Implicit and explicit drinker identities interactively predict in-the-moment alcohol placebo consumption

Does identity as a drinker predict problem recognition motivation in harmful drinkers?

Harmful drinking is associated with significant negative health and social outcomes, but drinkers are reticent to recognise personal drinking problems, hindering natural recovery or help-seeking. Recent evidence suggests that social identity as a drinker is associated with various drinking-related factors but has not been examined in relation to likelihood of problem recognition. In a group of ninety-six harmful drinkers (61 females, M age = 34 years) we explored how identity components associated with ingroup self-investment and ingroup self-definition in combination with implicit identity as a drinker accounted for degrees of problem recognition. In addition to demographic information, addiction experience and drinking behaviour (AUDIT), respondents completed measures of ingroup self-investment (identity centrality, solidarity, and satisfaction), ingroup self-definition (ingroup homogeneity and self-stereotyping), a "self as drinker" identity implicit association test and problem recognition (four items from the Stages of Change Readiness and Treatment Eagerness Scale). After controlling for possible covariates (age, gender and alcohol addiction experience) increased problem recognition was accounted for by explicit and not implicit identity components. More specifically, increasing perceived chronic saliency of one's drinker identity (self-investment in the drinker ingroup) and not an implicit association between the self and being a drinker was related to increased likelihood of problem recognition. This suggests that how chronically and explicitly accessible the identity of the drinker is for individuals might operate to stimulate the willingness or motivation to recognise potential drinking related harm.

Components of identity expression in problem and non-problem gamblers

Few studies have examined whether specific aspects of group identification predict problematic and non-problematic addictive behaviours and none have focused on gambling. Applying Leach et al.'s (2008) hierarchical model of in-group identification, we tested the associations between components of self-investment (satisfaction, solidarity, and centrality) and components of self-definition (individual self-stereotyping, in-group homogeneity) on distinguishing between problem and non-problem gambling (n = 10,157) and on the severity of problematic gambling behaviour (n = 2,568). Results showed that (i) in-group-based identities are important in predicting problematic vs. non-problematic gambling behaviours; (ii) in-group-based identities are important in predicting the severity of problematic gambling; (iii) how self-invested an individual is with their in-group and aspects associated with self-definition processes are both important predictors; (iv) perceptions related to how chronically salient one's group membership is for the self (centrality) are essential features of the self-investment mechanism; and (v) self-stereotypical beliefs about one's essential similarities to the prototypical gambling group member norm are fundamental for the defining oneself as a gambler.

The nomological network of drinker identity: A scoping review

BACKGROUND

Despite the growing interest in the construct of drinker identity and empirical evidence for its role in drinking behavior, there is a paucity of papers that evaluate and integrate the results of studies on drinker identity, leaving a gap in our knowledge of the importance of the drinker identity construct. The current paper addresses this gap by reviewing and integrating the results of the studies of drinker identity.

METHODS

The scoping review identified, retrieved, and evaluated the existing literature regarding drinker identity. English language studies from EBSCOHost, PubMed, ScienceDirect, and Scopus databases were reviewed. Studies were included in the review if they were data-based studies or theoretical publications with drinker identity as the primary topic published in peer-reviewed journals. Studies were reviewed and coded based on their reported methodology and findings and codes were used to integrate and present findings.

RESULTS

This review advances this line of research in four ways. First, the operationalization of drinker identity is evaluated by examining the theoretical frameworks defining the construct. Second, the conceptualization and measurement of drinker identity is assessed, with suggestions for future measurement research. Third, an integrated framework of predictors, outcomes, moderators, and mediators is presented. Finally, the research gaps, future recommendations, and clinical implications are discussed.

CONCLUSIONS

There is a need for continued research, specifically research which aims to standardize and improve measurement of drinker identity, considers longitudinal and developmental processes, and broadens the research samples and settings.

