Substance Use & Misuse, Early Online:1–9, 2015
C 2015 Informa Healthcare USA, Inc.
Copyright
ISSN: 1082-6084 print / 1532-2491 online
DOI: 10.3109/10826084.2015.1005315
ORIGINAL ARTICLE
Reward and Cognition: Integrating Reinforcement Sensitivity Theory
and Social Cognitive Theory to Predict Drinking Behavior
Subst Use Misuse Downloaded from informahealthcare.com by Curtin University of Technology on 02/23/15
For personal use only.
Penelope Hasking, Mark Boyes and Barbara Mullan
School of Psychology and Speech Pathology, Curtin University, Bentley, Australia
Theory (SCT; 1986, 1997) have been applied to better
understanding of the initiation and maintenance of problematic drinking, in an effort to inform optimal prevention, early intervention, and treatment initiatives.
Although each are well-supported, and offer unique contributions to furthering our understanding of drinking behavior, we propose that theoretical relationships between
these models support an integrated approach to understanding drinking behavior. Speciically, we propose that
the relationships between variables proposed in RST and
drinking behaviors are mediated by variables central to
SCT.
Background: Both Reinforcement Sensitivity Theory
and Social Cognitive Theory have been applied to understanding drinking behavior. We propose that theoretical relationships between these models support
an integrated approach to understanding alcohol use
and misuse. Objectives: We aimed to test an integrated model in which the relationships between reward sensitivity and drinking behavior (alcohol consumption, alcohol-related problems, and symptoms
of dependence) were mediated by alcohol expectancies and drinking refusal self-efficacy. Methods: Online questionnaires assessing the constructs of interest
were completed by 443 Australian adults (M age =
26.40, sd = 1.83) in 2013 and 2014. Results: Path analysis revealed both direct and indirect effects and implicated two pathways to drinking behavior with differential outcomes. Drinking refusal self-efficacy both
in social situations and for emotional relief was related
to alcohol consumption. Sensitivity to reward was associated with alcohol-related problems, but operated
through expectations of increased confidence and personal belief in the ability to limit drinking in social situations. Conversely, sensitivity to punishment operated
through negative expectancies and drinking refusal
self-efficacy for emotional relief to predict symptoms
of dependence. Conclusions: Two pathways relating reward sensitivity, alcohol expectancies, and drinking refusal self-efficacy may underlie social and dependent
drinking, which has implications for development of
intervention to limit harmful drinking.
Reinforcement Sensitivity Theory
In Gray’s (1970, 1982) original RST, the Behavioral Inhibition System (BIS), mediated by serotonergic projections, was proposed to be sensitive to punishment and
nonrewarding cues and regulate avoidant behavior leading to negative emotion, such as anxiety. The Behavioral
Approach System (BAS) was proposed to underpin differences in reward sensitivity, and to be associated with
impulsivity and positive emotion. Commensurate with its
focus on reward, the BAS is thought to be mediated by
dopimanergic pathways (Carver & White, 1994). More recent conceptualizations incorporate three biologically mediated motivational systems: (i) the BAS, (ii) the Fight,
Flight, Freeze System (FFFS), which is involved in threat
sensitivity, and (iii) the BIS, which detects and resolves
conlict between the BAS and the FFFS. In situations that
are neither clearly rewarding nor threatening, but contain elements of both, the BIS inhibits ongoing behavior,
arousal is increased, and an assessment of potential risk
versus reward is conducted which then drives behavioral
outcomes (Corr, 2002, 2004; McNaughton & Corr, 2004;
Smillie, Pickering, & Jackson, 2006).
While this later conceptualization of RST is theoretically sophisticated, most measures of RST assess the
Keywords alcohol, BIS/BAS, alcohol expectancies, self-eficacy
Heavy alcohol use presents a signiicant public health
concern with consumption causally related to more
than 200 health conditions (World Health Organisation, 2014). Both Gray’s Reinforcement Sensitivity Theory (RST; 1970, 1982) and Bandura’s Social Cognitive
Address correspondence to Penelope Hasking, School of Psychology and Speech Pathology, Curtin University, Bentley, Western Australia, 6102,
Australia; Email: penelope.hasking@curtin.edu.au
1
Subst Use Misuse Downloaded from informahealthcare.com by Curtin University of Technology on 02/23/15
For personal use only.
