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6, 1993
Many studies, notably those using the balanced placebo design (Marlatt &
Rohsenow, 1980), have shown how the belief that one has consumed al-
1We would like to acknowledge the expert statistical assistance given by Dr. David Chant and
the support given by Ms Gabrielle Crook in the preparation of this paper.
2Address all correspondence to Andrea R. Baldwin, Department of Psychology, University of
Queensland, St. Lucia, Queensland 4072, Australia.
511
0147-5916/93/1200-0511507.00/0 1993PlenumPublishingCorporation
512 Baldwin, Oei, and Young
cohol can affect certain subjective states and objective behaviors more pow-
erfully than the actual pharmacological effects of the drug (Abrams & Wil-
son, 1979; Cutter, Maloof, Kurtz, & Jones, 1976; Lang, Goeckner, Adesso,
& Marlatt, 1975; Ludwig, Wikler, & Stark, 1974; Polivy & Herman, 1976;
Wilson & Abrams, 1977). Although these changes presumably result from
the person's specific beliefs about the effects of alcohol, evaluating this
assumption lies beyond the scope of the balanced placebo design. Recently,
alcohol expectancies (ALE) have been claimed to play a part in both initia-
tion (Christiansen & Goldman, 1983) and maintenance (Brown, Goldman,
& Christiansen, 1985) of problem drinking patterns. There is also early
evidence that modification of alcohol-related beliefs through cognitive be-
havior therapy may be an effective approach to the treatment of alcohol
problems (Oei & Jackson, 1982, 1984).
The alcohol expectancy concept originated within the paradigm of in-
strumental learning, and in earlier research referred only to expectations
of reinforcement (Brown, Goldman, Inn, & Anderson, 1980; Leigh, 1989).
Learning-based theories in the cognitive-behavioral area are based on a
general model in which some motivation (a need or desire) prompts an
individual towards a goal (fulfillment of the need or desire), and the indi-
vidual chooses a behavioral response to the motivation in an attempt to
achieve the goal (Vuchinich & Tucker, 1988). Studies of alcohol consump-
tion classify goals as "avoid negative" or "approach positive" (Cox & Klin-
ger, 1988). The former group includes the adaptive orientation model
(Niaura et al., 1988), which argues that people expect alcohol to confer on
them coping skills in which they are deficient (Farber, Khavari, & Douglass,
1980; Marlatt & Gordon, 1985), and the tension reduction hypothesis (Mar-
latt, 1987), which states that people expect alcohol to help them avoid or
alleviate unpleasant states such as tension, anxiety, or depressed mood
(Marlatt, 1987). Obversely, approaches focusing on approach positive goals
argue that people expect alcohol to have particularly pleasant effects, such
as enhancing sexual relations or positive mood states ("conditioned appe-
titive motivational model," Niaura et al., 1988). Since the alcohol expec-
tancy concept has been expended to include negative expectancies as well
as positive expectancies, or expectations of reinforcement (Brown, Chris-
tiansen, & Goldman, 1987), the role of alcohol expectancies in the drinking
decision model has become clearer (Oei & Baldwin, 1993). Following
awareness of the motivational state, and preceding behavioral response, a
decision-making process occurs: Alcohol expectancies both positive and
negative are weighed up in order to determine whether or not alcohol con-
sumption is a behavioral response which will help the individual achieve
the desired goal. Whether motivation is approach positive or avoid nega-
tive, strong expectations of goal fulfillment (reinforcement) through alcohol
Alcohol Expectancies 513
drink and so increases the quantity of alcohol consumed within the session.
With regard to expectancies, it was hypothesized that a direct relationship
would be found between AE and quantity of alcohol consumed. A person
with stronger expectations that alcohol consumption will provide reinforce-
ment by helping fulfil his or her goals seems likely to consume more alcohol
than someone who does not strongly expect such reinforcement.
Although it seems logical that high AE would also predict higher con-
sumption frequency, this hypothesis was not included in the model since
it was expected to weaken rather than strengthen prediction. The initial
decision to begin a drinking episode is highly dependent on external factors
such as financial situation, spouse's approval, and other commitments. Low
DRSE may override other considerations; expectancies, in an initially sober
individual, are less likely to do so.
Previous studies have shown many effects of sex (Miller & Joyce,
1979; Orford & Keddie, 1985) and age (Christiansen Goldman, 1983; Chris-
tiansen et al., 1982) on drinking behavior, and some researchers have found
interactions between sex, age, and AE (Brown et al., 1980; Mooney et al.,
1987). Each model constructed in the current study therefore included and
evaluated all paths involving age and sex, to assess both their direct effects
on alcohol consumption, and their indirect effects via AE and DRSE.
METHOD
Subjects
The 118 subjects for this study were recruited from first-year psychol-
ogy courses. Forty-eight were male (mean age 19.3 years, range 17 to 29
years) and 70 were female (mean age 18.9 years, range 17 to 28 years).
