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We outline an implicit cognition, verbal, and nonverbal assessment approach that is feasible for a range of interventions in health behavior and addiction. This approach provides a way to assess whether interventions have an influence on the relatively spontaneous memories, thoughts, and evaluations that may mediate or precipitate health-related behaviors (alcohol, tobacco, and other drug use; HIV risk behavior; diet, exercise, and violent acts). We focus on feasible assessment applications in relapse prevention, and briefly provide several examples of assessments also relevant to secondary prevention and media interventions, with a focus on addictive and HIV risk behaviors. The assessment examples range from well-investigated tests with grounding in basic research to assessments that have much promise for application but are yet to be thoroughly evaluated. The approach suggests that implicit cognition assessments may help practitioners uncover and address plausible cognitive mediation effects that are unlikely to be currently assessed.

Objective: Retrospective reports of the association between drinking and high-risk sexual behavior can be biased by implicit theories of the effects of drinking or may represent post hoc justifications instead of accurate reports of behavior. Using data from a daily diary study, we compared daily reports of condom use when drinking and not drinking with the same participants' reports of these behaviors from a retrospective questionnaire administered after diary collection was complete. Method: Participants included adolescents (n = 145), adult sexually transmitted disease clinic clients (n = 167), college students (n = 145), and men who have sex with men (n = 147). All participants reported their alcohol consumption and sexual activity daily for 8 weeks and then completed a retrospective questionnaire about their behavior over the diary period. Results: Participants' retrospective judgments about whether they used condoms more or less when drinking were not significantly related to their behavior as reported in the diary. Fewer than two thirds of the participants were accurate in their recollection of the association of condom use and drinking. Teenagers and men who have sex with men were more likely to retrospectively overestimate the negative effect of alcohol on condom use. Conclusions: Retrospective questions about the association between drinking and condom use were consistent with actual behavior only among people who consistently either never or always used condoms. These individuals correctly reported that drinking had no effect on their condom use. For people whose condom use varies, questions about associations between drinking and sex may be difficult to answer, owing to their conditional nature, and may lead to error., RESEARCH ON FACTORS ASSOCIATED WITH high-risk sexual behavior for disease transmission has suggested that drinking alcohol at the time of sexual activity is related to the occurrence of unprotected sex. [...]

Most cognitive approaches to word association and some theories Of social cognition converge on the notion that the performance of repetitive behaviors should predict word association responses. To study this issue, the authors examined the frequencies of free-association responses of 1,003 subjects to ambiguous words, some of which had subdominant senses that were linked to repetitive behaviors (e.g., draft and alcohol use). Results showed that three out of four measures of individual differences in repetitive behaviors significantly predicted responses for words linked to their respective behaviors. Gender, age, and language background were controlled for in these analyses. Although cognitive approaches suggested that an experimental manipulation of item presentation (grouped vs. randomly mixed items) should influence responses, this effect was not significant. Implications are discussed in terms of theories of lexical ambiguity and implicit influences of memory for previous experiences., Cognitive research relies strongly on norms obtained from word association studies, but individual differences in word association have been mostly ignored by these approaches. Although word association responses are used [...]

The factor structures of alcohol effect expectancies in adolescents aged 12-17 years and adults aged 18 years and older are studied and compared. Discrepancies are minimized by using the same sampling frame, which includes assessment of positive and negative expectancies for all age groups. The pattern and magnitude of the loadings on the sets of factors for the participants are compared. The results are consistent with a two-factor model, positive and negative, of alcohol expectations, varying only in the adolescents' belief in alcohol's effect on sexual behavior.

The goal of this study was to explore the process by which sexual situations that involve alcohol are negotiated. A scenario depicting a drinking situation involving potential sexual activity was constructed and converted into a text-based interactive computer game, in which alcohol consumption of the subject and partner roles was varied. The program included a number of points at which the subject's response determined the subsequent course of action. At these choice points, questions were asked about perceptions of sexual interest and nervousness. The results showed strong gender differences in subjects' choices, judgments, and feelings throughout the hypothetical encounter, with men much more likely to choose responses leading to sexual activity and to express more attraction and sexual desire throughout. Alcohol interacted with gender such that among women, those in drinking scenarios were more likely than those in nondrinking scenarios to choose to have sex at the end of the scenario; this effect was not seen in male subjects.

Recent reports have indicated that the use of alcohol is related to sexual behavior (such as unprotected intercourse) that is high-risk for HIV infection. However, most of these studies have collected data from convenience samples, using measures of varying specificity. This paper describes a study designed to investigate the relationship of alcohol use to unsafe sexual activity in a representative sample of adults. Data were collected from 2058 respondents as part of a survey of a multi-stage area probability sample of the adult household population of the 48 contiguous United States. The interview instrument included measures of alcohol use, sexual activity and condom use. Logistic regression analyses showed that heavier drinkers were more likely to be sexually active, and if sexually active, were more likely to have had more than one sexual partner in the previous year. However, drinking variables were in general not significantly related to condom use. These results suggest that alcohol use may be more strongly related to lifestyle variables (general sexual activity and number of sexual partners) than to more concrete behavioral variables such as condom use. Because these data are correlational, the findings are also consistent with the notion of a general constellation of risk-taking or sensation-seeking activities that includes alcohol use and sexual activity. Key words - sexual activity, AIDS, alcohol

Research on attributions about drunken aggression has suggested that intoxication serves to excuse the aggressor while increasing blame to the victim. In this study, we examined subjects' responses to a scenario depicting a violent interaction in which intoxication of aggressor and victim, victim's behavior, and aggressor's previous violent background were varied. We predicted that to the extent that the violent act violated the expectations of the observer, alcohol intoxication would serve to decrease dispositional and responsibility attributions to the aggressor. Instead, the findings showed that alcohol use led to increased attributions of causality, blame, and responsibility for both aggressor and victim. The results are discussed in terms of both attribution theory and societal factors influencing the acceptability of excuses involving alcohol.

