The predictive utility of drinking refusal self-efficacy and alcohol expectancy

Addictive Behaviors, Vol. 25, No. 3, pp. 415–421, 2000 Copyright © 2000 Elsevier Science Ltd. Printed in the USA. All rights reserved 0306-4603/00/$–see front matter

Pergamon

PII S0306-4603(99)00004-0

BRIEF REPORT THE PREDICTIVE UTILITY OF DRINKING REFUSAL SELF-EFFICACY AND ALCOHOL EXPECTANCY: A DIARY-BASED STUDY OF TENSION REDUCTION R. McD. YOUNG*† and T. P. S. OEI† *The University of Queensland, Royal Brisbane Hospital; and †The University of Queensland

Abstract — The potential tension reduction effects of alcohol may be most appropriately tested by examining the role of alcohol related beliefs regarding alcohol’s anxiolytic properties. The relationship between affective change drinking refusal self-efficacy, tension reduction alcohol expectancies, and ongoing drinking behavior was examined amongst 57 regular drinkers. Alcohol consumption, antecedent, and consequent mood states were monitored prospectively by diary. Social leaming theory hypothesizes that low drinking refusal self-efficacy when experiencing a negative mood state should be associated with more frequent drinking when tense. Strong alcohol expectancies of tension reduction were hypothesized to predict subsequent tension reduction. Contrary to this hypothesis, the present study found that alcohol expectancies were more strongly related to antecedent mood states. Only a weak relationship between drinking refusal self-efficacy and predrinking tension, and between alcohol expectancy and subsequent tension reduction, was evident. © 2000 Elsevier Science Ltd.

Key Words. Self-efficacy, Alcohol expectancy, Diary, Tension.

It is hypothesized that beliefs about the consequences of drinking and the confidence in resisting alcohol in specific situations, in particular, alcohol expectancies (AE) and drinking refusal self-efficacy (DRSE), shape the decision to drink alcohol (Young & Oei, 1993). Social learning theory provides a framework to examine such beliefs in the genesis of drinking behavior (Oei & Baldwin, 1994; Young, 1994). Particular subsets of expectations, such as the belief that alcohol reduces tension, and low confidence in resisting alcohol when experiencing negative affective states, are associated with alcohol consumption and problems (Young, 1994). The historically prominent tension reduction hypothesis, where reduction of stress is proposed as a major reinforcer of alcohol use, may be refined by examining such expectancies (Greeley & Oei, 1999; Young, Oei, & Knight, 1990). Expectancy research to date has largely examined the relationship between expectancy scores and other self-report measures, however, “naturalistic” studies confer some additional advantages despite sacrifices regarding experimental control. Studying ongoing drinking may enhance ecological validity (Abbey, Smith, & Scott, 1993) and may be less likely to be influenced by memory distortions than retrospective data (Lemmens, Knibbe, & Tan, 1992). Only a handful of studies have utilised diaries to This research was partially supported by an Australian Research Council Small Grant A7931162 to Dr. Young and Professor Oei. We would like to thank Kath Begg and Gail Cohen for their assistance in the preparation of the manuscript and Liz Arnold for producing the two figures used. Requests for reprints should be sent to Dr. R. McD. Young, Department of Psychiatry, The University of Queensland, Royal Brisbane Hospital, Brisbane, Q 4029, Australia. 415

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examine the relationships between psychological constructs and ongoing drinking behavior, (e.g., Lex, Griffin, Mello, & Mendelson, 1989). The current study examined the predictive utility of the Drinking Expectancy Profile (DEP; Young & Oei, 1996), a measure of both AE and DRSE, with regard to tension reduction. It was hypothesized that those drinkers with low drinking refusal self-efficacy scores on the emotional relief factor of the DEP would report tension as a more typical antecedent of drinking than those with high emotional relief factor scores. Similarly, it was hypothesized that DEP tension reduction alcohol expectancy factor scores would be related to the outcomes of drinking. M E T H O D

