Using Young Adult Language to Describe the Effects of Simultaneous Alcohol and Marijuana Use: Implications for Assessment.

Introduction: Prevalence of alcohol and marijuana use is highest in young adulthood and an increasing number of young adults report simultaneous alcohol and marijuana (SAM) use, which is consistently linked with numerous negative consequences. To better understand reasons for engaging in SAM use and to refine measurement of subjective effects of SAM use, this study aimed to identify (1) how young adults describe subjective experiences during a SAM use occasion and (2) how language describing subjective effects changes as a function of level of alcohol and marijuana use. Methods: Using Amazon's Mechanical Turk (MTurk), 323 participants (53.6% women, 68.4% White, M age = 23.0 years) who reported past-month heavy episodic drinking and past-month SAM use were asked to list words to describe how they feel when using only alcohol, only marijuana, and various combinations of alcohol and marijuana. Results: SAM use language varied as a function of age and substance use behavior but was not associated with sex or race. Large differences in the terms used to describe subjective effects were observed when comparing different combinations of alcohol and marijuana use; most notably the term "cross-faded" appeared primarily when engaging at the heaviest combinations of alcohol and marijuana. Conclusion: Young adults have a wide range of vocabulary for describing subjective effects of SAM use, and subjective effects vary as a function of the level of each substance used. Future research should consider integrating such contemporary language when measuring subjective effects of SAM use.

What Predicts Willingness to Experience Negative Consequences in College Student Drinkers?

OBJECTIVE: Research has shown that students who were more willing to experience consequences reported higher rates of alcohol consumption and negative consequences. The present study used a longitudinal design to examine intra- and interpersonal consequence-specific predictors of willingness to experience negative consequences. METHOD: Students (N = 2,024) were assessed in the fall (Time [T] 1) and spring (T2) semesters of their first year in college. Intrapersonal constructs (i.e., expectancies, subjective evaluations, self-efficacy), interpersonal constructs (i.e., peer descriptive, injunctive norms), and personality constructs (i.e., self-regulation, impulsivity, sensation seeking) were assessed at T1 and willingness to experience negative alcohol-related consequences was assessed 6 months later. A structural path model examined the relationship between T1 predictors and T2 willingness. T1 drinking and sex were included as covariates. RESULTS: These results demonstrated significant positive relationships between T1 participants' subjective evaluations of consequences, expectancies of experiencing consequences, and T2 willingness to experience negative consequences. Further, impulsivity, sensation seeking, and T1 drinking showed significant, positive associations with willingness, whereas higher self-regulation was significantly associated with lower willingness. Men were significantly more willing to experience negative consequences than women. No significant associations were observed between normative perceptions and willingness. CONCLUSIONS: Intrapersonal and personality constructs, as well as previous drinking, were significantly associated with willingness to experience consequences whereas interpersonal constructs were not. Men were significantly more willing to experience negative consequences. College student interventions may benefit from focusing on significant constructs identified in the current study (e.g., enhancing self-regulation) and focusing on students with higher willingness to experience negative consequences.

Examining the impact of early college experiences on the cumulative number of alcohol-related consequences.

OBJECTIVE: To estimate the total number of alcohol-related consequences students experience during 4 years of college and examine early college indicators that result in higher rates of consequences. METHOD: Undergraduate drinkers (N = 1,744; 58% female; 87% White; 5% Hispanic) at a large northeastern university completed an online survey at the end of the fall and spring semesters during their first (T1, T2), second (T3, T4), third (T5, T6), and fourth (T7, T8) years of college (87% retention across the study). First, descriptive statistics were calculated to estimate the total number of alcohol-related consequences students experienced across all 4 years of college. Second, a structural equation model was examined to identify early college indicators that influence individuals experiencing more cumulative consequences. RESULTS: Students experienced an average of 102 (SD = 89.91) alcohol-related consequences during 4 years of college. Next, early parental approval of consequences, but not peer drinking norms, were positively associated with students' willingness to experience consequences, which in turn, were positively associated with higher alcohol consumption and greater total consequences. CONCLUSIONS: Results estimated that, on average, students experienced 102 alcohol-related consequences across all 4 years of college. Parental approval of consequences influenced students' total consequences through their willingness to experience consequences and drinking behaviors. Findings from the current study have several important implications for interventions.

Motivations to combine alcohol and nicotine in college students: A validation of the Alcohol and Nicotine Motives Scale.

