Matching Items (10)
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- All Subjects: subjective response
- All Subjects: Adolescent
- Creators: Chassin, Laurie
- Creators: Gonzales, Nancy A.
- Resource Type: Text
Description
Levels of heavy episodic drinking peak during emerging adulthood and contribute to the experience of negative consequences. Previous research has identified a number of trait-like personality characteristics that are associated with drinking. Studies of the Acquired Preparedness Model have supported positive expectancies, and to a lesser extent negative expectancies, as mediators of the relation between trait-like characteristics and alcohol outcomes. However, expectancies measured via self-report may reflect differences in learned expectancies in spite of similar alcohol-related responses, or they may reflect true individual differences in subjective responses to alcohol. The current study addressed this gap in the literature by assessing the relative roles of expectancies and subjective response as mediators within the APM in a sample of 236 emerging adults (74.7% male) participating in a placebo-controlled alcohol challenge study. The study tested four mediation models collapsed across beverage condition as well as eight separate mediation models with four models (2 beverage by 2 expectancy/subjective response) for each outcome (alcohol use and alcohol-related problems). Consistent with previous studies, SS was positively associated with alcohol outcomes in models collapsed across beverage condition. SS was also associated with positive subjective response in collapsed models and in the alcohol models. The hypothesized negative relation between SS and sedation was not significant. In contrast to previous studies, neither stimulation nor sedation predicted either weekly drinking or alcohol-related problems. While stimulation and alcohol use appeared to have a positive and significant association, this relation did not hold when controlling for SS, suggesting that SS and stimulation account for shared variability in drinking behavior. Failure to find this association in the placebo group suggests that, while explicit positive expectancies are related to alcohol use after controlling for levels of sensation seeking, implicit expectancies (at least as assessed by a placebo manipulation) are not. That the relation between SS and stimulation held only in the alcohol condition in analyses separate by beverage condition indicates that sensation seeking is a significant predictor of positive subjective response to alcohol (stimulation), potentially above and beyond expectancies.
ContributorsScott, Caitlin (Author) / Corbin, William (Thesis advisor) / Shiota, Michelle (Committee member) / Chassin, Laurie (Committee member) / Arizona State University (Publisher)
Created2012
Description
Although research has documented robust prospective relationships between externalizing symptomatology and subsequent binge drinking among adolescents, the extent to which internalizing symptoms increase risk for drinking remains controversial. In particular, the role of anxiety as a predictor of binge drinking remains unclear. Recent evidence suggests that one possible reason for these mixed findings is that separate dimensions of anxiety may differentially confer risk for alcohol use. The present study tested two dimensions of anxiety - worry and physiological anxiety -- as predictors of binge drinking in a longitudinal study of juvenile delinquents. Overall, results indicate that worry and physiological anxiety showed differential relations with drinking behavior. In general, worry was protective against alcohol use, whereas physiological anxiety conferred risk for binge drinking, but both effects were conditional on levels of offending. Implications for future research examining the role of anxiety in predicting drinking behavior among youth are discussed.
ContributorsNichter, Brandon (Author) / Chassin, Laurie (Thesis advisor) / Barrera, Manuel (Committee member) / Presson, Clark (Committee member) / Arizona State University (Publisher)
Created2014
Description
This study examined the influence of the traditional values held by Mexican heritage parents on the intention of their adolescent children to use drugs. Specifically, the study tested a mediation model in which the traditional cultural values of parents were hypothesized to influence adolescent drug use intentions indirectly by influencing ethnic identify and adolescent perceptions of parental injunctive norms against drug use. Parents reported on traditional cultural values and expectations for their child. Adolescents reported perceived reaction from parents if they used drugs (parental injunctive norms), ethnic identity, and their intention to use drugs in the future. Two direct effects were observed: parental values on expectations and parental injunctive norms on adolescent drug use intentions. Two paths were also moderated by the sex of the adolescent. The path from parent values to parent expectations was significantly stronger for adolescent girls than boys; the path from ethnic identity affirmation to drug intentions was protective for boys but not for girls. The negative relationship between perceived parental reaction and adolescent drug use intentions suggests that anti-drug norms communicated by parents had a protective influence and can deter youth from using drugs. The results of the current study did not support the hypothesized mediational model, but did provide additional support for the importance of parental influence on adolescents' plans and ideas about using alcohol, cigarettes, and marijuana. More research is necessary to examine the influence of culture and the mechanisms by which cultural values impact Mexican heritage adolescents' intentions to use drugs and subsequent use.