Objectives. One consequence of the acquired immunodeficiency syndrome (AIDS) epidemic has been to highlight the need for population-based estimates of the numbers of individuals engaging in sexual behaviors that place them at risk for human immunodeficiency virus (HIV) infection. This paper describes the prevalence of various sexual behaviors in a nationally representative sample of adults in the United States. Methods. Data were collected as part of a household probability survey of adults (n = 2058) in the United States. Data collected on sexual behavior included sexual orientation, frequency of intercourse, condom use, and number of sexual partners. Results. Nearly all respondents were sexually experienced. Of those who were currently sexually active, 13% (1% of married respondents) had had sex with more than one partner in the previous year. Of those reporting having intercourse with more than one partner in the previous year, 7% used condoms consistently and 23% used condoms consistently with their casual partners. Conclusions. A significant proportion of individuals were found to have intercourse with multiple partners without using condoms. A minority of these respondents acknowledged that their behavior may place them at risk for HIV transmission., A considerable number of US athletes were found to have had intercourse with multiple partners without using condoms. A need for population-based estimates of the numbers of individuals who engage in sexual behaviors that put them at risk for acquiring human immunodeficiency virus (HIV) has been highlighted as a consequence of the acquired immunodeficiency syndrome (AIDS) epidemic. The prevalence of a range of sexual behaviors in a nationally representative sample of adults in the United States is described in this paper. Almost all of the respondents were sexually experienced. Among those who were sexually active at that time, 13%, 1% of married respondents, had had sex with more than one partner during the previous 12 months. Among those with more than one partner, 7% always used condoms with their casual partners. A minority of the respondents acknowledged that their sexual behavior could place them at risk for the transmission of HIV.

Recent reports have suggested that the use of alcohol or drugs is related to sexual behavior that is high risk for HIV infection. If substance use leads to unsafe sexual activity, understanding the dynamics of this relationship can contribute to research and preventive and educational efforts to contain the spread of AIDS. In this article, we review research on the relationship between substance use and high-risk sexual behavior. We then consider the inherent limitations of the research designs used to study this relationship, outline some methodological concerns including measurement and sampling issues, and comment on causal interpretations of correlational research findings. We end with a consideration of potential avenues for future research and a discussion of implications of these findings for current AIDS prevention policies.

Ninety-nine people participated in a survey conducted to analyze the effects of alcohol consumption on their sexual lives. The participants recorded their alcohol consumption and sexual activity over a period of 10 weeks. Increased alcohol content did not result in increased sexual activity, but diminished the sexual instincts. Alcohol consumption does not precipitate the contraction of AIDS, which is usually the consequence of indiscriminate and unsafe sex.

The relationships between self-control concerns, drinking loss of control and heavy drinking behavior among general and clinical populations were studied. Results showed that alcohol treatment clients expressed significantly more control anxieties and loss of control over drinking than the general population. Concern over personal control only correlated to some extent with the loss of control in drinking. Self-control worries may be useful when considered in association with the conncept of drinking loss of control.

Traditional sex role characteristics suggest that women may be more dissatisfied with casual sex than men. We investigated this notion by examining the reactions of women and men to a hypothetical, first-time sexual encounter. An additional factor that was hypothesized to affect reactions was the presence of alcohol, which may serve as a cue for sexual disinhibition. College students read a scenario depicting a consensual sexual encounter between two people who met at a party, and made judgments about the partners' behavior and characteristics. Four versions of the scenario varied the alcohol consumption of both characters. Results showed that men were more likely than women to find the behavior of each partner socially acceptable, to foresee a positive future for the couple as a result of their sexual encounter, and to predict that they themselves would engage in similar behavior. Although no main effects for alcohol consumption were found, alcohol consumption interacted with gender to influence judgments about the characters' sexuality. Results are discussed in terms of sex role stereotyping and the tendency of both sexes to misunderstand or misperceive each other's sexual feelings.

An article by Leigh (1989d) examined certain substantive and measurement-related limitations of research on alcohol outcome expectancies. Leigh (1989d) criticized research in this field on both conceptual and methodological grounds and speculated on future theoretical directions for research in the field. In their response, Goldman, Brown, Christiansen, and Smith (1991) contended that Leigh's critique is faulty in important respects. However, some of their points are based on misinterpretations of Leigh's comments, and they appear to have insufficient appreciation of conditions necessary for comprehensive measurement validation and for meaningful application of theories of memory to alcohol expectancy research. Despite the limitations of expectancy research, exciting avenues exist for further work.

In recent years, the public health field has seen an increasing amount of research devoted to adolescent sexual behavior. In 1983, 74 percent of women and 83 percent of men […]