2
P. HASKING ET AL
original BIS/BAS components. Consequently, much of
the empirical support for the model is based on the twofactor approach. Not surprisingly, heavy drinkers consistently record higher scores on measures of reward sensitivity than lighter drinkers (Franken & Muris, 2006;
Hamilton, Sinha, & Potenza, 2012; Hundt, Williams,
Mendelson, & Nelson-Graym, 2013; Loxton & Dawe,
2001, 2006, 2007). BAS also differentiates individuals
with a DSM IV diagnosis of alcohol dependence (Johnson, Turner, & Iwata, 2003; Perry et al., 2013) and those
with a family history of alcohol dependence (Yarosh et al.,
2014) from controls. The role of BIS in drinking behavior is less clear, with some researchers observing higher
BIS scores among hazardous compared to nonhazardous
drinkers (Hamilton, Hasking, & Allen, 2012), some reporting weak-negative relationships between BIS and
drinking (Loxton & Dawe, 2001) and others inding no direct relationship (Feil & Hasking, 2008; Hasking, 2006).
Social Cognitive Theory
While traditional learning theories argue that an individual learns by behavioral association, social cognitive
theorists argue that cognitions mediate the inluence of
environmental stimuli in determining behavior (Bandura, 1986, 1997). Speciically, the cognitive outcome
expectancies that are formed as a result of the ability to
foresee the consequences of actions allow appraisal of
potential consequences, and the formation of informed
decisions about volitional behavior. Yet, intention to
act and a desired outcome are not suficient to enact
behavior, rather individuals must possess self-regulatory
mechanisms which allow them to exert control over their
behavior. Self-eficacy is the key factor underlying the
human agency central to SCT (Bandura, 1989, 1991).
Outcome expectancies and self-eficacy have long
been implicated in drinking behavior (Bandura, 1999).
Consistent with operant principles, in community-based
samples positive alcohol outcomes expectancies are associated with greater drinking and resultant alcohol-related
problems (Jones, Corbin, & Fromme, 2001; Ham &
Hope, 2003; Hasking & Oei, 2004, 2008). Conversely
negative expectancies are related to lower levels of
consumption (Jones et al., 2001; Jones & McMahon,
1992). However, the opposite is often observed in clinical
samples, and both alcohol expectancies and self-eficacy
differentiate samples of social and dependent drinkers
(Hasking & Oei, 2002; Oei, Hasking, & Young, 2005).
While this could be an artifact of the predominantly crosssectional, self-report designs used to relate expectancies
to drinking behavior, theoretical models assert the relative
importance of expectancies early in a drinking career
and the conditioned inability to refuse a drink among
clinical samples (Oei & Baldwin, 1994). Further, general
self-eficacy and alcohol-speciic self-eficacy appear to
exert different effects on drinking behavior, with alcoholspeciic self-eficacy being more salient in nonclinical
samples and general self-eficacy important in treatment
seeking samples (Oei, Hasking, & Phillips, 2007).
Drinking refusal self-eficacy refers to the perceived
ability to refuse a drink in a variety of situations (e.g.,
when upset, when friends are drinking). High drinking refusal self-eficacy is related to less alcohol consumption among community-based drinkers (Hasking
& Oei, 2004), and prospectively mediates the relationship between alcohol expectancies and drinking behavior (Baldwin, Oei, & Young, 1993; Bandura, 1999; Connor, George, Gullo, Kelly, & Young, 2011; Young & Oei,
1993). Not only are expectancies formed prior to considerations about the ability to resist drinking (Christiansen,
Smith, Roehling, & Goldman, 1989; Miller, Smith, &
Goldman, 1990), but also expectancies may inform refusal
self-eficacy. For example, the outcome expectancy that
alcohol use will reduce tension is likely to minimize an
individual’s belief in their ability to resist drinking when
tense.
An integrated Approach to Understanding Drinking
Behavior
An individual who responds to cues of reward, according to RST, is driven to seek rewarding environments and
situations that stimulate dopaminergic reward pathways
(Gray, 1970). Thus, an individual with high reward sensitivity is more likely to engage in behaviors that stimulate these dopaminergic pathways, including drinking.
However, the individual who seeks out rewarding environments (e.g., pubs), also has a greater opportunity to
learn behavioral consequences in this environment.1 Further, reward sensitive drinkers show a greater tendency to
notice and attend to alcohol-related cues (Kambouropoulos & Staiger, 2001). Thus, this individual is likely to have
strong outcome expectancies that have been formed over
numerous experiences, and lowered self-eficacy for refusing the temptations of reinforcing behaviors. As noted
above, the relationship between BIS and drinking is less
clear. However, given that BIS is thought to underlie anxiety, it is possible that people sensitive to punishment are
predisposed to the anxiolytic effects of alcohol, and more
likely to drink in the context of expectations of tension
reduction (e.g., Booth & Hasking, 2009). Consequently,
social cognitive constructs, such as expectancies and selfeficacy, may mediate the relationship between sensitivity
to punishment and drinking behavior.
