Rationale: Individuals with addictive disorders commonly exhibit a shortened temporal window, which interferes with treatment focusing on long-term sobriety. Episodic Future Thinking (EFT) involves generating personalized cues related to anticipated, positive events at various future time points. EFT has been shown to reduce the reinforcing value of addictive substances; however, this has only been shown in non-treatment samples. Purpose: To examine the feasibility, cumulative, and sustained effects of implementing EFT in a treatment seeking addiction sample over a 1-week protocol on decision-making and alcohol motivation. Methods: Twenty-eight treatment seeking individuals were randomly assigned to either undergo an EFT intervention or a control Episodic Recent Thinking (ERT) protocol. Assessments were completed at baseline, end of week 1, and a 1-week follow-up. Measures included a delay discounting task, hypothetical alcohol purchase task, clinical outcome measures, and cognitive mechanism measures. Results: There were significant reductions in alcohol demand indices, delay discounting rates, and an increase in mindful attention awareness after both acute and extended exposure to EFT. Furthermore, the EFT group showed greater reductions compared to the ERT group after extended exposure to their cues. Conclusion: The results suggest that early implementation of EFT in a treatment seeking addiction sample is beneficial to counteract motivating factors for relapse. This study lays the foundation for future clinical trials for EFT as a supplemental therapy for addictions treatment. / Thesis / Master of Science (MSc) / People with substance use disorders have a significantly shortened time perspective compared to healthy controls. This means that these individuals struggle with thinking about future events beyond several days to a week. Shortened time perspective can be a significant barrier to addiction treatments that typically focus on long-term positive benefits of sobriety or low-risk use. This study examined whether mindful thinking about future events impacted decision-making and motivation for alcohol and drugs. The study used an experimental protocol known as Episodic Future Thinking (EFT) that involves participants interacting with personalized cues related to positive future events. Prior research using EFT in addiction samples has found that interacting with future cues significantly increases delay of gratification, reduces cigarette use, and decreases reinforcing value of alcohol. In this study, we recruited 28 participants with an alcohol use disorder (AUD). Participants practiced EFT training over a two-week protocol. We tested decision making, alcohol craving, and other variables following a single EFT protocol, and changes in these measures over repeated practice. We found significant changes in alcohol craving, decision making, and mindfulness awareness. The study provides proof-of-concept for using EFT in an AUD treatment population and lays the foundation for future clinical trials of EFT as a complement to existing addiction treatments.

Alcohol use among international students in a U.S. community college setting was explored in regard to the interrelationships with acculturation stress and drinking motivations. Misuse of alcohol has been acknowledged as a serious problem on American college campuses. A positive relationship between stress and alcohol use has been documented among those who lack internal and external resources and support systems. International students have been recognized as higher-risk than other college students due to acculturation stress. However, very few studies have investigated the drinking behaviors of this population. To fill this research gap, a survey was conducted with non-immigrant international students (F-1 students) (N = 126) and immigrants international students (non-F-1 students) (N = 136) enrolled in English as a Second Language (ESL) programs in a U.S. community college. The results, which were derived from responses to three published instruments, Index of Life Stress (ILS), Core Alcohol and Drug Survey (CADS) Community College Long Form, and Revised Drinking Motivation Questionnaire (DMQ-R), as well as the researcher-made demographic information sheet, indicated that these groups were not engaged in abusive drinking behavior. This finding may reflect the support systems available to these students in an ESL setting and their family/friend networks. However, moderately strong zero-order correlations between acculturation stress and drinking motives to control negative affects were revealed. Further discussions and implication are provided. / Ph. D.