INTRODUCTION: Research on combining alcohol and nicotine (ALCNIC) has shown this risky behavior results in significantly more consequences than using either alcohol or nicotine alone. No measures currently exist to assess ALCNIC motives limiting intervention and prevention efforts. The present study developed a psychometrically sound and multidimensional measure of ALCNIC motives (the ANMS). METHODS: An initial item pool of ALCNIC items was developed from literature on college student drinking, focus groups, and individual interviews. Study 1 involved students from a northeastern university who completed an online survey on the ALCNIC items (N = 55; 57.1% female; Mage = 20.3). Analysis focused on reliability (exploratory factor analysis). Study 2 involved a cross-validation national sample of college students (N = 336; 49.7% female; Mage = 21.2) completing the same survey items. Confirmatory factor analysis, criterion-related validity (ALCNIC/weekend drinking), and discriminant validity (social desirability) were assessed using structural equation modeling. RESULTS: Results across two studies revealed three factors to engage in ALCNIC: antagonistic (party longer), synergistic (enhanced effects), and social (peer pressure); and one factor to avoid ALCNIC: negative effects (feeling anxious) (all alphas > 0.7). In study 2, criterion-related validity revealed that synergistic motives were significantly positively associated with ALCNIC use; and negative effects motives were significantly negatively associated with ALCNIC use. Discriminant validity showed ALCNIC subscales were not significantly associated with social desirability (except social). CONCLUSIONS: The study developed a reliable and valid measure of motives for ALCNIC use. Results were robust to cross-validation across two samples of college students. These measures provide targets for intervention and prevention efforts.

Remote skin self-examination training of melanoma survivors and their skin check partners: A randomized trial and comparison with in-person training.

BACKGROUND: Compared with other cancers, melanoma has the longest delays measured as the median time to patient presentation for care from symptom onset. Time to presentation for care is a key determinant of outcomes, including disease stage, prognosis, and treatment. METHODS: Melanoma survivors with localized disease and their skin check partners enrolled in two sequential randomized control trials of skin self-examination (SSE) training. In Phase 1, the pair read a workbook in the office and had quarterly total body skin examinations with a study dermatologist. In Phase 2, materials were mailed to pairs, whose surveillance was with a community physician. SSE knowledge, performance (frequency and extent), and identification of concerning moles were compared between phases. RESULTS: Among 341 patients, 197 received the workbook and the others were controls. Knowledge in performing SSE was higher for the workbook relative to controls in both phases. The SSE frequency ranged from 2.38 to 5.97 times in 9 months. Patients randomized to the workbook in both phases performed significantly more SSE than controls at 9 months (P < .05). In both phases, trained survivors performed significantly more SSEs on the scalp than controls at 9 and 18 months (P < .05). Phase 1 survivors performed significantly more SSEs on the abdomen, buttocks, and soles of the feet than controls, but this did not occur in Phase 2. Finally, in both phases, survivors trained with the workbook resulted in greater detection of suspicious lesions and melanomas. CONCLUSIONS: These findings justify the benefits of remote SSE training for patients as an adjunct to provider-administered screening.

An Examination of Parental Permissiveness of Alcohol Use and Monitoring, and Their Association with Emerging Adult Drinking Outcomes Across College.

BACKGROUND: Studies have shown that parents have a significant influence on emerging adult college students' drinking during the first year of college. Limited research has been conducted to address the question of whether parenting later in college continues to matter in a similar manner. The current study utilized a prospective design to identify associations between parental permissiveness toward alcohol use and monitoring behaviors and student drinking outcomes during the first and fourth years of college. METHODS: Participants (N = 1,429) at 3 large public universities completed surveys during the fall semesters of their first (T1) and fourth years (T2) (84.3% retention). The study employed a saturated autoregressive cross-lag model to examine associations between parental permissiveness of college student alcohol use, parental monitoring, student drinking, and consequences at T1 and T2, controlling for peer norms, sex, and campus. RESULTS: Examination of the association between parenting and student drinking outcomes revealed: (i) parental permissiveness was positively associated with drinking at T1 and again at T2; (ii) parental permissiveness had indirect effects on consequences via the effects on drinking at both times. Specifically, a 1-unit increase in parental permissiveness at T1 resulted in students experiencing 4 to 5 more consequences as a result of their drinking; (iii) parental permissiveness was not directly associated with monitoring at T1 or T2; and (iv) parental monitoring was significantly associated with drinking at T1 but not T2. CONCLUSIONS: The findings provide evidence for the continued importance of parenting in the fourth year of college and parents expressing low permissiveness toward student drinking may be beneficial to reducing risky drinking even as students turn 21.