The Current Study
We aimed to test the proposition that outcome expectancies and self-eficacy mediate the relationships between
sensitivity to punishment, sensitivity to reward, and
drinking behavior. Given the ability of these variables
to differentiate dependent and nondependent drinkers,
it is plausible that the variables differentially relate
to particular indices of drinking. Speciically, while
1
Dopamine is also activated in response to salient events (Franken,
Booij, & van den Brink, 2005), supporting Gray’s assertion that individuals highly sensitive to reward are likely to seek out such environments.
REWARD AND COGNITION
sensitivity to reward, positive expectancies and reduced
self-eficacy might increase alcohol consumption per
se, alcohol expectancies (for example) might be less
salient in predicting symptoms of alcohol dependence.
As such, we explored whether these relationships differed
for alcohol consumption, alcohol-related problems, and
symptoms of dependence (Figure 1), but did not propose
speciic hypotheses regarding these differential effects.
METHOD
Subst Use Misuse Downloaded from informahealthcare.com by Curtin University of Technology on 02/23/15
For personal use only.
Participants
This project was approved by the University Human Research Ethics Committee. A total of 443 participants
(83.3% female; mean age = 26.40, sd = 1.83) completed
anonymous self-report questionnaires assessing the constructs of interest. Of the sample, 77.7% identiied as
White/Caucasian, and a further 18.5% as Asian. A large
proportion were undergraduate students (44%) and a further 29.8% had completed an undergraduate degree. All
participants were aged over 18 years (the legal drinking
age in Australia, where this study was conducted) and only
4.3% had never consumed alcohol.2
Materials
Alcohol Use Disorders Identiication Test (AUDIT; Degenhardt, Conigrave, Wutzke, & Saunders, 2001). The
AUDIT is comprised of ten items and is used to screen
for excessive alcohol use and harmful drinking. While a
total score gives an indication of global risk, three subscales assess alcohol consumption (three items), alcoholrelated problems (three items), and symptoms of alcohol
dependence (four items). The AUDIT demonstrates high
internal consistency and adequate test–retest reliability
with nonclinical and alcohol-dependent samples (Reinert
& Allen, 2007). Reliability was acceptable in the current
sample: consumption α = .73; alcohol-related problems
α = .69; and dependence α = .71.
Sensitivity to Punishment/Sensitivity to Reward Questionnaire (SPSRQ; Torrubia, Avila, Molto, & Caseras,
2001). The SPSRQ was developed to assess BIS and BAS
through two scales of Sensitivity to Punishment (SP) and
Sensitivity to Reward (SR). Respondents indicate whether
they engage in each of 24 behaviors (no = 0; yes = 1) assessing each construct (48 items in total; e.g., “Are you
often afraid of new or unexpected situations?” “Do you
sometimes do things for quick gains?”). In the initial psychometric evaluation, the two scales were observed to be
independent, with acceptable reliability, convergent, and
discriminant validity (Torrubia et al., 2001). Reliabilities
of the two subscales were excellent in the current study:
SP α = .80; SR α = .86.
3
Drinking Expectancy Questionnaire-Revised (DEQ-R;
Lee, Oei, Greeley, & Baglioni, 2003). The ive DEQ-R
subscales (cognitive change, tension reduction, increased
conidence, sexual enhancement, and negative expectancies) measure anticipated positive and negative outcomes
of alcohol consumption3 . The test-retest reliability (r =
.72–88) and discriminant validity are well established
(Lee et al., 2003). In the current sample reliabilities ranged
from α = .67 for tension reduction to α = .91 for increased
conidence.
Drinking Refusal Self-Eficacy Questionnaire-Revised
(DRSEQ-R; Oei et al., 2005). The DRSEQ-R is comprised of three subscales (social pressure, emotional relief,
and opportunistic self-eficacy) assessing whether a person believes they can resist drinking in certain situations
or moods (e.g., “When I am at a pub or club,” “When I feel
down”). Higher scores indicate a greater belief in the ability to resist drinking. Alpha reliabilities for the DRSEQR range from .87 to .94, and test-retest reliabilities range
from .84 to .93 (Oei et al., 2005). Reliabilities were excellent in the current sample: social pressure α = .91, emotional relief α = .96, and opportunistic α = .90.
