Undifferentiated negative affect and impulsivity in borderline personality and depressive disorders: A momentary perspective.

Individuals with borderline personality disorder (BPD) often report experiencing several negative emotions simultaneously, an indicator of "undifferentiated" negative affect. The current study examined the relationship between undifferentiated negative affect and impulsivity. Participants with a current BPD (n = 67) or depressive disorder (DD; n = 38) diagnosis carried an electronic diary for 28 days, reporting on emotions and impulsivity when randomly prompted (up to 6 times per day). Undifferentiated negative affect was quantified using momentary intraclass correlation coefficients, which indicated how consistently negative emotion items were rated across fear, hostility, and sadness subscales. Undifferentiated negative affect at the occasion-level, day-level, and across 28 days was used to predict occasion-level impulsivity. Multilevel modeling was used to test the hypothesis that undifferentiated negative emotion would be a significant predictor of momentary impulsivity above and beyond levels of overall negative affect. Undifferentiated negative affect at the occasion and day levels were significant predictors of occasion-level impulsivity, but undifferentiated negative affect across the 28-day study period was only marginally significant. Results did not differ depending on BPD or DD status, though individuals with BPD did report significantly greater momentary impulsivity and undifferentiated negative affect. Undifferentiated negative affect may increase risk for impulsivity among individuals with BPD and depressive disorders, and the current data suggest that this process can be relatively immediate as well as cumulative over the course of a day. This research supports the consideration of undifferentiated negative affect as a transdiagnostic construct, but one that may be particularly relevant for those with BPD.

Relations Among Caffeine Consumption, Smoking, Smoking Urge, and Subjective Smoking Reinforcement in Daily Life.

Caffeine consumption and cigarette smoking tend to occur within the same individuals and at the same time. One potential explanation for this co-use is that caffeine consumption increases subjective smoking reinforcement. Electronic diaries were used to collect momentary reports of smoking, caffeine consumption, temptation/urge to smoke, and subjective smoking reinforcement in 74 prequit smokers. Momentary reports of caffeine consumption and smoking were associated, replicating previous findings. These results remained significant when contextual factors (time of day, weekday/weekend, presence of others, presence of others smoking, location, and past hour alcohol consumption) were covaried. Caffeine consumption was also associated with positive cigarette appraisals and reports of strong temptation/urge to smoke and urge reduction from the prior cigarette. Under the conditions of caffeine consumption versus at other times, smokers were significantly more likely to report their last cigarette as producing a rush/buzz, being pleasant, relaxing, and tasting good. The effects for temptation/urge to smoke and rush/buzz varied as a function of latency since smoking. Caffeine consumption increased reports of urge to smoke and rush/buzz only when smoking occurred more than 15 minutes prior to the diary entry. Findings suggest that caffeine consumption influences some aspects of smoking motivation or affects memorial processing of smoking reinforcement.

Spirituality and treatment of addictive disorders.

Spirituality is generally protective against the initiation of alcohol and drug use and progression to disordered use. In addition, mutual-help organizations, such as Alcoholics Anonymous, were founded on spiritual principles, and reliance on a "higher power" is a central component of the 12 steps. Despite this, spirituality is not commonly addressed in formal treatment of addictions. The purpose of this paper is to provide a summary of the role of spirituality in the development and recovery from addictive disorders for health care professionals.

Characterizing subjective responses to alcohol among adolescent problem drinkers.

Theoretical models of alcoholism emphasize the acute reinforcing properties of alcohol as chief determinants of drinking, and animal research suggests adolescents are uniquely sensitive to these effects. Human studies of these phenomena, however, are virtually nonexistent. We used ecological momentary assessment methods to capture adolescents' subjective responses to alcohol in real time in their natural environments. Adolescent participants were 22 problem drinkers, ages 15 to 19 years (M = 18.3, SD = 0.09; 55% female; 55% alcohol dependent). Participants consumed alcohol on 38% of days during a 1-week monitoring period, with an average of 5 drinks per occasion. Momentary data revealed that adolescents experience decreased stimulation and increased sedation and "high" across the ascending limb of the blood alcohol curve. Notably, greater craving predicted higher volumes of subsequent alcohol consumption during the episode, whereas greater "high" attenuated use. To test for developmental differences in these effects, we pooled these data with data from a similarly ascertained sample of 36 adult heavy drinkers, ages 24 to 64 years (M = 38.1, SD = 11.8; 50% female; 61% alcohol dependent). Adolescents were more sensitive to the stimulant effects of alcohol than adults. This study provides novel data on how adolescent problem drinkers experience alcohol in their natural contexts and illustrates how these effects, which appear to differ from adult problem drinkers, confer liability for future drinking.