A dietary survey of male volunteers, both drinkers, and nondrinkers of alcohol, on free choice diets, was conducted in Blacksburg, Virginia in the spring and summer of 1981. The survey was conducted to assess the relationship between the consumption of alcohol and the intake of selected nutrients on both a mean daily basis and on a per kilogram body weight basis. One hundred seventy-one subjects ages 18 through 56 kept food and beverage intake records for five consecutive days, including Saturday and Sunday. The food and beverage records were hand coded and processed by computer for nutrient analysis. Subjects were grouped, according to the amount of alcohol consumed, into nondrinkers, low, moderate or high drinkers. Regression and correlation analysis revealed that there was little difference among the groups of subjects in the effects of alcohol intake on intake of the traditional energy supplying nutrients, protein, fat, and carbohydrate expressed as mean daily intake and expressed on a per kilogram body weight basis. The expression of nutrient intake based on a per kilogram body weight basis made no difference in the significance of results when considering the relationship between the consumption of alcohol and calcium, iron, magnesium, phosphorus, vitamin A, thiamin, riboflavin, niacin, vitamin B6, vitamin B12, and vitamin C. The need for further investigation into the relationship between alcohol consumption and nutrient intake of social drinkers has been documented. / M.S.

Undergraduates at Virginia Polytechnic Institute and State University (N = 306) were surveyed to investigate the formation of alcohol and marijuana use motives. Based upon a hypothesized path model effect expectancies, use motives, use frequencies, and use-related problems for alcohol and marijuana were assessed via self-report. Personality factors of sensation-seeking, sociability, and neuroticism-anxiety were also assessed during this single session. Many of the hypothesized pathways were confirmed via multiple regression methods for path analysis. The findings indicated that use motives are related to theoretically more distal influences such as related personality factors and drug effect expectancies. Motives were found to consistently account for substantial variation in use and the development of problems related to alcohol and marijuana in the sample. In some cases these motives not only predicted use, but also appeared to mediate the influences of personality factors and expectancies. Finally, specific motives were found to account for significant variation in the development of substance-related problems even after controlling for the frequency of use. / Master of Science

This study focused on the alcohol use of college freshmen. It was designed to explore an area of student alcohol use that has not been well researched. An extensive amount of research has been done on reasons students use alcohol, the consequences of alcohol use, patterns of alcohol use, and the expected effects of alcohol consumption. However, very little is known about students’ expected use of alcohol. The study focused on student expectations for the use of alcohol prior to starting college and their actual use of alcohol in their first year of college. A qualitative research method was used to collect and analyze the data. Data were collected via individual and group interviews, and analyzed by gender, residency status, and living environment. This structure was used to identify differences and similarities between males and females, in-state and out-of-state students, and students assigned to small and large halls. The use of interviews proved to be a good way of gaining information on students’ expectations verses actual experiences with alcohol in college. Study findings indicated that students come to the college environment with some strong, deeply embedded preconceived notions about alcohol and its role on campus and that these expectations did, to some extent, influence student behaviors regarding their use of alcohol. Students in this sample held the expectation that alcohol would be very accessible and was just a part of college life. Findings about actual behaviors with alcohol indicated that students drink more during their first semester in college than in later semesters. Students reported their use of alcohol is influenced by a number of factors, including: peers, academic stress, the accessibility of alcohol, and the need to relax and become more sociable. / Master of Arts