Procedure
Participants self-selected into the study in response to advertisements posted around a large metropolitan university, community notice boards, and via social media. Advertisements included the study URL, and participants
completed the online questionnaire in their own time
(30–40 minutes). A Participant Information Sheet was
presented prior to the survey, and informed participants
of the study aims, participation requirements, voluntary
nature of participation, and the right to withdraw. To reimburse participants for their time, all were offered the
opportunity to enter a rafle to win an Apple IPad Mini,
or 2 Gold Class movie tickets. All participants were provided with mental health information and contact details
for crisis lines should they wish to further discuss any issues raised in the questionnaire.
Data Analysis
AUDIT data were positively skewed, as expected in a nonclinical sample. Mean replacement was utilized to replace
less than 1% of data on the AUDIT and less than 3%
on the other variables. To partially protect against nonnormal data, our mediational hypotheses were tested using
Bias-Corrected Bootstrap procedures in AMOS 22 (Efron
& Tibshirani, 1993; MacKinnon, Lockwood, & Williams,
2004). Given the correlations between our variables (Table 1), residuals were free to correlate. Model it was determined by it indices (CFI, NFI, GFI) greater than .95,
a χ 2 /df less than 4, and Root Mean Square Error of Approximation (RMSEA) less than .06 (Hu & Bentler, 1999;
Kline, 2010).
2
As low reward sensitivity, weak positive expectancies and high levels
of refusal self-eficacy may predict abstinence, and we were interested
in the continuum of drinking behavior, these 19 participants were included in analyses.
3
The negative expectancies subscale assesses anticipated negative outcomes; all other scales are considered positive expectancies.
4
P. HASKING ET AL
Subst Use Misuse Downloaded from informahealthcare.com by Curtin University of Technology on 02/23/15
For personal use only.
FIGURE 1. Hypothesized model: Alcohol expectancies and drinking refusal self-eficacy mediate the relationship between reward sensitivity
and different indices of drinking behavior.
RESULTS
Participants reported a pattern of drinking consistent with
similar Australian samples (M AUDIT score = 7.77,
SD = 5.86; Halim & Hasking, 2012). Scores on the consumption, dependence, and alcohol-related problems subscales were also consistent with previous reports in young
adult samples (Table 1; Lyvers, Hasking, Hani, Rhodes,
& Trew, 2010). The majority of the sample (74.58%) reported drinking four or fewer standard drinks on a typical drinking occasion; approximately 10% of the sample
reported consuming six or more drinks on a single occasion at least monthly, somewhat fewer than national igures suggest (AIHW, 2011).
The majority of variables were correlated in the expected direction (Table 1). Neither age (r = .04, p =
.46) nor gender [t(441) = 1.76, p = .08], were related
to drinking behavior, and therefore, were not included
in the models reported.4 The full model in which all direct and indirect paths between the variables (including
all DRSEQ and DEQ subscales) were speciied, provided
good it to the data; however, RMSEA and χ 2 /df did not
meet accepted guidelines for good model it: χ 2 (7, N =
443) = 48.183, p < .001, χ 2 /df = 9.21, CFI = .98, NFI
= .98, GFI = .98, RMSEA = .12 (Hu & Bentler, 1999;
Kline, 2010). We, therefore, tested a reduced model in
which nonsigniicant paths were removed.5 The model
it of the reduced model improved, and with the exception of χ 2 (which is sensitive to sample size) all it
statistics met accepted guidelines for good model it:
χ 2 (29, N = 443) = 85.32, p < .001, χ 2 /df = 2.94,
CFI = .98, NFI = .96, GFI = .97, RMSEA = .06
(Figure 2).
The inal model accounted for 52% of the variance
in alcohol consumption, 31% of the variance in alcoholrelated problems, and 35% of the variance in symptoms
of dependence. There were direct effects of sensitivity to
reward on both alcohol consumption and alcohol-related
4
As a check, we did include age and gender in the model and there
were no changes to the signiicance of any pathways or the percentage
of variance explained.
5
All variables remained in the model, but nonsigniicant pathways removed. Where remaining paths did not assist in interpretation of the
proposed mediation, variables were excluded from Figure 2.
problems, and indirect effects on consumption and symptoms of alcohol dependence. There were also signiicant
negative direct effects of sensitivity to punishment on alcohol consumption and symptoms of alcohol dependence,
and indirect effects on all indices of drinking (Table 2).