Perceived danger while intoxicated uniquely contributes to driving after drinking.

BACKGROUND: Previous findings suggest that alcohol alters perceptions of risky behaviors such as drinking and driving. However, studies testing these perceptions as a predictor of drinking and driving typically measure these perceptions while participants are sober. This study tested whether the perceived danger of driving after drinking assessed while intoxicated was associated with increased willingness to drive and self-reported drinking-and-driving behavior over and above perceptions assessed while sober. Additionally, we tested the effect of acute tolerance on the perceived danger of driving after drinking assessed on the ascending and descending limbs of the breath alcohol concentration (BrAC) curve. METHODS: Eighty-two young adults attended 2 counterbalanced laboratory sessions. In one session, participants consumed a moderate dose of alcohol (men: 0.72 g/kg, women: 0.65 g/kg) and reported their perceived danger of driving and willingness to drive at multiple points across the BrAC curve. On a separate occasion, participants remained sober and appraised the dangerousness of driving at a hypothetical, illegal BrAC. RESULTS: Perceptions of the dangerousness of driving following alcohol administration were associated with increased willingness to drive and higher rates of self-reported drinking-and-driving behavior over and above perceptions reported when sober. Furthermore, perceived danger was reduced on the descending limb of the BrAC curve, compared with the ascending limb, suggesting the occurrence of acute tolerance. CONCLUSIONS: Results from this study suggest that intoxicated perceptions are uniquely associated with drinking-and-driving decisions and that the perceived danger of drinking and driving is lower on the descending limb of the BrAC curve. Efforts to prevent alcohol-impaired driving have focused on increasing awareness of the danger of driving after drinking. Prevention efforts may be enhanced by educating drivers about how intoxication can alter perceived danger, and interventions may benefit from targeting perceptions of dangerousness while individuals are intoxicated in addition to when they are sober.

Testing measurement invariance of the protective behavioral strategies scale in college men and women.

This study tested whether the measurement parameters of the Protective Behavioral Strategies Scale (PBSS; Martens et al., 2005) were equivalent for men and women in a college student sample. Multi-group confirmatory factor analyses tested whether a similar 3-factor latent structure was shared across gender groups and whether item origins (i.e., thresholds) and the strength of associations between individual items and latent factors (i.e., factor loadings) were equivalent across gender groups. Multiple indicators multiple causes (MIMIC) models tested whether gender differences in measurement parameters were explained by drinking patterns among college men and women. Results evidenced significant measurement bias (i.e., non-invariant measurement parameters) across gender groups at both the factor structure and individual item level. In addition, MIMIC models suggested that gender differences in item loadings and thresholds were not better explained by discrepancies in drinking patterns among male and female college students. Findings indicate that gender differences in latent factor scores may reflect measurement bias rather than true mean differences between gender groups, restricting meaningful comparisons of PBSS scores between college men and women. Implications for the assessment of specific strategies as well as clinical interventions among college students that include components on protective behavioral strategies are discussed.

Sport-related achievement motivation and alcohol outcomes: an athlete-specific risk factor among intercollegiate athletes.

