Brief emotion regulation strategies to reduce alcohol craving: Mediating role of state difficulties in emotion regulation.

OBJECTIVE: This study experimentally compared the effects of emotion regulation (ER) strategies on alcohol craving and examined the mediating effect of state difficulties in emotion regulation (S-DER) on the relationship between negative/positive emotion and alcohol craving. METHOD: 417 participants (76.74% women, Mage = 20.76 years) endorsing past-month heavy/binge drinking were randomly assigned to one of four ER conditions (positive reappraisal, distancing, distraction, and acceptance). Participants completed state assessments, including negative/positive emotion, S-DER, and alcohol craving, prior to (T0) and after (T1) engaging in a negative emotion induction task. Subsequently, participants completed an ER strategy task based on their assigned ER strategy condition and completed a third state assessment (T2). RESULTS: Time had a significant quadratic effect on alcohol craving, such that craving increased from T0 to T1 and decreased from T1 to T2. There was no significant effect of ER strategy condition on craving. Change in S-DER mediated the relationship between the change in negative/positive emotion and the change in craving, with emotional modulation and emotional acceptance facets of S-DER dominating the mediating effect during negative emotion induction and ER strategy induction, respectively. CONCLUSIONS: Results suggest interventions targeting S-DER's emotional modulation and acceptance facets could reduce acute craving when experiencing undesired emotions.

A pilot trial of a brief intervention for cannabis use supplemented with a substance-free activity session or relaxation training.

OBJECTIVE: Cannabis use is increasing among college students and commonly co-occurs with anxiety symptoms in this age group. Interventions that reduce anxiety may also reduce cannabis use. Behavioral economic theory suggests that substance use reductions are most likely when there is an increase in substance-free reinforcement. This randomized pilot trial evaluated the efficacy of a brief motivational intervention (BMI) for cannabis supplemented by either a substance-free activity session (SFAS) or a relaxation training (RT) session for reducing cannabis use, problems, craving, and anxiety symptoms. METHOD: One hundred thirty-two college students (Mage = 19.9; 54% female; 67% White, 31% Black) who reported five or more past-month cannabis use days were randomized to: (a) assessment-only (AO); (b) BMI plus SFAS; or (c) BMI plus RT. Participants in the BMI conditions received two individual counselor-administered sessions plus a brief phone booster session. Outcomes were evaluated 1- and 6-months postintervention. RESULTS: Relative to assessment, both BMI + SFAS and BMI + RT were associated with significant reductions in cannabis problems and craving at 1-month follow-up, and significant reductions in anxiety at 6-month follow-up. Relative to AO, BMI + RT was associated with significant reductions in cannabis use at 1-month follow-up. There were no differences between BMI conditions. CONCLUSIONS: This pilot trial was not adequately powered to conclusively evaluate relative efficacy but provides preliminary support for the short-term efficacy of both two-session interventions for reducing anxiety and cannabis-related risk among nontreatment seeking emerging adults. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Perceptions of Health Risks and Benefits of Cannabis Use Among College Students: Prevalence and Associations With Cannabis Use.

OBJECTIVE: Health decision-making is influenced by perceived health risks and benefits. Greater understanding of these perceptions in college students, a population engaging in high rates of risky cannabis use, is needed. The primary aim of the current study was to examine both perceived risks and benefits of cannabis for short- and long-term health consequences and how these perceptions relate to cannabis use and related problems. METHOD: Using a large, diverse college sample from 10 institutions across the United States (N = 2,354), this cross-sectional study assessed health perceptions of cannabis, cannabis use, and related problems. We examined endorsement of various health perceptions by cannabis use status (never, lifetime, current) and other demographic factors. RESULTS: Participants endorsed a number of health risks (e.g., birth defects, memory problems) and benefits (e.g., pain relief, anxiety reduction) associated with cannabis use. Overall, there was stronger endorsement of health risks than benefits, although this relationship was reversed for individuals who currently use. With a few exceptions, perceptions of health risks and benefits did not differ across demographic variables, including state-level legal status of cannabis. Among individuals reporting past-month use, benefit perceptions were associated with more frequent use, and risk perceptions were associated with less frequent use. CONCLUSIONS: Detailed and nuanced understanding of perceived health risks and benefits could be used to identify common beliefs about cannabis and to develop prevention messaging and intervention targets, such as correcting normative beliefs or addressing misconceptions about the health risks and benefits of cannabis.

Cultural adaptations of motivational interviewing: A systematic review.