ContributorsGarvey, Meghan (Author) / Gonzales, Nancy A. (Thesis advisor) / Marsiglia, Flavio F. (Committee member) / Mackinnon, David P. (Committee member) / Arizona State University (Publisher)
Created2012
Description
Variability in subjective response to alcohol has been shown to predict drinking behavior as well as the development of alcohol use disorders. The current study examined the extent to which individual differences in alcohol pharmacokinetics impact subjective response and drinking behavior during a single session alcohol administration paradigm. Participants (N = 98) completed measures of subjective response at two time points following alcohol consumption. Pharmacokinetic properties (rate of absorption and metabolism) were inferred using multiple BAC readings to calculate the area under the curve during the ascending limb for absorption and descending limb for metabolism. Following the completion of the subjective response measures, an ad-libitum taste rating task was implemented in which participants were permitted to consume additional alcoholic beverages. The amount consumed during the taste rating task served as the primary outcome variable. Results of the study indicated that participants who metabolized alcohol more quickly maintained a greater level of subjective stimulation as blood alcohol levels declined and reported greater reductions in subjective sedation. Although metabolism did not have a direct influence on within session alcohol consumption, a faster metabolism did relate to increased ad-libitum consumption indirectly through greater acute tolerance to sedative effects and greater maintenance of stimulant effects. Rate of absorption did not significantly predict subjective response or within session drinking. The results of the study add clarity to theories of subjective response to alcohol, and suggest that those at highest risk for alcohol problems experience a more rapid reduction in sedation following alcohol consumption while simultaneously experiencing heightened levels of stimulation. Variability in pharmacokinetics, namely how quickly one metabolizes alcohol, may be an identifiable biomarker of subjective response and may be used to infer risk for alcohol problems.
ContributorsBoyd, Stephen (Author) / Corbin, William R. (Thesis advisor) / Chassin, Laurie (Committee member) / MacKinnon, David (Committee member) / Olive, Michael Foster (Committee member) / Arizona State University (Publisher)
Created2014
Description
Anxiety disorder diagnosis is a risk factor for alcohol use disorders (AUDs), but mechanisms of risk are not well understood. Studies show that anxious individuals receive greater negative reinforcement from alcohol when consumed prior to a stressor, but few studies have examined whether anxious individuals receive greater negative (or positive) reinforcement from alcohol in a general drinking context (i.e., no imminent stressor). Previous studies have also failed to examine possible moderating effects of specific drinking contexts (e.g., drinking in a group or alone). Finally, no studies have investigated mediating variables that might explain the relationship between anxiety and reinforcement from alcohol, such as physiological response to alcohol (e.g., cortisol response). Data for this study were drawn from a large alcohol administration study (N = 447) wherein participants were randomized to receive alcohol (target peak BAC: .08 g%) or placebo in one of four contexts: group simulated bar, solitary simulated bar, group sterile laboratory, solitary sterile laboratory. It was hypothesized that anxiety would be associated with positive subjective response (SR) under alcohol (above and beyond placebo), indicating stronger reinforcement from alcohol. It was also hypothesized that social and physical drinking context would moderate this relationship. Finally, it was hypothesized that anxiety would be associated with a blunted cortisol response to alcohol (compared to placebo) and this blunted cortisol response would be associated with stronger positive SR and weaker negative SR. Results showed that anxiety was not associated with positive SR in the full sample, but drinking context did moderate the anxiety/SR relationship in most cases (e.g., anxiety was significantly associated with positive SR (stimulation) under placebo in solitary contexts only). There was no evidence that cortisol response to alcohol mediated the relationship between anxiety and SR. This study provides evidence that anxious drinkers expect stronger positive reinforcement from alcohol in solitary contexts, which has implications for intervention (e.g., modification of existing interventions like expectancy challenge). Null findings regarding cortisol response suggest alcohol’s effect on cortisol response to stress (rather than cortisol response to alcohol consumption) may be more relevant for SR and drinking behavior among anxious individuals.