Intercollegiate athletes report greater alcohol consumption and more alcohol-related problems than their non-athlete peers. Although college athletes share many of the same problems faced by non-athletes, there are some consequences that are unique to athletes. Studies have demonstrated that alcohol negatively affects athletic performance including increased dehydration, impeded muscle recovery, and increased risk for injury. Beyond risk factors for alcohol misuse that may affect college students in general, research has begun to examine risk factors that are unique to collegiate athletes. For example, research has found that off-season status, the leadership role, and athlete-specific drinking motives are associated with increased alcohol use. Given these findings, it is possible that other athlete-specific variables influence alcohol misuse. One such variable may be sport achievement orientation. The purpose of the current study was to examine the relationship between sport achievement orientation and alcohol outcomes. Given previous research regarding seasonal status and gender, these variables were examined as moderators. Varsity athletes (n=263) completed the Sport Orientation Questionnaire, which assesses sport-related achievement orientation on three scales (Competitiveness, Win Orientation, and Goal Orientation). In addition, participants completed measures of alcohol use and alcohol-related problems. Results indicated that Competitiveness, Win Orientation, and Goal Orientation were all significantly associated with alcohol use, but not alcohol-related problems. Moreover, these relationships were moderated by seasonal status and gender. These interactions, clinical implications, and limitations are discussed.

The development and psychometric evaluation of the Smokeless Tobacco Expectancies Scale (STES).

Expectancies regarding the effects of various psychoactive substances are important predictors of the initiation and maintenance of substance use. Although measures of outcome expectancies exist for several addictive substances, there is currently no measure to assess smokeless tobacco (ST) expectancies in an adult population. This article presents 2 studies leading to the development and psychometric evaluation of the Smokeless Tobacco Expectancies Scale (STES). Initially, 155 individuals listed all outcomes they expected to occur if they were to use ST products. From these responses, an initial pool of potential STES items was identified. The STES was then administered to 2 samples totaling 813 individuals (265 ST users, 270 cigarette smokers, and 278 nontobacco users). The first study included 315 participants who completed a 68-item measure. An exploratory factor analysis identified 10 items that may account for individuals' ST expectancies. Items loaded on 2 factors: Negative Health Consequences and Positive Reinforcement. A confirmatory factor analysis on an independent sample (n = 498) supported the proposed factor structure. Furthermore, in both samples, the STES accurately discriminated ST users from smokers and nonusers. Findings are discussed in terms of the potential uses of the STES for advancing the understanding of ST use.

Marijuana use, driving, and related cognitions.

The purpose of the present study was to examine cognitive risk factors for driving after use of marijuana. We tested whether marijuana outcome expectancies and specific cognitions about driving after marijuana use were uniquely associated with the likelihood and frequency of driving while high (DWH) and riding with a high driver (RWHD). Participants were college students recruited from introductory psychology classes at a Midwestern university who reported ever using marijuana in their lifetime and reported having access to a car or driving at least once a month (n = 506). Greater perceived dangerousness of DWH was associated with decreased likelihood of DWH and RWHD. Negative marijuana expectancies were associated with decreased likelihood of DWH, and social norms were associated with decreased likelihood of RWHD. All cognitive predictors were associated with decreased frequency of DWH and RWHD for individuals with the propensity to engage in these behaviors. Findings suggest interventions to reduce risk of DWH and RWHD may benefit from targeting general expectancies about the negative effects of marijuana. Similarly, results suggest increasing students' knowledge of the potential danger of DWH may help to reduce the likelihood and frequency of DWH and RWHD.

Direct and indirect effects of impulsivity traits on drinking and driving in young adults.

OBJECTIVE: Impulsivity is strongly associated with alcohol-related risk-taking behavior, and this association has been found to be mediated by alcohol cognitions. The current study expanded this literature by comparing the relative association of distinct impulsivity traits with a specific risky behavior--drinking and driving. We then tested whether drinking-and-driving expectancies uniquely mediated this relation over and above other cognitions about alcohol and drinking and driving. METHOD: College student drivers (n = 816; 53.6% women) completed a paper-and-pencil survey in small groups. Self-report measures assessed alcohol use, impulsivity traits, alcohol expectancies, drinking-and-driving cognitions (i.e., expectancies, attitudes, beliefs), and drinking and driving. RESULTS: Although all impulsivity traits were correlated with drinking and driving, only urgency uniquely contributed to drinking and driving. Indirect effect tests indicated that drinking-and-driving convenience expectancies partially mediated this association as well as that between (lack of) perseverance and drinking and driving. These results remained significant after controlling for alcohol expectancies and other drinking-and-driving cognitions. CONCLUSIONS: These findings highlight the importance of distinguishing among impulsivity traits to improve theoretical models of the processes by which personality leads to specific alcohol-related consequences. In addition, results extend previous research by providing evidence for the unique importance of expectancies regarding the convenience of drinking and driving over and above more global alcohol expectancies and other drinking-and-driving cognitions.

