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Presentation 2

  1. 1. Alcohol Expectancies and ALDH2*2 inKorea<br />Benjamin Mahoney, <br />Dr. DeborahGraham & Dr. David Cottrell<br />
  2. 2. South Korea<br />Archeological findings date Korean civilization as early as 2333 BC <br />Civil war 1950 to 1953<br />South Korea is today the 15th biggest economy in the world<br />
  3. 3. Soju<br />Made from rice<br />Typically sold in 375ml <br /> bottles<br />Most frequently alcohol <br /> content is 20%<br />Usually drank neat<br />
  4. 4. Alcohol Consumption Rates<br />South Koreans consume 90 bottles of soju a year<br />5th highest for unrecorded alcohol consumption (est. 7 liters)<br />
  5. 5. Korean Alcohol Dependence Rates<br />The recent lifetime alcohol dependence rate<br /> has been reported as high as 11.7% (W.H.O, 2004)<br />Men are drinking far more than women, with all<br />available data indicating hugegender splits<br />In 2001, up to 22% of males suffered lifetime <br />dependence, and only 1-4% of women (W.H.O., 2004)<br />
  6. 6. Different Definition of Alcoholic<br />% Abstained <br />Korean sample maybe more representative of acute alcoholism<br />Alcoholism is effected<br /> by higher social tolerance of heavy drinking.<br />
  7. 7. ALDH2*2<br />ALDH2 mutations (2/1 & 2/2) fail <br /> to break down alcohol as effectively<br />Occursin high amounts in East Asian countries(China, Korea, Japan)<br />Those with the mutation suffer far greater<br /> negative physical effects when drinking<br />
  8. 8. Alcohol Metabolism<br />Alcohol <br />Dehydrogenaise<br />(ADH)<br />Aldehyde <br />Dehydrogenaise 2<br />(ALDH2)<br />If not processed, negative<br />physical effects occur<br />
  9. 9. ALDH2*2 FacialFlush<br />
  10. 10. Alcoholism RatesFor review, see Quertemont and Didone (2000)<br />Those with ALDH2 (1/1) can <br />maintain normal drinking rates<br />ALDH2 (1/1)<br />Those with ALDH2 (2/1) are 4<br /> times less likely to develop alcohol dependence<br />ALDH2 (2/1)<br />Those with ALDH2 (2/2) are 7 <br />times less likely to develop<br />alcohol dependence<br />ALDH2 (2/2)<br />
  11. 11. Placebo and Expectations<br />Lang et.al., 1975<br />Behavior changes when people <br />think they are consuming alcohol<br />Alcohol Makes Me….<br />Sociable!<br />Relaxed<br />Sick<br />Outcome expectancies are believed to<br /> mediate the changed behavior<br />Alcohol expectancies vary according to <br />peoples experience with the drug<br />
  12. 12. Alcohol Free Association (Reich and Goldman, 2005)<br />
  13. 13. ALDH2*2 Heavy Drinkers:<br />Significantly Higher Tension Reduction Expectancies<br />
  14. 14. Expectancy Challenges<br /> Research has shown that if you challenge expectancies you can change behavior<br />Expectancy challenges involve modified placebo exercises and expectancy information<br />
  15. 15. Expectancy ChallengesDarkes and Goldman (1993)<br />
  16. 16. Implicit Expectancy Activation<br />Alcohol expectancy words can also increase consumption levels<br />Participants presented with a neutral video, positive alcohol expectancies, and a video related to alcohol consumption, and combinations of the three<br />
  17. 17. Cheers Video<br />
  18. 18. Happy<br />Stroop Task<br />
  19. 19. Stroop Task<br />Confident<br />
  20. 20. Stroop Task<br />Sociable<br />
  21. 21. Roerich & Goldman (1995)<br />
  22. 22. ALDH2*2 FacialFlush<br /><ul><li>Facial Flushing
  23. 23. Dizziness
  24. 24. Nausea
  25. 25. Headaches
  26. 26. Drowsiness</li></li></ul><li>ALDH2*2<br />How can they drink on?<br />
  27. 27. Grays’ (1987)Reward and Punishment Model<br />Behavioral Activation System (BAS)<br /> Regulates approach action, <br />and is sensitive to cues of reward (SR)<br />Behavioral Inhibition System (BIS)<br /> Regulates evasive action, <br />and is sensitive to cues of punishment (SP)<br />
  28. 28. SPSR<br />While SR is a good predictor of heavy alcohol consumption, SP is not<br />It has been shown that those high in SR, low in SP and high in expectancies, are heavy consumers (Simons & Arens, 2007)<br />
  29. 29. Simons and Arens (2007)<br />High SR<br />High Positive<br />Expectancies<br />Heavy Drinking<br />Low SP<br />
  30. 30. Hypothesized ALDH2 (2/1) Heavy Drinker Model<br />ALDH2 (2/1) is the genetic mutation of interest due to higher drinking rates and prevalence<br />High SR and low<br />SP high and alcohol <br />expectancies <br />mediate problem <br />consumption<br />High Tension <br />Reduction Expectancies<br />ALDH2 (2/1)<br />High SR/Low SP<br />Heavy Drinking<br />ALDH2 (2/1) high in tension reduction, low in SP and High in <br />SR.<br />Tension reduction<br />expectancies are <br />constantly associated <br />with problematic <br />drinking<br />
