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Expectations of the effects of drinking on couple relationship functioning
Addictive Behaviors 27 (2002) 451 – 464
Expectations of the effects of drinking on couple relationship functioning: An assessment of women in distressed relationships who consume alcohol at harmful levels Adrian B. Kellya,*, W. Kim Halfordb, Ross McD. Youngc a
School of Applied Psychology, Griffith University, Gold Coast, PMB 50, Gold Coast Mail Centre, Gold Coast 4217, Australia b School of Applied Psychology, Griffith University, Mt. Gravatt, Brisbane, Australia c Department of Psychiatry, University of Queensland, Brisbane, Australia
Abstract Based on a cognitive – social learning model of alcohol use, it was hypothesised that women with both alcohol and relationship problems would endorse more positive expectations of the effects of alcohol consumption on their relationship and would report lower relational efficacy than women without relationship or alcohol problems. Measures of relationship-referent alcohol expectancies and relational efficacy were completed by 174 married women with both alcohol and relationship problems (n = 20), alcohol problems alone (n = 26), relationship problems alone (n = 30), or neither problem (n = 98). Women without either alcohol or relationship problems strongly rejected expectations of enhanced relationship functioning (e.g., enhanced intimacy, increased emotional expression) following alcohol consumption, whereas women with both alcohol and relationship problems were ambivalent about these positive expectations. Women with both problems also reported lower relational efficacy than the other groups of women. Negative expectations about the effect of alcohol consumption on relationships in women with low relational efficacy may inhibit harmful drinking. D 2002 Elsevier Science Ltd. All rights reserved. Keywords: Alcohol; Relationship; Expectancies; Relationship efficacy
* Corresponding author. Tel.: +61-7-5594-8052; fax: +61-7-5594-8291. E-mail address: [email protected] (A.B. Kelly). 0306-4603/02/$ – see front matter D 2002 Elsevier Science Ltd. All rights reserved. PII: S 0 3 0 6 - 4 6 0 3 ( 0 1 ) 0 0 1 8 5 - X
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1. Introduction Among people with alcohol problems, couple relationship conflict and distress increase heavy drinking. Alcohol-dependent people report that couple conflict is a high-risk context for relapse (Cummings, Gordon, & Marlatt, 1980), and relationship problems longitudinally predict renewed drinking (Haver, 1986; Humphreys, Moos, & Cohen, 1996; Maisto, O’Farrell, Connor, McKay, & Pelcovits, 1988). Relationship distress is even more closely related to drinking in women than men. Relative to men with alcohol problems, women with alcohol problems report relationship distress as a more severe life problem (Blankfield & Maritz, 1990), and more often report drinking in response to relationship difficulties (Olenick & Chalmers, 1991). From a cognitive–social learning perspective, drinking may continue in the context of relationship distress because of expectations that alcohol improves relationship functioning. For example, drinking may be expected to reduce depressed feelings about relationship problems. Relationship distress is a primary source of depression in women (Halford, Price, Bouma, Kelly, & Young, 1999). Many depressed women report self-medicating with alcohol (Aneshensel & Huba, 1983; Schutte, Moos, & Brennan, 1995), and that drinking initially improves reported mood (George & McAfee, 1987). Alcohol may also be expected to enhance emotional closeness, given that women with alcohol and relationship problems often report feeling lonely and experiencing low emotional support from their partner (Klee, Schmidt, & Ames, 1991; Lammers, Schippers, & Van der Staak, 1995). Alcohol may be expected to enhance sexual satisfaction, as many women report increased sexual desire with alcohol consumption (Leigh, 1990; Wilsnack, 1984; Wilsnack, Plaud, Wilsnack, & Klassen, 1997). Finally, drinking may be expected and anticipated to enhance efficacy and assertiveness. Female problem drinkers report greater feelings of powerlessness prior to drinking compared to men (Beckman, 1979; Radloff, 1975), and women with alcohol problems report that alcohol use is a way of coping with low power in couple relationships (Lammers et al., 1995). The likelihood of drinking in response to relationship distress may be increased if there is a low sense of relationship efficacy. Relationship efficacy is the confidence held that conflict can be resolved effectively in the relationship (Vanzetti, Notarius, & NeeSmith, 1992). Ineffective problem solving and low relational efficacy are key characteristics of distressed couples (Vanzetti et al., 1992; Weiss & Heyman, 1997). Low relational efficacy, combined with positive relationship-referent alcohol expectancies, could increase the risk of harmful levels of drinking. The first aim in this study was to develop a measure of relationship-referent alcohol expectancies. We followed widely accepted conventions in scale development (Clark & Watson, 1995; Comrey, 1988; DeVillis, 1991; Gorsuch, 1974; Nunnally, 1993), in item development, item selection, and assessment of the reliability and validity of the scale. The empirical literature, consultations with experts in couples-focused alcohol interventions, and focus groups with women with alcohol problems were used to generate a diverse and comprehensive pool of items. Item selection was based on the internal consistency of the scale evaluated using principle components factor analysis (Comrey,
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1988), and the effects of items on the scale a (Nunally, 1993). Given that expectations of alcohol consumption can vary by dose (Southwick, Steel, Marlatt, & Lindell, 1981), expectations were assessed at both low alcohol consumption (one to two standard drinks) and high consumption (five or more drinks). The second aim in this study was to examine the association of relationship-specific alcohol expectancies and relational efficacy with relationship and alcohol problems in women. The following are the formulated hypotheses: Hypothesis 1: At low doses of alcohol, distressed drinking women would show higher endorsement of positive relationship-specific expectancy items than women with either relationship or alcohol problems alone, or than women with neither problem. Hypothesis 2: At high doses, distressed drinking women would show higher endorsement of both positive and negative relationship-referent expectancies compared to the other three groups. This hypothesis was based on findings that people with alcohol problems report both positive and negative alcohol expectancies (Jones & McMahon, 1994; Young, 1994). Hypothesis 3: Women with relationship and alcohol problems would show lower relational efficacy than non-distressed women with alcohol problems, distressed women without alcohol problems, and women with neither problem. Hypothesis 4: Low relationship efficacy and positive alcohol expectancies would discriminate women with relationship distress and alcohol problems from nondistressed women with alcohol problems, distressed women without alcohol problems, and women with neither alcohol nor relationship problems.
