Sexual Attitudes Moderate the Effects of Alcohol Intoxication on Women's Risk Judgments.

This study evaluated the effects of alcohol intoxication, sexual attitudes, and sexual victimization history on the cognitive processes underlying undergraduate women's risk judgments. Participants were 116 unmarried, undergraduate women between the ages of 21 and 29. The sample was diverse ethnically and composed primarily of heterosexual women. Stimuli were written vignettes describing social situations that varied on dimensions of sexual victimization risk and potential impact on women's popularity. Participants were assigned randomly to an alcohol or a no-alcohol condition, and completed an explicit classification task in which they rated how risky each situation was in terms of their having an unwanted sexual experience. They then completed the Sexual Experiences Survey (SES) and the Sociosexuality Scale (SS); SES responses were used to quantify the severity of victimization experiences, and SS responses were used to measure endorsement of positive attitudes toward casual, impersonal sex. Although there was no main effect for condition, higher sociosexuality predicted use of higher thresholds for judging situations as risky. Importantly, sociosexuality interacted with condition such that higher sociosexuality predicted lower sensitivity to risk information in the alcohol condition but not in the no-alcohol condition. More severe victimization history predicted increased use of popularity impactwhen judging risk. This study emphasizes the importance of identifying specific cognitive processes affected by alcohol that may explain why women have difficulty processing contextual cues signaling risk in social situations. It demonstrates also the relevance of examining individual difference factors that may exacerbate the relationship between intoxication and cognitive processing of risk-relevant information.

Ethnicity and Sexual Attitudes Affect Women's Judgments of Sexual Victimization Risk.

This study evaluated the effects of ethnicity, sexual attitudes, and sexual victimization history on women's judgments of sexual victimization risk in a set of dating and social scenarios. An ethnically diverse sample of undergraduate women ( n = 408) were asked to rate how risky the situations were in terms of having an unwanted sexual experience. American Indian women rated the situations as more risky than did non-Hispanic White or Hispanic women. In addition, participants with more positive attitudes toward a range of sexual experiences rated the situations as less risky than did women with less positive attitudes. Possible implications are discussed.

Overcoming Addictions, a Web-Based Application, and SMART Recovery, an Online and In-Person Mutual Help Group for Problem Drinkers, Part 2: Six-Month Outcomes of a Randomized Controlled Trial and Qualitative Feedback From Participants.

BACKGROUND: Despite empirical evidence supporting the use of Web-based interventions for problem drinking, much remains unknown about factors that influence their effectiveness. OBJECTIVE: We evaluated the performance of 2 resources for people who want to achieve and maintain abstinence: SMART Recovery (SR) and Overcoming Addictions (OA). OA is a Web application based on SR. We also examined participant and intervention-related factors hypothesized to impact clinical outcomes of Web-based interventions. METHODS: We recruited 189 heavy drinkers through SR's website and in-person meetings throughout the United States. We began by randomly assigning participants to (1) SR meetings alone, (2) OA alone, and (3) OA and SR (OA+SR). Recruitment challenges compelled us to assign participants only to SR (n=86) or OA+SR (n=102). The experimental hypotheses were as follows: (1) Both groups will reduce their drinking and alcohol-related consequences at follow-up compared with their baseline levels, and (2) The OA+SR condition will reduce their drinking and alcohol or drug-related consequences more than the SR only condition. Additionally, we derived 3 groups empirically (SR, OA, and OA+SR) based on the participants' actual use of each intervention and conducted analyses by comparing them. Primary outcome measures included percent days abstinent (PDA), mean drinks per drinking day (DDD), and alcohol or drug-related consequences. Postbaseline assessments were conducted by phone at 3 and 6 months. Secondary analyses explored whether clinical issues (eg, severity of alcohol problems, level of distress, readiness to change) or intervention-related factors (eg, Internet fluency, satisfaction with site) affected outcomes. RESULTS: Both intent-to-treat analyses and the actual-use analyses showed highly significant improvement from baseline to follow-ups for all 3 groups. Mean within-subject effect sizes were large (d>0.8) overall. There was no significant difference between groups in the amount of improvement from baseline to the average of the follow-ups. We found that participants who stopped drinking before joining the clinical trial had significantly better outcomes than participants who were still drinking when they joined the study. Neither Internet fluency nor participants' reported ease of navigating the site had an impact on outcomes. CONCLUSIONS: These results support our first experimental hypothesis but not the second. On average, participants improved on all dependent measures. Both SR and OA helped participants recover from their problem drinking. Web-based interventions can help even those individuals with lengthy histories of heavy drinking to make clinically significant reductions in their consumption and related problems. These interventions work well for individuals in the action stage of change. TRIAL REGISTRATION: Clinicaltrials.gov NCT01389297; https://clinicaltrials.gov/ct2/show/NCT01389297 (Archived by WebCite at http://www.webcitation.org/6kLNUNDcc).

