR at 4-mmol threshold and MLSS (r = 0.844; SEE = 6.43 beats x min(-1); p < 0.001) and between HRMC and HR at MLSS (r = 0.820; SEE = 6.73 beats x min(-1); p < 0.001). Mean velocities at maximum constant HR trials and MLSS (r = 0.895; SEE = 0.185 m x s(-1); p < 0.001) as well as 4-mmol threshold and MLSS (r = 0.899; SEE = 0.186 m x s(-1); p < 0.001) were highly correlated. In conclusion, data presented in this study confirm that the determination of HRMC is a manageable method giving a highly accurate estimation of both HR and velocity at MLSS in running.

A review of expectancy theory and alcohol consumption.

Research is reviewed on the association between alcohol outcome expectancies and consumption which has led many to argue that manipulating expectancies might be a route to manipulating consumption for problem prevention and treatment. Studies indirectly and directly evaluating this latter position are reviewed. Expectancies predicting treatment outcome: two studies have shown that the more positive expectancies held at treatment, the poorer is treatment outcome, but five other studies have failed to find this. Three related studies have shown that the more negative expectancies held at treatment, the better the treatment outcome. This evaluation provides evidence inconsistent with the main position for positive expectancy and limited support for negative. Expectancy manipulations and ad libitum consumption: three studies in the laboratory have shown that increasing positive expectancies through word priming increases subsequent consumption and two studies have shown that increasing negative expectancies decreases it. A single study in the field showed a similar relationship. This evaluation provides evidence consistent with the main position but is limited by measuring consumption changes over only 1-2 hours. Prevention programmes with expectancy components: seven projects are reviewed in which positive expectancies were targeted, but only two report an expectancy change analysis and in both cases the expectancy change did not relate to subsequent consumption. This evaluation provides evidence inconsistent with the main position. Expectancy challenge: two related studies are reviewed in which positive expectancy challenges reduce subsequent consumption but changes in expectancy were not evaluated as predictors of consumption change. Two studies are reviewed which found a reduction in positive expectancy following expectancy challenge but no reduction in consumption. One study is reviewed in which when negative expectancy was increased in treatment there was a better treatment outcome at 3 months follow-up than when it was not. This evaluation provides evidence inconsistent with the main position for positive expectancy and limited consistent evidence for negative. It is concluded that the research has still to be done that securely links expectancy manipulations with subsequent changes in consumption, and fulfils the early promise from association studies.

Measuring adolescent alcohol outcome expectancies.

The psychometric properties and construct validity of the Comprehensive Effects of Alcohol (CEOA) questionnaire were compared with those of the Alcohol Expectancy Questionnaire--Adolescent version (AEQ-A) in relation to adolescent alcohol consumption. Both measures of adolescent alcohol expectancies were found to be internally reliable and temporally stable. Alcohol use was significantly associated with subjective evaluations for Cognitive and Behavioral Impairment and Self-Perception on the CEOA and with expected effects for Cognitive and Motor Impairment and Changes in Social Behavior on the AEQ-A. Compared with the AEQ-A, the CEOA explained more variance in quantity (28%) and a similar variance in frequency (15%) for adolescent alcohol use (AEQ-A quantity = 20%, frequency = 15%). Whereas the general content and psychometric properties of the 2 measures are markedly similar, the Likert response format, shorter length, and assessment of both expected effects and subjective evaluations with the CEOA may offer measurement advantages over the AEQ-A.

Intoxicated sexual risk taking: an expectancy or cognitive impairment explanation?

