Objective There is considerable excitement about implicit alcohol associations (IAAs) as predictors of college student hazardous drinking; however, few studies have investigated IAAs prospectively, included multiple assessments, or controlled for previous drinking. Doing so is essential to show their utility as a predictor and, ultimately, target for screening or intervention. Therefore, three IAAs (drinking identity, alcohol approach, alcohol excitement) were evaluated as prospective predictors of drinking in first- and second-year US undergraduates. Method A sample of 506 undergraduates completed eight online assessments of IAAs, explicit measures of the IAA constructs, and hazardous drinking (consumption, problems, and risk of alcohol use disorders) every three months over a 21-month period. Retention rates, ordered by follow-up points were 90%, 76%, 76%, 77%, 72%, 67%, and 66%, respectively. Fifty percent of participants were non-drinkers at baseline; 21% were above clinical cutoffs for hazardous drinking. Results Drinking identity and alcohol excitement associations predicted future alcohol consumption and problems after controlling for previous drinking and explicit measures; drinking identity also predicted future risk of alcohol use disorder. Relative to the other IAAs, drinking identity predicted alcohol consumption for the longest duration (i.e., 21 months). Alcohol approach associations rarely predicted variance in drinking. Conclusions IAAs vary in their utility as prospective predictors of college student hazardous drinking. Drinking identity and, to a lesser extent, alcohol excitement emerged as robust prospective predictors of hazardous drinking. Intervention and screening efforts could likely benefit from targeting those associations.

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.

There is preliminary evidence that approach avoid training can shift implicit alcohol associations and improve treatment outcomes. We sought to replicate and extend those findings in US undergraduate social drinkers (Study 1) and at-risk drinkers (Study 2). Three adaptations of the approach avoid task (AAT) were tested. The first adaptation – the approach avoid training – was a replication and targeted implicit alcohol approach associations. The remaining two adaptations – the general identity and personalized identity trainings – targeted implicit drinking identity associations, which are robust predictors of hazardous drinking in US undergraduates. Study 1 included 300 undergraduate social drinkers. They were randomly assigned to real or sham training conditions for one of the three training adaptations, and completed two training sessions, spaced one week apart. Study 2 included 288 undergraduates at risk for alcohol use disorders. The same training procedures were used, but the two training sessions occurred within a single week. Results were not as expected. Across both studies, the approach avoid training yielded no evidence of training effects on implicit alcohol associations or alcohol outcomes. The general identity training also yielded no evidence of training effects on implicit alcohol associations or alcohol outcomes with one exception; individuals who completed real training demonstrated no changes in drinking refusal self-efficacy whereas individuals who completed sham training had reductions in self-efficacy. Finally, across both studies, the personalized identity training yielded no evidence of training effects on implicit alcohol associations or alcohol outcomes. Despite having relatively large samples and using a well-validated training task, study results indicated all three training adaptations were ineffective at this dose in US undergraduates. These findings are important because training studies are costly and labor-intensive. Future research may benefit from focusing on more severe populations, pairing training with other interventions, increasing training dose, and increasing gamification of training tasks.

BackgroundHistorically, US federal policy has not supported harm reduction interventions, such as safe injection facilities (SIFs) and needle and syringe programs (NSPs), which can reduce the burden associated with injection drug use. Given recent increases in abuse of both legal and illegal opioids, there has been a renewed debate about effective ways to address this problem. The current study (1) assessed participants’ support for SIFs and NSPs, and (2) evaluated several demographic factors (e.g., age, gender, race, education, political ideology, and religiosity) and individual differences in stigmatizing beliefs about people who inject drugs (PWID) that might relate to support for these interventions.MethodsU.S. adults (N = 899) completed a web-based study that assessed self-reported support for NSPs and SIFs, and stigma about PWID.ResultsThe majority of participants were at least somewhat supportive of both NSPs and SIFs. Regression analyses indicated greater support for NSPs and SIFs was predicted by more liberal political ideology, more agreement that PWID deserve help rather than punishment, older age, and male gender. Also, participants who endorsed lower stigma about PWID were more supportive of NSPs and SIFs. Race, religiosity, and education did not predict support for NSPs and SIFs.ConclusionsMost participants tended to report support for harm reduction strategies. Age, political ideology, and individual differences in stigmatizing beliefs about PWID were significantly associated with support. Given the potential malleability of stigmatizing beliefs, efforts that seek to shift stigma about PWID could have important implications for public policy towards harm reduction strategies for PWID.