The mean age for the group was 19.1 years, ranging from 17 to 29 years.
Legal drinking age in the state where the study was conducted is 18 years,
and very few underage drinkers were represented in the sample.
Instruments
Procedure
RESULTS
The data were analyzed using the LISREL VII program (Joreskog
& Sorbom, 1988) for analysis of causal models. Since causal modeling is
based on the principles of multiple regression, SPSSx statistical procedures
were used to screen for violations of the major assumptions of linearity,
normality, and homoscedasticity. The data from the KAT and assertiveness
expectancy were found to have positively skewed distributions; thus log
transforms were performed on these variables. Following these transforma-
tions, preliminary procedures indicated that assumptions of normality,
linearity, and homoscedasticity had been adequately met. No multivariate
outliers were found using Mehalanobis' distance as a criterion.
The consumption variables functioned as criterion variables, while AE
and DRSE were predictor variables. Also included as predictor variables,
in a role parallel to that of covariates in multiple analyses of covariance,
were sex and age. Because theoretically sex and age may affect alcohol
II
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Alcohol Expectancies 519
consumption not only directly but also by moderating A E and DRSE, sex
and age are in this analysis termed exogenous or latent independent vari-
ables, while AE and D R S E are termed endogenous or latent dependent
variables. Direct paths between the exogenous variables and the criterion
variables, and paths from the exogenous variables through the endogenous
variables to the criterion variables, were all included and evaluated in the
model. This approach to the evaluation of sex as a predictor variable pro-
vided an alternative to dividing the sample and analyzing data for males
and females separately, a technique not feasible with this sample size.
Two major approaches were taken to analysis of the data. An em-
pirical, or "full-model," approach was used to evaluate all possible paths
between the predictor variables and the criterion variables. A second, "hy-
pothesis model," approach, was used to evaluate the specific hypotheses
put forward, namely, that DRSE relates to both quantity and frequency of
alcohol consumption, while AE relate only to quantity of alcohol consump-
tion. Both the full model and the hypothesis model were tested using the
six AE subscales and the three DRSe subscales separately. It should be
noted that each time a new model was calculated, all parameters were com-
pletely reestimated, independent of the computation of preceding models.
This means that coefficients for the same paths differed from one model
to another, owing to error variance, but between two models of good fit
the difference was expected to be small.
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Sex
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Alcohol Expectancies 523
Sex
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DISCUSSION
This study set out to examine relationships between AE, DRSE, fre-
quency of alcohol consumption, and quantity of alcohol consumption. Spe-
cifically it was hypothesized that AE would be related to quantity consumed
and not to frequency of drinking, while DRSE would be related to both
quantity and frequency of drinking. The results of this study support the
discrimination between frequency and quantity of drinking, and indicate
differential relationships between these aspects of consumption and the
cognitive variables AE and DRSE.
Findings from the full-model analyses indicate that high opportunistic
DRSE was associated with less frequent normal drinking episodes. None
of the DRSE scales individually made a significant contribution to predict-
ing quantity. When the models were constrained to include only those paths
predicted by the hypothesis, it was again found that subjects with stronger
opportunistic DRSE had normal drinking episodes less frequently. Subjects
with higher opportunistic DRSE, and those with stronger social DRSE, had
maximum drinking episodes less frequently. Subjects with higher assertive-
ness expectancy and those with higher dependence expectancy consumed
more alcohol on both a normal drinking occasion and a maximum drinking
occasion.
One unexpected finding from the full model was that subjects with
more positive affective change expectancies actually reported having nor-
mal drinking episodes less frequently, and drinking less on a maximal drink-
ing occasion. A n o t h e r was that m o r e positive sexual functioning
expectancies were associated with drinking less on a maximal drinking oc-
casion. Regarding these counterintuitive findings it is timely to note the
many theoretical arguments for specificity of AE: for example dose, tem-
poral, drinking environment, and beverage, specificities (Connors & Maisto,
1988; Critchlow, 1986; Leigh, 1989; Southwick et al., 1981). Drinkers may
expect positive effects from alcohol only at low dosages, for example, and
therefore endorse the AE while reporting low actual consumption. Leigh's
argument about the difficulty of determining the "desirability" of appar-
ently positive expectancies is also relevant: Drinkers who find alcohol highly
reinforcing in certain ways may not necessarily desire such reinforcement
on a frequent basis, possibly due to fear of becoming habituated to the
positive effects. At issue here is whether the usefulness of the expectancy
concept for prevention and treatment of alcohol problems warrants the de-
526 Baldwin, Oe|, and Young
REFERENCES
Abrams, D. B., & Wilson, G. T. (1979). Effects of alcohol on social anxiety in women:
Cognitive versus physiological processes. Journal of Abnormal Psychology, 88, 161-173.
