Negative Outcome Expectancies, Motivational Readiness to Change, and Addiction: A Study of Alcohol Consumption and Gambling

Abstract Introduction Alcohol Care Management (ACM) is a manualized treatment provided by behavioral health providers working in a primary care team aimed at increasing patients’ treatment engagement and decreasing their alcohol use. Research has shown that ACM is effective in reducing alcohol consumption; however, the mechanisms of ACM are unknown. Therefore, the purpose of this study is to examine the mechanisms of change in ACM in the context of a randomized clinical trial evaluating the effectiveness of ACM. Materials and Methods This study performed secondary data analysis of existing data from a larger study that involved a sample of U.S. veterans (N = 163) who met criteria for current alcohol dependence. Upon enrollment into the study, participants were randomized to receive either ACM or standard care. ACM was delivered in-person or by telephone within the primary care clinic and focused on the use of oral naltrexone and manualized psychosocial support. According to theory, we hypothesized several ACM treatment components that would mediate alcohol consumption outcomes: engagement in addiction treatment, reduced craving, and increased readiness to change. Parallel mediation models were performed by the PROCESS macro Model 4 in SPSS to test study hypotheses. The institutional review boards at each of the participating facilities approved all study procedures before data collection. Results As hypothesized, results showed that treatment engagement mediated the relation between treatment and both measures of alcohol consumption outcomes, the percentage of alcohol abstinent days, and the percentage of heavy drinking days. Neither craving nor readiness to change mediated the treatment effect on either alcohol consumption outcome. Conclusions Findings suggest that ACM may be effective in changing drinking patterns partially due to an increase in treatment engagement. Future research may benefit from evaluating the specific factors that underlie increased treatment engagement. The current study provides evidence that alcohol use disorder interventions should aim to increase treatment engagement and reduce barriers to care.

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STUDENTŲ ALKOHOLIO VARTOJIMO LŪKESČIŲ, SAVIVEIKSMINGUMO, MOTYVŲ IR ALKOHOLIO VARTOJIMO SĄSAJOS

Psichologija ◽

10.15388/psichol.2011.44.2546 ◽

2011 ◽

Vol 44 ◽

pp. 88-103 ◽

Cited By ~ 1

Author(s):

R. Baltrušaitytė ◽

L. Bulotaitė

Keyword(s):

Alcohol Consumption ◽

Self Efficacy ◽

Heavy Drinking ◽

Outcome Expectancies ◽

Drinking Motives ◽

Drinking Patterns ◽

Effective Prevention ◽

Alcohol Outcome Expectancies ◽

The Relationship ◽

Alcohol Related Problems

Straipsnio tikslas – išsiaiškinti studentų lūkesčių, motyvų ir saviveiksmingumo sąsajas su alkoholio vartojimu. Naudojant alkoholio vartojimo lūkesčių klausimyną, atsisakymo gerti saviveiksmingumo klausimyną, motyvų vartoti alkoholį klausimyną, motyvų nevartoti alkoholio klausimyną ir alkoholio vartojimo įpročių bei problemų anketą buvo apklausti 308 studentai iš 5 Lietuvos universitetų. Gauti rezultatai rodo, kad studentų motyvai vartoti alkoholį ir teigiamų pasekmių lūkesčiai yra teigiamai susiję su alkoholio vartojimo dažnumu, kiekiu ir vartojimo sukeltomis problemomis, o atsisakymo gerti saviveiksmingumas ir motyvai nevartoti alkoholio dėl abejingumo alkoholiui yra neigiamai susiję su alkoholio vartojimo ypatumais (dažnumu, kiekiu, problemomis). Vyriškoji lytis, stipresni motyvai vartoti alkoholį ir menkesnis saviveiksmingumas prognozuoja didesnius suvartojamo alkoholio kiekius, o dažnesnį alkoholio vartojimą prognozuoja dar ir jaunesnis alkoholio vartojimo pradžios amžius. Didesnį su alkoholio vartojimu susijusių problemų skaičių prognozuoja ne tik gausesnis alkoholio vartojimas, bet ir stipresni motyvai vartoti alkoholį bei silpnesnis saviveiksmingumas. Pagrindiniai žodžiai: alkoholio vartojimas, lūkesčiai, motyvai, saviveiksmingumas.Relationship between Alcohol Outcome Expectancies, Self-Efficacy, Motives and Alcohol Consumption among University StudentsBaltrušaitytė R., Bulotaitė L. SummaryAlcohol use is widespread among university students. While searching for the factors associated with drinking, scientists more often acknowledge the importance of various cognitive-motivational variables. It is recommended to consider these variables when developing effective prevention and intervention programs. The cognitive-motivational variables examined in this study were: alcohol outcome expectancies, drinking motives, motives for not drinking, and drinking refusal self-efficacy. The purpose of the study was to examine the relationship between alcohol outcome expectancies, motives, self-efficacy and alcohol consumption among Lithuanian university students. Another aim was to propose and test a meditational model in which alcohol consumption and alcohol-related problems are predicted by expectancies, motives and self-efficacy. 308 students from five Lithuanian universities participated in this study. All participants completed the Drinking Expectancy Questionnaire – revised (DEQ-r), Drinking Refusal Self-efficacy Questionnaire – revised (DRSEQ-r), Drinking Motives Questionnaire (DMQ), motives for not drinking questionnaire and one more questionnaire assessing drinking patterns and alcohol-related problems. The results have shown that the male gender, stronger motives to drink and a weaker drink ing refusal self-efficacy predict a larger quantity of alcohol consumed per occasion. More frequent drinking was also predicted by an earlier age of drinking onset. A larger number of alcohol-related problems was predicted not only by the frequency and quantity of alcohol consumption, but also by stronger motives to drink and a weaker drinking refusal self-efficacy. The relationship between positive alcohol outcome expectancies and alcohol consumption was mediated by motives and drinking refusal self-efficacy. Motives to drink predict alcohol consumption and alcohol-related problems directly and indirectly – through self-efficacy. Drinking refusal self-efficacy predicted alcohol consumption directly, and the relationship between self-efficacy and alcohol-related problems was mediated by alcohol consumption. Strong positive alcohol outcome expectancies and drinking motives may be considered as potential risk factors for heavy drinking and alcohol-related problems. Strong drinking refusal self-efficacy and strong motives for not drinking because of indifference toward alcohol may be considered as protective factors against drinking and alcohol-related problems among university students.Keywords: alcohol consumption, expectancies, motives, self-efficacy.15%; font-family: Calibri, sans-serif;">

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