Motivational interviewing (MI; Miller & Rollnick, 2012) has expanded from treating substance use disorders to other health concerns across a range of racial-ethnic groups and ages. The spirit of MI lends itself well to working with culturally diverse populations by eliciting the client's values and goals in a collaborative and client-centered approach in pursuit of behavior change. Additionally, MI has been further adapted for use with racial-ethnic minority groups to enhance its effectiveness with specific populations. The aim of this review was to investigate existing cultural adaptations of MI (CAMI), their effectiveness, and to provide directions for future cultural adaptations in both research and clinical settings. This systematic review identified studies of CAMI over the past 20 years using MEDLINE/Pubmed and Embase. The final dataset consisted of 25 peer review studies. In the randomized controlled trial (RCT) studies that utilized a control condition (n = 17), 10 studies showed that the CAMI condition performed significantly better on at least the primary outcome measure than the control condition. All 10 studies adapted Context, Content, and Concepts-three of the dimensions of cultural adaptation defined by the ecological validity framework used in this study (Bernal et al., 1995). (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Effects of content and valence of episodic future thinking on delay discounting and alcohol demand.

OBJECTIVE: This study examined whether the content (alcohol vs. nonalcohol) and valence (positive vs. negative) of episodic future thinking (EFT) are associated with delay discounting (DD) and alcohol demand. METHOD: Participants (N = 360) were college students (Mage = 21.64 years, 84.44% female, 76.11% White) reporting alcohol consumption in the past month recruited to participate in an online, cross-sectional study. Participants were randomly assigned to a control condition or one of four EFT cue-generation conditions (positive alcohol, negative alcohol, positive nonalcohol, and negative nonalcohol). Then participants in EFT conditions generated EFT cues based on the assigned condition. Afterward, all participants completed the DD task and alcohol purchase task; participants in the EFT conditions completed modified tasks during which their EFT cues were displayed. Finally, participants completed a self-report battery assessing alcohol consumption, alcohol-related problems, and demographics. RESULTS: Participants assigned to nonalcohol EFT conditions discounted future rewards significantly less than those in alcohol EFT conditions, F(1, 266) = 6.87, p = .009, ηp² = .025. However, there was no main effect of EFT valence on DD. EFT content around professional work, but not social relationships, was associated with less steep DD (ß = -.24, p < .001). No effect of EFT on alcohol demand intensity was found. CONCLUSIONS: EFT effect on DD may lie in content rather than valence, in which alcohol-free EFT, whether positive or negative, was associated with preference for later but larger rewards. Incorporating a professional goal into imagined events might play a key role in EFT effects on promoting the valuation of future consequences. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Young Adult Cannabis Users' Perceptions of Cannabis Risks and Benefits by Chronic Pain Status.

Purpose: Young adults experiencing chronic pain may self-medicate with cannabis. We examined perceived risks and benefits of cannabis use among young adult users by chronic pain status, and identified relationships among perceived risks and benefits, physical and mental health, and cannabis-related problems. Methods: Young adults reporting at least weekly cannabis use (N = 176, 50.9% with chronic pain) reported perceptions of lifetime risks and benefits associated with cannabis use, physical and mental health, and cannabis-related problems. Results: Young adults without chronic pain reported better physical and mental health than those with chronic pain. Cannabis use, problems, and risk and benefit perceptions did not differ by pain status. Risk and benefit perceptions were unrelated to physical health, perceiving fewer risks and more benefits was associated with better mental health, and perceiving more risk was associated with cannabis problems. Chronic pain status moderated the relationship between perceived benefits and outcomes, such that perceiving more benefits was associated with better physical health for those without chronic pain. Further, greater perceived benefits were associated with more cannabis-related problems for those without chronic pain but fewer problems for those with chronic pain. Conclusion: This study offers insight into the perceptions of risks and benefits among young adult cannabis users and associations with physical and mental health and cannabis-related problems. The effects of perceived benefits on physical health and cannabis-related problems differs for young adults with and without pain, suggesting assessment and consideration of pain status may be valuable in intervention contexts.

Social Anxiety, Cannabis Use Motives, and Social Context's Impact on Willingness to Use Cannabis.

