Short communicationThe moderating effects of tension-reduction alcohol outcome expectancies on placebo responding in individuals with social phobia
Introduction
In their now classic article on the balanced placebo design (BPD), Rohsenow and Marlatt (1981) highlighted several reasons why seemingly similar studies utilizing a placebo group could achieve vastly different results. These reasons included differences in the method of beverage presentation, in the credibility of the placebo manipulation, and in the specific dependent variables used, among others. They also suggested that individual difference variables (e.g., age, past drinking experience, or cultural background) might compromise the valid comparison of placebo subjects within a given study.
We conjectured that a wide range of individual difference variables could influence placebo responding via their impact on tension-reduction alcohol outcome expectancies (TR-AOEs). With this in mind, we tested whether TR-AOEs moderated placebo responding in an experimental study of alcohol and placebo effects on social anxiety in individuals with social phobia (Abrams, Kushner, Lisdahl Medina, & Voight, 2001). Specifically, we provide a secondary analysis of these experimental data to test the hypothesis that, among individuals given an alcohol placebo, those with stronger TR-AOEs would experience greater anxiety reduction than those with weaker TR-AOEs.
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Participants
Participants were required to be 21–55 years old, have a diagnosis of social phobia, and be a “social drinker.” We excluded individuals if they currently met the DSM-IV diagnostic criteria for depression, bipolar disorder, a psychotic disorder, or alcohol abuse/dependence. The sample used for the present report consisted of 41 individuals (25 females and 16 males) who ranged in age from 21 to 55 (M=32.5, S.D.=9.8).
The Alcohol Expectancies Questionnaire (AEQ)
TR-AOEs were measured prior to the experimental portion of the study by the
Results
Forms administered at several time points after the beverage phase suggest that participants in the placebo group felt at least somewhat intoxicated and lacked awareness of the placebo deception (Abrams et al., 2001).
The mean per-item score on the tension reduction factor of the AEQ was 2.16 (S.D.=1.12). ANOVA results show that scores did not significantly vary by gender or by beverage group. The absence of a significant beverage-group effect suggests that the placebo and control groups were
Discussion
We sought to study whether TR-AOEs moderate the association between the consumption of a placebo beverage and anxiety responding in individuals with social phobia. We found that men with strong TR-AOEs experienced a greater reduction in fear of negative evaluation and mental distress after consuming a placebo beverage than men with weak TR-AOEs. TR-AOEs did not moderate anxiety responding for women. In short, this study shows that, at least for men, the specific effects expected from alcohol
Acknowledgements
This research was supported, in part, by a grant from the National Institute on Alcoholism and Alcohol Abuse (R-29, AA09871) awarded to the second author and a grant from the National Institute of Mental Health (MH17069) awarded to the first author.
References (3)
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The pharmacologic and expectancy effects of alcohol on social anxiety in individuals with social phobia
Drug and Alcohol Dependence
(2001)
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