As expected, alcohol expectancies were negatively related
to drinking refusal self-eficacy, which in turn was negatively related to the drinking measures. Additional significant paths, not depicted in Figure 2, were observed between sensitivity to punishment and expectations of sexual enhancement (β = −.15, 95% CI −.23 to −.08, p =
.003), sensitivity to reward and expectations of cognitive
enhancement (β = .09, 95% CI .01 to .16, p = .05) and
between cognitive enhancement and opportunistic drinking refusal self-eficacy (β = −.04, 95% CI −.15 to −.04,
p = .01).
DISCUSSION
We proposed that the relationship between Gray’s (1970,
1982) original conceptualization of the RST and drinking behavior could be mediated by elements of Bandura’s (1986, 1997) SCT. Speciically, we tested the
proposition that relationships between both sensitivity
to reward and sensitivity to punishment and drinking
behavior operate indirectly through alcohol expectancies and drinking refusal self-eficacy. Predicted direct effects between reward sensitivity and drinking behavior were found, as were predicted indirect effects.
Evidence of indirect effects demonstrates the utility of integrating these theoretical frameworks in predicting drinking behavior and has implications for prevention and
treatment.
The inal model accounted for a substantial proportion
of the variance in drinking behavior (R2 = .31–.52);
however, reward sensitivity, alcohol expectancies, and
self-eficacy were differentially associated with indices
of drinking. Speciically, sensitivity to reward was associated with more alcohol consumption and alcohol-related
problems, both directly and indirectly via expectations
of increased conidence and lower drinking refusal
self-eficacy in social situations. In contrast, sensitivity
to punishment was negatively related to less alcohol
5
REWARD AND COGNITION
Subst Use Misuse Downloaded from informahealthcare.com by Curtin University of Technology on 02/23/15
For personal use only.
TABLE 1. Bivariate correlations between variables of interest
Variable
Mean (sd)
1. Consumption
2. Alcohol-related
problems
3. Dependence
4. Sensitivity to
punishment
5. Sensitivity to
reward
6. Sexual
enhancement
AE
7. Increased
conidence AE
8. Cognitive
enhancement
AE
9. Tension
reduction AE
10. Negative
expectancies
11. Social pressure
DRSE
12. Opportunistic
DRSE
13. Emotional
relief DRSE
4.65 (2.54) .57∗∗∗ .56∗∗∗ −.22∗∗∗ .25∗∗∗
2.25 (2.93)
–
.67∗∗∗ −.01 .26∗∗∗
.96 (1.43)
13.44 (5.47)
2
3
–
4
−.07
–
5
6
7
8
9
10
.16∗∗
−.06
.42∗∗∗
.34∗∗∗
−.07
.05
.52∗∗∗
.37∗∗∗
.05
.40∗∗∗
−.63∗∗∗ −.47∗∗∗ −.54∗∗∗
−.30∗∗∗ −.36∗∗∗ −.43∗∗∗
.19∗∗∗ −.07 .33∗∗∗
.15∗∗ −.16∗∗ .10∗
.06
.04
.39∗∗∗
−.08
.40∗∗∗
.14∗∗
−.31∗∗∗ −.41∗∗∗ −.49∗∗∗
.09
−.02
−.10∗
.04
.29∗∗∗
.12∗
.17∗∗∗
.13∗∗
−.23∗∗∗ −.24∗∗∗ −.26∗∗∗
−
.06
10.34 (4.39)
−
11.19 (2.33)
40.12 (8.86)
−
5.75 (1.97)
8.62 (2.94)
11
−.24∗∗∗ .18∗∗∗ −.39∗∗∗ −.19∗∗∗
.10∗
.30∗∗∗
.25∗∗∗
−
.04
.39∗∗∗
–
.11∗
30.49 (9.43)
−
14.45 (5.57)
12
−.04
13
−.03
−.44∗∗∗ −.19∗∗∗ −.35∗∗∗
.00
−.18∗∗∗
−.10∗
−.50∗∗∗ −.53∗∗∗ −.62∗∗∗
.12∗
−
34.59 (6.18)
31.03 (8.42)
−.22∗∗∗ −.27∗∗∗
.52∗∗∗
.59∗∗∗
–
.75∗∗∗
–
AE, alcohol expectancies; DRSE, drinking refusal self-eficacy.
∗
p < .05, ∗∗ p < .01, ∗∗∗ p < .001.