OBJECTIVE: Two experimental studies tested expectancy and impairment explanations for the association between alcohol consumption and unsafe sexual behaviors. METHOD: Young adults, who were administered alcohol (blood alcohol concentration mean = .08 mg%), placebo or water, rated the likelihood that potential consequences would result from risky sexual practices (Study 1, N = 161) and listed potential consequences that could result from having sex without a condom (Study 2, N = 135). RESULTS: Intoxicated participants reported lower perceptions of risk (mean [+/-SD] = 4.5+/-2.1) than those who received placebo (mean = 5.8+/-1.3) or water (mean = 5.5+/-1.7). Intoxicated participants also listed fewer negative consequences (mean = 1.3+/-1.2) than those who received placebo (mean = 1.5+/-1.2) or water (mean = 2.1+/-1.5). In addition, participants who expected alcohol to disinhibit their sexual behavior reported stronger postdrinking perceptions of benefit (mean = 2.6+/-1.8) and indicated that they were more likely to engage in risky sexual practices (mean = 2.4+/-1.7) than those who did not expect sexual disinhibition (mean = 2.0+/-1.7, benefit; mean = 1.8+/-1.1, involvement). CONCLUSIONS: Results support the hypotheses that (1) alcohol-related impairment reduces the drinker's perception of personal risk, and (2) positive outcome expectancies motivate drinkers to engage in risky sexual practices.

Health risk behaviors of adolescent and young adult siblings.

The present study tested the effects of older siblings' outcome expectancies, health risk behaviors, and consequences on the behavior and health-related expectancies of their younger adolescent siblings. Data were analyzed for 140 matched pairs of younger (n = 147) and older (n = 195) siblings. Younger siblings' alcohol use and expectancies were significantly associated with perceptions of their older siblings' drinking. Younger siblings' positive expectancies for other health risk behaviors (e.g., sex without a condom) were associated with their perceptions about the positive consequences their older sibling had experienced and with their older siblings' positive expectancies. These results suggest that vicarious learning from an older sibling is one mechanism through which adolescents form expectancies about health risk behaviors. Prevention strategies are discussed that focus on expectancies and older sibling influence on adolescent risk involvement.

Effects of alcohol intoxication on the perceived consequences of risk taking.

In 2 laboratory studies, the authors tested the hypothesis that intoxicated risk taking results from alcohol's effects on negative outcome expectancies. Young adults (N = 107) consumed alcohol or no alcohol and made ratings of the likelihood that negative and positive consequences would result from a variety of risky activities. Consistent with study hypotheses, participants rated negative consequences as less likely when they were intoxicated than when sober. Results were replicated in a second study (N = 88), which further showed that alcohol, rather than expectancy set, contributed to these reduced perceptions of risk. Findings provide the first experimental evidence that alcohol intoxication may contribute to risk-taking behavior be altering expectations about negative consequences.

[Gastroduodenal tolerance and clinical effectiveness of therapy with lonazolac-calcium in rheumatic diseases]. / Gastroduodenale Verträglichkeit und klinische Wirksamkeit der Therapie mit Lonazolac-Calcium bei rheumatischen Erkrankungen.

Most undesired side effects in therapy with non-steroidal antiinflammatory drugs (NSAID) mainly effect the gastric and duodenal mucosa. The radioimmunological determination of pepsinogen A and C (pepsinogen group I and II) is qualified for inclusion of the functional and morphologic state of the gastroduodenal mucosa. By determination of the pepsinogens group A and C the influence and the gastroduodenal compatibility of the non-steroidal antiinflammatory drug lonazolac Ca (LCa) [Irritren] were examined in a dosage of 600 mg/d during a 2-weeks therapy. 31 patients with various painful rheumatic diseases and 10 healthy probands as a control group were examined. The results show that the treatment with LCa did not significantly effect mean and median of pepsinogen A- and -C levels in serum. Only in 3.7% of the cases a contemporary increase of pepsinogen A and C occurred, which could be estimated as a beginning superficial gastritis. In addition the beneficial clinical efficacy of LCa was documented by a significant decrease of a tripartite pain score from 2.1 to 1.4. The results point to a very good proportion of clinical efficacy and gastroduodenal side-effects of LCa.

An experimental test of affect, subjective craving, and alcohol outcome expectancies as motivators of young adult drinking.

Research on motivations for alcohol use suggests that both positive and negative affect, craving, and outcome expectancies are good predictors of alcohol consumption. The present study tested the utility of these variables in predicting laboratory measures of alcohol consumption among young social drinkers. Two conditioning models of alcohol procurement guided analyses: the conditioned withdrawal model (represented by negative affect and craving) and the appetitive-motivational model (represented by positive outcome expectancies and subjective evaluations). Results showed that negative affect and craving did not significantly influence either subjects' latencies to begin drinking or speed of consuming one placebo beverage. Positive outcome expectancies and evaluations, however, had a marked impact on speed of drinking. Thus, the appetitive-motivational model appears to better characterize the drinking patterns of young social drinkers than does the conditioned withdrawal model.

