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Psychology of Addictive Behaviors - Vol 31, Iss 4

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Psychology of Addictive Behaviors The Psychology of Addictive Behaviors publishes peer-reviewed original articles related to the psychological aspects of addictive behaviors. Articles on the following topics are included: (a) alcohol and alcoholism, (b) drug use and abuse, (c) eating disorders, (d) smoking and nicotine addiction, and (e) other compulsive behaviors (e.g., gambling). Full-length research reports, literature reviews, essays, brief reports, and comments are published. The journal is published four times yearly and is abstracted by Psychological Abstracts.
Copyright 2017 American Psychological Association
  • Abstinence based incentives plus parent training for adolescent alcohol and other substance misuse.
    The purpose of this study was to conduct a randomized test of clinic- and home-based incentives plus parent training for adolescent problem alcohol use. Adolescents (N = 75) with alcohol misuse, with or without other substance misuse, were enrolled. All youth received individual Motivational Enhancement Therapy/Cognitive Behavior Therapy and weekly urine drug testing. The experimental condition (EXP) included Abstinence Incentives (clinic-based incentives for abstinence from all substances) plus weekly behavioral parent training that included a parent-delivered, abstinence-based, substance monitoring contract. The comparison condition (CONTROL) included Attendance Incentives (ATTI). All adolescents met DSM–IV criteria for alcohol abuse or dependence or reported recent binge drinking, and 77% (N = 58) met criteria for a cannabis use disorder or had recent cannabis use at baseline. Alcohol and cannabis use outcomes were compared across treatment conditions. A similar percentage of youth maintained complete alcohol abstinence across the 36-week follow-up in both conditions. However, among youth not entirely abstinent from alcohol, EXP resulted in a lower percentage of days using alcohol during the 36 weeks after the end of treatment than CONTROL. Among youth who also used cannabis at baseline, results showed similar benefits of EXP on cannabis use days. Combined individual and family based treatment, plus abstinence based incentives can reduce substance use days during and after treatment over and above individual evidence-based psychosocial treatment plus attendance incentives. Future research should focus on identifying cost-effective components and incentive levels and delivery via technology to facilitate dissemination. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Mindfulness-oriented recovery enhancement for internet gaming disorder in U.S. adults: A stage I randomized controlled trial.
    Empirical studies have identified increasing rates of Internet gaming disorder (IGD) and associated adverse consequences. However, very few evidence-based interventions have been evaluated for IGD or problematic video gaming behaviors. This study evaluated Mindfulness-Oriented Recovery Enhancement (MORE) as a treatment for IGD. Thirty adults (Mage = 25.0, SD = 5.4) with IGD or problematic video gaming behaviors were randomized to 8 weeks of group-based MORE or 8 weeks of a support group (SG) control condition. Outcome measures were administered at pre- and posttreatment and 3-months following treatment completion using self-report instruments. Linear mixed models were used for outcome analyses. MORE participants had significantly greater reductions in the number of Diagnostic and Statistical Manual of Mental Disorders–5 IGD criteria they met, craving for video gaming, and maladaptive cognitions associated with gaming than SG participants, and therapeutic benefits were maintained at 3-month follow-up. MORE is a promising treatment approach for IGD. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Follow-up treatment effects of contingency management and motivational interviewing on substance use: A meta-analysis.
    Motivation is an integral factor in substance use treatment and long-term recovery. However, it is unclear what role intrinsic and extrinsic motivation play across different treatment modalities. A meta-analysis (N = 84) was performed to estimate the pooled effect size of Motivational Interviewing (MI; primarily targeting intrinsic motivation) and contingency management (CM; primarily targeting extrinsic motivation) at different follow-up periods. Collapsed across all substance types, CM had a significant effect at 3-month follow-up, only. In contrast, MI had a significant effect at 6-month follow-up, only. CM had small and medium effects on multiple substances at 3-month follow-up (i.e., tobacco, marijuana, stimulants, polysubstances), but not at 6-month follow-up. MI had 1 significant medium effect at 3-month follow-up (i.e., marijuana), but several significant small effects at 6-month follow-up (i.e., alcohol, tobacco, polysubstances). This meta-analysis suggests that both CM and MI promote reductions in a range of substances, even several months after the intervention concludes. Further, these results provide some evidence that extrinsically focused CM may produce medium follow-up effects in the short run, but intrinsically focused MI may produce small but durable follow-up effects. However, this interpretation is complicated by the differences between the MI and CM studies that preclude statistical tests comparing effect sizes, and few studies assessed motivation itself. Future researchers should investigate how motivational dynamics impact lasting outcomes in substance use treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Predictors of smoking lapse during a 48-hour laboratory analogue smoking cessation attempt.