2. Method 2.1. Participants One hundred and seventy-four women were recruited (20 with relationship and alcohol problems, 26 with alcohol problems only, 30 with relationship problems only, and 98 with neither problem) through local media (these women were paid US$20 each to participate) and a hospital-based alcohol treatment unit (these women were not paid). Participants were included if they were in a couple relationship (married or defacto) of at least 12 months duration. Participants were excluded if they reported abuse of benzodiazepines or illicit drugs in the last 6 months (excluding occasional use of cannabis, defined as less than once a fortnight), or if a mental status examination indicated that a severe withdrawal syndrome or a psychotic episode was present at the time of testing. Women were defined as having a relationship problem if their total score on the Dyadic Adjustment Scale (DAS; described below) was less than 100. Women were defined as having an alcohol problem if they currently were receiving treatment for alcohol problems,
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and reported drinking more than 20 standard drinks per week on the Khavari Alcohol Test (KAT; described below). Women who reported drinking 10 or less standard drinks per week on the KAT and who were not receiving alcohol treatment were defined as not having a drinking problem. 2.2. Measures Measures included the DAS (Spanier, 1976), which is a 32-item measure of overall relationship satisfaction that reliably discriminates between distressed and non-distressed couples, and is sensitive to the effects of couple therapy (e.g., Margolin, 1983). The Relational Efficacy Questionnaire (REQ; Notarius & Vanzetti, 1983), which measures confidence about resolving problems as a couple and reliably discriminates between distressed and nondistressed couples, was administered (Vanzetti et al., 1992). The KAT (Khavari & Farber, 1978) was used to measure quantity and frequency of alcohol consumption. The KAT is a 12-item quantification of alcohol intake in the previous 12 months, which has demonstrated reliability and discriminant validity (Khavari & Farber, 1978). Women with alcohol problems completed two additional questionnaires. To measure the extent of alcohol problems, the Canterbury Alcohol Screening Test (CAST; Elvy & Wells, 1984) was administered. The CAST is a 28-item questionnaire measuring the severity of negative impacts of alcohol misuse, and has satisfactory discriminant validity and internal consistency using Australian and New Zealand populations (Elvy & Wells, 1984). The Severity of Alcohol Dependence Questionnaire (SADQ; Stockwell, Hodgson, Edwards, Taylor, & Rankin, 1979) was used to assess physiological dependence on alcohol.
2.3. Procedure The Alcohol and Relationships Questionnaire (ARQ) was developed from an initial pool of 45 items assessing expectations of the effects of alcohol on relationship interaction. These 45 items were generated to reflect six dimensions of relationship-referent expectancies: alcohol enhances emotional intimacy, communication, sexual intimacy, relationship power, assertiveness; reduces depressed feelings about the relationship; and changes anger and frustration towards the partner. Two five-point Likert scales (1 ‘strongly disagree,’ 2 ‘disagree,’ 3 ‘neutral,’ 4 ‘agree,’ and 5 ‘strongly agree’) were attached to each item. On the first scale, respondents rated their agreement with the item if they consumed one or two standard drinks, and on the second scale rated their agreement if they consumed five or more drinks. These dose levels reflect what is defined as low risk (mean of two standard drinks or less per day) and harmful drinking for women (four or more drinks per day) by the National Health and Medical Research Council of Australia (1992). All clinical interviews and self-report assessments were conducted at the Behaviour Research and Therapy Center. The center is a psychology research, training, and community service facility of the University of Queensland, which offers a range of outpatient services to the community on site at the Royal Brisbane Hospital in metropolitan Brisbane.
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3. Results 3.1. Psychometric properties of the ARQ Items were excluded from the low-dose or high-dose scales if the absolute item-total correlation was less than 0.50. This reduced the number of items from the initial pool of 45 to 23 items in the low-dose scale, and to 24 items in the high-dose scale. This produced a subject-to-variable ratio of approximately 6 for each scale, which is satisfactory for a factor analysis (Child, 1990). A principal axis factor analysis of low-dose items using oblique rotation revealed two factors that had eigenvalues greater than 1. In the rotated factor solution, the first factor had an eigenvalue of 11.36, consisted of 14 items, and accounted for 49.4% of total variance. The second factor had an eigenvalue of 1.29, consisted of nine items, and accounted for 5.6% of total variance. Items are presented in descending order of factor loading in Appendix A. The first factor was interpreted as the expectation that ‘‘low doses increase efficacy,’’ and the second factor as the expectation that ‘‘low doses increase intimacy.’’ The two-factor solution showed high coherence and independence of factors. A principal axis factor analysis of high-dose items using oblique rotation revealed two factors that had eigenvalues greater than 1. In the rotated factor solution, the first factor had an eigenvalue of 10.72, consisted of 17 items, and accounted for 46.60% of total variance. The second factor contained seven items, had an eigenvalue of 1.92, and accounted for an additional 8.34% of the variance. Items are presented in descending order of factor loading in Appendix A. It is notable that the items loading on this high-dose factor included those that loaded on both the efficacy and intimacy factors for low doses. More specifically, 8 of 10 highest loading items on the first factor at high doses were the same as the items on the intimacy subscale for low-dose responses. Also, six items on the first factor for high-dose responses were the same as those in the efficacy subscale for low-dose responses. Consequently, the first high-dose factor shared the expectancy content of both factors at low doses, with intimacy items showing the highest factor loading. The first high-dose factor was called ‘‘high doses increase intimacy and efficacy,’’ and the second factor was named ‘‘high doses increase negative affect.’’ The two-factor solution for high-dose responses showed high coherence and independence of factors. As a check on the internal consistency of the questionnaire, a coefficients were calculated for each of the four factors. For the subscales ‘‘low doses increase efficacy,’’ ‘‘low doses increase verbal intimacy,’’ ‘‘high doses increase intimacy and efficacy,’’ and ‘‘high doses increase expression of concerns,’’ the standardized item a coefficients were .93, .93, .94, and .95, respectively, indicating high intrascale consistency (Child, 1990). To check test– retest reliability, the questionnaire was re-administered 1 week later to 40 participants. The intraclass correlation coefficients (Bartko, 1966; Bartko & Carpenter, 1976) were calculated for the subscales of low doses increase efficacy, low doses increase intimacy, high doses increase intimacy and efficacy, and high doses increase expression of concerns. Intraclass correlation coefficients were .77, .81, .80, and .83, respectively, which represents high test– retest reliability (Bartko & Carpenter, 1976). To check subscale interdependence, correla-
