An Investigation of the Role of Negative Alcohol-Related Expectancy: A Predictor of Consumption and a Representation of Motivation for Abstinence

McMahon, John (1993) An Investigation of the Role of Negative Alcohol-Related Expectancy: A Predictor of Consumption and a Representation of Motivation for Abstinence. PhD thesis, University of Glasgow.

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A new instrument, the Negative Alcohol Expectancy Questionnaire, (NAEQ), is constructed by canvassing the negative expectancies held by 188 adults: problem drinkers in treatment; social drinkers; and ex-problem drinkers attending AA. It is found that the negative expectancies which subjects hold fall into three temporal contexts: the time of drinking; the day after; and long term consequences. Thus, the NAEQ was designed to reflect this by arranging the items into three sub-scales: That night; Next day; Continued drinking. In a study of 101 social drinkers using measures of positive expectancy (the AEQ) and negative expectancy (the NAEQ) it is found that the NAEQ is the best and most consistent predictor of consumption, predicting: quantity per session; frequency of drinking; and weekly consumption. Some evidence is also found which suggests that negative expectancy is involved in drinking restraint. Positive and negative expectancies of satisfied and dissatisfied social drinkers are compared. It is argued that since dissatisfied drinkers will be more motivated to abstain, they should hold higher negative expectancies of alcohol. The results of this study show that this is, indeed, the case with the most reliable differences found in the Next day sub-scale. No reliable differences were found between these two groups in any positive expectancies variables. A second study compares the the expectancies of satisfied social drinkers and non-problem abstainers. In this study, reliable differences were found for both positive and negative expectancies, with abstainers holding lower positive expectancies and higher negative expectancies than the social drinkers. An analysis of the expectancies of all three groups is then carried out, which demonstrates that while dissatisfied social drinkers most resemble satisfied drinkers in the positive expectancies which they hold, in negative expectancies they most resemble abstainers. It is concluded that the results of these two studies support the main hypothesis of this thesis, that is that negative expectancy represents motivation to abstain from alcohol. The investigation of positive and negative expectancy is extended to male problem drinkers. It was found that the results were consistent with the earlier findings since level of consumption was best predicted by negative expectancy as it was with social drinkers. A one month and three month follow-up study of 53 male problem drinkers in treatment found that abstinence was predicted by higher distal negative expectancies, lending support to the suggestion that negative expectancy represents motivation for abstinence. Positive expectancy did not predict outcome. In order to test the NAEQ's utility as an instrument to match clients to treatment by motivational level, subjects were allocated to groups according to their admission negative expectancy scores, both Total score and Distal score. Both measures gave similar results, although the distal score was slightly superior. It was found that there was little difference in outcome between subjects with high and moderate negative expectancies, however, there was a marked difference between these groups and the low group, where only one subject was abstinent at three months. Finally, it was shown that when positive and negative expectancy were processed against each other for all subject groups, (that is: problem drinkers; social drinkers and abstainers) a coherent and plausible picture of drinking decisions emerged. What was, perhaps, most striking was the similarity between dissatisfied social drinkers and treatment relapsers. For although these two groups have quite different expectancies when positive and negative are assessed separately, when a combined expectancy measure is used they are almost identical. Suggesting that in stages of change terms they are at the same point regarding a decision to change. DISCUSSION It is concluded that the results of this thesis show that when an empirically derived instrument for measuring negative expectancy is employed (the NAEQ) negative expectancy predicts consumption for both social drinkers and problem drinkers. Also that the thesis has demonstrated that negative expectancy can predict outcome of treatment for problem drinkers, lending support to the suggestion that negative expectancy represents motivation to abstain. When compared to other instruments for measuring negative expectancies, three main differences are found. First, that the sample of subjects used in its construction is far larger and more diverse than any of the others. Second, the NAEQ not only employs many more items but the range of the expectancies are much greater. Finally, the NAEQ is arranged to represent three temporal contexts whereas the others tend to be limited to the time of drinking. It is suggested that since the NAEQ has shown such an unparalleled success that researchers view expectancies in the wider context of the effects of drinking behaviour rather than alcohol effects. It is suggested that the NAEQ may prove to be a useful assessment instrument for therapists in two ways. First as a quantitative measure of the individual's level of motivation, which would allow better treatment match. Second, and as qualitative measure, allowing the infrastructure of motivation to be assessed, which may aid motivational style treatments. Two areas for future research have been suggested. First, measures of desirability should be included to ascertain whether they improve prediction. Second ways of combining positive and negative expectancy, to model decision making processes, should be explored to provide a better understanding of drinking decisions.

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Additional Information: Adviser: Barry Jones
Keywords: Clinical psychology, Behavioral psychology
Date of Award: 1993
Depositing User: Enlighten Team
Unique ID: glathesis:1993-75644
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 19 Dec 2019 09:15
Last Modified: 19 Dec 2019 09:15

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