Working memory moderates the association between condom use intentions and behavior among moderate-to-heavy drinking men who have sex with men.

Men who have sex with men (MSM) are a high-risk population for HIV infection and this risk is increased for those who consume alcohol. Condomless anal intercourse (CAI) is the central transmission risk factor for this population. This study examined whether individual differences in working memory moderated the association between intentions to use condoms and the frequency of CAI among MSM who engaged in anal intercourse over a subsequent 6-week period. Moderate- and heavy-drinking MSM (n = 207) completed questionnaires regarding alcohol use and condom use intentions and an operation span task to assess working memory at baseline. Participants then completed 6 weeks of morning surveys via a mobile phone app to assess anal intercourse frequency with and without condoms. Negative binomial regression analyses showed that the association between intentions to use condoms and episodes of CAI during the monitoring period was moderated by working memory such that intentions predicted CAI for those high in working memory but not those low in working memory. These results support the view that self-reported intentions may be less-likely to translate into health behaviors among those with poorer executive functioning skills.

Working memory moderates the association between perceived norms and heavy episodic drinking among college students.

Heavy episodic drinking (4+/5+ drinks/occasion for females/males) is highly prevalent among college students and is influenced by social factors. Among these social risk factors, perceived peer drinking norms have been shown to significantly predict heavy episodic drinking across a number of studies. However, there is little known about which students may be most and least susceptible to these influences or why individual differences may moderate the impact of norms on heavy drinking. Recent work has suggested self-control may be an important individual difference factor in this regard. Working memory (WM) is a central component of self-control that has been shown to buffer the effect of social influence variables. This study examined whether WM, as measured by memory span tasks, moderates the relationship between perceived drinking norms and alcohol use among college students reporting one or more past month drinking occasions (n = 98). Hierarchical linear regression analyses were used to examine whether WM significantly moderated the relationship between perceived norms and heavy drinking episodes (HDEs) as well as number of drinking days in the past month. Analyses revealed a significant WM x norms interaction for both drinking indices. Simple slopes analyses suggested a buffering effect of WM as higher perceived norms predicted more HDEs and drinking days at low (-1SD) and mean WM scores but not high (+1SD) WM. These results suggest WM serves as a protective factor for the influence of norms such that individuals high in WM may be more able to inhibit the impact of norms on alcohol use.

Readiness-to-change as a moderator of a web-based brief intervention for marijuana among students identified by health center screening.

INTRODUCTION: Electronic screening and brief intervention has been identified as a low cost strategy to address marijuana use among students, however there is little known about who may be most responsive to this intervention approach. This study examined whether readiness-to-change moderated the influence of a web-based intervention on frequency of use at 3-month outcomes. METHODS: One-hundred twenty-three students who smoked marijuana at least monthly were identified by screening in a student health center. Baseline and 3-month outcome assessments were conducted on-line. Participants were randomly assigned to either eCHECKUP TO GO-marijuana or a control condition after completing marijuana measures and the Readiness-to-Change Questionnaire (RTCQ). Negative binomial regression analyses were conducted to examine whether the effect of the intervention on marijuana use at 3-month outcomes was moderated by the Action and Problem Recognition dimensions of the RTCQ, adjusting for baseline use. RESULTS: Analyses showed a significant Intervention × Action interaction. Probing of interaction effects showed that among those with high scores on the Action scale participants in the intervention group reported significantly fewer days of use than those in the control condition at follow-up (IRR=0.53, 95%CI: 0.94, 2.08). The Problem Recognition dimension did not moderate the influence of the intervention on outcomes. CONCLUSION: These results suggest that this eSBI may bolster change efforts among students who have begun taking steps toward changing their marijuana use.

The influence of depressive symptoms on alcohol use among HIV-infected Russian drinkers.

BACKGROUND: Depressive symptoms have been linked to HIV progression through a number of biobehavioral mechanisms including increased alcohol use. Although research supports an association between alcohol use and depressive symptoms among HIV patients, there have been few studies that have examined whether depressive symptoms predict subsequent drinking, especially among heavy drinking HIV-infected patients. METHOD: Heavy drinking Russian HIV-infected patients (n=700) were recruited from addiction and HIV care settings for a randomized controlled trial of a risk reduction intervention [HERMITAGE]. GEE overdispersed Poisson regression analyses were conducted to assess the association between depressive symptoms and alcohol consumption 6-months later. RESULTS: In adjusted analyses, depressive symptom severity was significantly associated with drinks per day (global p=.02). Compared to the non-depressed category, mild depressive symptoms were significantly associated with more drinks per day [IRR=1.55, (95% CI: 1.14, 2.09)], while moderate [IRR=1.14, (95% CI: 0.83, 1.56)] and severe [IRR=1.48, (95% CI: 0.93, 2.34)] depressive symptoms were not. Associations between depressive symptom severity and heavy drinking days were not statistically significant (global p=.19). Secondary analyses using the BDI-II screening threshold (BDI-II>14) and the BDI-II cognitive subscale suggested an association between depressive symptoms and drinks per day over time but not heavy episodic drinking. CONCLUSIONS: Among heavy drinking HIV-infected patients, elevated depressive symptoms were associated with greater subsequent alcohol use. These findings suggest that depressive symptoms may be important to address in efforts to reduce alcohol-related risks among HIV-infected populations.

Individual differences in temptation and responses to alcohol cues.

