Gabriele Caselli: Outcome Expectancies, Metacognitive Beliefs And Alcohol Use

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Presentazione Congresso Internazionale Terapia Cognitiva Comportamentale, Roma, 2008


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  • The interview was based on metacognitive profiling template (Matthews & Wells, 1994), adapted to focus on cognitive experience associated with a drinking episode and to collect data related to social-cognitive expectancies and outcome
  • Gabriele Caselli: Outcome Expectancies, Metacognitive Beliefs And Alcohol Use

    1. 1. OUTCOME EXPECTANCIES, METACOGNITIVE BELIEFS AND ALCOHOL USE Gabriele Caselli 1,2 , Chiara Bortolai 3 , Mauro Leoni 1,4 , Francesco Rovetto 1 , Marcantonio Spada 5 1 Università degli studi di Parma, Parma, Italy 2 Studi Cognitivi, Scuola di Psicoterapia Cognitiva, Modena, Italy 3 Ospedale Privato Accreditato Villa Rosa, Modena, Italy 4 Fondazione Sospiro, Cremona, Italy 5 Roehampton University, London, United Kingdom
    2. 2. Special thank goes to… Giovanni M. Ruggiero, Sandra Sassaroli Studi Cognitivi, Cognitive Psychotherapy School Milano, Italy
    3. 3. Introduction <ul><li>Expectancies refer to a person’s evaluation of an anticipated outcome (Tolman, 1932) </li></ul><ul><li>Outcome alcohol expectancies (OAE) refer to a explicit or implicit set of beliefs about substance effects (Brown, 1985; Brown, Christiansen & Goldman, 1987) </li></ul><ul><li>The construct of OAE is multidimensional. A typical distinction is the one between positive and negative expectancies about alcohol use (Leigh & Stacy, 1993) </li></ul><ul><ul><li>Positive AE: Alcohol reduces my tension, Alcohol helps me to meet people </li></ul></ul><ul><ul><li>Negative AE: Alcohol causes health problems, Alcohol make me unpleasant </li></ul></ul>
    4. 4. Outcome expectancies and alcohol use <ul><li>Ambiguous role of outcome alcohol expectancies in the genesis, maintenance and relapse in pathological drinking behaviour </li></ul><ul><ul><li>Positive correlations (Eastman & Norris, 1982; Jones & McMahon, 1994) </li></ul></ul><ul><ul><li>Negative correlations (Leigh, 1989; Weirs, Hoogeveen, Sergeant & Gunning 1997; Kilbey, Downey & Breslau, 1998; Sharkansky & Finn, 1998) </li></ul></ul><ul><ul><li>No correlations (Southwick, Steele, Marlatt & Lindell, 1981; Fromme, Stroot and Kaplan, 1993) </li></ul></ul>
    5. 5. Metacognitive beliefs and alcohol use <ul><li>Metacognitive beliefs (MB) refer to the information individuals hold about their cognitive and emotional internal state and about strategies they could use to regulate it (Wells, 2000) </li></ul><ul><li>Metacognitive beliefs about alcohol use (MBA) refer to the functions and consequences of alcohol use on emotions, thoughts and private experience (Spada & Wells, 2005) </li></ul><ul><ul><li>Positive MBA: Alcohol helps me to stop my worries, Alcohol helps me not to focus my attention on the way other people look at me </li></ul></ul><ul><ul><li>Negative MBA: Alcohol makes me confused; I lose control on my behaviour when I begin to drink . </li></ul></ul>
    6. 6. Outcome expectancies vs metacognitive beliefs <ul><li>Expectancies models do not distinguish between social-cognitive and metacognitive domains </li></ul><ul><li>Expectancies measures do not clearly identify beliefs concerning the use of alcohol as a cognitive control and self-regulation tool </li></ul><ul><li>Expectancies models mainly measure general outcomes arising from alcohol use rather than focusing on its specific consequences on internal states </li></ul>There is a partial overlap but it is limited to beliefs regarding the effects of alcohol on emotional self-regulation
    7. 7. Aims <ul><li>The role of MBA may help understand the contradictory findings regarding the predictive power of general outcome expectancies on alcohol use </li></ul><ul><li>The goals of the present qualitative study was </li></ul><ul><ul><li>(1) to expand the MBA construct to include beliefs that were not considered by previous studies </li></ul></ul><ul><ul><li>(2) to compare the presence of social-cognitive OAE and MBA in a clinical and a community sample </li></ul></ul>
    8. 8. Method (1) <ul><li>Participants </li></ul><ul><ul><li>60 patients (18 females) seeking treatment for problem drinking (46.7 years; SD = 9.1) </li></ul></ul><ul><ul><li>60 social drinkers (19 females; 45.1 years; SD= 9.7) </li></ul></ul><ul><li>Materials </li></ul><ul><ul><li>Semi-structured interview was used to explore social-cognitive OAE and MBA by tracing a recent drinking episode (Matthews & Wells, 1994; Spada & Wells, 2005) </li></ul></ul><ul><ul><ul><li>When you were drinking, did you have any thought about the effect of alcohol use? Can you identify these thoughts? </li></ul></ul></ul><ul><ul><ul><li>After a drinking episode, did you have any thought about the effect of alcohol use? Can you identify these thoughts? </li></ul></ul></ul><ul><ul><ul><li>Were there any advantages or disadvantages to drinking? </li></ul></ul></ul><ul><ul><ul><li>Did you use alcohol as a coping strategy? If yes, What was your main goal? How did you know whether you had achieved your goal? What signal informed you that it was all right to stop drinking? </li></ul></ul></ul>
    9. 9. Method (2) <ul><li>Procedures </li></ul><ul><ul><li>Interviews transcripts were assessed by two postgraduate psychologists that were blinded relatively to both the experimental hypothesis and the group each participant belonged to </li></ul></ul><ul><ul><li>No significant difference between the two assessors was observed </li></ul></ul><ul><li>Statistics </li></ul><ul><ul><li>Chi-Square statistics were used to verify difference in OAE and MBA frequency between clinical and community samples </li></ul></ul>
    10. 10. Results (1)
    11. 11. Results (2) OAE in clinical and community samples **
    12. 12. Results (3) MBA in clinical and community samples ** ** ** ** * *
    13. 13. Preliminary conclusions <ul><li>Negative OAE about health damage from alcohol use are less frequent in problem drinkers than in social drinkers </li></ul><ul><li>All positive MBA and negative MBA about executive uncontrollability are more frequent in problem drinkers than in social drinkers </li></ul><ul><li>MBA may have a stronger impact than OAE on alcohol use (Spada, Moneta & Wells, 2007) </li></ul><ul><li>Cognitive regulatory function may be the core motivation for alcohol use in problem drinking </li></ul>

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