  31. 31. Implicit Expectancy Activation<br />237 Korean participants answered the question:<br /> Alcohol makes me….<br />Also filled out a survey with alcohol questions embedded<br />
  32. 32. Korean Alcohol Expectancies<br />
  33. 33. Expectancy Categories<br />8 Dimensions of expectancy Multi Dimensional Scaling<br />Aroused <br />Heavy Drinkers<br />Positive Aroused<br />Negative Aroused <br />Horny<br />Awake<br />Happy<br />Aggressive<br />Positive<br />Negative<br />Relaxed<br />Sick<br />Dizzy<br />Sleepy<br />Positive Sedated <br />Negative Sedated<br />Sedated <br />Lighter Drinker<br />
  34. 34. Korean Alcohol Expectancies<br />
  35. 35. Korean Alcohol Expectancies<br />
  36. 36. Back Translation<br />Original English Version<br />Korean Version<br />
  37. 37. Back Translation<br />Back Translated<br />English Version<br />Korean Version<br />
  38. 38. Back Translation<br />Back Translated <br />English Version<br />Original English Version<br />
  39. 39. Back Translation<br />Korean Version<br />
  40. 40. Method Outline<br />461 participants<br />Measures:<br /> -A demographic Survey<br /> -Alcohol Expectancy Questionnaire<br /> -SPSRQ (S)<br /> -Buccal Swap<br />
  41. 41. BuccalSawb<br />
  42. 42. Average Drinks per Occasion<br />
  43. 43. Gender and Global Positive Expectancy Moderating ALDH2 (1/1) Drinks per Occasion <br />
  44. 44. Tension Reduction Expectancy and SP Moderating ALDH2 (2/1) Drinks per Occasion <br />
  45. 45. Implicit Expectancy Activation<br />Do Korean expectancy words affect cognition?<br />Memory network can be activated by associated cues<br />Reich, Noll and Goldman (2005) demonstrated activation of alcohol memory network<br />
  46. 46. Implicit Expectancy Activation<br />30 word memory test<br />Two word categories embedded:<br /><ul><li>grocery items (e.g. bread, cheese)
  47. 47. alcohol expectancy words (e.g. happy confident)</li></ul>Two condition: <br /><ul><li>those who saw ‘milk’ first word
  48. 48. those who saw ‘beer’ first word</li></li></ul><li>Implicit Alcohol Cue<br />Beer<br />
  49. 49. Implicit Alcohol Cue<br />Bread<br />
  50. 50. Implicit Alcohol Cue<br />Happy<br />
  51. 51. Implicit Alcohol Cue<br />Sociable<br />
  52. 52. Implicit Alcohol Cue<br />Cheese<br />
  53. 53. Memory Test (Reich, Noll & Goldman, 2005)<br />
  54. 54. Implicit Expectancy Activation<br />30 word memory test<br />Two word categories embedded:<br /><ul><li>grocery items (e.g. bread, cheese)
  55. 55. alcohol expectancy words (e.g. happy confident)</li></ul>Two condition: <br /><ul><li>those who saw ‘kim chi’ first word
  56. 56. those who saw ‘soju’ first word</li></li></ul><li>Memory Test<br />
  57. 57. Major Findings<br /> Free association tests show higher levels of <br /> negative expectancy<br /> Genetic testing shows that ALDH2*2 <br /> drinking levels are mediated by and <br /> tension reduction expectancy SP<br />Memory test failed to show activation of <br /> alcohol memory network <br />Gender a big mediator<br />
  58. 58. Postulation<br />Tension reduction expectancy may aid ALDH 2*2 drinkers tolerate the negative effects<br /> SP appears to play a moderating role in this <br /> toleration of the punishing effects of <br /> alcohol<br /> ALDH2*2 may be moderating the high levels <br /> of negative expectancy and failure to see <br /> activation of a memory network<br />
  59. 59. Theoretical Questions<br /> Does acetaldehyde have stress relief <br /> properties?<br />How is ALDH2*2 impacting the larger than <br /> usual gender difference in alcohol <br /> consumption?<br />
  60. 60. Conclusion<br />Results lend support to research showing <br /> ALDH2*2 report higher tension reduction <br /> expectancy<br /> Results do not support research suggesting <br /> SR is a moderator of drinker level<br /> Results suggest that ALDH2*2 drinks per <br /> occasion is moderated by SP<br />
  61. 61. Conclusion<br />Results suggest that Koreans have higher <br /> levels of negative expectancy<br />Memory network activation may be more <br /> difficult in a Korean population, which may be mediated by higher levels of negative <br /> expectancy<br />
  62. 62. Practical Aplications<br />% Abstained <br />Intervention programs not working a well<br />Identifying ALDH2 may help better target motivation<br />
  63. 63. Korean Expectancy Challenges<br />Focus on disrupting tension reduction expectancy may help. <br />Focusing on negative effects to heighten SP<br />

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