OBJECTIVE: Research on the Temptation and Restraint Inventory has established that the Temptation factor is associated with greater use of alcohol, more alcohol-related problems, and more severe symptoms of alcohol dependence. However, there is little known about the mechanisms by which Temptation may be associated with these higher levels of alcohol involvement. The present study was designed to examine how individual differences in Temptation are associated with responses to alcohol cues. METHOD: Eighty-nine hazardous drinkers were exposed to the sight and smell of their favorite alcoholic beverage, attempted to control their urges, and then participated in a beer taste test. Subjective experience, alcohol-related cognitive processing, and behavioral responses were assessed in the context of these cues. RESULTS: Hierarchical regression analyses showed that Temptation was associated with stronger urges to drink alcohol, greater difficulty controlling urges, and increased alcohol consumption, even when controlling for alcohol consumption in the past month. CONCLUSIONS: The findings suggest that Temptation has utility for predicting responses to alcohol cues among hazardous drinkers even when the effects of typical drinking patterns are accounted for. Moreover, the results suggest that individuals who exhibit high levels of Temptation may be particularly reactive to anticipatory cues for alcohol consumption.

Negative emotional expectancies and readiness to change among college student binge drinkers.

While expectancies are considered to be an important cognitive variable in the etiology and maintenance of substance use, less is known about their role in attitudes toward addictive behavior change. It has recently been suggested that negative alcohol expectancies, in particular, might play a fundamental role in motivation to change. Among a population of college student binge drinkers, the differential ability of positive and negative expectancies to predict total readiness to change (RTC) scores was examined. Hierarchical regression analyses revealed that controlling for level of consumption and number of drinking-related problems, negative and not positive expectancies significantly predicted RTC. In an examination of expectancy subtypes, negative emotional expectancies emerged as the only significant predictor of change motivation. Possible explanations for the findings and implications for interventions with undergraduate heavy drinkers are discussed.

Social influence processes and college student drinking: the mediational role of alcohol outcome expectancies.

OBJECTIVE: Social influences are among the most robust predictors of adolescent substance use and misuse. Studies with early adolescent samples have supported the need to distinguish among various types of social influences to better delineate relations between social factors and alcohol use and problems. METHOD: The first major goal of the present study (N = 399, 263 women) was to examine unique relations between particular facets of social influence and alcohol use and problems in a relatively heavy-drinking population (i.e., college students). We hypothesized that active social influences (offers to drink alcohol) and passive social influences (social modeling and perceived norms) would demonstrate positive associations with measures of alcohol use and problems. We also tested the hypothesis that alcohol outcome expectancies would mediate associations between social influences and drinking behaviors. RESULTS: Structural equation modeling analyses provided strong support for the first hypothesis. Social modeling demonstrated the strongest association with alcohol use and problems, and active social influences demonstrated significant associations with both use and problems. Perceived norms were related to alcohol use, but not directly with alcohol problems. Support for the second hypothesis was positive but limited to one type of social influence. Strong evidence for a mediational role of outcome expectancies was found for relations between social modeling and alcohol use and problems. CONCLUSIONS: Together, these findings demonstrate the unique and relative contribution of active and passive social influences and provide limited support for a hypothesized process by which social factors influence cognitions and alcohol-related behaviors.

Effects of nicotine deprivation on alcohol-related information processing and drinking behavior.

This study examined the influence of smoking cues and nicotine deprivation on responses to alcohol among hazardous drinkers. Fifty-six daily smoking, hazardous drinkers were exposed to either smoking cues or control cues after either 6 hr of nicotine deprivation or no deprivation. Urges to drink alcohol, alcohol-related cognitive processing, and alcohol consumption were assessed after cue exposure. Results indicated that nicotine deprivation increased urges to drink, the accessibility of alcohol outcome expectancies, and the volume of alcohol consumed. There was little influence of the smoking cue manipulation on these processes. Implications for understanding the mechanisms underlying alcohol-tobacco interactions are discussed.

Anger coping styles and perceived social support.

This study was based on the hypothesis that perceived availability of social support, independent of the influence of social desirability, would be inversely related to both anger-in and anger-out coping styles. Participants were 101 college-aged Caucasians in the Northeast. In a regression analysis, the anger coping scales together accounted for 9% of the unique variance in total social support. Anger-in, but not anger-out, was a significant predictor of social support independent of the effects of social desirability. In addition, anger-in, independent of response bias, was inversely related to deficiencies in appraisal support, self-esteem support, tangible support, and belongingness support. These findings were interpreted in the context of the psychosocial vulnerability model of disease risk, which suggests that deficits in perceived social support may represent a diathesis for ill health among individuals exhibiting an anger-suppression coping style.

Effects of suppressing the urge to drink on the accessibility of alcohol outcome expectancies.

Previous work has shown that attempts to deliberately suppress a given thought is associated with heightened accessibility of thought-related information both during and following suppression (Wegner, 1994, Psychological Review, 101, 34-52). This study examined whether attempts to suppress the urge for alcohol would similarly be associated with heightened accessibility of alcohol-related information. Heavy social drinkers were exposed to the sight and smell of their usual alcoholic beverage either under the instructions to suppress their urge to drink alcohol or without such instruction. Following this task, participants were asked to make timed judgements about the applicability of a series of alcohol outcome expectancies. Results supported the view that suppression increases the accessibility of information in memory. Those in the Suppression condition were faster to endorse alcohol outcome expectancies following the exposure to alcohol cues than those in the Control condition. Findings are discussed in terms of cognitive strategies for regulating alcohol use and patterns of restrained drinking.