    Many individuals who attempt to quit smoking experience a smoking lapse early on in the quitting process, with most lapses resulting in a return to regular smoking. Using a novel laboratory model, this study sought to investigate baseline predictors of smoking lapse during a brief, simulated smoking quit attempt. Self-report baseline measures were completed by 81 smokers, who also smoked a cigarette in the laboratory to equate recent smoke exposure. Participants were then given brief face-to-face smoking-cessation counseling along with monetary incentives to abstain from smoking for 48 hr (i.e., $40). Participants returned to the laboratory after 24 hr and 48 hr for assessment of smoking behavior. By 48 hr, 25 participants lapsed, with rates equivalent among men and women (31% vs. 31%). Higher rates of delay discounting and a preference for menthol cigarettes significantly predicted greater odds of lapsing. Shorter time to first cigarette after waking (TTFC) was associated with greater lapse risk at trend levels. No effects were observed for demographic variables, cigarettes per day, prequit abstinence self-efficacy, or depressive symptoms. Future research examining predictors of early lapse and underlying mechanisms is needed, and laboratory analogue models offer a controlled time- and cost-effective framework in which to investigate smoking cessation processes. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Cognitive functioning of adolescent and young adult cannabis users in the Philadelphia Neurodevelopmental Cohort.
    Cannabis use in youth is rising and has been linked to deficits in cognitive functioning. However, cognitive findings have primarily been based on small samples of users seeking treatment, and few studies have evaluated cognition in occasional cannabis users. Here, we examined 4,568 adolescents and young adults (ages 14–21 years) drawn from the Philadelphia Neurodevelopmental Cohort, a prospective, population-based study. Participants were classified as cannabis Non-Users (n = 3,401), Occasional Users (twice per week or less; n = 940), or Frequent Users (>3 times per week; n = 227). Mixed-model analyses examined main effects of cannabis use and interactions between age and cannabis use on cognitive functioning. There was a significant interaction between cannabis group and age such that adolescent (but not young adult) Frequent Users performed worse than Non-Users on measures of executive control (p = .002). Earlier age of cannabis use was associated with worse performance in executive control in Occasional Users (p = .04). Unexpectedly, Occasional Users exhibited better executive control, memory, and social cognition than Non-Users (ps <.05). Although mild executive control deficits in adolescent frequent users and a relation between early cannabis initiation and cognitive performance are partially consistent with prior research, cognitive deficits were not found in other hypothesized domains in this community-based sample. Moreover, occasional cannabis users displayed equivalent or even slightly better executive control, social–cognitive, and memory abilities compared with nonusers, suggesting complex relationships between cannabis use and cognition in youth. Longitudinal studies with community samples are needed to identify variables affecting risk and resilience to cognitive deficits associated with cannabis. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Visual attention to alcohol cues and responsible drinking statements within alcohol advertisements and public health campaigns: Relationships with drinking intentions and alcohol consumption in the laboratory.
    Both alcohol advertising and public health campaigns increase alcohol consumption in the short term, and this may be attributable to attentional capture by alcohol-related cues in both types of media. The present studies investigated the association between (a) visual attention to alcohol cues and responsible drinking statements in alcohol advertising and public health campaigns, and (b) next-week drinking intentions (Study 1) and drinking behavior in the lab (Study 2). In Study 1, 90 male participants viewed 1 of 3 TV alcohol adverts (conventional advert; advert that emphasized responsible drinking; or public health campaign; between-subjects manipulation) while their visual attention to alcohol cues and responsible drinking statements was recorded, before reporting their drinking intentions. Study 2 used a within-subjects design in which 62 participants (27% male) viewed alcohol and soda advertisements while their attention to alcohol/soda cues and responsible drinking statements was recorded, before completing a bogus taste test with different alcoholic and nonalcoholic drinks. In both studies, alcohol cues attracted more attention than responsible drinking statements, except when viewing a public health TV campaign. Attention to responsible drinking statements was not associated with intentions to drink alcohol over the next week (Study 1) or alcohol consumption in the lab (Study 2). However, attention to alcohol portrayal cues within alcohol advertisements was associated with ad lib alcohol consumption in Study 2, although attention to other types of alcohol cues (brand logos, glassware, and packaging) was not associated. Future studies should investigate how responsible drinking statements might be improved to attract more attention. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Problem gambling symptomatology and alcohol misuse among adolescents: A parallel-process latent growth curve model.
