Evaluación del Modelo de Predisposición Adquirida para consumo de alcohol en adolescentes / Evaluation of the Acquired Preparedness Model for Alcohol Use in Adolescents / Avaliação do Modelo de Predisposição Adquirida para o consumo de álcool em adolescentes

Durante la adolescencia se observan altas tasas de consumo elevado de alcohol. El Modelo de Predisposición Adquirida (mpa) postula que la confluencia de factores de personalidad (como la impulsividad) y factores psicosociales (como las expectativas hacia el alcohol [ea]) predice el consumo de sustancias. Algunos resultados previos respaldan el mpa para explicar el uso de alcohol en adolescentes argentinos; sin embargo, no queda claro el modo en que distintas dimensiones de impulsividad se asocian con el uso de alcohol en esta etapa del desarrollo. El objetivo de este trabajo fue examinar, en una muestra de adolescentes argentinos, el rol mediador de las ea en la relación entre cinco dimensiones de impulsividad rasgo, medidas con la escala upps-p y la frecuencia de Consumo Episódico Elevado de Alcohol (ceea). Materiales y métodos: participaron 427 adolescentes de 13 a 18 años (58 % mujeres; M edad = 15.72, de = 1.48), escolarizados en el nivel medio (91.1 % en gestión privada). Resultados: apoyando el mpa, la tendencia a actuar precipitadamente bajo estados emocionales intensos (tanto positivos como negativos) se asoció a una mayor frecuencia de ceea vía una mayor anticipación de efectos positivos del consumo de alcohol. Urgencia positiva tuvo, además, un efecto directo sobre la frecuencia de ceea. Conclusiones: esta información puede ser de utilidad para el desarrollo de intervenciones destinadas a disminuir el desarrollo o mantenimiento de las positivas y, de esta manera, reducir el consumo de alcohol en los adolescentes.

High rates of heavy alcohol use are observed among adolescents. The Acquired Preparedness Model (apm) posits that the confluence of personality factors (e.g., impulsivity) and psychosocial factors (e.g., alcohol expectancies [aes]) predicts substance use. Research supports the use of the apmto explain alcohol use in Argentinean adolescents; however, how different dimensions of impulsivity are associ-ated with alcohol use at this developmental stage is unclear. This study was designed to examine the mediational role of aes in the relationship between multiple dimensions of trait-like impulsivity using the upps-p scale and the frequency of heavy episodic drinking (hed) in Argentinean adolescents. Materials and Methods: In this study, 427 adolescents (58% were women) with a mean age of 15.72 ± 1.48 years (range, 13­18 years) were enrolled. Results: In line with the associations proposed by the apm, this study showed that the tendency to act rashly under intense negative and positive emotions was positively associated with the frequency of hed, via the anticipation of more positive effects of alcohol use. Positive urgency also had a direct effect on the frequency of hed. This information may be useful in developing interventions to reduce positive aes to decrease adolescent alcohol use.

na adolescência observam-se altas taxas de consumo de álcool. O Modelo de Predisposição Adquirida (mpa) postula que a confluência de fatores de personalidade (como a impulsividade) e fatores psicossociais (como expectativas em relação ao álcool [ea]) prediz o uso de substâncias. Alguns resul-tados anteriores corroboram o mpa para explicar o consumo de álcool em adolescentes argentinos; no entanto, não está claro como as diferentes dimensões da impulsividade estão associadas ao consumo de álcool nesta fase do desenvolvimento. O objetivo deste trabalho foi examinar, em uma amostra de adolescentes argentinos, o papel mediador da ea na relação entre cinco dimensões do traço de impul-sividade, medidas com a escala upps-p e a frequência de Consumo Episódico Elevado de Álcool (ceea). Materiais e métodos: participaram 427 adolescentes de 13 a 18 anos (58% mulheres; M idade = 15,72; dp = 1,48), matriculados no ensino médio (91,1% em escola particular). Resultados: apoiando o mpa, mostra-se que a tendência a agir precipitadamente sob estados emocionais intensos ­tanto positivos quanto negativos­ foi associada a uma maior frequência de ceea por meio de uma maior antecipação dos efeitos positivos do consumo de álcool. A urgência positiva também teve efeito direto na frequência de ceea. Conclusões: esta informação pode ser útil para o desenvolvimento de intervenções que visem reduzir o desenvolvimento ou manutenção de ea positivas e, desta forma, reduzir o consumo de álcool em adolescentes.