Social anxiety is related to various comorbidities, with the most common being elevated alcohol use (Bolton et al., 2006). The symptom profile of this unique subset of cases with social anxiety and comorbid alcohol use is more complex and experiences higher resistance to treatment (Buckner et al., 2008). Both social anxiety and alcohol use emerge during the adolescent developmental period, and yet there remains a gap in the understanding of potential developmental risk factors associated with the onset and maintenance of these co-occurring symptoms. The current study investigated trait impulsivity, cognitive flexibility, and risk-seeking during adolescence and associations with alcohol use and social anxiety in young adulthood. Participants included 167 adolescents (Mage = 14.07 years, SD = 0.54; 52.7% male) followed to young adulthood (Mage = 22.30, SD = 0.69). Growth mixture models indicated that high levels of risk-seeking during adolescence predicted social anxiety in young adulthood. Contrary to hypotheses, high (compared to moderate) risk-seeking participants had lower alcohol use. Longitudinal patterns of high attentional impulsivity during adolescence into young adulthood predicated later social anxiety, whereas non-planning and motor impulsivity did not. Linear regression analyses indicated that lower cognitive flexibility during early adolescence was associated with social anxiety and alcohol use in young adulthood. Finally, moderation models suggested that global trait impulsivity was not a significant moderator of the relation between alcohol use during adolescence and social anxiety in young adulthood. This is the first work to evaluate these developmental risk-factors in relation to comorbid social anxiety and alcohol use, and has important implications for bolstering therapeutic interventions, especially for those with elevated impulsivity. / Doctor of Philosophy / Some socially anxious young adults have more difficulties with alcohol use compared to their peers. The combination of social anxiety and elevated alcohol use can lead to challenges in various aspects of life, such as school, work, and social functioning. Previous literature in the field suggests that both social anxiety and alcohol use emerge during early adolescence (ages 13-14); however, risk-factors during this important developmental period are still being explored. This dissertation evaluated the following possible risk-factors during adolescence that may be associated with the later development of social anxiety and alcohol use: trait impulsivity, cognitive flexibility, and risk-seeking. These risk-factors were explored using a dataset collected in Virginia that followed 167 adolescents over an eight-year period. Results indicated that youth with higher risk-seeking and attentional impulsivity during adolescence (ages 13-21) had significant social anxiety symptoms once they reached young adulthood (ages 22-23). Additionally, lower cognitive flexibility during ages 13-14 was associated with higher social anxiety and alcohol use in young adulthood. This is the first work to evaluate these risk-factors in relation to social anxiety and alcohol use, and has important implications for interventions, especially for those who have increased impulsivity and risk-seeking behaviors.

No description available.

Maladaptive habits, such as substance use, that are highly ingrained and automatized behaviors with negative long-term health consequences need effective interventions to promote change towards more healthful behaviors. Implementation intentions, the structured linking of critical situations and alternative, healthier responses, have been shown to improve health-benefiting behaviors such as eating more fruits and vegetables and being more physically active (Sheeran, Milne, Webb, and Gollwitzer, 2005). Here, a laboratory analogue for smoking relapse and a pilot clinical trial of alcohol use are assessed using implementation intention interventions to reduce these health risk behaviors. In Study 1, heavy smokers completed a smoking resistance task that is a candidate analogue for smoking relapse. Participants were exposed to an in-laboratory implementation intention and/or monetary incentive condition during each of four experimental sessions. The combined implementation intention and monetary incentive condition resulted in the greatest delay to smoking initiation. In Study 2, individuals with alcohol use disorder completed an active or control implementation intention treatment condition. Remotely, both treatment groups received a daily ecological momentary intervention, thrice daily biologic breath alcohol ecological momentary assessments, and once daily self-report ecological momentary assessment of alcohol consumption during the intervention period. The active implementation intention group was associated with a greater reduction in alcohol consumption compared to the control group. Together, these studies provide experimental and initial clinical evidence for implementation intentions, in conjunction with other effective treatments (Study 1) and technological advancements (Study 2), to intervene on and reduce substance use. This project is the first to use implementation intentions in a laboratory evaluation of smoking resistance and in an initial clinical trial to reduce alcohol consumption in a naturalistic community sample using both ecological momentary assessments and ecological momentary interventions. / Ph. D. / The following studies provide evidence for the use of implementation intentions, a planning-based intervention, to reduce health risk behaviors. Implementation intentions are structured if-then statements that help individuals to identify critical situations where health risk behaviors are likely and to predetermine alternative and healthier responses when these situations are encountered. In the first study, nicotine-deprived cigarette smokers completed a laboratory task where they were asked to resist smoking. The participants were exposed to different conditions (implementation intentions and monetary incentives) to help them to resist smoking. The study found that the combination of both implementation intentions and monetary incentives were associated with the longest time to smoking reinitiation; however, the combination of both interventions was not significantly greater than monetary incentives alone. The second study employed implementation intentions as a strategy to reduce alcohol use over a two-week period in individuals with alcohol use disorder. The study found that implementation intentions reduced the amount of alcohol consumed on days where participants were drinking and these reductions were maintained at one-month follow-up. Together, these two studies provide support for translational work that evaluates interventions in the laboratory and then also in clinical trials. Furthermore, these studies show the trans-disease applications of interventions such as implementation intentions across health risk behaviors.