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tions between the four ARQ subscale scores were calculated. All correlations were significantly different from zero ( P < .001) and moderate to high in magnitude (ranging from r =.54 to r =.76). 3.2. Description of sample on demographic variables Two-way ANOVAs of relationship distress (yes/no) by harmful drinking (yes/no) showed that there were no significant differences between the groups on the women’s age, years of education, years married, number of children, or couple socioeconomic status (measured using the coding system of Congalten & Daniel, 1976). Across the whole sample, the women’s mean age was 39 years (S.D. = 8.5), the men’s mean age was 42.6 years (S.D. = 7.7), and mean years in the relationship was 13.5 years (S.D. = 9.2). The women had completed a mean of 11.7 years of formal education, and had a mean socioeconomic status rating of 4.4, corresponding to a largely middle class sample. A two-way chi-square of group by prior relationship separations (present/ absent) was significant [c2(3) = 49.07, P < .001], with distressed drinking women more likely to have separated than distressed women without alcohol problems [c2(1) = 6.34, P < .025]. A two-way chi-square of group by previous marriage (present/absent) was significant [c2(3) = 8.23, P < .05]. More women with both relationship and alcohol problems had been married previously than distressed women without alcohol problems [c2(1) = 4.63, P < .05]. Women in the two problem drinking groups reported a mean of 8.2 (S.D. = 9.0)-year history of concern about their drinking, and reported moderate to severe impact of drinking on personal, social, and occupational functioning (CAST score M = 16.6, S.D. = 3.9). Two-way ANOVAs of relationship distress (yes/no) by harmful drinking (yes/no) were conducted on relationship satisfaction assessed on the DAS, and alcohol consumption assessed on the KAT. Means, standard deviations, and results of these analyses are presented in Table 1. The two distressed relationship groups (with and without alcohol problems) were both in the severely distressed relationship range on the DAS (M = 74), whereas nondistressed women were in the highly satisfied range on the DAS (M = 122). The mean daily alcohol consumption of women in the two harmful drinking groups (with and without relationship problems), as assessed on the KAT, was almost three times the levels considered to be harmful for women by the National Health and Medical Research Council (1992) (M = 11 standard drinks/day). In contrast, women with no alcohol problems were drinking well below National Health and Medical Research Council hazardous drinking limits for women (M = 0.3 standard drinks/day). 3.3. Alcohol expectancies and relational efficacy To test Hypotheses 1 and 2, a two-way MANOVA of relationship distress by harmful drinking was conducted on the four ARQ subscales of ‘‘low doses increase efficacy,’’ ‘‘low doses increase verbal intimacy,’’ ‘‘high doses increase intimacy and efficacy,’’ and ‘‘high doses increase expression of concerns.’’ There were significant main effects for relationship distress [ F(4,165) = 4.69, P < .001] and problem drinking [ F(4,165) = 8.22, P < .001], respectively, but the interaction was not significant. Separate two-way ANOVAs were conducted on
Problem drinking Variable Relationship satisfaction Alcohol consumptiony Low doses increase intimacy High doses increase intimacy and efficacy High doses increase expression of concerns Relational efficacy
Relationship distressed a
Not problem drinking Relationship satisfied b
Relationship distressed a
Relationship satisfied b
F ratio Distress
Drinking
Interaction <1 <1 <1 1.00
69.3 (20.0) 11.8 (8.4)a 26.18 (5.83)a 36.94 (13.37)a
122.0 (11.9) 10.6 (9.7)a 22.21 (9.23)a 32.39 (13.32)a,b
77.9 (14.9) 0.3 (0.5)b 22.88 (7.80)a 34.00 (13.85)a
125.6 (11.7) 0.4 (0.4)b 16.37 (6.47)b 24.84 (10.44)b
408.34** <1 14.52** 8.85**
5.55 * 160.1** 11.16** 5.19 *
24.03 (6.00)a
18.52 (9.1)a,b
16.48 (6.05)b,c
13.06 (6.10)c
11.93**
25.40**
<1
42.3 (21.5)a
82.6 (14.7)b
57.2 (17.6)c
90.6 (8.5)d
22.0 *
<1
226.2**
For significant main effects, means on the same line with the same superscripts are not significantly different from each other at P < .05 using Ramsay’s (1980) modification of the Bonferroni correction. Univariate F values based on (1,165) degrees of freedom. SD = standard drinks. * P < .05. ** P < .001. y Consumption in standard drinks per day.
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Table 1 Cell means and standard deviations (in parentheses) for independent and dependent measures
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each subscale to assess the source of the significant multivariate effects, them means, standard deviations, and results of these analyses are presented in Table 1. As is shown in Table 1, at both low and high doses, the women with alcohol and relationship problems agreed significantly more with the positive expectations of the effects of alcohol consumption on their relationship than did women with neither relationship or alcohol problems. Women with either alcohol problems or relationship problems alone endorsed the positive expectations of alcohol consumption on their relationships at a level midway between the high endorsement of the dual-problem group and the low endorsement of the no-problem group. These results support both Hypotheses 1 and 2. Group differences in the level of agreement on each subscale were explored by dividing total subscale scores by the number of items in each subscale. Mean item scores indicated that distressed drinking women rated expectancy items close to the midpoint of the Likert scale (ranging from 2.17 to 3.44 out of five for the four ARQ subscales), reflecting means from low-level disagreement through uncertainty to low-level agreement with items. Women in the distressed group and drinking group had means in the ‘‘disagree’’ response range (ranging from 1.91 to 2.65 for the four subscales), reflecting mild to strong disagreement with items. Women with neither problem strongly disagreed with positive expectations of the effects of alcohol on their relationships (ranging from 1.46 to 1.86). To test Hypothesis 3, a two-way ANOVA of relationship distress by problem drinking was conducted on relational efficacy as assessed on the REQ. Means, standard deviations, and results of these analyses are presented in Table 1. As is evident from Table 1, relational efficacy was significantly different across the four groups. Both distressed groups had lower efficacy than the non-distressed groups, and the distressed and problem drinking group had significantly lower efficacy than the distressed but not problem drinking group. Within the non-distressed groups, the problem-drinking group had significantly lower efficacy than the non-problem drinking group. Overall, there was a large effect size for differences in REQ scores across groups (d = 1.13; Cohen, 1992). To test Hypothesis 4, a stepwise discriminant analysis was performed using the four ARQ subscales and REQ score as predictor variables, with membership of the four groups (women with relationship distress and drinking problems, distress only, drinking problems only, and women with neither problem) as the dependent variable. The highest F-to-Enter ratio was for relational efficacy [ F(3,155) = 96.43, P < .001], which accounted for 64% of variance. The next highest F-to-Enter ratio was for the expectancy ‘‘five or more drinks increases expression of concerns’’ [ F(3,155) = 5.31, P < .001], which accounted for 9% of variance. No other variables significantly increased variance accounted for. To determine how well these two variables classified participants into their correct groups, a second discriminant analysis was conducted. With scores for relational efficacy scores and ‘‘low doses increases expression of concerns’’ as the independent variables, 73% of the complete sample was correctly classified. Correct group classification was attained for 95% of women with neither problem, 48% of women with relationship problems only, 28% of women with problem drinking only, and 56% of women with both relationship and drinking problems. In summary, the function was best at the discrimination of those women with the most problems from those with the least problems (i.e., neither relationship distress nor problem drinking).
