An appraisal-disruption model of alcohol's effects on stress responses in social drinkers.

This article reviews the effects of alcohol on stress responses among social drinkers. Despite considerable research, the relationship between alcohol and stress has remained unclear. An appraisal-disruption model of alcohol's effects on stress responses is proposed, which attempts to integrate many divergent findings. According to this model, alcohol disrupts initial appraisal of stressful information by constraining the spread of activation of associated information previously established in long-term memory. The conditions under which such disruption is likely to occur are outlined. Evidence relevant to each of the model's propositions is considered. It is concluded that the appraisal-disruption model provides a framework for integrating many of the findings from past investigations. Theoretical issues pertinent to the model are addressed.

A multi-dimensional analysis of cue-elicited craving in heavy smokers and tobacco chippers.

AIMS: This research examined the performance of a broad range of measures posited to relate to smoking craving. DESIGN: Heavy smokers and tobacco chippers, who were either deprived of smoking or not for 7 hours, were exposed to both smoking (a lit cigarette) and control cues. PARTICIPANTS: Smokers not currently interested in trying to quit smoking (n = 127) were recruited. Heavy smokers (n = 67) averaged smoking at least 21 cigarettes/day and tobacco chippers (n = 60) averaged 1-5 cigarettes on at least 2 days/week. MEASUREMENTS: Measures included urge rating scales and magnitude estimations, a rating of affective valence, a behavioral choice task that assessed perceived reinforcement value of smoking, several smoking-related judgement tasks and a measure of cognitive resource allocation. FINDINGS: Results indicated that both deprivation state and smoker type tended to affect responses across these measurement domains. CONCLUSIONS: Findings support the use of several novel measures of craving-related processes in smokers.

The measurement of drug craving.

This paper reviews theoretical and methodological issues in the measurement of drug craving, with an emphasis on self-report assessment. Despite the important role that craving plays in many research and clinical settings, the way in which the construct is conceptualized and measured rarely receives sufficient attention. Issues pertinent to conceptualizing craving are identified. Because there is no single perfect measure of craving, it is essential that researchers understand the limitations of each measure. Measurement performance concerns that affect the validity of different measures are reviewed. Non-verbal assessment methods are also reviewed. Research factors that may help determine the optimal measures for a given study are highlighted. It is concluded that advances in assessment will proceed only when combined with additional research and a better theoretical understanding of craving.

Effects of cue exposure and deprivation on cognitive resources in smokers.

This research examines the effects of manipulations designed to induce an urge to smoke on cognitive resources. Two cue-exposure experiments were conducted in which current smokers' reported urge to smoke and cognitive resources, as measured by a secondary reaction time (RT) probe, were assessed. In each study, subjects came to the laboratory twice, once while deprived of smoking for 12 hr and once when they were nondeprived. During each session, subjects were exposed to both smoking and control cues. Results indicated that experimental manipulations designed to elicit a strong urge to smoke led to an increase in self-reported urge to smoke and a decrease of available cognitive resources, as measured by RT. In addition, these 2 measures were significantly correlated. These data, in conjunction with previous findings using alcohol-dependent subjects (M. A. Sayette et al., 1994), lend support to the validity of RT as an objective measure of the effects of cue exposure on cognitive resources.

Intoxication and exposure to stress: effects of temporal patterning.

In this study we explored the temporal patterning of intoxication and exposure to a stress-producing situation on alcohol's effects on stress. Forty male social drinkers received either a 0.7 g/kg dose of alcohol or a placebo. When exposure to a social stressor preceded intoxication, a significant alcohol-induced increase in heart-rate reactivity was found. When intoxication preceded exposure to the stressor, conventional analysis of the data indicated a stress-dampening effect on alcohol on heart rate. No differences were obtained from self-reports of anxiety in either pattern. The findings are explained in terms of attentional and cognitive-encoding processes.

Survey of current clinical and research trends in clinical psychology.