The Alcohol Skills Training Program: a group intervention for young adult drinkers.

Development, content, and evaluation of the Alcohol Skills Training Program (ASTP) is described. Patterned after strategies for relapse prevention, the ASTP is a cognitive behavioral approach to the secondary prevention of alcohol problems. Format and context of the six group sessions are detailed, and process considerations are discussed. Results are summarized for two controlled investigations of the ASTP with young adult drinkers. The psychoeducational approach of the ASTP is recommended as an effective means for changing drinking patterns among young adults who are at risk for alcohol-related problems.

Mediators and moderators of young adults' drinking.

Direct effects of modeling and indirect effects of social perception processes have been implicated in the acquisition and maintenance of alcohol use. Parental and peer drinking behavior (assessed from self-reports), and student perceptions about parent and peer drinking (assessed from student estimates of their parents' and friends' alcohol use) were examined through surveys of college students, their parents, and a same-sex best friend. Results showed that students' perceptions about their parents' drinking and parents' self-reported quantity of alcohol consumed were significant correlates of students' own drinking. Perceptions about their friends' alcohol use were found to mediate the strong correlation between student and friend drinking. Perceived similarity to parents, but not perceived similarity to their friend, moderated the relation between students' alcohol use and their perceptions about the alcohol use of significant others. When parents were asked to estimate the alcohol use of their sons, daughters, and the average college student, they consistently estimated lower consumption for their offspring than for the average student.

An experimental test of three methods of alcohol risk reduction with young adults.

This study tested 3 forms of alcohol risk reduction programming for young adults. Volunteers were randomly assigned to receive a 6-week class and discussion group, a 6-unit self-help manual, or a single 1-hr feedback and advice session with professional staff. Results reveal significant reductions in self-reported drinking at the end of the intervention phase and maintenance of drinking changes throughout a 2-year follow-up period. Comparable drinking reductions were rated across treatments; however, noncompliance with the self-help reading program suggested limited utility. Treatment response was related to subject age, as subjects showed increased drinking during the year they reached legal drinking status. The efficacy of brief motivational interventions and client matching in prevention programs is discussed.

Alcohol expectancies, social and environmental cues as determinants of drinking and perceived reinforcement.

Increasing evidence suggests that outcome expectancies and environmental cues interact to influence post-drinking behaviors. Using an experimental methodology in a simulated social drinking setting, this research tested the potential influence of expectations for the effects of drinking, environmental cues, and beverage content on ad lib consumption and post-drinking self-perception. Eighty-eight moderate to heavy-drinking males were randomly assigned to one of eight experimental conditions in which beverage content (alcohol or placebo), social environment (friendly or unfriendly), and physical environment (simulated bar or residence) were varied. Subjects were further divided into high and low groups on three outcome expectancy factors. Unaffected by environmental cues, beverage self-administration increased when subjects strongly expected behavioral impairment from drinking but received placebo beverage. Post-drinking reports of disinhibition increased in response to friendly social cues but were not affected by beverage content or amount. Results therefore suggest that individual's beliefs about the effects of drinking influence the amounts of beverage they consume, whereas social cues more greatly affect post-drinking self-perception.

Secondary prevention with college drinkers: evaluation of an alcohol skills training program.

This study evaluated secondary prevention approaches for young adults (N = 36, mean age 23 years) at risk for alcohol problems. Subjects were randomly assigned to cognitive-behavioral alcohol skills training, a didactic alcohol information program, or assessment only. The skills program included training in blood alcohol level estimation, limit setting, and relapse prevention skills. All subjects maintained daily drinking records during the 8-week intervention and for 1 week at each follow-up. Repeated measures MANOVA found a significant reduction over 1-year follow-up in self-reported alcohol consumption for the total sample. For all drinking measures, the directional findings consistently favored skills training. Despite overall reductions, most subjects continued to report occasional heavy drinking.