FIGURE 2. The relationship among sensitivity to punishment (SP), sensitivity to reward (SR), and drinking is mediated by alcohol expectancies and drinking refusal self-eficacy (DRSE). ∗ p < .05 ∗∗ p < .01. Note: Signiicant direct paths are also evident between: increased
conidence, tension reduction, and negative expectancies with each of the three drinking variables (all positively related; all p < .05). Expectations of cognitive enhancement were also directly related to drinking (all negatively related; all p < .05). To aid interpretation, these paths
are not illustrated in the igure.
TABLE 2. Summary of all standardized indirect effects predicting drinking variables and drinking refusal self-eficacy.
Drinking variables
Sensitivity to punishment
Sensitivity to reward
Increased conidence
Tension reduction
Negative expectancies
Drinking refusal self-eficacy
Sensitivity to punishment
Sensitivity to reward
Consumption (95% CI)
Alcohol-related problems (95% CI)
Dependence (95% CI)
−.01∗ (−.02 to −.001)
.06∗∗ (.03 to .10)
.15∗∗ (.11 to .19)
.23∗∗ (.18 to .27)
−.05∗ (−.10 to −.01)
Social pressure (95% CI)
−.02∗∗ (−.04 to −.01)
−.09∗∗ (−.13 to −.04)
.04∗∗ (.020 to .07)
.02 (−.002 to .05)
.05∗∗ (.03 to .09)
.06∗∗ (.03 to .09)
−.04∗∗ (−.06 to −.02)
Opportunistic (95% CI)
−.02∗∗ (−.04 to −.01)
−.01∗ (−.02 to −.001)
.04∗∗ (.02 to .07)
.03∗ (.01 to .06)
.04∗∗ (.02 to .06)
.14∗∗ (.08 to .20)
.04∗∗ (.02 to .06)
Emotional relief (95% CI)
−.02∗∗ (−.04 to −.01)
−.03∗∗ (−.06 to −.02)
Note: All 95% CIs are bias corrected and estimated from 1,000 bootstrapped resampling draws. ∗ p < .05, ∗∗ p < .01.
Subst Use Misuse Downloaded from informahealthcare.com by Curtin University of Technology on 02/23/15
For personal use only.
6
P. HASKING ET AL
consumption and dependence; however, positive indirect
effects operating via negative expectancies and drinking
refusal self-eficacy both in social situations and for
emotional relief were observed.
Taken together, the results suggest that changing
alcohol expectancies and self-eficacy may interrupt
well-established pathways between reward sensitivity
and drinking behavior, and that interventions can target individuals according to reward sensitivity. Reduced
drinking refusal self-eficacy in both social situations and
for emotional relief is related to greater alcohol consumption, suggesting increasing self-eficacy can reduce the
amount of alcohol consumed. However, although preliminary, the indings implicate two pathways, mediated
by different internal states, in differentially predicting
social drinking and symptoms of dependence. Speciically, for people who are sensitive to reward, the social aspects of drinking (expectations of increased conidence, resisting drinking in social situations) appear
to be key and interventions might target socially salient
cues. In contrast, punishment sensitivity appears to be indirectly linked to symptoms of dependence via a pathway that is characterized by emotion regulation (e.g.,
negative expectancies, drinking refusal self-eficacy for
emotional relief). Similar relationships have previously
been noted, with avoidant coping mediating the relationship between BIS and drug and alcohol use (Hundt
et al., 2013). Intervention for individuals high in punishment sensitivity might, therefore, target improving selfregulatory processes including emotion regulation, coping, and stress reduction (Feil & Hasking, 2008; Lyvers,
Hasking, Albrecht, & Thorberg, 2012). Future testing
of these proposed pathways and resultant outcomes is
warranted.
A number of unexpected indings emerged. First, opportunistic drinking refusal self-eficacy was not related
to drinking. Arguably in a nonclinical sample, social factors are more salient and opportunities to drink are not
necessarily cues to drink. Future testing of whether resistance to drinking when the opportunity presents itself is an
important predictor of drinking in clinical samples is warranted. Second, alcohol expectancies were directly related
to symptoms of alcohol dependence, contradicting theoretical and empirical accounts that expectancies are less
salient to alcohol dependence (Oei & Baldwin, 1994; Oei,
Fergusson, & Lee, 1998; Oei & Morawska, 2004). This
may be a function of the current community-based sample; however, it does suggest that the relationship between
alcohol expectancies and alcohol dependence may be on
a continuum and change as drinking behaviors/problems
get more severe.