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4. Discussion One goal in this study was to develop a measure of expectations about the effects of alcohol consumption on couple relationships. The items of the ARQ were developed. Four subscales were found that had high internal consistency and test–retest reliability: (i) efficacy at low doses, (ii) intimacy at low doses, (iii) intimacy and efficacy at high doses, (iv) and expression of concerns at high doses. Hypothesis 1 was confirmed. Women with relationship and alcohol problems had higher scores on the ‘‘low doses increase efficacy’’ and ‘‘low doses increase intimacy’’ subscales than women with neither problem. Hypothesis 2 also was confirmed. Women with relationship and alcohol problems had higher agreement ratings on the ‘‘high doses enhance intimacy and efficacy’’ and ‘‘high doses enhance expression of concerns’’ subscales than women with neither problem. Women with alcohol or relationship problems alone had scores on the four subscales (two subscales at each dose) that lay between the extreme scores of the women with both problems, and the women with neither problem. Consistent with Hypothesis 3, women with relationship and alcohol problems reported the lowest relational efficacy of all groups, women with relationship problem were next lowest, then women with alcohol problems alone. Women with neither relationship nor alcohol problems reported the highest relational efficacy. Finally, consistent with Hypothesis 4, relational efficacy and the ARQ ‘‘high doses increases expression of concerns’’ subscale each was a significant discriminator between women with and without relationship and alcohol problems. As predicted, women without relationship or alcohol problems disagreed that alcohol consumption would have positive effects on their relationship more than women with both alcohol and relationship problems. However, rather than endorsing positive expectations of alcohol consumption, the mean scores for women with alcohol and relationship problems corresponded with being neutral about positive expectations of alcohol consumption. These findings are somewhat at odds with alcohol expectancy theory in which it is argued that expected positive consequences from drinking mediate alcohol consumption. The neutral ratings of women with relationship and alcohol problems probably reflect indifference to positive expectations (neither agreement nor disagreement). Neutral ratings also could reflect ambivalence (believing both negative and positive outcomes result from drinking) in the ratings. If women with both alcohol and relationship problems were strongly agreeing with some positive and some negative consequences, the variance in ratings in this group of women should be higher than in the other groups. Examination of Table 1 shows this is not the case, so the neutral ratings probably reflect indifference. Women without drinking or relationship problems strongly disagreed that positive relationship consequences emanate from alcohol consumption, which probably reflect expectations that negative relationship consequences result from drinking. These negative expectations may inhibit drinking. In the absence of the restraining influence of negative relationship expectations drinking, other expectations or influences may prompt drinking. For example, expectations of stress relief or easing of craving may initiate drinking when there is indifference to negative relationship expectations.
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There are many possible causal links between relationship problems, alcohol abuse, and expectations of the effects of drinking on relationships. The current study is cross-sectional and correlational, which precludes causal analyses. Future research exploring the longitudinal development of relationship and alcohol problems and relationship-referent alcohol expectancies could help to clarify the causal associations that underlie the correlations observed in the current research.
5. Conclusion Women without alcohol or relationship problems have high relational efficacy, and expect alcohol consumption to have a negative impact on relationship efficacy, intimacy, and expression of concerns. Women with relationship and alcohol problems have low relational efficacy, and expect alcohol consumption to have a neutral impact on relationship efficacy, intimacy, and expression of concerns. Beliefs that alcohol has negative effects on relationship functioning may inhibit alcohol consumption in some women.
Appendix A. Relational and alcohol questionnaire instructional set and items This questionnaire is aimed at finding out about what you expect to happen in interactions with your partner after drinking different amounts of alcohol. Even if you do not drink, or have not ever consumed the amount specified, indicate what you would expect to happen if you did consume this amount. There are two columns of numbers, one on each side of the list of questions. The left-hand side is for what you would expect to happen if you had one or two drinks. The right-hand side is for what you would expect to happen if you had five or more drinks. Go down the left-hand column first for all questions, then move onto the right-hand column. Circle one number in each column which best describes how strongly you agree or disagree with each statement, using the following key.
Loadings Factor/item Factor 1: ‘‘Low doses increase efficacy’’ I would feel more in control of what I do around the house if I had. . . My partner’s expectations of me would be less important after. . . I would seem more in control in our relationship if I had. . .
Factor 1
Factor 2
0.86
0.03
0.83
0.22
0.70
0.13
(continued on next page)
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I would feel better about my partner if I had. . . I would be able to resist pressure from my partner to do things I don’t want to do if I had. . . I would be more likely to do what I want to do, rather than what my partner wants me to do if I had. . . I would not be able to say exactly what I mean to my partner unless I had. . . Keeping up with household chores wouldn’t hassle me as much as usual if I had. . . I would be less likely to get frustrated or angry with my partner if I had. . . I would feel better about our relationship if I had. . . There are topics I wouldn’t talk about with my partner unless I had. . . I would feel I am a better partner after having. . . My partner and I would enjoy being with each other more if I had. . . I would be more assertive with my partner if I had. . . Factor 2: ‘‘Low doses increase intimacy’’ I would relax and enjoy my partner’s company more if I had. . . I would feel in the right mood to talk with my partner if I had. . . It would be easier to talk about any problems with my partner if we had. . . My partner and I would feel closer after. . . My partner and I would have a better time together if we had. . . I would talk about problems more if I had. . . It would be easier to express how I feel to my partner after I had. . . I would enjoy sex with my partner more if I had. . . I would feel closer to my partner if I had. . . Factor 3: ‘‘High doses increase intimacy and efficacy’’ I would feel closer to my partner if I had. . . My partner and I would feel closer after. . . I would relax and enjoy my partner’s company more if I had. . . My partner and I would have a better time together if we had. . . It would be easier to talk about any problem with my partner if we had. . . My partner and I would enjoy being with each other more if I had. . . I would enjoy sex with my partner more if I had. . . I would feel in the right mood to talk with my partner if I had. . .
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0.69 0.65
0.08 0.07
0.64
0.13
0.63
0.08
0.63
0.03
0.62
0.15
0.60 0.60
0.17 0.08
0.54 0.46
0.25 0.32
0.45
0.31
0.10 0.02 0.03
0.89 0.84 0.82
0.05 0.03 0.06 0.07 0.14 0.29
0.78 0.73 0.71 0.71 0.64 0.52
0.87 0.87 0.87 0.79 0.78
0.11 0.17 0.11 0.09 0.08
0.77
0.08
0.77 0.75
0.10 0.07
(continued on next page)
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I would feel better about my partner if I had. . . It would be easier to express how I feel to my partner if I had. . . I would feel I am a better partner if I had. . . I would feel better about our relationship if I had. . . I would not be able to say exactly what I mean to my partner unless I had. . . I would seem more in control in our relationship if I had. . . I would talk about problems more if I had. . . I would feel more in control of what I do around the house if I had. . . There are topics I wouldn’t talk about with my partner unless I had. . . Factor 4: ‘‘High doses increase expression of concerns’’ I would lose my temper more with my partner if I had. . . I would feel more negative towards my partner if I had. . . My partner’s behaviour would annoy me more if I had. . . My partner’s expectations of me would be less important after. . . I would be more likely to do what I want to do, rather than what my partner wants me to do, if I had. . . I would be more assertive with my partner if I had. . . I would be able to resist pressure from my partner to do things I don’t want to do if I had. . .