Disentangling the within- and between-person aspects of implicit alcohol associations on hazardous drinking

Indirect measures have been used to assess the strength of automatically activated, alcohol-related associations and their relation to hazardous drinking. However, little is known about the longitudinal contributions of between-person and within-person components of implicit alcohol associations (IAAs) to college students' hazardous drinking over time. This study examined how within- and between-person variability in three measures of IAA (drinking identity, alcohol approach, and alcohol excite) are related to hazardous drinking while controlling for their explicit, self-report counterparts. First- and second-year U.S. college students (N = 506; 57% female) completed web-based assessments once every 3 months up to eight assessments, which included IAA measures (Implicit Association Tests), explicit counterparts of the IAAs, and self-reported hazardous drinking (alcohol consumption, problems, and risk of alcohol use disorder). Bayesian generalized multilevel models were used to examine between- and within-person associations among IAA, their explicit counterparts, and hazardous drinking. Results showed that between persons, mean levels of all three IAAs were positively associated with hazardous drinking over time. Once their explicit, self-report counterparts were included, however, only drinking identity IAA remained significant. Within persons, increases in drinking identity IAA were associated with increases in subsequent hazardous drinking risk, even after controlling for its explicit counterpart. These results suggest the importance of disentangling and simultaneously investigating between- and within-person processes in IAAs. Although the between-person component of IAAs may play a larger role in the prediction of hazardous drinking, examining the within-person component of IAA, at least for drinking identity, also appears to be important. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Pain as a causal motivator of alcohol consumption: Associations with gender and race

Despite accumulating evidence indicating reciprocal interrelations between pain and alcohol consumption, no prior work has examined pain as a proximal antecedent of drinking. The goal of the current study was to test the effects of experimental pain induction on ad-lib alcohol consumption among moderate-to-heavy drinkers without chronic pain (N = 237; 42% female; 37% Black; M = 3.26daily drinks). Participants were randomized to either pain-induction (capsaicin + thermal heat paradigm) or no-pain-control conditions. Experimental pain induction lasted for 15 minutes, during which ad-lib alcohol consumption was assessed using an established taste test paradigm. As hypothesized, results indicated that participants randomized to the pain-induction condition poured and consumed more alcohol and reached a higher peak blood alcohol concentration than those randomized to the no-pain condition (ps < 0.05; ηp² range = 0.018-0.021). Exploratory analyses revealed the effects of pain on alcohol consumption to be most pronounced among participants who self-identified as male or Black (relative to female or White, respectively). These findings indicate that the experience of pain serves as a causal, situational motivator for alcohol consumption, and suggest that current drinkers may be susceptible to escalating their consumption of alcohol in the context of pain. Future research is needed to explicate observed differences in the effects of pain on drinking as a function of gender and race, and to extend this work to individuals with chronic pain and varying levels of alcohol use. Collectively, these findings may help inform the development of integrated treatments to address co-occurring pain and alcohol use. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Individual differences in selective attentional bias for healthy and unhealthy food-related stimuli and social identity as a vegan/vegetarian dissociate "healthy" and "unhealthy" orthorexia nervosa

Previous work identified the operation of an attentional bias (AB) towards healthy food related stimuli among those with increasing tendencies towards orthorexia nervosa (ON) using a modified Stroop task. The current work aimed to replicate and extend our understanding of this effect by incorporating alternative measures of AB (i.e., the dot probe task) and ON (i.e., the Teruel Orthorexia Scale [ToS]) in a sample of self-defined vegans/vegetarians. The theoretical assertion of the ToS is the conceptual broadening of orthorexia with differentiable dimensions - one characterised as a "healthy" preoccupation with healthy food/eating patterns (HeOr) and the other by a more underlying pathology (OrNe). This study also aimed to examine the pattern of responding across these two dimensions according to factors known to predict ON. Eighty-six participants (mean age = 33.0 years; 20 males, 66 females) completed measures of obsessive compulsivity, perfectionism, state/trait anxiety and ToS as well as a dot probe designed to measure AB for healthy and unhealthy-related food stimuli, threat ratings of each of words utilised and perceived identity centrality as a vegan/vegetarianism. Results showed a dissociation of predicted determinants for "healthy" ON (HeOr) and pathological ON (OrNe). HeOr was predicted by increasing identity centrality whereas OrNe was predicted by increased OCD and perfectionism, and increased interference for healthy-related food words (in particular slowed disengagement) and not unhealthy related food words. Threat-related ratings of unhealthy food words was shown to be common across both dimensions. This pattern highlights cognitive and individual differences-based correlates of pathological and non-pathological ON.

