Kim Fromme - US grants

By altering one's appraisal of risky situations, alcohol use may increase the propensity for engaging in dangerous or illegal activities. In this series of studies, drinking habits, alcohol intoxication and alcohol expectancy will be investigated as determinants of risk appraisal, reported likelihood of engaging in risky behaviors, and physiological responses to risky stimuli. In Study 1 questionnaire assessment will examine drinking habits, alcohol outcome expectancies, personality traits, age and gender as correlates of risk appraisal and reported frequency of engaging in risky behaviors. Study 2 will assess the effects of drinking habits and gender on pre- and post-drinking appraisals of written descriptions of 27 risky behaviors. Using videotaped stimuli, Experiments 3 - 5 will (a) investigate alcohol intoxication and alcohol expectancy as determinants of risk appraisal, and (b) conduct exploratory studies of the physiological correlates of risk appraisal. Study 3 will examine risk appraisal and physiological responses at two doses of alcohol, and for high, moderate and low risk stimuli. Experimental manipulation of beverage content and instruction in Study 4 will determine whether alcohol, or the belief that alcohol has been consumed, alters risk appraisal or reported likelihood of engaging in risky behaviors. Last, in Study 5 individuals will be recruited who differ in their beliefs about the effects of drinking alcohol. These alcohol outcome expectancies will be assessed as determinants of risk appraisal, reported likelihood of engaging in risky behaviors, and physiological responses to risky stimuli. In providing an understanding of the relation between alcohol and risk appraisal this research may facilitate development of risk-reduction programs, thereby alleviating some of our most significant medical and social problems.

By altering one's appraisal of risky situations, alcohol use may increase the propensity for engaging in dangerous or illegal activities. In this series of studies, drinking habits, alcohol intoxication and alcohol expectancy will be investigated as determinants of risk appraisal, reported likelihood of engaging in risky behaviors, and physiological responses to risky stimuli. In Study 1 questionnaire assessment will examine drinking habits, alcohol outcome expectancies, personality traits, age and gender as correlates of risk appraisal and reported frequency of engaging in risky behaviors. Study 2 will assess the effects of drinking habits and gender on pre- and post-drinking appraisals of written descriptions of 27 risky behaviors. Using videotaped stimuli, Experiments 3 - 5 will (a) investigate alcohol intoxication and alcohol expectancy as determinants of risk appraisal, and (b) conduct exploratory studies of the physiological correlates of risk appraisal. Study 3 will examine risk appraisal and physiological responses at two doses of alcohol, and for high, moderate and low risk stimuli. Experimental manipulation of beverage content and instruction in Study 4 will determine whether alcohol, or the belief that alcohol has been consumed, alters risk appraisal or reported likelihood of engaging in risky behaviors. Last, in Study 5 individuals will be recruited who differ in their beliefs about the effects of drinking alcohol. These alcohol outcome expectancies will be assessed as determinants of risk appraisal, reported likelihood of engaging in risky behaviors, and physiological responses to risky stimuli. In providing an understanding of the relation between alcohol and risk appraisal this research may facilitate development of risk-reduction programs, thereby alleviating some of our most significant medical and social problems.

DESCRIPTION: There is growing evidence that college student binge drinking contributes to a host of negative consequences (e.g., fatal accidents, AIDS-related sexual behavior). In cooperation with the Dean of Students and the Student Health Center, the current research will test the efficacy of a brief, moderation management approach to reducing heavy episodic drinking and related problems among alcohol-related disciplinary referrals at a large public university. The program targets individual motivation, outcome expectancies, peer influence, and behavioral skills in a group psycho-educational format. Like prevention programs on many college campuses, the Lifestyle Management Class (LMC) has been offered for over a decade, it utilizes peer advisors and student health center staff to provide the program, and it has not been evaluated through controlled research. Cost-effectiveness of this program will be examined by testing delivery of the program by undergraduate peer advisors and Masters level paid staff. The LMC wait list controls and a matched community sample will serve as comparison groups. Pretest, post-test, and one-year follow-up surveys will assess changes in drinking, physical and social consequences, driving after drinking, unsafe sexual practices, and sexual assault. A subset of participants who are of legal drinking age will also complete pre-and post-test laboratory assessments that examine the acute effects of alcohol intoxication. In controlled experimental studies, the effects of program participation will be tested on post-drinking cognitive processes and behavioral skills that mediate decisions to drink heavily and to engage in other potentially dangerous post-drinking behavior. Unlike previous prevention research in which effectiveness is evaluated only when participants are sober, this research offers the opportunity to generalize effects of the program to individuals who have consumed alcohol. Thus, the research will quantify cognitive mechanisms that underlie post-drinking behavior and identify cognitive processes that may be changed.