ContributorsMenary, Kyle Robert (Author) / Corbin, William (Thesis advisor) / Chassin, Laurie (Committee member) / Meier, Madeline (Committee member) / Grimm, Kevin (Committee member) / Arizona State University (Publisher)
Created2018
Description
This study examined an adverse effect of an adolescent group intervention. Group interventions represent one of the most economical, convenient, and common solution to adolescent behavior problems, although prior findings from program evaluation studies have suggested that these groups can unexpectedly increase the externalizing behaviors that they were designed to reduce or prevent. The current study used data from a longitudinal, randomized controlled trial of the Bridges to High School / Puentes a La Secundaria Program, a multicomponent prevention program designed to reduce risk during the middle school transition, which has demonstrated positive effects across an array of outcomes. Data were collected at the beginning of 7th grade, with follow-up data collected at the end of the 7th, 8th, 9th, and 12th grade from a sample of Mexican American adolescents and their mothers. Analyses evaluated long-term effects on externalizing outcomes, trajectories of externalizing behaviors across adolescence, and potential mediators of observed effects. Results showed that the adverse effect that was originally observed based on adolescent self-report of externalizing symptoms at 1-year posttest among youth with high pretest externalizing symptoms was not maintained over time and was not reflected in changes in adolescents' trajectories of externalizing behaviors. Moreover, neither of the peer mediators that theory suggests would explain adverse effects were found to mediate the relationship between intervention status and externalizing symptoms at 1-year posttest. Finally, only beneficial effects were found on externalizing symptoms based on mother report. Together, these findings suggest that the Bridges intervention did not adversely affect adolescent problem behaviors and that future studies should use caution when interpreting unexpected adverse effects.
ContributorsWong, Jessie Jong-Chee (Author) / Gonzales, Nancy A. (Thesis advisor) / West, Stephen G. (Thesis advisor) / Chassin, Laurie (Committee member) / Dishion, Thomas (Committee member) / Arizona State University (Publisher)
Created2015
Description
Positive alcohol outcome expectancies (AOEs) are consistent longitudinal predictors of later alcohol use; however, exclusion of solitary drinking contexts in the measurement of AOEs may have resulted in an underestimation of the importance of low arousal positive (LAP) effects. The current study aimed to clarify the literature on the association between AOEs and drinking outcomes by examining the role of drinking context in AOE measurement. Further, exclusion of contextual influences has also limited understanding of the unique effects of AOEs relative to subjective responses (SR) to alcohol. The present study addressed this important question by exploring relations between AOEs and SR when drinking context was held constant across parallel measures of these constructs. Understanding which of these factors drives relations between alcohol effects and drinking behavior has important implications for intervention. After conducting confirmatory factor analysis (CFA) and tests of measurement invariance for the AOE and SR measures, 4 aims collectively examined the role of context in reporting of AOEs (Aims 1 and 2), the extent to which context specific AOEs uniquely relate to drinking outcomes (Aim 3), and the importance of context effects on correspondence between AOEs and SR (Aim 4). Results of Aims 1 and 2 demonstrated that participants are imagining contexts when reporting on measures of AOEs that do not specify the context, and found significant mean differences in high and low arousal positive AOEs across contexts. Contrary to the hypotheses of Aim 3, context-specific AOEs were not significantly associated with drinking behavior. Results of Aim 4 indicated that while LAP AOEs for both unspecified and solitary contexts were associated with LAP SR in a solitary setting, unspecified context AOEs had a stronger relation than the solitary context AOEs. No significant relations between high arousal positive (HAP) AOEs and HAP SR emerged. The findings suggest that further investigation of the relation between context-specific AOEs and drinking outcomes/SR is warranted. Future studies of these hypotheses in samples with a wider range of drinking behavior, or at different stages of alcohol involvement, will elucidate whether mean level differences in context specific AOEs are important in understanding alcohol related outcomes.