Social anxiety is often purported to be a risk factor for increased cannabis use. Cannabis use motives are strong explanatory predictors of cannabis use embedded within social contexts. This investigation explored the impact of social anxiety, cannabis motives, and their interaction on willingness to use cannabis in a community sample of emerging adults. Social anxiety was anticipated to positively correlate with coping and conformity motives and greater willingness to use cannabis in peer social contexts. Motives to use were hypothesized to potentiate social anxiety's influence on cannabis use decision-making. In total, 124 participants completed an audio simulation of social cannabis use contexts (Can-SIDE) and standard measures of social anxiety (SIAS) and use motives (MMM). Contrary to expectations, social anxiety exerted a protective effect on willingness to use cannabis, but only when conformity, social, and expansion motives were at or below average. These effects varied by social contexts of use. Social anxiety leading to increased cannabis use may be most apparent in clinical samples and in high-risk cannabis users, but this pattern was not supported in this sample of community living emerging adults below clinical cutoffs for cannabis use disorder with relatively high social anxiety.

Integration of motivational interviewing and behavioral economic theories to enhance brief alcohol interventions: Rationale and preliminary examination of client language.

Motivational interviewing (MI) is a widely disseminated evidence-based therapeutic approach for engaging clients and motivating health behavior change, especially risky substance use. Refinement of MI theory over the past few decades has provided empirical evidence that the technical component of MI (in-session client language) is a promising mechanism of behavior change (MOBC). However, heterogeneous and small to moderate effect sizes suggest the need for refinement of MOBC measurement and consideration of other types of client language. The current article presents a complementary integration of current MI theory and behavioral economic (BE) mechanisms to further understanding of in-session factors associated with subsequent behavior change. In this paper, we define some of the key MOBCs from MI and BE theories, describe our integrated framework, and present preliminary findings from a pilot study of the effectiveness and MOBCs of a novel BE-informed application of MI in risky college student drinkers. Results from preliminary coding development suggest that BE-informed measures of client language better predict response to a brief intervention in risky college students than traditional change talk measures. We posit that BE theory can offer insight into meaningful session content beyond the current MI constructs of change talk and sustain talk, which in turn may serve to enhance development of clinical practice and inform scientific investigations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Inaccuracies in survey reporting of alcohol consumption.

BACKGROUND: Alcohol consumption estimates in public health predominantly rely on self-reported survey data which is likely to underestimate consumption volume. Surveys tend to ask specifically about standard drinks and provide a definition or guide in an effort to gather accurate estimates. This study aimed to investigate whether the inclusion of the term standard drinks with pictorial guide is associated with an adjustment in self-reported alcohol volume. METHODS: A web-based survey was administered with AUDIT-C questions repeated at the beginning and end of the survey with and without the standard drink term and guide. The order in which respondents were presented with the different question types was randomised. Two cohorts of university/college students in NSW Australia (n = 122) and the US Pacific Northwest (n = 285) completed the survey online. RESULTS: Australian students did not adjust their responses to questions with and without the standard drink term and pictorial guide. The US students were more likely to adjust their responses based on the detail of the question asked. Those US students who drank more frequently and in greater volume were less likely to adjust/apply a conversion to their consumption. CONCLUSIONS: This study supports previous findings of the inaccuracy of alcohol consumption volume in surveys, but also demonstrates that an assumption of underestimation cannot be applied to all individual reports of consumption. Using additional questions to better understand drink types and serving sizes is a potential approach to enable accurate calculation of underestimation in survey data.

Pain Relief as a Motivation for Cannabis Use Among Young Adult Users With and Without Chronic Pain.

This study aims to determine the rate of chronic pain in a community sample of young adult cannabis users, assess the extent to which pain relief is an important motivation for cannabis use, and explore differences in consumption patterns and problem behaviors between users with and without chronic pain. The study design was cross-sectional. Self-selected community-dwelling young adults (ages 18-29 years; n = 143) who regularly use cannabis completed an online survey. Results revealed that approximately 40% of the sample met the criteria for chronic pain, and pain relief was their primary motivation for use. There were no differences between groups with respect to frequency of use or estimated potency of their preferred strains; however, users with chronic pain reported using a wider variety of administration methods and a greater quantity of cannabis with each use. Users with chronic pain also reported more extensive histories of use, with younger age at initiation and longer duration of regular use. Despite riskier consumption patterns, there were no between-group differences in negative consequences owing to use after controlling for gender and educational status. On average, the total sample reported approximately 8 problems in the past 30 days owing to use. These findings suggest that chronic pain is commonly experienced among young adult cannabis users and pain relief is the primary motivation for users with pain. For some users, clinically significant chronic pain and pain-related interference persist despite heavy use. Cannabis users with and without chronic pain report experiencing several negative consequences owing to their use. PERSPECTIVE: This article compares motivations for cannabis use and describes differences in consumption patterns among a community sample of young adult users with and without chronic pain. This information may be useful for providers who assess and treat pain in young adults, particularly in settings that have legalized recreational use.