Modelo de predisposición adquirida para el uso de alcohol en adolescentes argentinos / The acquired preparedness model for alcohol use in Argentinian adolescents

Se analizó, en una muestra de adolescentes argentinos, el modelo de predisposición adquirida. El modelo propone que el rasgo desinhibición influye de manera indirecta, a través de variables cognitivas, sobre el consumo de alcohol. La exposición a modelos de consumo del grupo de pares influye directa e indirectamente (mediante las expectativas hacia el alcohol) sobre el uso de alcohol. Participaron 343 adolescentes asistentes a colegios públicos de educación media de la ciudad de Córdoba (Argentina). Se midió impulsividad, expectativas hacia el alcohol, motivos de consumo de alcohol, normas sociales de consumo y consumo de alcohol de los adolescentes. Para determinar el efecto de las variables señaladas como antecedentes del consumo se aplicó un análisis de senderos. Se propusieron dos modelos teóricos que diferían en la inclusión, o no, de las normas sociales del consumo de alcohol. Los resultados apoyan el modelo de predisposición adquirida e indican que el efecto de impulsividad sobre el consumo de alcohol es indirecto mediado por las expectativas hacia el alcohol. Aunque ambos modelos presentan adecuado ajuste a los datos, el modelo que incorpora el efecto de las normas sociales de consumo presenta un ajuste excelente. Los resultados de este trabajo, el primero de nuestro medio en evaluar el modelo de predisposición adquirida sobre el consumo de alcohol, destacan la utilidad de diagramar esfuerzos preventivos focalizados en el control de los impulsos, en las expectativas positivas hacia el alcohol y en la reducción de la percepción del consumo de los pares.

The acquired preparedness model was examined in a sample of Argentinian adolescents. This model suggests that disinhibition has an indirect effect, through cognitive variables, on alcohol consumption. Asample of 343 adolescents from the city of Cordoba (Argentina) from public secondary education schools took part in the study. Standardised measurements were used to assess impulsivity, alcohol expectancies, social norms of alcohol drinking, and drinking patterns. A path analysis was conducted to determine the effect of these variables on quantity of alcohol consumption. Two theoretical models, that differed in the inclusion - or not - of social norms of alcohol drinking, were evaluated. The results, according to the acquired preparedness model, indicate that impulsivity influences alcohol consumption through alcohol expectancies. The model that incorporates the effect of social norms of alcohol drinking showed an excellent fit to the data. This study - the first in Argentina that evaluates this model - emphasises the usefulness of addressing impulse control and alcohol expectancies when developing interventions aimed at reducing alcohol consumption.

Análisis factorial confirmatorio del Cuestionario de Expectativas hacia el Alcohol para adolescentes (CEA-A) / Confirmatory factor analysis of the Expectations Questionaire on Alcohol Intake for Adolescents (CEA-A) / Análise fatorial confirmatória do Questionário de Expectativas Relacionadas com o Álcool para Adolescentes (CEA-A)

Para complementar el proceso de validación del Cuestionario de Expectativas hacia el Alcohol para Adolescentes (CEA-A) iniciado en una etapa previa, se llevó adelante un análisis factorial confirmatorio (AFC). En el estudio participaron 343 adolescentes con edades entre 13 y 18 años, asistentes a escuelas de nivel medio del sector público. Se empleó el Cuestionario de Expectativas hacia el Alcohol para Adolescentes (CEA-A) para la medición de los efectos que los adolescentes anticipan del consumo de alcohol. Se evaluó el ajuste de los datos al modelo que propone a las expectativas divididas en tres escalas correspondientes a los efectos positivos y otras tres referidas a los efectos negativos del alcohol mediante los siguientes índices de ajuste: CIMIN/df, GFI, CFI, RMSEA. Los resultados permitieron confirmar la estructura previamente hallada, dando cuenta que el CEA-A es un instrumento válido y fiable para la medición de las expectativas hacia el alcohol en adolescentes argentinos.

In order to complete the validation process of the Cuestionario de Expectativas sobre el Alcohol para Adolescentes [Expectations Questionnaire on Alcohol Intake for Adolescents -CEA-A for its Spanish acronym] initiated at an earlier stage, a confirmatory factor analysis (CFA) was conducted. A sample of 343 adolescents aged 13 to 18 from public high schools participated in the present study. The Expectations Questionnaire on Alcohol Intake for Adolescents was used to assess the effects that adolescents anticipate from drinking alcohol. Data were assessed by means of a fit model whereby expectations are divided into three scales corresponding to the positive effects of alcohol intake and another three referring to the negative ones. The indices used were the following: CIMIN/df, GFI, CFI, RMSEA.Results confirmed the previously found structure of three scales for positive expectations on alcohol intake and three scales for negative expectations. According to that, the CEA-A is a valid and reliable measure to assess alcohol expectations of Argentinean adolescents.