0.68 0.66 0.66 0.63 0.59
0.08 0.25 0.06 0.07 0.19
0.58 0.57 0.55
0.24 0.18 0.25
0.45
0.39
0.14 0.04 0.04 0.16 0.26
0.89 0.80 0.79 0.56 0.53
0.36 0.31
0.50 0.48
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Expectations of the effects of drinking on couple relationship functioning: An assessment of women in distressed relationships who consume alcohol at harmful levels Adrian B. Kellya,*, W. Kim Halfordb, Ross McD. Youngc a
School of Applied Psychology, Griffith University, Gold Coast, PMB 50, Gold Coast Mail Centre, Gold Coast 4217, Australia b School of Applied Psychology, Griffith University, Mt. Gravatt, Brisbane, Australia c Department of Psychiatry, University of Queensland, Brisbane, Australia
Abstract Based on a cognitive – social learning model of alcohol use, it was hypothesised that women with both alcohol and relationship problems would endorse more positive expectations of the effects of alcohol consumption on their relationship and would report lower relational efficacy than women without relationship or alcohol problems. Measures of relationship-referent alcohol expectancies and relational efficacy were completed by 174 married women with both alcohol and relationship problems (n = 20), alcohol problems alone (n = 26), relationship problems alone (n = 30), or neither problem (n = 98). Women without either alcohol or relationship problems strongly rejected expectations of enhanced relationship functioning (e.g., enhanced intimacy, increased emotional expression) following alcohol consumption, whereas women with both alcohol and relationship problems were ambivalent about these positive expectations. Women with both problems also reported lower relational efficacy than the other groups of women. Negative expectations about the effect of alcohol consumption on relationships in women with low relational efficacy may inhibit harmful drinking. D 2002 Elsevier Science Ltd. All rights reserved. Keywords: Alcohol; Relationship; Expectancies; Relationship efficacy
* Corresponding author. Tel.: +61-7-5594-8052; fax: +61-7-5594-8291. E-mail address: [email protected] (A.B. Kelly). 0306-4603/02/$ – see front matter D 2002 Elsevier Science Ltd. All rights reserved. PII: S 0 3 0 6 - 4 6 0 3 ( 0 1 ) 0 0 1 8 5 - X
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1. Introduction Among people with alcohol problems, couple relationship conflict and distress increase heavy drinking. Alcohol-dependent people report that couple conflict is a high-risk context for relapse (Cummings, Gordon, & Marlatt, 1980), and relationship problems longitudinally predict renewed drinking (Haver, 1986; Humphreys, Moos, & Cohen, 1996; Maisto, O’Farrell, Connor, McKay, & Pelcovits, 1988). Relationship distress is even more closely related to drinking in women than men. Relative to men with alcohol problems, women with alcohol problems report relationship distress as a more severe life problem (Blankfield & Maritz, 1990), and more often report drinking in response to relationship difficulties (Olenick & Chalmers, 1991). From a cognitive–social learning perspective, drinking may continue in the context of relationship distress because of expectations that alcohol improves relationship functioning. For example, drinking may be expected to reduce depressed feelings about relationship problems. Relationship distress is a primary source of depression in women (Halford, Price, Bouma, Kelly, & Young, 1999). Many depressed women report self-medicating with alcohol (Aneshensel & Huba, 1983; Schutte, Moos, & Brennan, 1995), and that drinking initially improves reported mood (George & McAfee, 1987). Alcohol may also be expected to enhance emotional closeness, given that women with alcohol and relationship problems often report feeling lonely and experiencing low emotional support from their partner (Klee, Schmidt, & Ames, 1991; Lammers, Schippers, & Van der Staak, 1995). Alcohol may be expected to enhance sexual satisfaction, as many women report increased sexual desire with alcohol consumption (Leigh, 1990; Wilsnack, 1984; Wilsnack, Plaud, Wilsnack, & Klassen, 1997). Finally, drinking may be expected and anticipated to enhance efficacy and assertiveness. Female problem drinkers report greater feelings of powerlessness prior to drinking compared to men (Beckman, 1979; Radloff, 1975), and women with alcohol problems report that alcohol use is a way of coping with low power in couple relationships (Lammers et al., 1995). The likelihood of drinking in response to relationship distress may be increased if there is a low sense of relationship efficacy. Relationship efficacy is the confidence held that conflict can be resolved effectively in the relationship (Vanzetti, Notarius, & NeeSmith, 1992). Ineffective problem solving and low relational efficacy are key characteristics of distressed couples (Vanzetti et al., 1992; Weiss & Heyman, 1997). Low relational efficacy, combined with positive relationship-referent alcohol expectancies, could increase the risk of harmful levels of drinking. The first aim in this study was to develop a measure of relationship-referent alcohol expectancies. We followed widely accepted conventions in scale development (Clark & Watson, 1995; Comrey, 1988; DeVillis, 1991; Gorsuch, 1974; Nunnally, 1993), in item development, item selection, and assessment of the reliability and validity of the scale. The empirical literature, consultations with experts in couples-focused alcohol interventions, and focus groups with women with alcohol problems were used to generate a diverse and comprehensive pool of items. Item selection was based on the internal consistency of the scale evaluated using principle components factor analysis (Comrey,
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1988), and the effects of items on the scale a (Nunally, 1993). Given that expectations of alcohol consumption can vary by dose (Southwick, Steel, Marlatt, & Lindell, 1981), expectations were assessed at both low alcohol consumption (one to two standard drinks) and high consumption (five or more drinks). The second aim in this study was to examine the association of relationship-specific alcohol expectancies and relational efficacy with relationship and alcohol problems in women. The following are the formulated hypotheses: Hypothesis 1: At low doses of alcohol, distressed drinking women would show higher endorsement of positive relationship-specific expectancy items than women with either relationship or alcohol problems alone, or than women with neither problem. Hypothesis 2: At high doses, distressed drinking women would show higher endorsement of both positive and negative relationship-referent expectancies compared to the other three groups. This hypothesis was based on findings that people with alcohol problems report both positive and negative alcohol expectancies (Jones & McMahon, 1994; Young, 1994). Hypothesis 3: Women with relationship and alcohol problems would show lower relational efficacy than non-distressed women with alcohol problems, distressed women without alcohol problems, and women with neither problem. Hypothesis 4: Low relationship efficacy and positive alcohol expectancies would discriminate women with relationship distress and alcohol problems from nondistressed women with alcohol problems, distressed women without alcohol problems, and women with neither alcohol nor relationship problems.
