Elsevier

Addictive Behaviors

Volume 29, Issue 6, August 2004, Pages 1221-1224
Addictive Behaviors

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The moderating effects of tension-reduction alcohol outcome expectancies on placebo responding in individuals with social phobia

https://doi.org/10.1016/j.addbeh.2004.03.020Get rights and content

Abstract

We conjectured that individual differences in tension-reduction alcohol outcome expectancies (TR-AOEs) could produce widely varying responses to manipulations in alcohol-placebo studies and tested this idea by having individuals with social phobia give speeches in front of a group. One speech occurred before and one after participants consumed either a placebo beverage or a control beverage (i.e., a nonalcoholic drink described as containing no alcohol). Study results indicate that the placebo manipulation reduced cognitive and affective symptoms of anxiety to a greater extent for males with high TR-AOEs than for males with low TR-AOEs. This pattern was not found for women in the placebo group or for individuals in the control group. These findings demonstrate a moderating effect of TR-AOEs on the association between the consumption of a placebo beverage and response to an anxiety challenge and highlight the importance of accounting for gender and outcome expectancies when evaluating psychoactive substances.

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.

Section snippets

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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