DESCRIPTION (provided by applicant): Excellent longitudinal data are available on the development of alcohol use and abuse across the college years but little is known about the behavioral risks (e.g. risky sex, aggression, academic failure) that have been associated with collegiate drinking. Using web-based surveys and daily monitoring, the proposed research will track the alcohol use and behavioral risks of 6,600 students during the transition from high school to college and in each semester oftheir college years. Laboratory assessments will also be used to assess potential differences in cognitive abilities, risk perceptions, and behavioral inhibition among a subset of the sample that change (increase or decrease) and those who do not change their alcohol use, behavioral risks, or both, over time. Simultaneous equations analyses, latent growth curve models, and hierarchical multiple regression will be used to test five models of the associations among trait, background, individual beliefs and motivations, environmental factors, alcohol use, and behavioral risks: (a) a fully mediated model in which trait and background factors are mediated by individual and environmental factors in predicting alcohol use and behavioral risks, (b) a multiple pathway model in which trait and background factors influence alcohol use and behavioral risks through either individual or environmental factors, (c) a general deviancy model in which trait and background characteristics are directly associated with individual and environmental factors, alcohol use, and behavioral risks, which are correlated with one another, (d) an alcohol main effects model in which alcohol use and other risk factors are directly associated with participation in behavioral risks and alcohol-related behavioral risks, and (e) a moderated effects model whereby traits, individual beliefs, and motivations moderate the effects of alcohol on behavioral risks and alcohol-related behavioral risks. Assumptions underlying all models are that (a) the transition from high-school to college will be characterized by decreased supervision and increased accessibility of alcohol, and Co) developmental processes contribute to changes in both individual and environmental factors across the college years. By following a large sample of young adults as they transition from high school to college and becomesocialized into the college environment, the proposed research will document the natural evolution of drinking and the behavioral risks that may be exacerbated by alcohol. Identification of factors that increase or decrease both alcohol use and behavioral risks during college will have significant implications for policy and prevention efforts on college campuses.

DESCRIPTION (provided by applicant): This application addresses the NIAAA Research Initiative to characterize the mechanisms of behavior change in drinking. Heavy alcohol use and alcohol use disorders (AUDs) peak between ages 18 and 25, representing a serious public health concern. It is estimated that roughly 50% of the risk for alcohol use disorders is genetic, and new technology has facilitated the identification of specific target genes that confer risk. In order to design effective early interventions, we must better understand the mechanisms through which target genes contribute to different patterns of drinking behavior. Involvement in multiple deviant behaviors (generalized deviance) and individual differences in alcohol response are established risk factors for later AUDs, and both are driven, at least in part, by genetic influences. The proposed study will address three major research aims: (1) Identify unique genetic associations with four different developmental trajectories of heavy drinking: Stable {High}, Late Increasing, Developmentally Limited, and Stable {Light}; (2) Identify genetic influences on individual differences in alcohol response in a laboratory-based, placebo-controlled alcohol challenge; and (3) Test alcohol response and generalized deviance as phenotypic mediators of the effects of five candidate genes on the four trajectories of heavy drinking. Our multi-method approach to these research aims is unique in four important respects. First, rather than rely on a cross-sectional sample, we will collect salivary DNA samples from an ethnically diverse prospective cohort (N = 1,060) who have previously reported on their alcohol use and other deviant behaviors (e.g., drug use, sexual risk-taking) across 10 waves of assessments from age 18 to 24. Second, we will capitalize on cutting-edge innovations in biotechnology that allow for cost- effective genotyping of candidate genes. We will focus on a panel of 63 polymorphisms in 5 candidate genes related to cholinergic (CHRM2), opioid (OPRM1), dopaminergic (DRD4), serotonergic (SLC64A), and GABA- ergic (GABRA2) neurotransmission, plus an array of Ancestry Informative Markers (AIMs) to identify ethnic ancestry and correct for population substructure. Third, 44% of the prospective sample will be tested in a placebo-controlled alcohol challenge to identify genetic influences on individual differences in response to the effects of alcohol. {Finally, we will assess mechanisms of genetic risk within a sophisticated structural equation modeling framework for longitudinal, multivariate data.} Thus, the proposed project will integrate 6 years of prospective behavioral data with new genotypying data and laboratory-assessed alcohol response endophenotypes. Results from the proposed project will facilitate early identification of individuals at high risk for developing an AUD and will contribute to the ultimate goal of developing more personalized targets of intervention. PUBLIC HEALTH RELEVANCE: Young adults are at heightened risk for heavy alcohol use and alcohol use disorders (AUDs), which peak between 18 and 25 years. The proposed study will examine the impact of specific genes on patterns of heavy drinking during these critical years. The study also seeks to identify distinct behavioral mechanisms (alcohol response and generalized deviance) through which genes influence heavy drinking. Results will aid in tailoring intervention efforts to the specific mechanisms of risk for each individual.