    The objective of the current study was to examine the possible temporal associations between alcohol misuse and problem gambling symptomatology from adolescence through to young adulthood. Parallel-process latent growth curve modeling was used to examine the trajectories of alcohol misuse and symptoms of problem gambling over time. Data were from a sample of adolescents recruited for the Leisure, Lifestyle, and Lifecycle Project in Alberta, Canada (n = 436), which included 4 assessments over 5 years. There was an average decline in problem gambling symptoms followed by an accelerating upward trend as the sample reached the legal age to gamble. There was significant variation in the rate of change in problem gambling symptoms over time; not all respondents followed the same trajectory. There was an average increase in alcohol misuse over time, with significant variability in baseline levels of use and the rate of change over time. The unconditional parallel process model indicated that higher baseline levels of alcohol misuse were associated with higher baseline levels of problem gambling symptoms. In addition, higher baseline levels of alcohol misuse were associated with steeper declines in problem gambling symptoms over time. However, these between-process correlations did not retain significance when covariates were added to the model, indicating that one behavior was not a risk factor for the other. The lack of mutual influence in the problem gambling symptomatology and alcohol misuse processes suggest that there are common risk factors underlying these two behaviors, supporting the notion of a syndrome model of addiction. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Negative affect in at-risk youth: Outcome expectancies mediate relations with both regular and electronic cigarette use.
    Despite the general trend of declining use of traditional cigarettes among young adults in the United States, alternative high school students continue to smoke cigarettes and electronic cigarettes at rates much higher than do students attending regular high schools. Challenging life circumstances leading to elevated levels of negative affect may account for increased smoking behavior in this population. Further, a belief in the negative affect-reducing qualities of nicotine may mediate this effect. The current study tested the hypothesis that negative reinforcing outcome expectancies mediate the relationship between negative affect on smoking susceptibility in nonusers, smoking frequency in users, and smoking experimentation in the overall sample. Results support the hypothesis that negative affect in alternative high school students is correlated with smoking experimentation, smoking willingness, and smoking frequency and that the relationship between negative affect and smoking behavior outcomes is mediated by negative reinforcing outcome expectancies (i.e., beliefs in the negative affect-reducing effects of smoking). This finding was supported for both cigarettes and electronic cigarettes and coincides with a rapid increase in the number of high school students nationally who have experimented with electronic cigarettes. Future antismoking initiatives directed at at-risk youth should consider integrating healthier negative affect reduction techniques to counter the use of nicotine products. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Identity change among smokers and ex-smokers: Findings from the ITC Netherlands Survey.
    Successful smoking cessation appears to be facilitated by identity change, that is, when quitting or nonsmoking becomes part of smokers’ and ex-smokers’ self-concepts. The current longitudinal study is the first to examine how identity changes over time among smokers and ex-smokers and whether this can be predicted by socioeconomic status (SES) and psychosocial factors (i.e., attitude, perceived health damage, social norms, stigma, acceptance, self-evaluative emotions, health worries, expected social support). We examined identification with smoking (i.e., smoker self-identity) and quitting (i.e., quitter self-identity) among a large sample of smokers (n = 742) and ex-smokers (n = 201) in a cohort study with yearly measurements between 2009 and 2014. Latent growth curve modeling was used as an advanced statistical technique. As hypothesized, smokers perceived themselves more as smokers and less as quitters than do ex-smokers, and identification with smoking increased over time among smokers and decreased among ex-smokers. Furthermore, psychosocial factors predicted baseline identity and identity development. Socioeconomic status (SES) was particularly important. Specifically, lower SES smokers and lower SES ex-smokers identified more strongly with smoking, and smoker and quitter identities were more resistant to change among lower SES groups. Moreover, stronger proquitting social norms were associated with increasing quitter identities over time among smokers and ex-smokers and with decreasing smoker identities among ex-smokers. Predictors of identity differed between smokers and ex-smokers. Results suggest that SES and proquitting social norms should be taken into account when developing ways to facilitate identity change and, thereby, successful smoking cessation. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Social mediation of persuasive media in adolescent substance prevention.
    Social commentary about prevention messages may affect their likelihood of acceptance. To investigate this possibility, student participants (N = 663) viewed 3 antimarijuana advertisements, each followed immediately by videotaped discussions involving 4 adults or 4 adolescents using either extreme or moderate language in their positive commentaries. The commentaries were expected to affect participants’ perceptions of the extent to which the ads were designed to control their behavior (perceived control), which was hypothesized to inhibit persuasion. Two indirect effects analyses were conducted. Marijuana attitudes and usage intentions were the outcome variables. Both analyses revealed statistically significant source by language interactions on participants’ perceived control (both p <.02). Further analyses revealed significant indirect effects of language extremity on attitudes and intentions through perceived control with adult, but not peer sources (both p <.05). These perceptions were associated with more negative marijuana attitudes and diminished usage intentions when adults used moderate (vs. extreme) language in their favorable ad commentaries (both p <.05). The findings may facilitate development of more effective prevention methods that emphasize the importance of the role of perceived control in persuasion, and the impact of interpersonal communication variations on acceptance of media-transmitted prevention messages. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • The effects of next-day class characteristics on alcohol demand in college students.