2. Method 2.1. Participants One hundred and seventy-four women were recruited (20 with relationship and alcohol problems, 26 with alcohol problems only, 30 with relationship problems only, and 98 with neither problem) through local media (these women were paid US$20 each to participate) and a hospital-based alcohol treatment unit (these women were not paid). Participants were included if they were in a couple relationship (married or defacto) of at least 12 months duration. Participants were excluded if they reported abuse of benzodiazepines or illicit drugs in the last 6 months (excluding occasional use of cannabis, defined as less than once a fortnight), or if a mental status examination indicated that a severe withdrawal syndrome or a psychotic episode was present at the time of testing. Women were defined as having a relationship problem if their total score on the Dyadic Adjustment Scale (DAS; described below) was less than 100. Women were defined as having an alcohol problem if they currently were receiving treatment for alcohol problems,
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and reported drinking more than 20 standard drinks per week on the Khavari Alcohol Test (KAT; described below). Women who reported drinking 10 or less standard drinks per week on the KAT and who were not receiving alcohol treatment were defined as not having a drinking problem. 2.2. Measures Measures included the DAS (Spanier, 1976), which is a 32-item measure of overall relationship satisfaction that reliably discriminates between distressed and non-distressed couples, and is sensitive to the effects of couple therapy (e.g., Margolin, 1983). The Relational Efficacy Questionnaire (REQ; Notarius & Vanzetti, 1983), which measures confidence about resolving problems as a couple and reliably discriminates between distressed and nondistressed couples, was administered (Vanzetti et al., 1992). The KAT (Khavari & Farber, 1978) was used to measure quantity and frequency of alcohol consumption. The KAT is a 12-item quantification of alcohol intake in the previous 12 months, which has demonstrated reliability and discriminant validity (Khavari & Farber, 1978). Women with alcohol problems completed two additional questionnaires. To measure the extent of alcohol problems, the Canterbury Alcohol Screening Test (CAST; Elvy & Wells, 1984) was administered. The CAST is a 28-item questionnaire measuring the severity of negative impacts of alcohol misuse, and has satisfactory discriminant validity and internal consistency using Australian and New Zealand populations (Elvy & Wells, 1984). The Severity of Alcohol Dependence Questionnaire (SADQ; Stockwell, Hodgson, Edwards, Taylor, & Rankin, 1979) was used to assess physiological dependence on alcohol.
2.3. Procedure The Alcohol and Relationships Questionnaire (ARQ) was developed from an initial pool of 45 items assessing expectations of the effects of alcohol on relationship interaction. These 45 items were generated to reflect six dimensions of relationship-referent expectancies: alcohol enhances emotional intimacy, communication, sexual intimacy, relationship power, assertiveness; reduces depressed feelings about the relationship; and changes anger and frustration towards the partner. Two five-point Likert scales (1 ‘strongly disagree,’ 2 ‘disagree,’ 3 ‘neutral,’ 4 ‘agree,’ and 5 ‘strongly agree’) were attached to each item. On the first scale, respondents rated their agreement with the item if they consumed one or two standard drinks, and on the second scale rated their agreement if they consumed five or more drinks. These dose levels reflect what is defined as low risk (mean of two standard drinks or less per day) and harmful drinking for women (four or more drinks per day) by the National Health and Medical Research Council of Australia (1992). All clinical interviews and self-report assessments were conducted at the Behaviour Research and Therapy Center. The center is a psychology research, training, and community service facility of the University of Queensland, which offers a range of outpatient services to the community on site at the Royal Brisbane Hospital in metropolitan Brisbane.
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3. Results 3.1. Psychometric properties of the ARQ Items were excluded from the low-dose or high-dose scales if the absolute item-total correlation was less than 0.50. This reduced the number of items from the initial pool of 45 to 23 items in the low-dose scale, and to 24 items in the high-dose scale. This produced a subject-to-variable ratio of approximately 6 for each scale, which is satisfactory for a factor analysis (Child, 1990). A principal axis factor analysis of low-dose items using oblique rotation revealed two factors that had eigenvalues greater than 1. In the rotated factor solution, the first factor had an eigenvalue of 11.36, consisted of 14 items, and accounted for 49.4% of total variance. The second factor had an eigenvalue of 1.29, consisted of nine items, and accounted for 5.6% of total variance. Items are presented in descending order of factor loading in Appendix A. The first factor was interpreted as the expectation that ‘‘low doses increase efficacy,’’ and the second factor as the expectation that ‘‘low doses increase intimacy.’’ The two-factor solution showed high coherence and independence of factors. A principal axis factor analysis of high-dose items using oblique rotation revealed two factors that had eigenvalues greater than 1. In the rotated factor solution, the first factor had an eigenvalue of 10.72, consisted of 17 items, and accounted for 46.60% of total variance. The second factor contained seven items, had an eigenvalue of 1.92, and accounted for an additional 8.34% of the variance. Items are presented in descending order of factor loading in Appendix A. It is notable that the items loading on this high-dose factor included those that loaded on both the efficacy and intimacy factors for low doses. More specifically, 8 of 10 highest loading items on the first factor at high doses were the same as the items on the intimacy subscale for low-dose responses. Also, six items on the first factor for high-dose responses were the same as those in the efficacy subscale for low-dose responses. Consequently, the first high-dose factor shared the expectancy content of both factors at low doses, with intimacy items showing the highest factor loading. The first high-dose factor was called ‘‘high doses increase intimacy and efficacy,’’ and the second factor was named ‘‘high doses increase negative affect.’’ The two-factor solution for high-dose responses showed high coherence and independence of factors. As a check on the internal consistency of the questionnaire, a coefficients were calculated for each of the four factors. For the subscales ‘‘low doses increase efficacy,’’ ‘‘low doses increase verbal intimacy,’’ ‘‘high doses increase intimacy and efficacy,’’ and ‘‘high doses increase expression of concerns,’’ the standardized item a coefficients were .93, .93, .94, and .95, respectively, indicating high intrascale consistency (Child, 1990). To check test– retest reliability, the questionnaire was re-administered 1 week later to 40 participants. The intraclass correlation coefficients (Bartko, 1966; Bartko & Carpenter, 1976) were calculated for the subscales of low doses increase efficacy, low doses increase intimacy, high doses increase intimacy and efficacy, and high doses increase expression of concerns. Intraclass correlation coefficients were .77, .81, .80, and .83, respectively, which represents high test– retest reliability (Bartko & Carpenter, 1976). To check subscale interdependence, correla-