Para completar o processo de validação do Questionário de Expectativas relacionadas com o Álcool para Adolescentes (CEA-A), iniciado em uma etapa prévia, foi realizada uma análise fatorial confirmatória (AFC). No estudo participaram 343 adolescentes com idades entre 13 e 18 anos, estudantes de escolas do nível médio do setor público. Empregou-se o Questionário de Expectativas relacionadas com o Álcool para Adolescentes (CEA-A) para a medição dos efeitos que os adolescentes antecipam com respeito ao consumo de álcool. Avaliou-se o ajuste dos dados ao modelo que propõe as expectativas divididas em três escalas correspondentes aos efeitos positivos e outras três correspondentes aos efeitos negativos do álcool mediante os seguintes índices de ajuste: CIMIN/df, GFI, CFI, RMSEA. Os resultados permitiram confirmar a estrutura previamente encontrada, mostrando que o CEA-A é um instrumento válido e confiável para a medição das expectativas relacionados com o álcool em adolescentes argentinos.

Expectancies toward the intake of alcohol in young adults of Bucaramanga, Colombia, 2005 / Expectativas hacia el consumo de alcohol en adultos jóvenes de Bucaramanga, Colombia, 2005

Objective: To settle down in young adults of Bucaramanga if the statistical and conceptual performance of the test AEQ-III is similar to the one reached in young adults from Mexico, and to describe the relationship of these expectancies with some variables of the context. Methods: Study of factorial validation and internal consistency. In Bucaramanga, Colombia, 156 young adults, answered 51 items of the alcohol expectancy questionnaire. A model of structural equation was developed to evaluate the goodness of fit of the factorial solution through the reason of verisimilitude Chi-square (X2) and the half quadratic approach error (RMSEA). The global internal consistency and intra expectancies were carried out with the alpha of Cronbach. The scores for the expectancies were calculated with base in additives scales. Results: The value reached for the X2 was 6921, with 1196 grades of freedom, p=0.000. The RMSEA was 0.18. The global internal consistency and for the factors, it was bigger in this sample with regard to the Mexican. Equally, all the scores means was bigger in each factor and the smallest variability (p<0.001). Conclusion: In young adults of Bucaramanga, the internal consistency in the eight expectancies is good. However, the statistical coherence is poor. It is necessary to adapt the questionnaire to Bucaramanga culture and in other age groups, before applying their results.

Objetivos: Establecer en adultos jóvenes de Bucaramanga si el desempeño estadístico y conceptual de la prueba "Expectativas positivas hacia el consumo de alcohol -AEQ-III" es similar al alcanzado en adultos jóvenes de México, y describir la relación de estas expectativas con algunas variables del contexto. Métodos: Estudio de validación factorial y consistencia interna. En Bucaramanga 156 adultos jóvenes contestaron 51 ítems del formulario AEQ-III. Se desarrolló una ecuación estructural para evaluar la bondad de ajuste a través de la razón de verosimilitud Chi-cuadrado (X2) y el error de aproximación cuadrático medio (RMSEA). La consistencia interna global e intra expectativas se realizó con el alfa de Cronbach. Los puntajes para las expectativas se calcularon con base en escalas aditivas. Resultados: El valor alcanzado para X2 fue 6921, con 1196 grados de libertad, p=0,000. El RMSEA fue 0.18. La consistencia interna global y para los factores fue mayor en esta muestra con respecto a la mexicana. Igualmente, todos los puntajes medios alcanzados en las ocho expectativas fueron mayores y la variabilidad menor (p<0.000). Conclusión: En adultos jóvenes de Bucaramanga, la consistencia interna en las ocho expectativas es adecuada. Sin embargo, la coherencia estadística del modelo es pobre. En este grupo de edad es necesario adaptar el formato AEQ-III antes de utilizarlo en estudios epidemiológicos.

Expectativas relacionadas con el alcohol en la predicción del abuso en el consumo en jóvenes