Alcohol Behavioral Couple Therapy: In-session behavior, active ingredients and mechanisms of behavior change.

OBJECTIVE: Alcohol Behavioral Couple Therapy (ABCT) is an efficacious alcohol treatment. The purpose of the study was to describe patient and partner language and therapist behavior during therapy sessions and test a proposed causal model linking active ingredients of ABCT as measured by therapist behaviors, hypothesized mechanisms of behavior change as measured by in-session patient and partner language, and alcohol use outcomes. METHOD: Data came from couples in four ABCT clinical trials (N = 188; 86 males, 102 females, and their partners). Patient and partner verbal behaviors in session one and a mid-treatment session were coded using the System for Coding Couples' Interactions in Therapy-Alcohol. Therapist behavior was coded using the Couples Treatment Integrity Rating System. Percent days abstinent was calculated from daily drinking data for the first and second half of treatment and six months post-treatment. RESULTS: Therapists delivered an adequate level of the ABCT interventions during treatment. During treatment, couples increased positive behaviors, talked less about drinking, and decreased their amount of motivational language. Therapist behaviors did not predict patient or partner behaviors during treatment or drinking outcomes. Partner advice in the first session predicted poorer drinking outcomes. At mid-treatment, patient behaviors as a block, and specific behaviors of contemptuousness toward their partner and sustain talk, predicted poorer drinking outcomes. CONCLUSIONS: During ABCT, patients decrease their drinking, and patient and partner behaviors change in predicted ways. Partner advice, patient contemptuousness, and patient sustain talk predicted poorer outcomes. Analyses of within-session verbal behavior did not support the hypothesized mechanisms for change for ABCT.

Towards an understanding of self-directed language as a mechanism of behavior change: A novel strategy for eliciting client language under laboratory conditions.

INTRODUCTION: Change talk (CT) and sustain talk (ST) are thought to reflect underlying motivation and be important mechanisms of behavior change (MOBCs). However, greater specificity and experimental rigor is needed to establish CT and ST as MOBCs. Testing the effects of self-directed language under laboratory conditions is one promising avenue. The current study presents a replication and extension of research examining the feasibility for using simulation tasks to elicit self-directed language. METHODS: First-year college students (N = 92) responded to the Collegiate Simulated Intoxication Digital Elicitation, a validated task for assessing decision-making in college drinking. Verbal responses elicited via free-response and structured interview formats were coded based on established definitions of CT and ST, with minor modifications to reflect the non-treatment context. Associations between self-directed language and alcohol use at baseline and eight months were examined. Additionally, this study examined whether a contextually-based measure of decision-making, behavioral willingness, mediated relationships between self-directed language and alcohol outcome. RESULTS: Healthy talk and unhealthy talk independently were associated with baseline alcohol use across both elicitation formats. Only healthy talk during the free-response elicitation was associated with alcohol use at follow up; both healthy talk and unhealthy talk during the interview elicitation were associated with 8-month alcohol use. Behavioral willingness significantly mediated the relationship between percent healthy talk and alcohol outcome. CONCLUSIONS: Findings support the utility of studying self-directed language under laboratory conditions and suggest that such methods may provide a fruitful strategy to further understand the role of self-directed language as a MOBC.

A novel application in the study of client language: Alcohol and marijuana-related statements in substance-using adolescents during a simulation task.

The current study explored whether laboratory-based techniques can provide a strategy for studying client language as a mechanism of behavior change. Specifically, this study examined the potential of a simulation task to elicit healthy talk, or self-motivational statements in favor of healthy behavior, related to marijuana and alcohol use. Participants (N = 84) were adolescents reporting at least 10 lifetime substance use episodes recruited from various community settings in an urban Pacific Northwest setting. Participants completed the Adolescent Simulated Intoxication Digital Elicitation (A-SIDE), a validated paradigm for assessing substance use decision making in peer contexts. Participants responded to 4 types of offers in the A-SIDE: (a) marijuana, (b) food (marijuana control), (c) alcohol, and (d) soda (alcohol control). Using a validated coding scheme adapted for the current study, client language during a structured interview assessing participants' response to the simulated offers was evaluated. Associations between percent healthy talk (PHT, calculated by dividing the number of healthy statements by the sum of all substance-related statements) and cross-sectional outcomes of interest (previous substance use, substance use expectancies, and behavioral willingness) were explored. The frequency of substance-related statements differed in response to offer type; rate of PHT did not. PHT was associated with behavioral willingness to accept the offer. However, PHT was not associated with decontextualized measures of substance use. Associations between PHT and global expectancies were limited. Simulation methods may be useful in investigating the impact of context on self-talk and to systematically explore client language as a mechanism of change. (PsycINFO Database Record

Assessing Treatment Integrity in Alcohol Behavioral Couple Therapy.