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tions between the four ARQ subscale scores were calculated. All correlations were significantly different from zero ( P < .001) and moderate to high in magnitude (ranging from r =.54 to r =.76). 3.2. Description of sample on demographic variables Two-way ANOVAs of relationship distress (yes/no) by harmful drinking (yes/no) showed that there were no significant differences between the groups on the women’s age, years of education, years married, number of children, or couple socioeconomic status (measured using the coding system of Congalten & Daniel, 1976). Across the whole sample, the women’s mean age was 39 years (S.D. = 8.5), the men’s mean age was 42.6 years (S.D. = 7.7), and mean years in the relationship was 13.5 years (S.D. = 9.2). The women had completed a mean of 11.7 years of formal education, and had a mean socioeconomic status rating of 4.4, corresponding to a largely middle class sample. A two-way chi-square of group by prior relationship separations (present/ absent) was significant [c2(3) = 49.07, P < .001], with distressed drinking women more likely to have separated than distressed women without alcohol problems [c2(1) = 6.34, P < .025]. A two-way chi-square of group by previous marriage (present/absent) was significant [c2(3) = 8.23, P < .05]. More women with both relationship and alcohol problems had been married previously than distressed women without alcohol problems [c2(1) = 4.63, P < .05]. Women in the two problem drinking groups reported a mean of 8.2 (S.D. = 9.0)-year history of concern about their drinking, and reported moderate to severe impact of drinking on personal, social, and occupational functioning (CAST score M = 16.6, S.D. = 3.9). Two-way ANOVAs of relationship distress (yes/no) by harmful drinking (yes/no) were conducted on relationship satisfaction assessed on the DAS, and alcohol consumption assessed on the KAT. Means, standard deviations, and results of these analyses are presented in Table 1. The two distressed relationship groups (with and without alcohol problems) were both in the severely distressed relationship range on the DAS (M = 74), whereas nondistressed women were in the highly satisfied range on the DAS (M = 122). The mean daily alcohol consumption of women in the two harmful drinking groups (with and without relationship problems), as assessed on the KAT, was almost three times the levels considered to be harmful for women by the National Health and Medical Research Council (1992) (M = 11 standard drinks/day). In contrast, women with no alcohol problems were drinking well below National Health and Medical Research Council hazardous drinking limits for women (M = 0.3 standard drinks/day). 3.3. Alcohol expectancies and relational efficacy To test Hypotheses 1 and 2, a two-way MANOVA of relationship distress by harmful drinking was conducted on the four ARQ subscales of ‘‘low doses increase efficacy,’’ ‘‘low doses increase verbal intimacy,’’ ‘‘high doses increase intimacy and efficacy,’’ and ‘‘high doses increase expression of concerns.’’ There were significant main effects for relationship distress [ F(4,165) = 4.69, P < .001] and problem drinking [ F(4,165) = 8.22, P < .001], respectively, but the interaction was not significant. Separate two-way ANOVAs were conducted on
Problem drinking Variable Relationship satisfaction Alcohol consumptiony Low doses increase intimacy High doses increase intimacy and efficacy High doses increase expression of concerns Relational efficacy
Relationship distressed a
Not problem drinking Relationship satisfied b
Relationship distressed a
Relationship satisfied b
F ratio Distress
Drinking
Interaction <1 <1 <1 1.00
69.3 (20.0) 11.8 (8.4)a 26.18 (5.83)a 36.94 (13.37)a
122.0 (11.9) 10.6 (9.7)a 22.21 (9.23)a 32.39 (13.32)a,b
77.9 (14.9) 0.3 (0.5)b 22.88 (7.80)a 34.00 (13.85)a
125.6 (11.7) 0.4 (0.4)b 16.37 (6.47)b 24.84 (10.44)b
408.34** <1 14.52** 8.85**
5.55 * 160.1** 11.16** 5.19 *
24.03 (6.00)a
18.52 (9.1)a,b
16.48 (6.05)b,c
13.06 (6.10)c
11.93**
25.40**
<1
42.3 (21.5)a
82.6 (14.7)b
57.2 (17.6)c
90.6 (8.5)d
22.0 *
<1
226.2**
For significant main effects, means on the same line with the same superscripts are not significantly different from each other at P < .05 using Ramsay’s (1980) modification of the Bonferroni correction. Univariate F values based on (1,165) degrees of freedom. SD = standard drinks. * P < .05. ** P < .001. y Consumption in standard drinks per day.
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Table 1 Cell means and standard deviations (in parentheses) for independent and dependent measures
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each subscale to assess the source of the significant multivariate effects, them means, standard deviations, and results of these analyses are presented in Table 1. As is shown in Table 1, at both low and high doses, the women with alcohol and relationship problems agreed significantly more with the positive expectations of the effects of alcohol consumption on their relationship than did women with neither relationship or alcohol problems. Women with either alcohol problems or relationship problems alone endorsed the positive expectations of alcohol consumption on their relationships at a level midway between the high endorsement of the dual-problem group and the low endorsement of the no-problem group. These results support both Hypotheses 1 and 2. Group differences in the level of agreement on each subscale were explored by dividing total subscale scores by the number of items in each subscale. Mean item scores indicated that distressed drinking women rated expectancy items close to the midpoint of the Likert scale (ranging from 2.17 to 3.44 out of five for the four ARQ subscales), reflecting means from low-level disagreement through uncertainty to low-level agreement with items. Women in the distressed group and drinking group had means in the ‘‘disagree’’ response range (ranging from 1.91 to 2.65 for the four subscales), reflecting mild to strong disagreement with items. Women with neither problem strongly disagreed with positive expectations of the effects of alcohol on their relationships (ranging from 1.46 to 1.86). To test Hypothesis 3, a two-way ANOVA of relationship distress by problem drinking was conducted on relational efficacy as assessed on the REQ. Means, standard deviations, and results of these analyses are presented in Table 1. As is evident from Table 1, relational efficacy was significantly different across the four groups. Both distressed groups had lower efficacy than the non-distressed groups, and the distressed and problem drinking group had significantly lower efficacy than the distressed but not problem drinking group. Within the non-distressed groups, the problem-drinking group had significantly lower efficacy than the non-problem drinking group. Overall, there was a large effect size for differences in REQ scores across groups (d = 1.13; Cohen, 1992). To test Hypothesis 4, a stepwise discriminant analysis was performed using the four ARQ subscales and REQ score as predictor variables, with membership of the four groups (women with relationship distress and drinking problems, distress only, drinking problems only, and women with neither problem) as the dependent variable. The highest F-to-Enter ratio was for relational efficacy [ F(3,155) = 96.43, P < .001], which accounted for 64% of variance. The next highest F-to-Enter ratio was for the expectancy ‘‘five or more drinks increases expression of concerns’’ [ F(3,155) = 5.31, P < .001], which accounted for 9% of variance. No other variables significantly increased variance accounted for. To determine how well these two variables classified participants into their correct groups, a second discriminant analysis was conducted. With scores for relational efficacy scores and ‘‘low doses increases expression of concerns’’ as the independent variables, 73% of the complete sample was correctly classified. Correct group classification was attained for 95% of women with neither problem, 48% of women with relationship problems only, 28% of women with problem drinking only, and 56% of women with both relationship and drinking problems. In summary, the function was best at the discrimination of those women with the most problems from those with the least problems (i.e., neither relationship distress nor problem drinking).