resumen está disponible en el texto completo

Abstract: In México, addictions among the middle- and high-school student population have been widely studied, which has shed light on certain risks associated with alcohol abuse, including a higher probability of expriencing with other drugs -particularly in the case of males-, engaging in risky sexual practices and attempting suicide, a situation that is twice as common among those who drink and drive. Nevertheless, research on alcohol abuse among the university population has been less explored, particularly as regards the identification of the variables that predict excessive alcohol consumption. A review of the international literature on factors associated with alcohol abuse in this type of population indicates that it is among university students that high or explosive consumption tends to be largest, even among young people who do not attend school, and that the period of higher consumption is between 17 and 21 years of age. Other factors that have been identified include exposure to negative life events, inappropriate coping styles, personality variables, resorting to alcohol to reduce tension, and environmental and socio-cognitive variables, foremost among which are expectations of the positive effects of alcohol. These expectations not only predict alcohol consumption but also differentiate between problem and non-problem drinking. For example, while social drinkers tend to harbor more social expectations when drinking alcohol, excessive drinkers expect alcohol to increase their aggressive and social behavior, while reducing stress or tension. This paper seeks to evaluate the impact of expectations regarding alcohol, in predicting alcohol abuse among students at public and private universities in Mexico City. Indicators of alcohol abuse include consumption of five or more drinks on each occasion, drunkenness during the past month and year as well as associated problems. The study also seeks to determine the way in which sub-scales of expectations interact with each other. An ex post facto transversal study was carried out on a sample of 678 university male and female students aged 17 to 25, with an average age of 20 (s.d. = 1.80). Participants were asked to complete a self-report which included the following areas: a) Sociodemographic data, b) Questionnaire on Expectations regarding Alcohol (AEQ), in a version adapted to this population and c) Alcohol consumption habits over the past month and year. As regards drinking habits, a comparative analysis was carried out by sex and age. Consumption of 5 or more drinks per occasions tends to be more common among men, while the consumption of 5 drinks or less is more frequent in women. At the same time, a higher proportion of heavy drinkers was concentrated in the 20 to 22 age range. Consumers of over 5 glasses of alcohol began drinking at an average age of 14 (s.d. = 2.55) whereas consumers of fewer than 5 drinks began drinking at the age of 15 (t= 4.79 , p < .001). In both cases, the means obtained from the indicators of abuse were highest among consumers of five or more drinks. Males take more drinks than women when they get drunk, consuming an average of 9 glasses (s.d. = 4.7) whereas women get drunk after an average of 5 glasses (s.d. = 3.2) (t= -10.80, p < .001). Out of a total of 26% of young people who mentioned having problems associated with their drinking, most were men (17.9%) as opposed to women (8.2%). The multiple regression analysis carried out to determine the impact of the sub-scales of AEQ expectations on alcohol abuse found that expectations regarding alcohol as a "facilitator of group interaction" and the sub-scale of "reduction of psychological tension" were the main predictors of abuse. This model explained 20% of the variance (F=19.35, p < .001). A logistic regression analysis found that the sub-scale of expectations regarding "increase of power and aggression" as well as alcohol abuse predicted problems associated with drinking. A model was subsequently designed to integrate the expectations that predicted alcohol abu se and associated problems. A structural equations model was used which found that expectations regarding "reduction of psychological tension" and alcohol as a jacilitator of group interaction predicted 30% and 24% of abuse, respectively (X2sb = 33.52, p >0.00, CFI = 0.99 and RMSEA = 0.01). The rest of the sub-scales concerning expectations were regarded as mediating varia bles to see how they interacted with each other. As one can see, although the sub-scales of expectations are inter-related, group expectations were specifically associated with the sub-scales of "increase in sexuality," "physical tension" and "increase in power and aggression." At the same time, expectations regarding "reduction of psychological tension" are closely linked to the social sphere, specifically the expectations regarding "verbal expressiveness" and "lack of inhibition." Along these same lines, alcohol abuse and the expectations regarding alcohol as an agent that increases feelings of power and aggression predicted 26% and 28% of alcohol-related problems. One of the contributions of this research is that it considered the inter-relationship of sub-scales of expectations to explain alcohol abuse. Psychological tension, for example, appears to be linked to social aspects, specifically to verbal expressiveness and lack of inhibition, while group expectations refer to sexuality, the reduction of psychological tension and the increase of aggressiveness and feelings of power. Likewise, it is interesting to note that in addition to alcohol abuse, expectations regarding an increase in power and feelings of aggression are the best predictors of problems associated with alcohol use. The results have implications at the intervention level for developing programs specifically aimed at this population. The fact that expectations regarding alcohol as a "facilitator of social interaction" is one of the main predictors of abuse indicates the importance of considering environmental factors in the development of prevention programs. This involves including not only young people but also parents, schools, and other adults in order to question the cultural norms that promote beliefs regarding alcohol consumption, as a way of enjoying social interaction with positive, pleasurable states, and as a socially appropriate response for coping with negative events that arise in everyday life, such as drinking to relieve tension, handle crises and as an escape from chronic stress, by providing information on the negative consequences of use and promoting healthier lifestyles. At the intervention level, it is essential to target university students through programs specially designed for young people who engage in high-risk drinking. As regards expectations, actions must be carried out to resignify the positive beliefs surrounding alcohol, by providing information on the high health costs of heavy drinking and offering alternative resources oriented towards other means of responding to stress that do not involve excessive alcohol consumption.