OBJECTIVES: Alcohol Behavioral Couple Therapy (ABCT) is an efficacious treatment for alcohol use disorders. Coding treatment integrity can shed light on the active ingredients of ABCT, but there are no published studies of treatment integrity instruments for ABCT. The present study describes the development and initial reliability of the Treatment Integrity Rating System - Couples Version (C-TIRS) for ABCT. METHODS: The C-TIRS was used to rate 284 first- and mid-treatment ABCT sessions of 188 couples in four randomized clinical trials. RESULTS: Average inter-rater reliability for distinguishing ratings between C-TIRS items was fair-to-good for quantity items (intraclass correlation [ICC] = 0.64) and poor-to-fair for quality items (ICC = 0.41). Five C-TIRS subscales were defined a priori to measure treatment components involving cognitive-behavioral therapy, spouse involvement, couple therapy, common therapeutic factors, and overall adherence to the treatment protocol and had adequate internal reliability (α = 0.74-0.89). Inter-rater reliability was fair to good on seven of ten scales but poor on three scales (ICC range = 0.17-0.72). CONCLUSIONS: The C-TIRS was designed to provide information about quantity and quality of the delivery of ABCT components; however, further refinement of the C-TIRS is warranted before it should be used in frontline practice. Clinical implications and recommendations for future research are discussed.

Psychometric Properties of the Adolescent Reinforcement Survey Schedule-Alcohol Use Version with College Student Drinkers.

BACKGROUND: Behavioral economic theories of drinking posit that the reinforcing value of engaging in activities with versus without alcohol influences drinking behavior. Measures of the reinforcement value of drugs and alcohol have been used in previous research, but little work has examined the psychometric properties of these measures. OBJECTIVES: The present study aims to evaluate the factor structure, test-retest reliability, and concurrent validity of an alcohol-only version of the Adolescent Reinforcement Survey Schedule (ARSS-AUV). METHODS: A sample of 157 college student drinkers completed the ARSS-AUV at two time points 2-3 days apart. Test-retest reliability, hierarchical factor analysis, and correlations with other drinking measures were examined. RESULTS: Single, unidimensional general factors accounted for a majority of the variance in alcohol and alcohol-free reinforcement items. Residual factors emerged that typically represented alcohol or alcohol-free reinforcement while doing activities with friends, romantic or sexual partners, and family members. Individual ARSS-AUV items had fair-to-good test-retest reliability, while general and residual factors had excellent test-retest reliability. General alcohol reinforcement and alcohol reinforcement from friends and romantic partners were positively correlated with past-year alcohol consumption, heaviest drinking episode, and alcohol-related negative consequences. Alcohol-free reinforcement indices were unrelated to alcohol use or consequences. CONCLUSIONS/IMPORTANCE: The ARSS-AUV appears to demonstrate good reliability and mixed concurrent validity among college student drinkers. The instrument may provide useful information about alcohol reinforcement from various activities and people and could provide clinically-relevant information for prevention and treatment programs.

Drinking, abstinence, and academic motives: Relationships among multiple motivational domains and alcohol use in college students.

BACKGROUND: Drinking, abstinence, and academic motives have been previously linked with alcohol consumption in high school and college students; however, little research has examined the impact of such sources of motivations concurrently. OBJECTIVE: Drawing from self-determination theory (SDT; Ryan & Deci, 2000), the current study tested the hypothesis that alcohol-related and academic motives would be associated with one another along internal vs. external focused dimensions. We also examined the relative influence of these motives on alcohol consumption. METHODS: College students (N=226) completed self-report measures assessing drinking motives, abstinence motives, academic motives, and alcohol-related outcomes. RESULTS: Findings suggest that drinking motives are related to abstinence motives but not academic motives. Both forms of alcohol-related motives were related to alcohol use and consequences; no associations between academic motives and alcohol variables were observed. CONCLUSIONS/IMPORTANCE: The lack of associations among academic motives, alcohol-related motives, and alcohol variables departs from previous findings suggesting that academic motives impact alcohol use. The current findings indicate a greater understanding of the interplay of motivational sets related to salient issues for youth, such as academics, is needed in order to expand intervention models for alcohol use in such populations.