Arrindell, W. A., Sanderman, R., Van der Molen, H., Van der Ende, J., & Mersh, P, (1988).
The structure of assertiveness: A confirmatory approach. Behaviour Research and Therapy,
26, 357-339.
528 Baldwin, Oei, and Young
Marlatt, G. A. (1987). Alcohol, the magic elixir: Stress, expectancy, and the transformation
of emotional states. In E. Gottheil, K. A. Druly, S. Pshko, and S. P. Weinstein (Eds.),
Stress and addiction (pp. 302-322) New York: Brunner/Mazel.
Marlatt, G. A., & Gordon, J. R. (1985). Relapse prevention: Maintenance strategies in the
treatment of addictive behaviors. New York: Guildford Press.
Marlatt, G. A., & Rohsenow, D. J. (1980). Cognitive processes in alcohol use: Expectancy
and the balanced-placebo design. In N. K. Mello (Ed.), Advances in substance abuse:
Behavioural and biological research (pp. 155-199) CT: JAI Press.
Miller, W. R., & Joyce, M. A. (1979). Prediction of abstinence, controlled drinking and heavy
drinking outcomes following behavioral self-control training. Journal of Consulting and
Clinical Psychology, 47, 773-775.
Mooney, D. K., Fromme, K., Kivlahan, D. R., & Marlatt, G. A. (1987). Correlates of alcohol
consumption: Sex, age, and expectancies relate differentially to quantity and frequency.
Addictive Behaviors, 12, 235-240.
Niaura, R. S., Rohsenow, D. J., Binkoff, J. A., Monti, P. M., Pedraza, M., & Abrams, Do B.
(1988). Relevance of cue reactivity to understanding alcohol and smoking relapse. Journal
of Abnormal Psychology, 97, 133-152.
Oei, T. P. S., & Baldwin, A. R. (1993). The expectancy construct in cognitive-behavioral models
of problem drinking. Manuscript submitted for publication.
Oei, T. P. S., Foley, G., & Young, R. McD. (1990). The 'in-vivo' manipulation of alcohol
related cognitions in male social drinkers in a public bar. British Journal of Medical
Psychology, 63, 279-286.
Oei, T. P. S., & Jackson, P. (1982). Social skills and cognitive behavior approaches to the
treatment of problem drinking. Journal of Studies on Alcohol, 43, 532-547.
Oei, T. P. S., & Jackson, P. (1984). Some effective treatments in group cognitive behavior
therapy with problem drinkers. Journal of Studies on Alcohol, 45, 119-123.
Oei, T. P. S., Lirn, B., & Young, R. (1991). Cognitive process and cognitive behavior therapy
for the treatment of problem drinking. Journal of Addictive Diseases, 10, 63-80.
Oei, T. P. S., & Mewett, A. (1987). The role of alcohol-dependent self-statements on drinking
behavior in a public bar. British Journal of Addiction, 89, 1125-1131.
Oei, T. P. S., & Pacey, P. (1988). Changes in cognitions for social drinkers in a naturalistic
setting. Addictive Behaviors, 13, 45-49.
Oei, T. P. S., & Sweeney, M. (1993).. Alcohol beliefs, coping and self-efficacy: Can they
discriminate between different drinkers types? Manuscript submitted for publication.
Orford, J., & Keddie, A. (1985). Gender differences in the functions and effects of moderate
and excessive drinking. British Journal of Clinical Psychology, 24, 265-279.
Polivy, J., & Herman, C. P. (1976). Effects of alcohol on eating behavior: Influence of mood
and perceived intoxication. Journal of Abnormal Psychology, 85, 595-606.
Solomon, K. E., & Annis, H. M. (1990). Outcome and efficacy expectancy in the prediction
of post-treatment drinking behavior. British Journal of Addiction, 85, 659-665.
Southwick, L. L., Steele, C. M., Marlatt, G. A., & Lindell, M. (1981). Alcohol-related
expectancies: Defined by phase of intoxication and drinking experience. Journal of
ConsulthTg and Clinical Psychology, 49, 713-721.
Vuchinich, R. E., & Tucker, J. A. (1988). Contributions from behavioral theories of choice
to an analysis of alcohol abuse. Journal of Abnormal Psychology, 97, 181-195.
Wilson, G. T., & Abrams, D. (1977). Effects of alcohol on social anxiety and physiological
arousal: Cognitive versus pharmacological processes. Cognith~e Therapy and Research, 1,
195-210.
Young, R., & Knight, R. C. (1989). The Drinking Expectancy Questionnaire: A revised
measure of alcohol-related beliefs. Journal of Psychopathology and Behavioral Assessment,
11, 99-112.
Young, R., & Oei, T. P. S. (1990a, February). The development of the Drinking Expectancy
Profile. paper presented at the Fifth International Congress for the Treatment of
Addictive Behaviours, Sydney.
530 Baldwin, Oei, and Young