A survey of the directors of APA accredited clinical psychology programs was conducted to explore current trends in the training of clinical psychologists. Specifically, information was obtained regarding the research areas represented at each school, the types of clinical training sites available to graduate students, and the prevalence of different clinical orientations (e.g., cognitive-behavioral, systems, or psychoanalytic). Results of the survey provide a summary of the activities of faculty and students at the more than 100 fully accredited clinical psychology programs.

Admission requirements, acceptance rates, and financial assistance in clinical psychology programs. Diversity across the practice-research continuum.

129 directors (80% response) of APA-accredited clinical psychology programs provided information pertaining to admission requirements, acceptance rates, financial assistance, and theoretical orientations. Summary data are presented and comparisons are made among 4 types of clinical programs: PsyD programs, practice-oriented PhD programs, equal-emphasis PhD programs, and research-oriented PhD programs. Clinical doctoral programs held similar expectations for undergraduate preparation in psychology, but robust differences emerged on preferred Graduate Record Examination scores, acceptance rates, and financial assistance. In the most extreme comparison (PsyD vs. research-oriented PhD programs), students were 4 times more likely to gain acceptance but 6 times less likely to receive full financial assistance in PsyD programs. Implications of these results for potential graduate students and for the future of applied psychology programs are briefly discussed.

Alcohol and correspondence between self-report and physiological measures of anxiety.

The present study was designed to determine the main effects of alcohol intoxication on self-report and physiological measures of anxiety. Second, we aimed to assess the role of the Marlowe-Crowne Social Desirability (MCSD) scale in predicting the relationship between self-report and physiological indices of anxiety irrespective of drink content. A final purpose of the study was to determine whether the MCSD could account for discrepancies in the effects of alcohol on the two anxiety response systems. Subjects were male social drinkers who received an 0.70 g/kg dose of alcohol or placebo. Results indicated that irrespective of drink content, subjects with high MCSD scores reported lower levels of anxiety than did subjects with low MCSD scores. This relationship was not evident for heart rate. These results for measures of anxiety were not influenced by drink content.

Cognitive moderators of alcohol's effects on anxiety.

The present study was designed to test the prediction from the attention-allocation model that intoxication in the absence of a pleasant distractor will fail to produce anxiolytic effects. A second prediction, that the sequence of intoxication and exposure to the anxiety-producing situation would influence alcohol's effects, was also tested. Subjects were male social drinkers who received an 0.85 g/kg dose of alcohol or a placebo. Conventional statistical analysis of the results indicated an anxiolytic effect of alcohol on heart rate but a problem with this analysis is identified. An alternative interpretation provides no support for an anxiolytic effect. Exposure to the anxiety-producing stimulus prior to intoxication led to greater heart rate reactivity than if it followed intoxication.

Effects of smoking opportunity on attentional bias in smokers.

The emotional Stroop task was used to examine the influence of opportunity to smoke on attentional bias to smoking-related stimuli. At the outset of the study, 92 nicotine-deprived smokers were told that they (a) would, (b) would not, or (c) might be able to smoke during the experiment. Next, participants completed an emotional Stroop task, in which they were presented with smoking-related or -unrelated words in an unblocked format. Smokers demonstrated interference to the smoking words, relative to matched neutral words, F(1, 87) = 18.0, p < .0001. Moreover, smoking opportunity affected the degree of interference, F(2, 87) = 4.35, p < .02, with participants who had been told they would be able to smoke during the study showing the most interference. The results suggest that smoking opportunity affects the salience of smoking-related stimuli among nicotine-deprived smokers.

Experimental design in alcohol administration research: limitations and alternatives in the manipulation of dosage-set.