ContributorsScott, Caitlin (Author) / Corbin, William (Thesis advisor) / MacKinnon, David (Committee member) / Barrera, Manuel (Committee member) / Chassin, Laurie (Committee member) / Arizona State University (Publisher)
Created2016
Description
Both subjective response to alcohol and acute tolerance possess unique biphasic relations with the blood alcohol concentration curve. However, prior work has generally failed to examine shared relations between the two constructs and has yet to consider the full valence by arousal affective space of subjective response, nor individual differences in metabolism or peak levels of subjective intoxication. As such, the present study sought to characterize acute tolerance to subjective response in addition to examining relations between acute tolerance, subjective response, and related outcomes. Participants (N=258) were randomly assigned to receive alcohol (target blood alcohol concentration = .08 g%) as part of a large placebo-controlled alcohol administration study. Participant family history of alcohol use problems and personal history of alcohol use were collected at baseline. Subjective response to alcohol was assessed across the full valence by arousal affective space at equivalent points on the ascending and descending limbs of the blood alcohol concentration curve. Latent change scores were calculated to characterize the development of acute tolerance, and path analyses tested relations between acute tolerance to subjective response, concurrent patterns of alcohol use, and negative alcohol-related consequences. Age, sex, race/ethnicity, and drinking context were included as covariates. Acute tolerance to low arousal positive (i.e., relaxed, mellow) effects were found to be inversely related to negative consequences such that a maintenance of low arousal positive effects was associated with more negative consequences. The amount of time elapsed between measurements was found to be significantly related to the development of acute tolerance to high arousal positive (i.e., talkative, stimulated) effects, such that more time between measurements was related to a greater decrease in high arousal positive effects. Peak high arousal positive effects were found to be related to increased drinking and indirectly related to more negative consequences via drinking, whereas high arousal negative was protective against increased drinking and negative consequences. Results suggest that a maintenance of negatively reinforcing effects across the blood alcohol concentration curve may confer risk for negative consequences. Results also suggest that considering individual differences in alcohol metabolism may be useful in understanding alcohol’s rewarding, stimulating effects.
ContributorsKing, Scott Edward (Author) / Corbin, William R. (Thesis advisor) / Chassin, Laurie (Committee member) / Grimm, Kevin (Committee member) / Arizona State University (Publisher)
Created2022
Description
Past research suggests that both Alcohol Expectancies and Subjective Response are strong predictors of drinking. However, most studies do not account for the shared variance or relations between the two. Social cognitive and expectancy theories suggest that cognitions may distort reality, creating a discrepancy between expected and subjective effects. Only one study has tested the effects of such discrepancies (Morean et al., 2015), but that study was cross-sectional, making it impossible to determine the direction of effects. As such, the present study sought to test prospective associations between expectancy-subjective response interactions and future drinking behavior. Participants (N=448) were randomly assigned to receive alcohol (target blood alcohol alcohol =.08 g%) or placebo, with 270 in the alcohol condition. Alcohol expectancies and subjective response were assessed across the full range of affective space of valence by arousal. Hierarchical regression tested whether expectancies, subjective response, and their interaction predicted follow-up drinking in 258 participants who reached a blood alcohol curve of >.06 (to differentiate blood alcohol curve limbs). Covariates included gender, age, drinking context, and baseline drinking. High arousal subjective response was tested on the ascending limb and low arousal subjective response on the descending limb. High arousal positive expectancies and subjective response interacted to predict future drinking, such that mean and low levels of high arousal positive subjective response were associated with more drinking when expectancies were higher. High arousal negative expectancies and subjective response also interacted to predict future drinking, such that high levels of high arousal negative subjective response marginally predicted more drinking when expectancies were lower. There were no interactions between low arousal positive or low arousal negative expectancies and subjective response. Results suggest that those who expected high arousal positive subjective response but did not receive many of these effects drank more, and those who did not expect to feel high arousal negative subjective response but did in fact feel these effects also drank more. The results suggest that challenging inaccurate positive expectancies and increasing awareness of true negative subjective response may be efficacious ways to reduce drinking.