Subjects Subjects were recruited from first year Psychology classes and paid $10 upon completion of diaries for 1 month. Of the original sample of 65, 29 mates and 28 females were in the final sample. Subjects had a mean age of 20.1 years (SD ⫽ 5.8 years), and 94% were single. The 57 subjects who completed diaries reported a mean consumption of 158 g of pure ethanol per week (SD ⫽ 226 g). The mean MAST score(Selzer, 1971) was 4.0 (SD ⫽ 3.0), 35.2% of the sample scored above the cut-off of 5 indicating alcohol related problems. P R O C E D U R E

Subjects were recruited on the basis of being regular consumers of alcohol (at least one alcoholic drink per 2 weeks) through posters. All subjects completed a consent form regarding being over the legal drinking age, never having been treated for an alcohol problem, not taking medication which contraindicated drinking, and not being pregnant or trying to get pregnant. The DEP (Young & Oei, 1996), the KAT (Khavari & Farber, 1978), the MAST (Selzer, 1971) and a demographic data sheet, which included questions about parental drinking, were presented in counterbalanced order. Subjects were given a weekly packet of two diaries. A drinking diary to note drinking settings, alcohol consumed, mood state, cognitions, and the duration of the drinking session was to be completed as close to the cessation of drinking as possible. Subjects also completed a daily mood diary which contained 12 bipolar mood adjectives regarding the mean intensity of feelings experienced. Only the ratings of tension were of direct interest with others included to blind subjects to the experimental hypothesis. Subjects were instructed to complete the mood diary immediately before retiring to bed. Subjects returned diary packets weekly, otherwise they were excluded. Following the last diary submitted, subjects completed a questionnaire recalling the episode of highest recent alcohol consumption. Both recall and diary mood data were classified by independent raters with agreement on the categorisation of 98.7% of the mood descriptors, including all of those describing tension. The recall and diary descriptors were identical in 89.6% of cases. Table 1 presents the antecedents and consequences coded from the 528 drinking diary entries. R E S U L T S

Table 2 indicates that the only significant correlation between individual drinking refusal self-efficacy scores and “marker” mood states was between emotional relief

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417

Table 1. Percentage of drinking sessions in which specified mood states were reported pre- and postdrinking Predrinking mood Relaxed Happy Negative physical state Tense Bored Outgoing Neutral Positive physical state Sad Angry

%

Postdrinking mood

%

19 17 15 10 6 5 5 5 3 0.5

Relaxed Happy Negative physical state Tense Bored Outgoing Neutral Positive physical state Sad Angry

30 21 19 2 1 7 3 9 2 1

self-efficacy and proportion of drinking days characterized by predrinking tension. Drinking refusal self-efficacy, on the emotional relief factor, was classified using a median split. The median score was 47. Twenty-seven subjects were assigned to the “low” group (12 males, 17 females), and 30 to the “high” group (17 males, 13 females). Differences between the “high” and “low” drinking refusal self-efficacy groups were examined using t-tests and presented as Table 3. The high emotional relief self-efficacy group consumed significantly more alcohol over the month-long monitoring period, and drank more frequently than the low self-efficacy group. To examine the relationships between diary variables and self-efficacy, a 2 (high or low emotional relief self-efficacy) ⫻ 2 (predrinking, postdrinking) MANOVA was conducted. Proportion of drinking episodes characterised by one of three index moods was used as the dependent variable. The MANOVA indicated a significant effect due to time only, F(3,53) ⫽ 5.24, p ⬍ .005, with univariate F-tests showing that the significant effect was for tension, F(1,55) ⫽ 15.40, p ⬍ .001. These results are presented as Figure 1. Changes for happiness, F(1,55) ⫽ 1.15, and being “outgoing,” F(3,55) ⫽ 1.16, were not significant. Table 4 indicates tension reduction expectancies significantly correlated with predrinking tension. Two significant postdrinking correlations were evident between sexual enhancement expectancies and postdrinking happiness (negative correlation) and postdrinking reports of feeling outgoing (positive correlation). Subjects were classified using a median split of the tension reduction factor score. The median score was 13 with 27 subjects assigned to the “weak” tension reduction expectancy group (14 males, 13 females) and 30 assigned to the “strong” group (15 males, 15 females). Table 5 shows that those with strong tension reduction expectancies reported consuming significantly more alcohol over the previous month, and drank more often than those Table 2. Self-efficacy factor correlations with both antecedent and consequent mood states Drinking diary mood state Predrinking

Postdrinking

Factor

Tense

Happy

Outgoing

Tense

Happy

Social pressure Emotional relief Opportunistic

⫺.18 ⫺.51* .05

.09 .19 ⫺.01

⫺.14 ⫺.13 ⫺.18

.19 ⫺.18 .12

⫺.01 .15 .14

* p ⬍ .001.