Of particular interest, there was no relationship between sensitivity to punishment and beliefs that alcohol
consumption would reduce tension. Given the extensive
literature relating anxiety, particularly social anxiety, to
drinking through expectations of tension reduction (e.g.,
Booth & Hasking, 2009; Burke & Stephens, 1999), it may
have been expected that punishment sensitivity would op-
erate in a similar manner. One explanation might relate
to Gray’s original conceptualization of RST. While BIS is
thought to underlie anxiety, within the revised model it is
portrayed as incorporating both BIS and threat sensitivity (FFFS). Studies that have assessed FFFS show results
consistent with ours, with the relationship between FFFS
and drinking mediated by self-regulatory processes, such
as avoidant and emotion-focused coping (Ivory & Kambouropoulos, 2012).
Also of interest, while there are direct negative
relationships between sensitivity to punishment and
drinking outcomes, there are indirect positive effects on
alcohol-related problems and symptoms of dependence.
This appears to be driven by a negative indirect effect
on drinking refusal self-eficacy, through alcohol expectancies. Speciically, sensitivity to punishment per se
appears to be protective, but when this lowers the ability
to refuse a drink then it ultimately increases drinking
behavior and the associated consequences. This indirect
effect may explain the inconsistencies in work relating
BIS to alcohol-related outcomes, and suggests more
complex relationships than typically assessed. More
work is needed to explore how the revised RST can best
be measured (Jackson, 2009; Smillie et al., 2006) and
to investigate the exact mechanisms by which threat
sensitivity relates to drinking and alcohol expectancies.
These unexpected indings might also relate to the
cross-sectional self-report nature of the study. Speciically, people who drink less may have fewer opportunities
to drink and thus opportunistic self-eficacy would not
be a precursor to drinking. This would also explain
the inverse relationship between negative outcome
expectancies and drinking refusal self-eficacy (i.e.,
people who consume more alcohol report more negative
outcomes). Similarly, social desirability bias may mask
associations among reward sensitivity, alcohol expectancies, and drinking refusal self-eficacy. Unfortunately,
our cross-sectional design precludes the ability to draw
conclusions regarding the temporal relationships between
the variables. Both prospective (i.e., longitudinal) studies
and more objective behavioral outcomes measures (e.g.,
including ecological momentary assessment) would provide further evidence for these arguments. For example,
assessing reward sensitivity and the social cognitive
variables before a drinking occasion, and subsequently
counting the number of alcoholic drinks consumed,
would provide prospective data in an ecologically valid
context.
CONCLUSION
The outcomes of the current study highlight the utility of
integrating RST and SCT in understanding factors thought
to initiate and maintain drinking behavior. Importantly,
differential pathways from reward sensitivity to speciic
drinking indices were evident.
While prospective work testing whether these pathways lead to different drinking outcomes over time is
REWARD AND COGNITION
still needed, this research highlights important avenues to
explore for the development of optimal prevention, early
intervention, and treatment efforts.
Declaration of Interest
The authors report no conlicts of interest. The authors
alone are responsible for the content and writing of the
article.
Subst Use Misuse Downloaded from informahealthcare.com by Curtin University of Technology on 02/23/15
For personal use only.
THE AUTHORS
Penelope Hasking’s research
focus is on high-risk behaviors,
particularly alcohol abuse and
nonsuicidal self-injury (NSSI),
exhibited by young people. Her
focus has been on the sociocognitive and emotional factors
underlying these behaviors
among adolescents and young
adults.
Mark Boyes’ interests
span the domains of
health, developmental,
and clinical psychology,
with the overarching aim
of understanding how both
individual difference and
social/community variables are
related to psychological, social,
and educational outcomes across
the life-span.
Barbara Mullan is an Associate
Professor with the Health
Psychology & Behavioral
Medicine Research Group,
in the School of Psychology
and Speech Pathology at
Curtin University. She has
worked in health psychology
for more than 15 years. Her
research interests include social
cognition models in predicting
and intervening to improve
health, particularly food-related
behaviors, physical health, and addiction. She has over 100 peer
reviewed publications.
GLOSSARY
Alcohol expectancies: Beliefs about the anticipated consequences of consuming alcohol.
Behavioral Approach System (BAS): Biologically mediated motivational system proposed to underpin individual differences in sensitivity to reward.
Behavioral Inhibition System (BIS): Biologically mediated motivational system proposed to underpin individ-
7
ual differences in sensitivity to punishment and situations of nonreward.
Drinking refusal self-eficacy: An individual’s belief in
their own ability to resist consuming alcohol in a given
situation.