Transitions in drinking behaviors across the college years: A latent transition analysis.

OBJECTIVE: College student alcohol use remains a considerable concern. While many colleges provide universal interventions surrounding matriculation, trends indicate alcohol use increases over the college years. This study utilized a person-centered approach to examine changes in drinking across college and predictors (expectancies, attitudes, norms, and gender) of increases in risky drinking. Understanding transitions in drinking patterns and predictors of risky transitions can help identify risky students, periods of increased risk, and inform prevention efforts. METHOD: 1429 first-year students were recruited from three universities across the USA. Students were assessed in the fall of each of the four years of college using a wide variety of drinking-related measures. RESULTS: Latent transition analysis (LTA) identified five classes of students (Non-Drinkers, Weekend Light Drinkers, Weekend Heavy Drinkers, Occasional Heavy Episodic Drinkers, Heavy Drinkers). Heavy-Drinkers were not likely to move out of their status during all four years of college. All psychosocial factors were shown to predict class membership during the first year (e.g., higher positive expectancies were associated with greater likelihood of being in a higher risk class). Increased psychosocial risk factors also predicted transitioning to higher risk drinking classes, mostly for Non-Drinkers. Differences by gender were observed. CONCLUSIONS: Results indicate many students maintain or increase risky drinking practices, rather than mature out, suggesting continued need for early prevention. Targeting positive attitudes during the first year may be particularly important for later transitions. Males may benefit more from targeted intervention during the transition between third and fourth years.

Using latent transition analysis to compare effects of residency status on alcohol-related consequences during the first two years of college.

The current study examined two research aims: (1) Identify latent statuses of college students who share common patterns of single or repeated experiences with distinct types of negative alcohol-related consequences during the first two years of college; and (2) Examine how changes in students' living arrangements were associated with transitions in the consequence statuses. Using a sample of college student drinkers (N = 1706), four latent statuses were identified that distinguished among distinct combinations of single and repeated experiences across the multiple consequence subtypes: No Consequences, Physical Non-Repeaters, Multiple Consequences, and Multiple Consequences Repeaters. Students who remained in on-campus living spaces were most likely to belong to lower-risk statuses at T1, and remain in those statuses at T2. We found that moving into Greek housing had strongest effects among students who started in the No Consequences status, while students who moved to off-campus housing were most likely to remain in the Multiple Consequences status. Given that students who moved out of on-campus residences were more likely to transition into high-risk statuses, interventions that target students who intend to move to off-campus or fraternity housing should be implemented during the first year of college.

Evaluation of a Brief Dermatologist-Delivered Intervention vs Usual Care on Sun Protection Behavior.

Importance: Despite receiving dermatologic care, many patients with or without a history of skin cancer either do not use sun protection or fail to use it in an effective manner. Objective: To examine the association of a brief dermatologist-delivered intervention vs usual care with patient satisfaction and sun protection behavior. Design, Setting, and Participants: A longitudinal controlled cohort study among adults receiving dermatology care was conducted from April 25 to November 6, 2017, at 2 dermatologic clinic sites within a Northeastern health care system to compare outcomes associated with the intervention with that of usual care on 1- and 3-month patient outcomes. The sample consisted primarily of non-Hispanic white patients aged 21 to 65 years. Participants were assigned to the intervention group (n = 77) or the control group (n = 82) based on the site location of their dermatologists. Interventions: The intervention (<3 minutes) was delivered by dermatologists during a skin examination or the suturing phase of skin cancer surgery. The intervention consisted of 6 components targeting sun risk and protective behaviors. Main Outcomes and Measures: First, patient's satisfaction with the dermatologist's communication was assessed. Second, the association of the intervention with changing sun protection behavior of the patient was examined. Results: Patients in the intervention group (46 women and 31 men; mean [SD] age, 52.4 [9.6] years) rated dermatologist-patient communication more positive compared with patients in the control group (59 women and 23 men; mean [SD] age, 51.4 [11.3 years]). Eighteen percent (14 of 77) of patients in the intervention group reported 1 or more sunburns 1 month after the intervention compared with 35% (29 of 82) of patients in the control group (P = .01). No differences in report of sunburns were seen at the 3-month follow-up. Patients in the intervention group reported increased use of sunscreen across 3 months (face: intervention, increased 12% and controls, decreased 4%; P = .001; body: intervention, increased 12% and controls, decreased 1%; P = .02; reapplication: intervention, increased 15% and controls, remained stable; P = .002). Conclusions and Relevance: The intervention was delivered by dermatologists after minimal standardized training and resulted in a higher level of satisfaction with dermatologist-patient communication and improved sun protection behavior among patients across several months.