    Behavioral economic principles have been useful for addressing strategies to reduce alcohol consumption among college students. For example, academic variables (such as class schedule or academic rigor) have been found to affect alcohol demand assessed with a hypothetical alcohol purchase task (APT). The present studies used the APT to address the effects of 2 academic variables: next-day course level (no class, introductory level or upper level) and class size (no class, 30-student or 12-student). In each of 2 experiments, undergraduate participants read a description of a drinking context (either a no-class control version or 1 of the academic constraint conditions) and were asked to indicate how many drinks they would purchase at a variety of prices. Hursh and Silberberg’s (2008) exponential demand equation was used to determine intensity and elasticity of demand, and Hursh and Roma’s (2015) essential value (EV) parameter was calculated to assess essential value. In both experiments, a next-day class reduced alcohol demand, and alcohol consumption decreased as drink price increased. The presence of a smaller next-day class reduced alcohol demand compared with a larger next-day class; however, course level did not differentially affect alcohol demand. These results suggest that smaller next-day classes may reduce alcohol demand among college students and also provide initial evidence for the reliability of EV across studies. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Discrepancy in caregiving expectations predicts problematic alcohol use among caregivers of trauma injury patients six months after ICU admission.
    This prospective study examined the influence of caregiving variables on the development of problematic alcohol use among family members of patients admitted to an urban Level I trauma center. Data were collected from 124 caregivers 48 hrs after initial hospitalization of their family member. The final sample included 81 participants (24.6% male; Mage = 47.8) who completed their follow-up assessment at 6 months. Hierarchical linear and logistic regression analyses assessed increases in consumption and odds of a positive screen for problematic alcohol use in association with caregiver burden, actual time spent in the caregiving role, and caregiving differential (i.e., anticipated time spent caregiving at baseline in relation to actual time caregiving at 6 months). At 6 months, 24.7% of caregivers screened positive for problematic alcohol use. Results uniquely highlighted caregiving differential as a significant predictor of both increases in general alcohol consumption (ΔR2 = .06, p <.01) and odds of screening positive for problematic alcohol use at 6 months (Odds Ratio = 1.05, 95% CI [1.02–1.09]). More specifically, our adjusted model found that providing 10% more time caregiving, relative to expectations at baseline, was associated with an increase in the probability of problematic alcohol use by 22% (95% CI: 8–37%) at 6 months. These results suggest that a discrepancy in expectations regarding anticipated time caregiving and actual time caregiving, rather than solely the amount of caregiving or perceived caregiver burden, may be an important predictor of caregiver alcohol use 6 months after a family member’s ICU hospitalization. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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  • Digital recovery management: Characterizing recovery-specific social network site participation and perceived benefit.
    Research shows that digital social network sites (SNSs) may be valuable platforms to effect health behavior change. Little is known specifically about their ability to help address alcohol and other drug problems. This gap is noteworthy, given that individuals are already participating in existing, recovery-specific SNSs (hereafter referred to as recovery SNSs): online communities with the functionality of conventional SNSs (e.g., Facebook) that focus on substance use disorder (SUD) recovery. For example, (ITR) is a large, well-known recovery SNS that is available for free 24 hr/day via website and mobile smartphone applications. It offers recovery tools within a digital social milieu for over 430,000 registered users. To augment the knowledge base on recovery SNS platforms, we conducted an online survey of 123 ITR participants (M = 50.8 years old; 56.9% female; 93.5% White; M = 7.3 years of abstinence, range of 0–30 years; 65% cited alcohol as their primary substance). Respondents engaged with ITR, on average, for about 30 min/day several times each week. Daily meditation prompts and live online video meetings were the most commonly utilized resources. Participants generally endorsed ITR as a helpful platform, particularly with respect to increased abstinence/recovery motivation and self-efficacy. Compared to individuals abstinent for 1 or more years, those abstinent less than 1 year (including nonabstinent individuals) showed similar rates of engagement with ITR activities and similar levels of perceived benefit. Our findings suggest that longitudinal studies are warranted to examine the clinical utility of ITR and other recovery SNSs as SUD treatment adjuncts and/or recovery self-management tools. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
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