Daily Associations Between Injunctive Drinking Norms and Alcohol Consumption.

OBJECTIVE: Perception of others' approval of alcohol use (i.e., injunctive drinking norms) is strongly predictive of alcohol use, particularly among young adults (Krieger et al., 2016). While between-person injunctive norms predict alcohol use (Neighbors et al., 2008), there is evidence of within-person fluctuations in the relationship between norms and drinking (Graupensperger et al., 2021). The current study used ecological momentary assessment (EMA) to test within-person, day-level associations between injunctive norms and alcohol use, and to test whether social context moderated this association. METHOD: Participants (n=83, M age=24.0, 50.9% female) completed a two-week EMA protocol using a smartphone application. Injunctive norms, social context (type and gender of companions), and number of drinks consumed were assessed each morning following a drinking event. Multilevel models with repeated measures nested within participants tested main effects and interactions of between- and within-person injunctive norms, type of drinking companions, and gender of drinking companions on number of drinks consumed. RESULTS: Day-level injunctive norms were positively associated with drinking quantity over and above baseline norms. The effect of norms differed by social context such that norms were only positively related to drinking quantity when drinking with a friend or romantic partner (vs. drinking alone). Gender of friends with whom participants drank did not moderate the effect of norms on quantity. CONCLUSIONS: This study provides one of the first examinations of daily fluctuations in injunctive drinking norms. As norms represent a malleable target for intervention (White et al., 2019), results offer new information regarding possible intervention targets.

A multi-site proof-of-concept investigation of computerized approach-avoidance training in adolescent cannabis users.

BACKGROUND: Few effective treatment options exist for cannabis-using youth. This pilot study aimed to test Approach-Avoidance Training to reduce cannabis use with non-treatment-seeking adolescents. METHODS: Eighty cannabis-using non-treatment-seeking adolescents (average age 19) were recruited from San Diego, California and Charleston, South Carolina, and randomized to complete either six sessions of Cannabis Approach-Avoidance Task Training (CAAT-training) designed to reduce automatic approach biases for cannabis cues or CAAT-sham training. Change in two primary outcome variables was examined: 1) cannabis approach bias and 2) percent cannabis use days over study enrollment. Change in percent alcohol use days over study enrollment was explored as a secondary outcome. RESULTS: A mixed models repeated measures analysis confirmed the group by time interaction effect for approach bias failed to reach statistical significance (p = .06). Significant group by time interaction effects (ps < 0.05) predicted percent days of cannabis and alcohol use over study enrollment. Participants randomized to the avoid cannabis condition (CAAT-training) reported 7% fewer days of cannabis use compared to 0% change for sham; unexpectedly, those in the avoid cannabis condition reported 10% percent more alcohol use days compared to 3% more for sham. CONCLUSIONS: Computerized cognitive bias modification paradigms may have utility in reducing adolescent cannabis use. Future work should consider developing a paradigm that addresses both cannabis and alcohol, as well as alternative computerized approaches for coping with addictive behavior in conjunction with bias modification.