Outgoing .01 ⫺.01 .12

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Table 3. Differences on drinking measures between subjects classified as having “low” or “high” emotional relief drinking refusal self-efficacy (t-tests) Mean Drinking measure Consumption total (diary) grams abs. alcohol per month Frequency of drinking (days per month in diary) MAST score Mean rate of consumption (diary) grams alcohol per hour Number of days of reported tensiona Age (years) aRefers

Low self-efficacy (SD)

High self-efficacy (SD)

449.73 (406.04) 6.50 (4.14) 4.00 (3.34) 37.43 (33.84) 9.01 (5.78) 20.80 (4.81)

726.38 (513.55) 10.67 (5.26) 4.12 (2.67) 31.67 (11.59) 10.82 (6.13) 21.52 (7.08)

t

Sig

2.27

p ⬍ .05

3.30

p ⬍ .0005

0.14

N.S.

⫺0.84

N.S.

0.94

N.S.

0.45

N.S.

to the number of days tension was rated as 4 or 5 on the daily mood diary.

with weak expectancies. More strong tension reduction expectancy subjects reported that at least one parent with an alcohol problem than did those with weak expectancies, (␹2 (1) ⫽ 5.56, p ⬍ .025). A similar MANOVA to that used previously, employing mood as the dependent variable, indicated a significant main effect due to expectancy, F(3,53) ⫽ 2.87, p ⬍ .05 and time, F(3,53) ⫽ 5.01, p ⬍ .005. For both main effects, univariate post-hoc F-tests indicated that the only significant effects were due to tension. For the expectancy main effect, predrinking tension was highly significant, F(1,55) ⫽ 8.48, p ⬍ .005, but predrinking happiness, F(1,55) ⫽ 0.09, N.S. and reports of feeling “outgoing,” F(1,55) ⫽ 0.09, N.S. were not. Similarly, as regards the time effect, change in tension was significant, F(1,55) ⫽ 14.83, p ⬍ .001, changes in happiness, F(1,55) ⫽ 1.64, N.S. and “outgoing,” F(1,55) ⫽ 0.46, N.S. were not. The tension reduction expectancy by tension interaction approached significance, F(3,53) ⫽ 2.64, p ⫽ .059. These data are presented as Figure 2.

Fig. 1. Reports of tension, both pre- and postdrinking, among subjects with high and low emotional relief drinking refusal self-efficacy scores.

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419

Table 4. Alcohol expectancy factor correlations with both antecedent and consequent mood states Drinking diary mood states Predrinking

Postdrinking

Factor

Tense

Happy

Outgoing

Tense

Happy

Outgoing

Assertion Affective change Sexual enhancement Cognitive change Tension reduction Dependence

.21 ⫺.08 .21 .07 .44** .20

⫺.08 ⫺.08 ⫺.06 ⫺.15 ⫺.01 ⫺.09

⫺.05 .20 ⫺.04 .50 ⫺.08 .02

.03 ⫺.06 .02 .02 .17 .08

⫺.03 .15 ⫺.28* .16 ⫺.23 ⫺.01

.10 .01 .27* ⫺.29 .07 .03

*p ⬍ .05; **p ⬍ .001.