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4. Discussion One goal in this study was to develop a measure of expectations about the effects of alcohol consumption on couple relationships. The items of the ARQ were developed. Four subscales were found that had high internal consistency and test–retest reliability: (i) efficacy at low doses, (ii) intimacy at low doses, (iii) intimacy and efficacy at high doses, (iv) and expression of concerns at high doses. Hypothesis 1 was confirmed. Women with relationship and alcohol problems had higher scores on the ‘‘low doses increase efficacy’’ and ‘‘low doses increase intimacy’’ subscales than women with neither problem. Hypothesis 2 also was confirmed. Women with relationship and alcohol problems had higher agreement ratings on the ‘‘high doses enhance intimacy and efficacy’’ and ‘‘high doses enhance expression of concerns’’ subscales than women with neither problem. Women with alcohol or relationship problems alone had scores on the four subscales (two subscales at each dose) that lay between the extreme scores of the women with both problems, and the women with neither problem. Consistent with Hypothesis 3, women with relationship and alcohol problems reported the lowest relational efficacy of all groups, women with relationship problem were next lowest, then women with alcohol problems alone. Women with neither relationship nor alcohol problems reported the highest relational efficacy. Finally, consistent with Hypothesis 4, relational efficacy and the ARQ ‘‘high doses increases expression of concerns’’ subscale each was a significant discriminator between women with and without relationship and alcohol problems. As predicted, women without relationship or alcohol problems disagreed that alcohol consumption would have positive effects on their relationship more than women with both alcohol and relationship problems. However, rather than endorsing positive expectations of alcohol consumption, the mean scores for women with alcohol and relationship problems corresponded with being neutral about positive expectations of alcohol consumption. These findings are somewhat at odds with alcohol expectancy theory in which it is argued that expected positive consequences from drinking mediate alcohol consumption. The neutral ratings of women with relationship and alcohol problems probably reflect indifference to positive expectations (neither agreement nor disagreement). Neutral ratings also could reflect ambivalence (believing both negative and positive outcomes result from drinking) in the ratings. If women with both alcohol and relationship problems were strongly agreeing with some positive and some negative consequences, the variance in ratings in this group of women should be higher than in the other groups. Examination of Table 1 shows this is not the case, so the neutral ratings probably reflect indifference. Women without drinking or relationship problems strongly disagreed that positive relationship consequences emanate from alcohol consumption, which probably reflect expectations that negative relationship consequences result from drinking. These negative expectations may inhibit drinking. In the absence of the restraining influence of negative relationship expectations drinking, other expectations or influences may prompt drinking. For example, expectations of stress relief or easing of craving may initiate drinking when there is indifference to negative relationship expectations.
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There are many possible causal links between relationship problems, alcohol abuse, and expectations of the effects of drinking on relationships. The current study is cross-sectional and correlational, which precludes causal analyses. Future research exploring the longitudinal development of relationship and alcohol problems and relationship-referent alcohol expectancies could help to clarify the causal associations that underlie the correlations observed in the current research.
5. Conclusion Women without alcohol or relationship problems have high relational efficacy, and expect alcohol consumption to have a negative impact on relationship efficacy, intimacy, and expression of concerns. Women with relationship and alcohol problems have low relational efficacy, and expect alcohol consumption to have a neutral impact on relationship efficacy, intimacy, and expression of concerns. Beliefs that alcohol has negative effects on relationship functioning may inhibit alcohol consumption in some women.
Appendix A. Relational and alcohol questionnaire instructional set and items This questionnaire is aimed at finding out about what you expect to happen in interactions with your partner after drinking different amounts of alcohol. Even if you do not drink, or have not ever consumed the amount specified, indicate what you would expect to happen if you did consume this amount. There are two columns of numbers, one on each side of the list of questions. The left-hand side is for what you would expect to happen if you had one or two drinks. The right-hand side is for what you would expect to happen if you had five or more drinks. Go down the left-hand column first for all questions, then move onto the right-hand column. Circle one number in each column which best describes how strongly you agree or disagree with each statement, using the following key.
Loadings Factor/item Factor 1: ‘‘Low doses increase efficacy’’ I would feel more in control of what I do around the house if I had. . . My partner’s expectations of me would be less important after. . . I would seem more in control in our relationship if I had. . .
Factor 1
Factor 2
0.86
0.03
0.83
0.22
0.70
0.13
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I would feel better about my partner if I had. . . I would be able to resist pressure from my partner to do things I don’t want to do if I had. . . I would be more likely to do what I want to do, rather than what my partner wants me to do if I had. . . I would not be able to say exactly what I mean to my partner unless I had. . . Keeping up with household chores wouldn’t hassle me as much as usual if I had. . . I would be less likely to get frustrated or angry with my partner if I had. . . I would feel better about our relationship if I had. . . There are topics I wouldn’t talk about with my partner unless I had. . . I would feel I am a better partner after having. . . My partner and I would enjoy being with each other more if I had. . . I would be more assertive with my partner if I had. . . Factor 2: ‘‘Low doses increase intimacy’’ I would relax and enjoy my partner’s company more if I had. . . I would feel in the right mood to talk with my partner if I had. . . It would be easier to talk about any problems with my partner if we had. . . My partner and I would feel closer after. . . My partner and I would have a better time together if we had. . . I would talk about problems more if I had. . . It would be easier to express how I feel to my partner after I had. . . I would enjoy sex with my partner more if I had. . . I would feel closer to my partner if I had. . . Factor 3: ‘‘High doses increase intimacy and efficacy’’ I would feel closer to my partner if I had. . . My partner and I would feel closer after. . . I would relax and enjoy my partner’s company more if I had. . . My partner and I would have a better time together if we had. . . It would be easier to talk about any problem with my partner if we had. . . My partner and I would enjoy being with each other more if I had. . . I would enjoy sex with my partner more if I had. . . I would feel in the right mood to talk with my partner if I had. . .
461
0.69 0.65
0.08 0.07
0.64
0.13
0.63
0.08
0.63
0.03
0.62
0.15
0.60 0.60
0.17 0.08
0.54 0.46
0.25 0.32
0.45
0.31
0.10 0.02 0.03
0.89 0.84 0.82
0.05 0.03 0.06 0.07 0.14 0.29
0.78 0.73 0.71 0.71 0.64 0.52
0.87 0.87 0.87 0.79 0.78
0.11 0.17 0.11 0.09 0.08
0.77
0.08
0.77 0.75
0.10 0.07
(continued on next page)
462
A.B. Kelly et al. / Addictive Behaviors 27 (2002) 451–464
I would feel better about my partner if I had. . . It would be easier to express how I feel to my partner if I had. . . I would feel I am a better partner if I had. . . I would feel better about our relationship if I had. . . I would not be able to say exactly what I mean to my partner unless I had. . . I would seem more in control in our relationship if I had. . . I would talk about problems more if I had. . . I would feel more in control of what I do around the house if I had. . . There are topics I wouldn’t talk about with my partner unless I had. . . Factor 4: ‘‘High doses increase expression of concerns’’ I would lose my temper more with my partner if I had. . . I would feel more negative towards my partner if I had. . . My partner’s behaviour would annoy me more if I had. . . My partner’s expectations of me would be less important after. . . I would be more likely to do what I want to do, rather than what my partner wants me to do, if I had. . . I would be more assertive with my partner if I had. . . I would be able to resist pressure from my partner to do things I don’t want to do if I had. . .
0.68 0.66 0.66 0.63 0.59
0.08 0.25 0.06 0.07 0.19
0.58 0.57 0.55
0.24 0.18 0.25
0.45
0.39
0.14 0.04 0.04 0.16 0.26
0.89 0.80 0.79 0.56 0.53
0.36 0.31
0.50 0.48
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