Background and Objectives-Prominent theories suggest that explicit and implicit cognitive biases are critical in the development and maintenance of posttraumatic stress disorder (PTSD). However, studies evaluating implicit PTSD-related cognitive biases are rare, and findings are mixed. We developed two adaptions of the Implicit Association Test (IAT), the "traumatized self" IAT (evaluations of the self as traumatized vs. healthy) and the "dangerous memory" IAT (evaluations of remembering as dangerous vs. safe), and investigated their psychometric properties and relations to PTSD symptoms and trauma exposure. Results-BothIATs had good internal consistency, but only the traumatized self IAT was correlated with PSTD symptoms and identified participants meeting clinical cutoffs for PTSD symptoms. Study 2 focused on the traumatized self IAT and included explicit cognitive bias measures. The IAT correlated with PTSD symptoms and explicit cognitions, and predicted variance in PSTD symptoms above and beyond trauma exposure and explicit cognitions.Limitations-Study designs were cross-sectional; samples were unselected; and PTSD symptoms were self-reported.Conclusions-Despite these limitations, these studies provide preliminary validation of an implicit measure of PTSD-related cognitive bias -the traumatized self IAT -that is consistent with PTSD theories and may ultimately improve the identification and treatment of individuals with PTSD.

Drinking identity (viewing oneself as a drinker) is a potential risk factor for problematic drinking in US undergraduate samples. Whether that risk extends to a broader, more general US sample is unknown. Additionally, there are critical, unanswered questions with respect to moderators of the drinking identity–problematic drinking relationship; an important issue for designing prevention efforts. Study aims were to assess the unique associations and interactive effects of implicit and explicit measures of drinking identity on problematic drinking, and to evaluate age and sex as potential moderators of the drinking identity–problematic drinking relationship. A sample of 11,320 adults aged 18–98 completed measures of implicit and explicit drinking identity and problematic drinking (the Alcohol Use Disorder Identification Test; AUDIT). Implicit and explicit drinking identity had positive, significant associations with AUDIT scores, as expected. Moderation analyses indicated small, but significant, interactions. There was an implicit by explicit identity interaction consistent with a synergistic effect: lower implicit and explicit identity was linked to a greater probability of being a non-drinker. Age moderated explicit but not implicit identity: lower drinking identity appeared to be more protective for younger individuals. Sex moderated implicit but not explicit identity: a weaker positive association with implicit identity and AUDIT scores was observed among men, potentially reflecting stigma against women’s drinking. Findings suggest that drinking identity’s potential as a risk factor for problematic drinking extends to a more general US sample and that both implicit and explicit identity should be targeted in prevention efforts.

Introduction Implicit drinking identity (i.e., cognitive associations between the self and drinking) is a reliable predictor of drinking. However, whether implicit drinking identity might mediate the relationship between other robust predictors of drinking and drinking outcomes is unknown. We hypothesized that implicit drinking would mediate the relationship between drinking motives and alcohol consumption and craving. Method We assessed drinking motives at Time 1, implicit drinking identity at Time 2 (on average, 11 days later) and self-reported alcohol consumption and craving at Time 3 (on average, 6 days later) in a sample of 194 US undergraduates (54% women) who reported at least one heavy drinking episode (4 drinks for women, 5 for men) in the past month. Participants completed self-report measures of drinking motives, daily alcohol consumption, and current craving. Results Implicit drinking identity uniquely mediated the relationship between social motives and alcohol consumption. It did not, however, mediate the relationship between motives and craving. Time 2 implicit drinking identity was positively associated with greater alcohol consumption and craving at Time 3, even after controlling for drinking motives. Subsequent analyses indicated significant indirect effects between social, enhancement, and coping motives (but not conformity) and consumption and craving when each motive was evaluated individually. Conclusions Implicit drinking identity continues to have promise as a predictor of drinking outcomes and as a target for interventions. Future experimental and prospective studies will be critical to establish the circumstances under which implicit drinking identity is strengthened and/or activated and the resulting effects on hazardous drinking.

Approximately 10% of US college students are engaged in non-medical use of prescription stimulants (NMUPS) and that use is linked to concerning health, educational, and societal consequences. Few studies have assessed normative perceptions surrounding NMUPS. Accordingly, we examined self-reported use and normative perceptions for NMUPS and demographic factors that may be associated with them. We also investigated whether higher normative perceptions for NMUPS were related to the most commonly used and abused substance among college students (alcohol). METHOD 1106 undergraduates participated in an online survey of normative perceptions of NMUPS and students’ own drinking and stimulant use habits. RESULTS Students overestimated NMUPS by other students and those normative estimates were associated with higher NMUPS. Living in a fraternity or sorority was related to higher NMUPS and perceived norms. Finally, higher normative perceptions of NMUPS were associated with higher hazardous drinking. CONCLUSION The large discrepancy between actual use (generally low) and students’ perceptions (generally high), and the relationship of these perceptions to both one’s own use of NMUPS and alcohol suggests that interventions aimed at correcting norms may be useful.