Feasibility and Reliability of a Coding System to Capture In-Session Group Behavior in Adolescents.

Limited research has explored the role of in-session behavior during motivational enhancement (ME) in group formats. The current study presents initial feasibility of assessing behavior of high school students (N = 425) attending Project Options, a voluntary secondary drug and alcohol prevention program utilizing ME techniques. Building on previous research exploring client language supporting/opposing health behavior, student group behavior was coded live at the specific utterance and global level; group leader behavior was also coded globally. Interrater reliability of the coding system was assessed, and preliminary validity of the coding system was examined by exploring associations between characteristics of group members and in-session group behavior. Initial reliability estimates were excellent for the specific behavior codes. Reliability of the global codes was mixed, with raters demonstrating good reliability on support for unhealthy behavior, opposition to unhealthy behavior, and support for healthy behavior. Reliability of the group leader codes was fair to poor. Greater percent healthy talk was associated with a lower percentage of group members reporting lifetime alcohol use. The results of the current study suggest that some in-session behavior at the group level can be coded reliably via live observation and that in-session behavior at the group level is associated with alcohol use prior to attending the program. Future research is needed to explore the utility of in-session behavior in terms of predicting future behavior at the group and individual level.

Marijuana use/cessation expectancies and marijuana use in college students.

BACKGROUND: Research suggests that marijuana expectancies are associated with problematic marijuana use; however, these marijuana-related cognitions remain relatively understudied. OBJECTIVE: This study examined marijuana-related decision-making among college students by exploring the relationships among marijuana expectancies and marijuana use variables. METHOD: College students (N = 357) endorsing lifetime marijuana use completed an online survey on marijuana use expectancies, marijuana cessation expectancies, marijuana use, and future marijuana use intentions. A simple regression framework was used to test the effect of each type of expectancies on marijuana outcome; a hierarchical regression framework tested the unique predictive validity when both types were entered into the same model. RESULTS: Both marijuana use expectancies and marijuana cessation expectancies independently predicted a number of marijuana use variables. Additionally, marijuana use expectancies and marijuana cessation expectancies contributed significant unique variance to the prediction of marijuana use. CONCLUSIONS: It is important to consider both use expectancies and cessation expectancies, as these two domains of marijuana-related cognitions appear to act independently, rather than as opposite ends of the same construct. Longitudinal studies are needed to further examine how these factors interact to influence marijuana use and problems over time.

Typology of Couples Entering Alcohol Behavioral Couple Therapy: An Empirical Approach and Test of Predictive Validity on Treatment Response.

This study aimed to examine whether classification of couples in which one partner has an alcohol problem is similar to that reported in the general couples literature. Typologies of couples seeking alcohol behavioral couple therapy (ABCT) were developed via hierarchical cluster analysis using behavioral codes of couple interactions during their first ABCT session. Four couples types based on in-session behavior were established reliably, labeled avoider, validator, hostile, and ambivalent-detached. These couple types resembled couples types found in previous research. Couple type was associated with baseline relationship satisfaction, but not alcohol use. Results suggest heterogeneity in couples with alcohol problems presenting to treatment; further study is needed to investigate the function of alcohol within these different types.

Effects of sex composition on group processes in alcohol prevention groups for teens.

Although most alcohol and other drug prevention programs for adolescents are offered in group settings, little is known about the possible effects of sex composition on group processes and mechanisms of change. Using the Group Actor-Partner Interdependence Model framework, we examined how the sex constellation of adolescent prevention group members influenced youth satisfaction, engagement, and endorsement of healthy behavior during group. Participants in Project Options (N = 379; 61.8% girls; Mage = 16.1; SD = 1.4), a voluntary school-based alcohol prevention program, completed measures of satisfaction at each prevention session and observers rated engagement and change talk for each group. When analyses were oriented toward girls, their personal satisfaction, group-rated satisfaction, and group-level engagement were positively related to having more girls in the group. Similarly, in boys, personal satisfaction, satisfaction of the group as a whole, and engagement in groups improved when groups were composed of more girls. Statements supportive of healthy alcohol/drug-related decision making were unrelated to group composition. The findings suggest that the composition of girls and boys in groups has differential effects on some group processes. This avenue of research has merit for understanding the mechanisms associated with satisfaction and engagement in adolescent substance use prevention programs.