Spinal cord monitoring during intraspinal extramedullary tumor operations (peroneal nerve evoked responses).

Longterm scalp recording of early SEP components triggered by peroneal or tibial nerve stimulation detects functional disturbances of spinal cord transmission due to mechanical trauma. We confirm previous observations that preoperative SEP patterns reflect neurological deficits and clearly show functional disturbances even on the side where they are not manifest. Peroneal nerve SEP have a well-known P40-peak corresponding to activities of neurons at the postcentral cortical layers. The P40-peak was identified in only 55% of our recordings. We therefore, tried to use the P50-peak that could be identified in 100% of the recordings under the difficult recording circumstances in the operating room. Other authors demonstrate that the P40 component varies spontaneously about 7 ms during operations; we found variation of P50-latencies of 9 ms. We found the P50 component to be a valid and reproducable SEP event for intraoperative monitoring. Decline of SEP amplitudes during the operation occurred especially during dissection of the tumor. We once found intermittent loss of the P50 component with complete recovery after several minutes. This study shows that peroneal nerve SEP monitoring during intraspinal tumor operations is a feasible and valid measure. It provides the surgeon with a new alarm parameter for spinal cord lesions.

Correlates of alcohol consumption: sex, age, and expectancies relate differentially to quantity and frequency.

Expectations of the effects of alcohol have been related to drinking behaviors for both problem and nonproblem drinkers. The present investigation expanded on previous research by considering age, sex, and alcohol expectancies as differential predictors of frequency and quantity of drinking. Subjects, 157 males and 168 females, completed alcohol expectancy, drinking habits, and demographic questionnaires. Results showed significant sex differences in predictors of drinking frequency. Males who reported most frequent drinking tended to have stronger expectations of increased Social and Physical Pleasure, Global Positive Changes, and Sexual Enhancement. On the other hand, frequent consumption among females was best predicted by stronger expectations that alcohol would reduce tension. The amount consumed per drinking occasion was predicted by the same two expectancy factors for males and females: Social and Physical Pleasure and Social Assertion. Age was an important contributing predictor of quantity and frequency for females only. Results indicated the importance of investigating the mediating role of expectancies (a) within sex and (b) with respect to frequency versus quantity of drinking behavior.

Effects of alcohol intoxication on metamemory and on retrieval from long-term memory.

In a balanced-placebo design, people expected either an alcohol drink or placebo drink and consumed either alcohol (1 ml/kg) or placebo. Shortly thereafter, each person attempted to recall the answers to general-information questions (e.g., "What is the capital of Chile?"), made confidence judgments about the accuracy of recall, made feeling-of-knowing judgments on all nonrecalled items, and received a recognition test. Unanticipated outcomes included: Alcohol intoxication significantly hindered recall from long-term memory, contrary to previous conclusions that alcohol does not affect retrieval; people's expectancy of alcohol had no significant effect on memory or metamemory performance, contrary to its established effects on other kinds of performance; and alcohol intoxication produced no significant overconfidence in judgments about recall or in feeling-of-knowing judgments, contrary to the overconfidence produced in other kinds of judgments such as an intoxicated person's assessment of his driving ability. This last outcome implies that alcohol intoxication does not produce a general lowering of the threshold for confidence but rather has effects that are situation specific.

Social drinking in a simulated tavern: an experimental analysis.

Five groups of five male social drinkers, who frequently drank with one another, were observed during a 30-min drinking period in an experimental tavern. Audio/video tapes of each session were rated by two observers for onset and duration of drinking and talking using a computer scoring system. Drinking was found to follow a negatively accelerating function, with session intakes correlated with reported weekly drinking. Group talking was found to increase during the session, supporting previous reports of increased socialization following drinking. Drinking patterns and intakes were found to be comparable to some of the observations from naturalistic tavern settings suggesting that the simulated tavern is an appropriate environment in which to study drinking consequences.

A survey analysis of first intoxication experiences.

In men and women, there has been a significant decrease in the age at first intoxication over the last 20 years. Significant differences were also found between men and women in their drinking partners during their first intoxication.