Mechanisms of Behavior Change Within Peer-Implemented Alcohol Interventions.

OBJECTIVE: Colleges continue to experience a high number of referred students because of campus alcohol violations. Subsequently, there has been a trend to use peer-implemented minimal interventions (PMIs), often using motivational interviewing (MI). However, little is known about how PMIs facilitate behavior change. This study aims to examine the mechanisms of behavior change within PMIs and their influence on alcohol reduction among mandated students. METHOD: Participants (N = 146; mean age = 18.7 years; 67% male; 94% White) were college students who violated campus alcohol policy at a Northeastern liberal arts college who received a 15-minute PMI addressing their alcohol use. The Motivational Interviewing Skill Code (Miller et al., 2003) was used to identify peer counselor behaviors that were MI consistent (MICO), client change talk (CT), and client self-exploration. RESULTS: MICO behaviors were positively associated with CT and self-exploration. Client CT and self-exploration were negatively associated with alcohol-related outcomes. Furthermore, mediational models examining MICO behaviors revealed effects for two paths: (a) from MICO to client CT to reduced alcohol use; and (b) from MICO to client self-exploration to reduced alcohol-related consequences and use. CONCLUSIONS: These data support the primary causal chain examining the influence of MICO on in-session client behaviors and related post-session behavior change in PMIs among at-risk students.

Adolescents who experienced negative alcohol-related consequences are willing to experience these consequences again in the future.

Alcohol use and risky single occasion drinking are common among adolescents and are associated with a higher risk of various negative social, physical, academic, or sexual consequences. Studies have shown that among college students, willingness to experience negative consequences is associated with a higher likelihood of experiencing these consequences in the future. However, it remains unclear how experiencing negative consequences influences adolescents' willingness to experience them again. Based on a representative sample of 1,333 alcohol-using 14- to 15-year-olds (47.9% female), a path model was used to examine the associations between risky drinking, negative social and physical consequences, and willingness to experience the specific consequence in the future. As hypothesized, more frequent risky drinking was positively associated with experiencing negative consequences (i.e., saying or doing embarrassing things, regretted sexual experiences, impairment of schoolwork, problems with parents/friends, accident or injury, hangover, vomiting, memory lapses). Contrary to our second hypothesis, adolescents who experienced a negative consequence were also consistently willing to experience it in the future. Findings suggest that adolescents may see the experience of negative consequences as a necessary evil to attain the positive consequences. Prevention efforts may benefit from focusing on ways of attaining positive consequences by promoting alternatives to engaging in risky drinking practices, as well as reducing negative consequences (e.g., by promoting protective behavioral strategies). (PsycINFO Database Record

When alcohol is only part of the problem: An event-level analysis of negative consequences related to alcohol and other substance use.

While alcohol remains the drug of choice for most college students, national data show that 40% of college students also use other substances (e.g., marijuana, cocaine, etc.). Longitudinal studies indicate that students who report use of both alcohol and other substances experience more consequences (e.g., blackout, arrests). The current study expands upon this research by using a multilevel approach to examine average and event-level alcohol combined with other substance use (ALC+) and its role on consequences experienced. In addition, the research examined which substance combined with alcohol posed the most risk. A total of 461 students reported on alcohol use, substance use, and consequences experienced (e.g., Young Adult Alcohol Consequences Questionnaire [YAACQ]) on 12 weekend nights (Thursday, Friday, Saturday) across 4 weekends in an academic year. Multilevel model analyses revealed a positive association between both average and event-level ALC+ use and the number of consequences experienced. A significant cross-level interaction was also revealed indicating students who typically combine alcohol and other substances experienced more consequences on occasions when they use more substances relative to students who typically use alcohol only. Finally, alcohol plus nicotine, or marijuana, or attention-deficit/hyperactivity disorder (ADHD) medications, or cocaine were all significantly positively related to increased consequences. These findings provide consistent evidence that ALC+ use is a highly prevalent behavior among college students that increases risk of problematic consequences. (PsycINFO Database Record

An Examination of the Relationship Between Consequence-Specific Normative Belief Patterns and Alcohol-Related Consequences Among College Students.