D I S C U S S I O N

The current study hypothesized that emotional relief self-efficacy would be related to predrinking anxiety and tension reduction expectancies would be related to outcomes of reduced tension. A strong relationship between emotional relief self-efficacy and drinking antecedents of tension was not evident, however, in contrast to the hypothesis, the alcohol expectancy tension reduction factor was related to such cues. As strong and weak expectancy groups did not differ in terms of the frequency of daily tension experienced, it seems likely that drinking was a product of both strong alcohol expectancies and predrinking affect, rather than more general mood state. Perhaps those drinkers with weak expectancies were not as likely to resort to drinking as the “first line of defense” against anxiety states, with drinking forming a more dominant coping skill amongst those with strong expectancies (McCubbin, Needle, & Wilson, 1985). The interaction term on the MANOVA approached significance, however, the correlation with reported drinking consequences was not significant, suggesting that alcohol expectancies of tension reduction are more related to “when” people drink rather than the magnitude of tension reduction effects obtained. This may reflect

Table 5. Differences on drinking measures between subjects classified with “strong” or “weak” tension reduction alcohol expectancies (t-tests) Mean Drinking measure Consumption total (diary) grams abs. alcohol per month Frequency of drinking (days per month of diary) MAST score Mean rate of consumption (diary) grams alcohol per hour Number of days reporting Tensiona Age (years) aRefers

Weak expectancies (SD)

Strong expectancies (SD)

441.29 (381.39) 7.03 (4.32) 3.82 (2.95) 36.18 (30.13) 9.61 (5.20) 20.51 (6.02)

802.68 (535.24) 10.77 (5.51) 4.45 (3.24) 32.35 (17.05) 10.39 (4.97) 22.14 (5.82)

to the number of days tension was rated as 4 or 5 on the daily mood diary.

t

Sig

⫺2.76

p ⬍ .005

⫺2.71

p ⬍ .01

⫺0.71

N.S.

0.61

N.S.

0.56

N.S,

⫺1.01

N.S.

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Fig. 2. Reports of tension, both pre- and postdrinking, among subjects with high and low tension reduction expectancy scores.

drinkers with strong tension reduction expectancies being more likely to attribute the onset of drinking as tension related, independent of actual mood state. The significant correlations between expectancies and tension itself were specific to tension-related beliefs confirming the relative independence of DEP factors. The significant correlations between sexual enhancement expectancies and postdrinking mood state are consistent with Leigh (1990), where such expectancies were related to assertion about sexual needs when drinking. The association of family history with high tension reduction expectancy is also consistent with previous research indicating the likely role of parental modeling in expectancy development (Christiansen, Smith, Roehling, & Goldman, 1989). Experimentation with alcohol would probably fulfill these expectancies and it is possible that drinking in response to anxiety could inhibit the acquisition of more adaptive skills, thus, further increasing risk. In summary, the results of this naturalistic study suggest that drinking refusal selfefficacy and alcohol expectancy are distinct cognitive sets. Contrary to the original hypotheses, affective change drinking refusal self-efficacy was not strongly associated with drinking antecedents. While tension reduction alcohol expectancy was associated with drinking in response to antecedent tension, the predictive power of alcohol expectancy regarding subsequent mood change only approached significance. R E F E R E N C E S Abbey, A., Smith, M. J., & Scott, R. O. (1993). The relationship between reasons for drinking alcohol and alcohol consumption: An interactional approach. Addictive Behaviors, 18, 659–670. Christiansen, B. A., Smith, G. T., Roehling, P. V., & Goldman, M. S. (1989). Using alcohol expectancies to predict adolescent drinking behavior at one year. Journal of Consulting and Clinical Psychology, 57, 93–99. Greeley, J., & Oei, T. P. S. (1999). Alcohol and tension reduction. In Blane, T. & Leonard, K. (Eds.), Psychological theories of drinking and alcoholism (2nd ed.). New York: Guilford Press. Khavari, K. A., & Farber, P. D. (1978). A profile instrument for the quantification and assessment of alcohol consumption. The Khavari Alcohol Test. Journal of Studies on Consulting and Clinical Alcohol, 39, 1525–1539. Leigh, B. C. (1990). The relationship of sex-related alcohol expectancies to alcohol consumption and sexual behavior. British Journal of Addiction, 85, 919–928. Lemmens, P., Knibbe, R. A., & Tan, E. S. (1992). Measuring quantity and frequency of drinking in a general population survey: A comparison of five indices. Journal of Studies on Alcohol, 53, 476–486.

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