Acute alcohol effects on impulsivity: associations with drinking and driving behavior.

AIMS: Although drink drivers exhibit higher levels of trait impulsivity, no studies have tested the hypothesis that drink drivers experience increased impulsivity while intoxicated. We tested this hypothesis for two impulsivity constructs: delay discounting and behavioral inhibition. DESIGN: A within-subjects study comparing performance of drink drivers and non-drink drivers on behavioral measures of impulsivity in alcohol and no-beverage sessions. SETTING: A laboratory setting at the University of Missouri. PARTICIPANTS: Twenty-nine young adults who were at least moderate drinkers were recruited from the local community and the University of Missouri. MEASUREMENTS: Impulsivity was assessed using the Two Choice Impulsivity Paradigm (TCIP) and the Stop-Signal Task. Participants also completed self-report measures of binge drinking and trait impulsivity. FINDINGS: In the no-beverage session, TCIP impulsive choices did not differ between drinking and driving groups (P = 0.93). In the alcohol session, drink drivers made more TCIP impulsive choices on both the ascending (P < 0.01) and descending limb (P < 0.01) of the blood alcohol concentration curve than their peers who did not drink and drive. Drinking and driving groups did not differ on the Stop-Signal Task. Supplementary analyses indicated that effects for the TCIP were not explained by individual differences in trait impulsivity. CONCLUSIONS: Individuals who report having three or more drinks before driving show greater impulsivity when under the influence of alcohol than those who do not report heavy drinking before driving.

Effects of mood and urgency on activation of general and specific alcohol expectancies.

We tested the interaction of a mood manipulation with positive and negative urgency on activation of general and specific alcohol expectancies. In Study 1, high negative urgency was associated with increased positive-alcohol IAT scores following a negative mood induction, F(1, 93)=5.71, p<.01. In Study 2, high positive and negative urgency were associated with faster ETASK reaction times for global positive and tension reduction expectancies. These associations did not differ across mood conditions or expectancy subtypes. Our results suggest that positive and negative urgency are associated with increased activation of general, positive alcohol cognitions, rather than mood-specific subtypes.

Differences in implicit associations about alcohol between blacks and whites following alcohol administration.

OBJECTIVE: Implicit cognitions about alcohol have been shown to be an important predictor of alcohol use. Relatively little research has been conducted on racial/ethnic differences in implicit cognitions or changes in implicit cognitions while intoxicated. This study examined differences between Blacks and Whites in positive and negative implicit associations about alcohol, as measured by the Implicit Association Test (IAT) and tested differences in IAT scores when participants were sober and intoxicated. METHOD: One hundred thirty-five young adults (46% of Black descent) participated in an alcohol-administration study, receiving a moderate dose of alcohol (0.72 g/kg alcohol for men, 0.65 g/kg for women). The IAT was administered in two sessions, one in which alcohol was administered (30 minutes after alcohol consumption) and one in which it was not, approximately 1 week apart. RESULTS: Repeated-measures mixed-factorial analyses of variance were conducted separately for positive and negative IAT scores. Blacks held lower positive and negative implicit cognitions about alcohol compared with Whites. Positive and negative IAT scores did not change as a function of intoxication. Positive explicit expectancies and self-reported past-month drinking behavior were related to positive IAT scores. Positive and negative IAT scores were also related to acute subjective response to alcohol, and this association differed by race. CONCLUSIONS: Results extend previous studies by providing evidence for racial differences in implicit cognitions about alcohol and by showing the stability of the IAT while participants are intoxicated. Future studies are needed to determine what factors contribute to racial differences in implicit cognitions.