This article reviews literature on the utility of different experimental designs in human alcohol administration research, with particular attention to the balanced-placebo design (BPD). Many believe the BPD can orthogonally manipulate alcohol's pharmacological effects and the effects of dosage-set (believing that one has consumed a certain amount of alcohol). However, research has accumulated that suggests these effects cannot be disentangled at moderate to high doses of alcohol. The strengths and weaknesses of a number of experimental designs are discussed with regard to the variables that designs can assess or control. Methodological issues in deception conditions and manipulation checks are reviewed. Topics in need of empirical investigation are highlighted. It is concluded that the appropriate alcohol administration design depends on the particular theoretical and methodological issues of a research program.

Alcohol and aggression: a social information processing analysis.

The present study represents a preliminary exploration of the effects of alcohol on aggression (a hypothetical response to a videotaped provocation), using a social information processing model. Subjects were male social drinkers who received either a control beverage (ginger ale), placebo, .45 g/kg alcohol or .85 g/kg alcohol. Subjects observed a series of videotaped scenes of potential conflict occurring in the lounge of a college dormitory. In these scenes, an intruder switched the channel on a television set without asking the person watching for permission. The four groups were similar in their ability to encode and interpret social cues. Subjects in the 0.85 g/kg group were less able to generate competent (nonaggressive) solutions and were less likely than controls to select adaptive (nonaggressive) solutions. Subjects in the .85 g/kg group were more likely than control subjects to respond aggressively after being frustrated by the intruder's negative reaction to the initial attempt to resolve the conflict.

The effect of alcohol on emotional response to a social stressor.

Social drinkers were administered either an alcoholic, placebo or no-alcohol control beverage. Subjects were next informed that they were to give a self-disclosing speech about their body and physical appearance. Subjects' heart rate and videotapes of their facial expression were recorded during this instruction. Facial reactions to the stressor were analyzed using a system based on the Maximally Discriminative Facial Coding System (Izard, 1979). Subjects who were intoxicated showed significantly less negative emotion, as measured by the facial expression analysis, than those subjects consuming either the control or placebo beverage. We attribute this effect of alcohol to its actions on subjects' appraisal of anxiety-inducing information.

A test of the appraisal-disruption model of alcohol and stress.

OBJECTIVE: Faced with a large body of contradictory findings, investigators have begun to propose cognitive factors that moderate the effects of alcohol on stress. We tested the hypothesis, stemming from the appraisal-disruption model (ADM), that alcohol would be more likely to reduce stress when consumed prior to exposure to a stressor than when consumed following exposure. METHOD: Male and female social drinkers (N = 169, 85 men) with or without a parental history of alcoholism were recruited using separate structured clinical interviews with the participant and with a biological parent. Participants drank a moderate dose of alcohol or a placebo in one of two temporal sequences. Stress was induced by asking participants to present a self-disclosing speech about their physical appearance. Stress responses were assessed using four types of measures: self-reported anxiety, pulse rate, facial expression associated with negative affect and threat-related interference on a color-naming task. RESULTS: Alcohol was generally more likely to attenuate stress responses when initial exposure to a social stressor followed drinking than when it preceded drinking. CONCLUSIONS: Findings were consistent with predictions stemming from the ADM. Alcohol appears to be more likely to reduce stress when initial stress appraisal occurs during intoxication. In contrast, when initial appraisal occurs prior to drinking, alcohol is less effective in attenuating stress.

Parental history of alcohol abuse and the effects of alcohol and expectations of intoxication on social stress.

Male and female social drinkers, half of whom had a biological father who abused alcohol, were exposed to a social stressor (anticipation and delivery of a public speech) after consuming either a moderate dose of alcohol or tonic water. Half of each group were led to believe that they had consumed alcohol, the other half tonic water, yielding a 2 x 2 x 2 x 2 factorial design. Intoxication, but not beliefs about having consumed alcohol, significantly reduced subjective anxiety and negative self-evaluation in response to the stressor in both men and women. Parental history of alcohol abuse differentially affected alcohol's influence on mood, but not measures of subjective intoxication, subjective physiological responses to alcohol, beliefs about alcohol's effects on behavior, or reactivity to the stressor.

The effects of cue exposure on reaction time in male alcoholics.