BACKGROUND: Research has previously identified a high-risk subgroup of college students who experience high levels of multiple and repeated alcohol-related consequences (MRC group). The purpose of this study was to examine the association between consequence-specific normative influences and experiencing multiple and repeated drinking-related consequences using a person-centered approach. Normative subgroups were identified using latent profile analysis (LPA), which were then used to predict MRC group status at 6-month follow-up. METHODS: First-year college student drinkers (N = 2,024) at a large northeastern university completed online surveys during the fall and spring semesters of their freshman year. Retention was high with 92% of invited participants completing T2, of which the MRC group accounted for 27%. RESULTS: Three student profiles were identified from LPA on T1 data: Nonpermissive Parents (77%), Positive Peer and Parent Norms (21%), and Permissive Parents (3%). Logistic regression revealed that both the Positive Peer and Parent Norms and Permissive Parents profiles had significantly higher odds of MRC group membership at follow-up (1.81 and 2.78 times greater, respectively). CONCLUSIONS: The results suggest value in prevention efforts that include normative beliefs about alcohol-related consequences. Further, parental norms in particular have the potential to enhance interventions, especially through direct communication of disapproval for experiencing consequences.

A Dual-Process Examination of Alcohol-Related Consequences Among First-Year College Students.

OBJECTIVE: Despite showing reductions in college student drinking, interventions have shown some inconsistency in their ability to successfully decrease consequences. With the goal of improving prevention efforts, the purpose of this study was to examine the role of consequence-specific constructs, in addition to drinking, that influence students' experiences with alcohol-related problems. The study examined how drinking and protective behaviors mediated the relationships between students' willingness to experience consequences, intentions to avoid them, and four categories of alcohol-related problems (physiological, social, sexual, and academic). METHOD: First-year college student drinkers (n = 2,024) at a large northeastern university completed surveys during the fall and spring of their freshman year. RESULTS: As expected, different patterns of associations emerged for physiological and nonphysiological consequences. When physiological consequences (e.g., hangover, vomiting) were examined, drinking significantly mediated the effect of willingness on the consequences. Drinking-specific protective behaviors indirectly influenced consequences through drinking behaviors whereas general protective behaviors did not. When nonphysiological (e.g., social, sexual, academic) consequences were examined, drinking and general protective behaviors emerged as significant mediators of the effects of willingness and intentions on the consequences, whereas drinking-specific protective behaviors did not. CONCLUSIONS: The results suggest that prevention efforts (e.g., personalized feedback) could be tailored to address specific types of protective behaviors as well as specific types of consequences frequently experienced by college students.

Who Will Experience the Most Alcohol Problems in College? The Roles of Middle and High School Drinking Tendencies.

BACKGROUND: Previous work examining college drinking tendencies has identified a disproportionately small (20%), but uniquely high-risk group of students who experience nearly 50% of the reported alcohol-related consequences (i.e., the multiple repeated consequences, or MRC, group). With the goal of reducing drinking-related consequences later in college, this study sought to identify potential MRC group members in their first semester by examining: (i) early-risk subgroups based on analysis of early-risk screening constructs (e.g., age of drinking onset, middle school alcohol exposure, high school drinking, and consequences); and (ii) their association with MRC criteria early in the first semester of college. METHODS: A random sample of 2,021 first-year college student drinkers (56% female) completed a web-based drinking survey in their first semester on campus. RESULTS: Latent class analysis revealed 4 early-risk subgroups: (i) an early-onset risk group who endorsed early age of drinking onset and engaged in heavy middle and high school drinking (10%); (ii) a late-onset risk group who engaged in weekend drinking and drunkenness and experienced 6 or more unique consequences as seniors in high school (32%); (iii) an early-onset limited risk group who only endorsed early age of onset and middle school drinking (3%); and (iv) a minimal risk group who did not engage in any early-risk behaviors (55%). Members of both the early- and late-onset risk groups had significantly higher odds of MRC membership in their first semester of college (9.85 and 6.79 greater, respectively). CONCLUSIONS: Results suggest age of onset, middle and high school drinking and drunkenness, and frequency of unique consequences could be particularly useful in brief screening tools. Further, findings support early screening and prevention efforts for MRC membership prior to college matriculation.

