The present study proposed and tested a motivational model of alcohol use in which people are hypothesized to use alcohol to regulate both positive and negative emotions. Two central premises underpin this model: (a) that enhancement and coping motives for alcohol use are proximal determinants of alcohol use and abuse through which the influence of expectancies, emotions, and other individual differences are mediated and (b) that enhancement and coping motives represent phenomenologically distinct behaviors having both unique antecedents and consequences. This model was tested in 2 random samples (1 of adults, 1 of adolescents) using a combination of moderated regression and path analysis corrected for measurement error. Results revealed strong support for the hypothesized model in both samples and indicate the importance of distinguishing psychological motives for alcohol use.

A stressor vulnerability model of stress-induced drinking was tested in a stratified random sample of 1,316 Black and White adult drinkers. Stressors were highly predictive of both alcohol use and drinking problems among men who relied on avoidant forms of emotion coping or held strong positive expectancies for alcohol's effects and accounted for more than 35% of the variance in alcohol use among the subgroup of men who were high in both vulnerability factors. In contrast, stressors were negatively related among men who were low in both and were unrelated among women regardless of their coping or expectancies. These findings suggest that tension reduction theories of alcohol use are overly broad and that individual characteristics must be considered to account for stress-related effects on alcohol use and abuse.

The efficacy of alcohol screening questionnaires, the TWEAK, T-ACE, NET, MAST, and CAGE, in detecting periconceptional risk-drinking, > or = 1 oz absolute alcohol/day, was investigated in 4743 African-American women attending an inner-city prenatal clinic who had reported ever drinking. Sensitivity, specificity, positive predictive value, efficiency, follow-up rates, and receiver operating characteristics of the questionnaires were examined to compare the overall effectiveness of the questionnaires and their performance at cut-points defining positive scores ranging from 1 to 3. Relatively little difference between TWEAK, T-ACE, and MAST was seen in the receiver operating characteristic accuracy indices; NET and CAGE lagged behind. Sensitivity/specificity scores for the two questionnaires most sensitive at cut-point 1 were TWEAK (87/72) and T-ACE (83/75). At cut-point 2, sensitivity was optimized with respect to specificity; TWEAK (79/83) was significantly more sensitive than T-ACE (70/85; p = 0.002). At cut-point 3, the two most sensitive tests were MAST (61/92) and TWEAK (59/94). In general, measures of merit were not greatly affected by the time between conception and the administration of the screens. Screening was most sensitive for women interviewed during the first 15 weeks of pregnancy; risk-drinkers tended to delay entry into prenatal care, increasing positive predictive values associated with screening later in pregnancy. This study confirms the utility, when screening for risk-drinking during pregnancy, of brief questionnaires that assess alcohol intake indirectly by asking women about their tolerance to alcohol's effects, psychological consequences of drinking, and significant others' concern about their drinking. It validates T-ACE and provides preliminary data indicating that TWEAK may outperform T-ACE.

The longitudinal relations among contact with one's social network (social contact), perceived social support, depression, and alcohol use were examined. An integrative model was developed from affect regulation theory and theories of social support and dysfunctional drinking. Data were obtained from a random sample of 1,192 adults. The 3-wave panel model was tested using structural equation modeling analysis. Results revealed that (a) social contact was positively related to perceived social support; (b) perceived social support was, in turn, negatively related to depression; and (c) depression was, in turn, positively related to alcohol use for 1 of 2 longitudinal lags. There was partial support for the feedback hypothesis that increased alcohol use leads to decreased contact with family and friends. Although the results generally supported the authors' hypotheses, the significant coefficients in the model were generally small in size.

This study examined the longitudinal relationships among adult drinking, partner drinking, and peer drinking over the transition to marriage. Newlywed couples were assessed with respect to alcohol involvement, peer drinking, and risk factors and reassessed at their 1st anniversary. Husbands' premarital drinking was predictive of wives' drinking at the 1st anniversary, indicating partner influence. The results did not support a peer-influence hypothesis in that peer drinking at marriage was not predictive of husbands' or wives' drinking at the 1st anniversary. There was evidence, however, for a peer-selection effect with husbands' premarital drinking predicting peer drinking for both husbands and wives. Wives' premarital drinking was unrelated to the subsequent drinking of their peers or their husbands' peers.

OBJECTIVES: This study investigated the efficacy of screening for risk drinking during pregnancy with two brief questionnaires, TWEAK and T-ACE. Both include an assessment of tolerance based on the number of drinks women report they can hold. METHODS: Subjects were disadvantaged African-American obstetric patients in Detroit, Mich. Traditional alcoholism screens (Michigan Alcohol Screening Test [MAST], CAGE) and the tolerance question were administered (n = 2717); TWEAK and T-ACE were constructed from tolerance and embedded MAST and CAGE items. In a separate sample (n = 1420), only the T-ACE was administered. Periconceptional risk drinking was the gold standard. Screen evaluations were based on receiver-operating characteristic analyses. RESULTS: At the cutpoint of 2, sensitivity/specificity for embedded screens were 91/77 for TWEAK and 88/79 for T-ACE; comparable values for T-ACE alone were 67/86. TWEAK and T-ACE screened more effectively than CAGE or MAST. CONCLUSIONS: Embedded versions of TWEAK and T-ACE were both highly sensitive to periconceptional risk drinking in this population. Administering T-ACE alone reduced its sensitivity; this suggests that MAST and CAGE administration improves its performance.

Previous research indicates that husbands' drinking before marriage is predictive of wives' drinking after marriage. A relationship motivation model was tested in which this influence was moderated by wives' dependence, relationship satisfaction, peer group size, and the belief that alcohol positively impacts relationships. Newlyweds were assessed at the time of marriage and were reassessed at their 1st and 2nd anniversaries. Results supported a relationship motivation model. Husband-to-wife drinking influence was moderated by wives' interpersonal dependence, number of peers, and positive relationship alcohol expectancies. The direction of the spousal influence changed in the 2nd year of marriage, with wives' drinking over the 1st year predicting husbands' drinking in the 2nd. Implications with respect to marriage and the drinking partnership are discussed.

The configuration of partners' drinking patterns may be most critical to marital functioning. Implications of discrepant husband and wife smoking, drinking, and drug use for relationship quality at the transition to marriage were examined. Participants were 642 couples entering into their 1st marriage. Separate, self-administered questionnaires were completed at home by each partner. Both husbands and wives in couples in which only 1 partner drank heavily or used drugs reported significantly lower marital quality than other spouses. Husband Use x Wife Use interactions were not significant for cigarette use, alcohol use, or regular drinking. Discrepancies in more deviant substance use behaviors may be most relevant to marital functioning.