I that the disclosure of emotions can have positive consequences for individuals-that emotional disclosure is a Good Thing like democracy, mother, and an annual physical. But, although contemporary psychologists may view emotional disclosure as a Good Thing, this has not been the prevailing view in much of Western thought nor even in twentieth century psychology. For example, the psychologists who first studied human intelligence contrasted rational thought with emotional experience (Schaffer, Gilmer,

Three studies are conducted to assess the uncertainty- threat model of political conservatism, which posits that psychological needs to manage uncertainty and threat are associated with political orientation. Results from structural equation models provide consistent support for the hypothesis that uncertainty avoidance (e.g., need for order, intolerance of ambiguity, and lack of openness to experience) and threat management (e.g., death anxiety, system threat, and perceptions of a dangerous world) each contributes independently to conservatism (vs. liberalism). No support is obtained for alternative models, which predict that uncertainty and threat management are associated with ideological extremism or extreme forms of conservatism only. Study 3 also reveals that resistance to change fully mediates the association between uncertainty avoidance and conservatism, whereas opposition to equality partially mediates the association between threat and conservatism. Implications for understanding the epistemic and existential bases of political orientation are discussed.

A motivational model of alcohol involvement (M. L. Cooper, M. R. Frone, M. Russell, & P. Mudar, 1995) was replicated and extended by incorporating social antecedents and motives and by testing this model cross-sectionally and longitudinally in a sample of college students. Participants (N = 388) completed a questionnaire battery assessing alcohol use and problems, alcohol expectancies, sensation seeking, negative affect, social influences, and drinking motives. Associations among psychosocial antecedents, drinking motives, and alcohol involvement differed from those found by M. L. Cooper et al. (1995). These findings point to the importance of social influences and of positive reinforcement motives but not to the centrality of drinking motives in this population.

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Social influences are among the most robust predictors of adolescent substance use and misuse. Studies with early adolescent samples have supported the need to distinguish among various types of social influences to better delineate relations between social factors and alcohol use and problems. Method: The first major goal of the present study (N = 399, 263 women) was to examine unique relations between particular facets of social influence and alcohol use and problems in a relatively heavy-drinking population (i.e., college students). We hypothesized that active social influences (offers to drink alcohol) and passive social influences (social modeling and perceived norms) would demonstrate positive associations with measures of alcohol use and problems. We also tested the hypothesis that alcohol outcome expectancies would mediate associations between social influences Social influences Social influence variables have been observed to be among the strongest correlates of adolescent substance use and misuse (Hawkins et al., 1992; Jacob and Leonard, 1994). As noted by Jacob and Leonard (1994), there is little doubt that others' substance use, particularly that of close friends, is among the strongest predictors of adolescent substance use. Some research in the area of alcohol use and misuse among underage drinkers has suggested the utility of distinguishing among various types of social influences in order to parse out differing effects on drinking behaviors and suggest optimal intervention strategies (De Vries et al., 1995; Flay and Petraitis, 1993; Oostveen et al., 1996). To this end, Graham and colleagues (1991) proposed a framework that delineated two distinct mechanisms by which social reference groups might influence drinking and labeled these "active" and "passive" social influences.

IMPORTANCE The United States has invested substantially in screening and brief intervention for illicit drug use and prescription drug misuse, based in part on evidence of efficacy for unhealthy alcohol use. However, it is not a recommended universal preventive service in primary care because of lack of evidence of efficacy. OBJECTIVE To test the efficacy of 2 brief counseling interventions for unhealthy drug use (any illicit drug use or prescription drug misuse)—a brief negotiated interview (BNI) and an adaptation of motivational interviewing (MOTIV)—compared with no brief intervention. DESIGN, SETTING, AND PARTICIPANTS This 3-group randomized trial took place at an urban hospital-based primary care internal medicine practice; 528 adult primary care patients with drug use (Alcohol, Smoking, and Substance Involvement Screening Test [ASSIST] substance-specific scores of $4) were identified by screening between June 2009 and January 2012 in Boston, Massachusetts. INTERVENTIONS Two interventions were tested: the BNI is a 10- to 15-minute structured interview conducted by health educators; the MOTIV is a 30- to 45-minute intervention based on motivational interviewing with a 20- to 30-minute booster conducted by master’s-level counselors. All study participants received a written list of substance use disorder treatment and mutual help resources. MAIN OUTCOMES AND MEASURES Primary outcome was number of days of use in the past 30 days of the self-identified main drug as determined by a validated calendar method at 6 months. Secondary outcomes included other self-reported measures of drug use, drug use according to hair testing, ASSIST scores (severity), drug use consequences, unsafe sex, mutual help meeting attendance, and health care utilization. RESULTS At baseline, 63% of participants reported their main drug was marijuana, 19% cocaine, and 17% opioids. At 6 months, 98% completed follow-up. Mean adjusted number of days using the main drug at 6 months was 12 for no brief intervention vs 11 for the BNI group (incidence rate ratio [IRR], 0.97; 95% CI, 0.77-1.22) and 12 for the MOTIV group (IRR, 1.05; 95% CI, 0.84-1.32; P = .81 for both comparisons vs no brief intervention). There were also no significant effects of BNI or MOTIV on any other outcome or in analyses stratified by main drug or drug use severity. CONCLUSIONS AND RELEVANCE Brief intervention did not have efficacy for decreasing unhealthy drug use in primary care patients identified by screening. These results do not support widespread implementation of illicit drug use and prescription drug misuse screening and brief intervention. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00876941

The Implicit Association Test (IAT; A. G. Greenwald, D. E. McGhee, & J. L. K. Schwartz, 1998) has recently been used to assess the role of alcohol-affect associations in drinking behavior. The current study examined the validity of an alcohol IAT with 88 hazardous-drinking college students who completed measures of drinking behavior, an explicit measure of alcohol motivation, and an IAT that assessed alcohol-motivation associations. Regression analyses indicated that IAT scores correlated with binge drinking and cue reactivity, replicating T. P. Palfai and B. D. Ostafin's (2003) results. Results also indicated convergent validity (the IAT was related to an explicit measure of alcohol motivation) and incremental validity (IAT scores were correlated with alcohol behavior after controlling for the explicit measure). Implications for understanding the self-regulation of drinking are discussed.

Brief intervention is insufficient for linking medical inpatients with treatment for alcohol dependence and for changing alcohol consumption. Medical inpatients with unhealthy alcohol use require more extensive, tailored alcohol interventions.