Do students use contextual protective behaviors to reduce alcohol-related sexual risk? Examination of a dual-process decision-making model.

Recent studies suggest drinking protective behaviors (DPBs) and contextual protective behaviors (CPBs) can uniquely reduce alcohol-related sexual risk in college students. Few studies have examined CPBs independently, and even fewer have utilized theory to examine modifiable psychosocial predictors of students' decisions to use CPBs. The current study used a prospective design to examine (a) rational and reactive pathways and psychosocial constructs predictive of CPB use and (b) how gender might moderate these influences in a sample of college students. Students (n = 508) completed Web-based baseline (mid-Spring semester) and 1- and 6-month follow-up assessments of CPB use; psychosocial constructs (expectancies, normative beliefs, attitudes, and self-concept); and rational and reactive pathways (intentions and willingness). Regression was used to examine rational and reactive influences as proximal predictors of CPB use at the 6-month follow-up. Subsequent path analyses examined the effects of psychosocial constructs, as distal predictors of CPB use, mediated through the rational and reactive pathways. Both rational (intentions to use CPB) and reactive (willingness to use CPB) influences were significantly associated with increased CPB use. The examined distal predictors were found to effect CPB use differentially through the rational and reactive pathways. Gender did not significantly moderate any relationships within in the model. Findings suggest potential entry points for increasing CPB use that include both rational and reactive pathways. Overall, this study demonstrates the mechanisms underlying how to increase the use of CPBs in programs designed to reduce alcohol-related sexual consequences and victimization.

Longitudinal patterns of alcohol mixed with energy drink use among college students and their associations with risky drinking and problems.

OBJECTIVE: The consumption of alcohol mixed with energy drinks (AmEDs) is a form of risky drinking among college students, a population already in danger of heavy drinking and associated consequences. The goals of the current longitudinal study were to (a) identify types of AmED users between the first and second year of college and (b) examine differences among these groups in rates of highrisk drinking and consequences over time. METHOD: A random sample of college student drinkers (n = 1,710; 57.7% female) completed baseline and 6-month follow-up measures assessing alcohol-related behaviors. RESULTS: AmED use was endorsed by 40% of participants during the course of the study. As anticipated, four distinct groups of AmED users were identified (nonusers, initiators, discontinuers, and continuous users) and were significantly different from one another on drinking and consequence outcomes. Further, significant Time × Group interaction effects were observed for drinking and overall consequences. Generally, across all outcomes and time points, nonusers reported the lowest rates of drinking and consequences, whereas continuous users consistently reported the highest rates of drinking and consequences. Students who initiated AmED use during the course of the study also reported anabrupt increase in alcohol use and reported consequences. CONCLUSIONS: Findings suggest students who consistently engage in and initiate AmED use also engage in riskier drinking behaviors and experience higher rates of consequences. Interventions that specifically target AmED use may be warranted and have the potential to reduce alcohol-related consequences.

The comparison question polygraph test: a contrast of methods and scoring.

We conducted a mock crime experiment with 250 paid participants (126 females, Mdn age = 30 years) contrasting the validity of the probable-lie and the directed-lie variants of the comparison question test (CQT) for the detection of deception. Subjects were assigned at random to one of eight conditions in a Guilt (Guilty/Innocent) × Test Type (Probable-Lie/Directed-Lie) × Stimulation (Between Repetition Stimulation/No Stimulation) factorial design. The data were scored by an experienced polygraph examiner who was unaware of subject assignment to conditions and with a computer algorithm known as the Objective Scoring System Version 2 (OSS2). There were substantial main effects of guilt in both the OSS2 computer scores F(1, 241) = 143.82, p < .001, η(p)(2) = 0.371, and in the human scoring, F(1, 242) = 98.92, p<.001, η(p)(2) = .29. There were no differences between the test types in the number of spontaneous countermeasure attempts made against them. Although under the controlled conditions of an experiment the probable-lie and the directed-lie variants of the CQT produced equivocal results in terms of detection accuracy, the directed-lie variant has much to recommend it as it is inherently more standardized in its administration and construction.