ContributorsWaddell, Jack Thomas (Author) / Corbin, William R. (Thesis advisor) / Chassin, Laurie (Thesis advisor) / Anderson, Samantha F. (Committee member) / Arizona State University (Publisher)
Created2020
Description
Background: The cost of substance use (SU) in the United States (U.S.) is estimated at $1.25 trillion annually. SU is a worldwide health concern, impacting physical and psychological health of those who use substances, their friends, family members, communities and nations. Screening, Brief Intervention (BI) and Referral to Treatment (SBIRT) provides an evidence-based (EB) framework to detect and treat SU. Evidence shows that mental health (MH) providers are not providing EB SU management. Federally grant-funded SBIRT demonstrated evidence of decreased SU and prevention of full disorders. Implementation outcomes in smaller-scale projects have included increased clinician knowledge, documentation and interdisciplinary teamwork.
Objective: To improve quality of care (QOC) for adolescents who use substances in the inpatient psychiatric setting by implementing EB SBIRT practices.
Methods: Research questions focused on whether the number of SBIRT notes documented (N=170 charts) increased and whether training of the interdisciplinary team (N=26 clinicians) increased SBIRT knowledge. Individualized interventions used existing processes, training and a new SBIRT Note template. An SBIRT knowledge survey was adapted from a similar study. A pre-and post-chart audit was conducted to show increase in SBIRT documentation. The rationale for the latter was not only for compliance, but also so that all team members can know the status of SBIRT services. Thus, increased interdisciplinary teamwork was an intentional, though indirect, outcome.
Results: A paired-samples t-test indicated clinician SBIRT knowledge significantly increased, with a large effect size. The results suggest that a short, 45-60-minute tailored education module can significantly increase clinician SBIRT knowledge. Auditing screening & BI notes both before and after the study period yielded important patient SU information and which types of SBIRT documentation increased post-implementation. The CRAFFT scores of the patients were quite high from a SU perspective, averaging over 3/6 both pre- and post-implementation, revealing over an 80% chance that the adolescent patient had a SU disorder. Most patients were positive for at least one substance (pre- = 47.1%; post- = 65.2%), with cannabis and alcohol being the most commonly used substances. Completed CRAFFT screenings increased from 62.5% to 72.7% of audited patients. Post-implementation, there were two types of BI notes: the preexisting Progress Note BI (PN BI) and the new Auto-Text BI (AT BI), part of the new SBIRT Note template introduced during implementation. The PN BIs not completed despite a positive screen increased from 79.6% to 83.7%. PN BIs increased 1%. The option for AT BI notes ameliorated this effect. Total BI notes completed for a patient positive for a substance increased from 20.4% to 32.6%, with 67.4% not receiving a documented BI. Total BIs completed for all patients was 21.2% post-implementation.
Conclusion: This project is scalable throughout the U.S. in MH settings and will provide crucial knowledge about positive and negative drivers in small-scale SBIRT implementations. The role of registered nurses (RNs), social workers and psychiatrists in providing SBIRT services as an interdisciplinary team will be enhanced. Likely conclusions are that short trainings can significantly increase clinician knowledge about SBIRT and compliance with standards. Consistent with prior evidence, significant management involvement, SBIRT champions, thought leaders and other consistent emphasis is necessary to continue improving SBIRT practice in the target setting.
Keywords: adolescents, teenagers, youth, alcohol, behavioral health, cannabis, crisis, documentation, drug use, epidemic, high-risk use, illicit drugs, implementation, mental health, opiates, opioid, pilot study, psychiatric inpatient hospital, quality improvement, SBIRT, Screening, Brief Intervention and Referral to Treatment, substance use, unhealthy alcohol use, use disorders
ContributorsMaixner, Roberta (Author) / Guthery, Ann (Thesis advisor) / Mensik, Jennifer (Thesis advisor) / Uriri-Glover, Johannah (Thesis advisor)
Created2019-05-02