A New Perspective on "Drinking" Self: A Network Approach to Characterizing Drinking-Related Changes in Personality

BACKGROUND

Previous research suggests that self-knowledge, particularly perceptions of oneself as a "drinker," may influence the development and progression of alcohol use and related problems, such as binge drinking. While existing studies have provided empirical evidence for the importance of assessing drinking self-perception within the five-factor model of personality framework, further examination with novel analytic methods, such as network analyses, could improve understanding of the drinker self-concept. Methods: Five factor traits of openness to experience, conscientiousness, extraversion, agreeableness, and emotional stability were assessed among a large sample of young adults (n = 423) across "general" and "drinking" contexts. Features of the personality networks were investigated, including topology, network centrality, stability of the network across "general" and "drinking" assessments, as well as differences in the network across the two assessments. Results: Individual personality items were more related to other items within the same trait than to other traits. There was no most central item in the networks, but item strength was uncorrelated to mean-level of the item. The network structure was stable across both assessments, although the overall strength of item relationships significantly increased in the drinking personality network. Conclusions: Examining drinking personality using a network analytic framework provided novel insights into drinker self-concept and the role drinking contexts might play in self-perception of personality in those contexts.

Supplemental data for this article is available online at https://doi.org/10.1080/10826084.2022.2034874 .

Implicit and Explicit Self-Identification as a Drug User in People Who Used Heroin and Methamphetamine

Implicit and explicit self-identification as a drug user specific to the substance used (e.g., viewing oneself as a drinker) have been examined, as they relate to that drug use. However, studies have rarely explored whether identifying as a "drug user" differs implicitly and explicitly for people who use different drugs and how this identification relates to drug-use behaviors or abstinence. This study examined implicit and explicit self-identification as a "drug user" and their associations with drug-use behaviors and abstinence in people who used heroin (PWUH) and people who used methamphetamine (PWUM). Forty PWUH and 35 PWUM in a rehabilitation facility completed the single category implicit association test (SC-IAT), which evaluated implicit associations of a "drug user" with "self," and a measure of explicit self-identification as a "drug user." Prior drug-use behaviors and current abstinence duration of the participants were assessed. PWUH demonstrated stronger implicit "self + drug user" associations and higher levels of explicit self-identification as a "drug user" than PWUM. A higher frequency of drug use was associated with higher levels of explicit drug-user self-identity, and longer abstinence duration was positively related to stronger implicit "self + drug user" associations in PWUH. The drug type of heroin (vs. methamphetamine) participants used was associated with a higher frequency of use, which, in turn, predicted higher levels of explicit drug-user self-identity. Given that the PWUH group differs from the PWUM group in terms of implicit and explicit self-identification as "drug users," it would be more appropriate to address drug-user self-identity of individuals according to the substance they use rather than as a collective group.

Does alcohol-related desire thinking predict in-the-moment drinking behaviours?

Desire thinking (voluntary thinking involving a perseverative focusing on desired target-related memories, images, and information), is an important factor in the experience of drinking urges and cravings. Research has not examined the relationship between desire thinking, behavioural intention and the implementation of that behaviour into action, nor how one's past repeated behaviour in situ (expressed as habit) may moderate these relationships. We employed an ad libitum drinking paradigm to provide indirect measures of in-the-moment drinking behaviours (amount poured [mls] and amount consumed [mls]) in a group of eighty-eight self-defined social drinkers immediately after measuring self-reported drinking habit, drinking-related desire thinking, and general drinking behaviour. Results confirmed the predicted positive relationship between desire thinking and in-the-moment drinking behaviour with the effects increasing as a function of rising drinking habit strength. We also observed a dissociation between desire thinking components (verbal perseveration and imaginal prefiguration) in the moderating effects of habit strength on drinking behaviour. For imaginal prefiguration (thoughts related to construction of mental images of a desired target or of its context for consumption) a direct effect on drinking behaviours was shown. In comparison, the effect for verbal perseveration (repetitive self-talk regarding the need to achieve a desired target) was not shown to independently predict drinking-related behaviour but was significantly moderated by increasing drinking-related habit strength. Future work should formulate the nature of this moderating influence on perseverative goal-directed thinking.

I am what I am: A meta-analysis of the association between substance user identities and substance use-related outcomes

OBJECTIVE

Research indicates that a substance user identity (i.e., drinking, smoking, and marijuana identity) is positively correlated with substance use-related outcomes (e.g., frequency, quantity, consequences, and disorder symptoms). The current study aimed to meta-analytically derive single, weighted effect size estimates of the identity-outcome association as well as to examine moderators (e.g., substance use type, explicit/implicit assessment, demographic characteristics, and research design) of this association.

METHOD

Random effects meta-analysis was conducted on 70 unique samples that assessed substance user identity and at least one substance use-related outcome (frequency, quantity, consequences, and/or disorder symptoms), and provided the necessary information for effect size calculations.