The role of ethnicity, sexual attitudes, and sexual behavior in sexual revictimization during the transition to emerging adulthood.

An experience of child sexual abuse (CSA) substantially increases women's risk of adult sexual assault (ASA), but the mechanisms underlying this relationship are unclear. Previous research often has not examined the full range of ASA experiences or included the influence of ethnicity, sexual behavior, and sexual attitudes on CSA and severity of ASA. The current study utilized path analysis to explore the relationships among ethnicity, sexual attitudes, number of lifetime sexual partners, CSA, and severity of ASA in emerging adult women. Results indicated a significant relationship between CSA and more severe ASA that was partially explained by having more lifetime sexual partners. Additionally, European American women, relative to Hispanic women, reported more severe victimization, which was fully explained by more positive attitudes toward casual sex and having more lifetime sexual partners. These results have implications in the design and implementation of universal and selective prevention programs aimed at reducing ASA and revictimization among emerging adult women.

Overcoming Addictions, a Web-based application, and SMART Recovery, an online and in-person mutual help group for problem drinkers, part 1: three-month outcomes of a randomized controlled trial.

BACKGROUND: Overcoming Addictions (OA) is an abstinence-oriented, cognitive behavioral, Web application based on the program of SMART Recovery. SMART Recovery is an organization that has adapted empirically supported treatment strategies for use in a mutual help framework with in-person meetings, online meetings, a forum, and other resources. OBJECTIVE: To evaluate the effectiveness of OA and SMART Recovery (SR) with problem drinkers who were new to SMART Recovery. Our experimental hypotheses were: (1) all groups will reduce their drinking and alcohol/drug-related consequences at follow-up compared to their baseline levels, (2) the OA condition will reduce their drinking and alcohol/drug-related consequences more than the control group (SR), and (3) the OA+SR condition will reduce their drinking and alcohol/drug-related consequences more than the control group (SR only). METHODS: We recruited 189 heavy problem drinkers primarily through SMART Recovery's website and in-person meetings throughout the United States. We randomly assigned participants to (1) OA alone, (2) OA+attend SMART Recovery (SR) meetings (OA+SR), or (3) attend SR only. Baseline and follow-ups were conducted via GoToMeeting sessions with a Research Assistant (RA) and the study participant. We interviewed significant others to corroborate the participant's self-report. Primary outcome measures included percent days abstinent (PDA), mean drinks per drinking day (DDD), and alcohol/drug-related consequences. RESULTS: The intent-to-treat analysis of the 3-month outcomes supported the first hypothesis but not the others. Participants in all groups significantly increased their percent days abstinent from 44% to 72% (P<.001), decreased their mean drinks per drinking day from 8.0 to 4.6 (P<.001), and decreased their alcohol/drug-related problems (P<.001). Actual use relationships were found for the OA groups, between SR online meetings and improvement in PDA (r=.261, P=.033). In addition in the OA groups, the number of total sessions of support (including SR & other meetings, counselor visits) was significantly related to PDA (r=.306, P=012) and amount of improvement in alcohol-related problems (r=.305, P=.012). In the SR only group, the number of face-to-face meetings was significantly related to all three dependent variables, and predicted increased PDA (r=.358, P=.003), fewer mean DDD (r=-.250, P=.039), and fewer alcohol-related problems (r=-.244, P=.045), as well as to the amount of improvement in all three of these variables. Six-month follow-ups have been completed, and the results are currently being analyzed. CONCLUSIONS: These results support our first experimental hypothesis but not the second or third. All groups significantly increased their PDA and decreased both their mean DDD and their alcohol-related problems, which indicates that both interventions being investigated were equally effective in helping people recover from their problem drinking.

Predictors of sexual aggression among male juvenile offenders.

The purpose of this study was to conduct a longitudinal examination of predictors of sexual aggression among male juvenile offenders. Four hundred and four adolescent males between the ages of 14 and 17 years were recruited from juvenile probation offices to take part in a prospective study of substance use and sexual risk. At baseline, participants completed a series of questionnaires that assessed putative risk factors for sexual aggression. They then completed a measure of sexual aggression at the 6-month follow-up period. Correlational analyses revealed that participants who reported hard drug use, more frequent alcohol and marijuana use, and less severe offenses reported engaging in more severe sexual aggression. In addition, participants who reported higher impulsivity, sensation seeking, and externalizing behaviors also reported participating in more severe sexual aggression. When these variables were included in a regression analysis, only externalizing behaviors and severity of offense uniquely predicted severity of sexual aggression at the 6-month follow-up.