This study examines the relationship of role parenting behaviors and adolescent depression in adolescent outcomes. Parenting behaviors considered were authoritative parenting, parental monitoring, and parental care. Adolescent outcomes considered were depression, alcohol use, tobacco use, and grades. A path model was employed to examine these variables together. A sample of (n=3,174) of 9th -12th grade high school students from seven contiguous counties in rural Virginia were examined on these variables. Logistic regression analysis revealed parental monitoring and adolescent depression predicted all outcome variables tested. Authoritative parenting predicted adolescent alcohol use and grades and parental care only predicted adolescent depression. Logistical regression also reveled gender difference with parental care, authoritative parenting and male and female alcohol use and grades. Authoritative parenting predicted female alcohol use, and female grades were predicted by parental care. For males, authoritative parenting predicted male grades, and parental care predicted male alcohol use. / Master of Science

Intimate partner violence (IPV; psychological, physical, and sexual abuse) victimization is prevalent among college women and is linked to alcohol-related problems. Theory and prior data suggest that women may be more likely to drink after IPV if they have difficulty regulating their emotions; yet the moderating effect of daily emotion dysregulation on the proximal IPV-alcohol use association remains unexamined. This study investigated the hypothesis that daily IPV victimization would positively and prospectively associate with same-day alcohol use (any drinking, number of drinks, and heavy episodic drinking [HED]), and that higher levels of daily emotion dysregulation would strengthen this association. College women (N = 161) completed daily reports of emotion dysregulation, alcohol use, and IPV over 60 consecutive days. Multilevel modeling did not support hypotheses. IPV victimization did not significantly associate with odds of subsequent, same-day alcohol use, number of drinks consumed, or HED, regardless of daily emotion dysregulation level. Main effects revealed that daily emotion dysregulation positively associated with alcohol use across all models. The effects of IPV on alcohol use may accumulate over time rather than having a subsequent, proximal effect. Enhancing college women’s ability to regulate emotions may mitigate alcohol use and HED, regardless of women’s IPV experiences. / Master of Science / Intimate partner violence (IPV), including physical, psychological, and sexual abuse is common amongst college women and is often linked with alcohol use problems. Previous research suggests that women may be more inclined to consume alcohol following IPV victimization, particularly if they struggle with regulating their emotions. However, the specific role of daily emotion dysregulation in moderating the relationship between IPV victimization and subsequent alcohol use has not been thoroughly investigated. This study aimed to investigate whether daily experiences of IPV victimization would positively associate with same-day alcohol consumption, evaluated through overall drinking, the amount consumed, and the occurrences of heavy episodic drinking (HED), and whether greater levels of daily emotion dysregulation would intently this relationship. A sample of 161 college women completed daily assessments over 60 consecutive days, reporting their experiences with IPV victimization, alcohol use, and emotion dysregulation. The findings did not support the initial hypotheses. IPV victimization did not significantly increase odds of same-day alcohol use, the number of drinks consumed, or HED, irrespective of the levels of daily emotion dysregulation. However, the data revealed that emotion dysregulation was positively associated with alcohol use across all models. This suggests that the effects of IPV victimization on alcohol use may accumulate over time rather than wield an immediate influence. Improving emotion regulation skills among college women could potentially mitigate alcohol use and instances of HED, independent of their experiences with IPV victimization.