RESULTS

Substance user identity was found to be a statistically significant moderate-to-large correlate of all substance use-related outcomes examined in the current study (r _w = .365, p < .001, r_w² = .133). The strongest associations were observed between identity and disorder symptoms (alcohol) and frequency of substance use (tobacco or marijuana). In terms of moderators of the identity-outcome association, the link between explicit drinking identity and alcohol use-related outcomes appeared to be stronger in magnitude than the relationship between implicit drinking identity and alcohol use-related outcomes; however, this difference appears to be largely due to the finding that implicit measures have lower reliability. The strongest identity-outcome association was observed among younger individuals.

CONCLUSIONS

Substance user identity is clearly an important correlate of substance use-related outcomes and this association is stronger among younger individuals. Additional theoretical, empirical, and intervention research is needed to utilize knowledge gleaned from the current study on the identity-outcome association. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

What really matters in binge drinking: A dominance analysis of binge drinking psychological determinants among University students

Introduction

Binge drinking (BD) is a public health concern, especially in young people. Multiple individual factors referring to different level of analyses - positional, inter-individual and intra-individual - are associated to BD. As they have mainly been explored separately, little is known about the psychological variables most associated with BD. This study, based on an integrative model considering a large number of variables, aims to estimate these associations and possible dominance of some variables in BD.

Methods

A sample of university students (N = 2851) participated in an internet survey-based study. They provided information on alcohol related variables (AUDIT, BD score), positional factors (sex, age), inter-individual factors (subjective norm, social identity, external motivations), and intra-individual factors (internal motivations, meta-cognitions, impulsivity and personality traits). The data were processed via a backward regression analysis including all variables and completed with a dominance analysis on variables that are significantly associated with BD intensity.

Results

The strongest variables associated with BD intensity were enhancement motives and drinking identity (average ΔR ² = 21.81%), followed by alcohol subjective norm and social motives (average ΔR ² = 13.99%). Other associated variables (average ΔR ² = 2,84%) were negative metacognition on uncontrollability, sex, coping motives, lack of premeditation, positive metacognition on cognitive self-regulation, positive urgency, lack of perseverance, age, conformity motives and loneliness.

Conclusion

Results offer new avenues at the empirical level, by spotting particularly inter-individual psychological variables that should be more thoroughly explored, but also at the clinical level, to elaborate new prevention strategies focusing on these specific factors.

Implicit Cognition and Psychopathology: Looking Back and Looking Forward

Implicit cognitive processing is theorized to have a central role in many forms of psychopathology. In the current review, we focus on implicit associations, by which we mean evaluative representations in memory that are difficult to control and do not require conscious reflection to influence affect, cognition, or behavior. We consider definitional and measurement challenges before examining recent empirical evidence for these associations in anxiety, obsessive–compulsive, posttraumatic stress, depressive, and alcohol use disorders. This examination is framed by a brief review of the ways that prominent models of psychopathology represent biased implicit processing of disorder-relevant information. We consider to what extent models reflect more traditional automatic/implicit versus strategic/explicit dual-process perspectives or reflect more recent dynamical systems perspectives in which mental representations are iteratively reprocessed, evolving continuously. Finally, we consider the future research needed to better understand the interactive and temporal dynamics of implicit cognition in psychopathology.

Effect of e-cigarette advertisements and antismoking messages on explicit and implicit attitudes towards tobacco and e-cigarette smoking in 18-65-year-olds: a randomised controlled study protocol

INTRODUCTION

Since the advent of e-cigarettes, e-cigarette advertising has escalated and companies are able to use marketing strategies that are not permissible for tobacco products. Research into the effect of e-cigarette advertising on attitudes towards tobacco and e-cigarettes is in its infancy. To date, no research has compared indirect (implicit) measures of attitude towards e-cigarettes with direct (explicit) measures. Furthermore, little consideration has been given to how viewing online advertisements may have an effect on attitudes towards e-cigarettes or how positive attitudes to e-cigarettes may undermine antismoking public health messages. The objectives of this study are to investigate (1) the relationship between explicit and implicit attitudes towards tobacco and e-cigarettes, (2) the effect of e-cigarette advertising on these attitudes and (3) the effect of these attitudes on the efficacy of antismoking health messages.