The present study investigates reaction time (RT) as a measure of attentional deficits produced during alcohol cue exposure. Twenty-four male alcoholic patients responded to a series of computer-generated tones as rapidly as possible during baseline and again during either an alcohol cue exposure period or exposure to a control beverage (water). Patients required increased time to respond to the tones when exposed to alcohol cues. No such increase in RT was found during exposure to a control beverage. In addition, RT was significantly correlated with self-reported urge to drink. These data provide initial validation for the use of RT as an objective measure of cue reactivity. Both theoretical and clinical implications for the use of RT as a measure of the effects of cue exposure are discussed.

A review of the effects of perceived drug use opportunity of self-reported urge.

Although persons addicted to drugs reliably report experiencing cravings or urges during drug cue exposure, less is known about factors that may moderate this effect. This article reviews cue exposure studies with people who smoke, are dependent on alcohol, or are addicted to cocaine or opiates. Perceived drug use opportunity is found to affect urge ratings. Specifically, people who are addicted to substances and who perceive an opportunity to consume their drug of choice report higher urges than do those who do not anticipate being able to use the drug. This factor was proposed to explain why those in treatment for substance dependence report urges that are about half the strength of those in nontreatment settings. The impact of perceived drug use opportunity on urge is considered from a variety of perspectives, including conditioning theories, a cognitive appraisal framework, and motivated reasoning theory. Conceptual and methodological implications of perceived drug use opportunity are addressed.

Effects of olfactory stimuli on urge reduction in smokers.

This study examined the possibility that exposure to olfactory stimuli can reduce self-reported urge to smoke. After an initial assessment of self-reported urge, nicotine-deprived smokers evaluated the pleasantness of a series of 8 odors. Facial expressions during odor presentations were coded with P. Ekman and W. V. Friesen's (1978a) Facial Action Coding System. After odor administration, participants were exposed to smoking cues. Next, participants were administered their most pleasant, least pleasant, or a control odor (water) and reported their urge to smoke. Results indicated that sniffing either a pleasant or unpleasant odor reduced reported urge to smoke relative to the control odor. Reported pleasantness of the odors did not differentially affect urge reduction. Odors eliciting negative-affect-related expressions, however, were less effective than odors that did not elicit negative-affect-related expressions in reducing reported urge. Results of this preliminary investigation provide support for the consideration of odor stimuli as an approach to craving reduction.

Parental alcoholism and the effects of alcohol on mediated semantic priming.

In this study, researchers tested the effects of a moderate dose of alcohol on the spread of activation of associated information in memory using a mediated semantic priming task in which target words are preceded by primes that are either unrelated or indirectly related to the target. Male and female participants with or without a parental history (PH+ and PH-, respectively) of alcoholism were administered the priming task after consuming alcohol or a placebo beverage. Among PH- individuals, alcohol constrained the spread of activation of associated information, as manifested by a reduced priming effect. In contrast, alcohol enhanced priming effects among PH+ participants, though this latter effect appears to be due to a particularly slow response among these individuals to unprimed words. Results are discussed with regard to theories of alcohol's effects on cognitive processes.

An evaluation of the balanced placebo design in alcohol administration research.

Results from a study using the balanced placebo design to assess alcohol's effects on anxiety raise serious doubts about the utility of the design even at moderate blood alcohol concentrations. Despite being informed that they were not drinking alcohol, 44% of the subjects who were administered alcohol reported consuming at least some alcohol. Moreover, subjects' scores on the Marlowe-Crowne Social Desirability Index (MCSD) were associated with deception success, suggesting that individual differences in reporting bias influence the manipulation. In contrast, only 6% of subjects who were told that they had consumed alcohol but were given tonic water were not deceived. Among subjects in this placebo condition, scores on the MCSD were not associated with success of the deception. These data suggest that at a moderate dose of alcohol, drink deception in the antiplacebo condition is much more difficult to execute than in the placebo condition, and that deception in the former condition may be confounded with experimenter demand.