METHODS AND ANALYSIS

In experiment 1 an analysis of covariance will be conducted to determine whether viewing an e-cigarette advertisement, compared with a neutral image, has an effect on implicit or explicit attitudes towards tobacco and e-cigarettes, and if these attitudes differ between smokers, vapers and non-smokers aged 18 - 25 years. In experiment 2, moderation analysis will be conducted to assess whether attitudes towards e-cigarettes moderate the psychological efficacy of antismoking health messages in participants aged 18-65 years. In each experiment, attitudes will be measured preintervention and postintervention and 1 week later (n=150) in participants who are smokers (n=50), vapers (n=50) or non-smokers (n=50).

ETHICS AND DISSEMINATION

Approval for this study has been given by the London South Bank University's (LSBU) Research Ethics Committee. The findings of these studies will be submitted for publication and disseminated via conferences. The results will be integrated into course provision for practitioners training at LSBU.

Evaluating the Relationship between Explicit and Implicit Drinking Identity Centrality and Hazardous Drinking

INTRODUCTION

Drinking identity strength (how strongly one views oneself as a drinker) is a promising risk factor for hazardous drinking. A critical next step is to investigate whether the centrality of drinking identity (i.e., the relative importance of drinking vs. other identity domains, like well-being, relationships, education) also plays a role. Thus, we developed explicit and implicit measures of drinking identity centrality and evaluated them as predictors of hazardous drinking after controlling for explicit drinking identity strength.

METHODS

Two studies were conducted (Ns = 360 and 450, respectively). Participants, who self-identified as full-time students, completed measures of explicit identity strength, explicit and implicit centrality, and the Alcohol Use Disorders Identification Test (AUDIT). Study 1a evaluated two variants of the implicit measure (short- vs. long-format of the Multi-category Implicit Association Test); Study 1b only included the long form and also assessed alcohol consumption.

RESULTS

In Study 1a, implicit and explicit centrality measures were positively and significantly associated with AUDIT scores after controlling for explicit drinking identity strength. There were no significant differences in the implicit measure variants, but the long format had slightly higher internal consistency. In Study 1b, results replicated for explicit, but not implicit, centrality.

CONCLUSIONS

These studies provide preliminary evidence that drinking identity centrality may be an important factor for predicting hazardous drinking. Future research should improve its measurement and evaluate implicit and explicit centrality in experimental and longitudinal studies.

Associations between social identity diversity, compatibility, and recovery capital amongst young people in substance use treatment

This study explored associations between group memberships and recovery capital amongst 20 young adults aged 18 to 21 years in residential alcohol and drug treatment.

METHOD

Participants completed an interviewer administered research interview based on measures of recovery capital and a social networks assessment mapping group memberships, group substance use, and relationships between groups.

RESULTS

Higher personal and social recovery capital was associated with lower diversity of group memberships, a higher number of positive links between groups, and greater compatibility of lower substance-using groups with other groups in the network. Higher compatibility of heavier-using groups was also associated with having a higher number of negative, antagonistic ties between groups.

CONCLUSIONS

These findings indicate that it is higher compatibility of a lower substance-using social identity and lower-using group memberships that contributes to recovery capital. Further, positive ties between groups and lower diversity of group memberships appear to be key aspects in how multiple social identities that are held by young adults relate to personal and social recovery capital.

A review of implicit and explicit substance self-concept as a predictor of alcohol and tobacco use and misuse

BACKGROUND

This paper provides an overview of the self-concept as it relates to substance use. Self-concept has a long history in psychological theory and research; however, substance self-concept (e.g., viewing one's self as a drinker or smoker) is an understudied area of research with the potential to expand existing conceptualizations of substance use, addiction, and prevention and treatment efforts, and should receive greater research attention.

OBJECTIVES

First, we review and provide a theoretical framework of substance self-concept that draws from dual process models and distinguishes between implicit and explicit self-concept. Next, we summarize key findings related to substance use in the extant literature, focusing on alcohol and tobacco (smoking).

RESULTS

Across both substances, there is converging evidence that substance self-concept is associated with substance use outcomes, including quantity and frequency of use and problems associated with use, and that change in substance self-concept is associated with recovery from substance misuse. Recommendations for the substance self-concept research agenda include routine assessment of substance self-concept, expanded use of implicit measures, investigation of moderators of substance self-concept, and targeting substance self-concept directly in prevention and intervention efforts.

CONCLUSION

Ultimately, we suggest that substance self-concept is a promising, but understudied, construct. Greater research attention to substance self-concept could clarify its potential as an important risk factor for hazardous use and addiction as well as its utility as a prevention and treatment target.