REFERENCES
AIHW, Australian Institute of Health and Welfare (2011). 2010
National drug strategy household survey report, Drug Statistics Series 25, Australian Institute of Health and Welfare,
Canberra.
Baldwin, A. R., Oei, T. P. S., & Young, R. (1993). To drink or not to
drink: The differential role of alcohol expectancies and DRSE in
quantity and frequency of alcohol consumption. Cognitive Therapy and Research, 17, 511–530.
Bandura, A. (1986). Social foundations of thought and action: A
Social Cognitive Theory. NJ: Prentice Hall.
Bandura, A. (1989). Human agency in social cognitive theory.
American Psychologist, 44, 1175–1184.
Bandura, A. (1991). Social cognitive theory of self-regulation.
Organizational Behavior and Human Decision Processes, 50,
248–287.
Bandura, A. (1997). Self-eficacy: The exercise of control. New
York: W. H. Freeman and Co.
Bandura, A. (1999). A sociocognitive analysis of substance abuse:
An agentic perspective. Psychological Science, 10, 214–217.
Booth, C., & Hasking, P. A. (2009). Social anxiety and alcohol consumption: The role of alcohol of alcohol expectancies and reward sensitivity. Addictive Behaviors, 34, 730–736.
doi:10.1016/j.addbeh.2009.04.010
Burke, R. S., & Stephens, R. S. (1999). Social anxiety and drinking
in college students: A social cognitive theory analysis. Clinical
Psychology Review, 19, 513–530.
Carver, C. S., & White, T. L. (1994). Behavioral inhibition, behavioral activation, and affective responses to impending reward and
punishment: the BIS/BAS scales. Journal of Personality and Social Psychology, 67, 319–33.
Christiansen, B. A., Smith, G. T., Roehling, P. V., & Goldman, M. S.
(1989). Using alcohol expectancies to predict adolescent drinking behaviour after one year. Journal of Studies on Alcohol, 57,
93–99.
Connor, J. P., George, S. M., Gullo, M. J., Kelly, A. B., & Young,
R. McD. (2011). A prospective study of alcohol expectancies and self-eficacy as predictors of young adolescent alcohol misuse. Alcohol and Alcoholism, 46, 161–169. doi:10.
1093/alcalc/agr004
Corr, P. J. (2002). Gray’s RST: tests of the joint subsystems hypothesis of anxiety and impulsivity. Personality and Individual
Differences, 33, 511–32.
Corr, P. J. (2004). Reinforcement sensitivity theory and personality.
Neuroscience & Biobehavioral Reviews, 28, 317–332.
Degenhardt, L. J., Conigrave, K. M., Wutzke, S. E., & Saunders,
J. B. (2001). The validity of an Australian modiication of the
AUDIT questionnaire. Drug and Alcohol Review, 20, 143–154.
doi: 10.1080/09595230124592.
Efron, B., & Tibshirani, R. (1993). An introduction to the bootstrap.
New York: Chapman & Hall/CRC.
Feil, J., & Hasking, P. A. (2008). The relationship between personality, coping strategies and substance use. Addiction, Research
& Theory, 16, 526–537. doi:10.1080/16066350802025714
Franken, I. H. A., Booij, J., & van den Brink, W. (2005). The role
of dopamine in human addiction: From reward to motivated
Subst Use Misuse Downloaded from informahealthcare.com by Curtin University of Technology on 02/23/15
For personal use only.
8
P. HASKING ET AL
attention. European Journal of Pharmacology, 526, 199–206.
doi:10.1016/j.ejphar.2005.09.025
Franken, I. H. A., & Muris, P. (2006). BIS/BAS personality characteristics and college students’ substance use. Personality and
Individual Differences, 40, 1497–1503.
Gray, J. A. (1970). The psychophysiological basis of introversionextraversion. Behaviour Research and Therapy, 8, 249–266.
Gray, J. A. (1982). The neuropsychology of anxiety: An equiry into
the functions of the septo-hippocampal system. Oxford: Clarendon Press.
Halim, A., Hasking, P., & Allen, F. (2012). The role of social
drinking motives in the relationship between social norms and
alcohol consumption. Addictive Behaviours, 37, 1335–1341.
doi:10.1016/j.addbeh.2012.07.004
Ham, L. S., & Hope, D. A. (2003). College students and problematic
drinking: A review of the literature. Clinical Psychology Review,
23, 719–759. doi:10.1016/S0272-7358(03)00071-0
Hamilton, K. R., Sinha, R., & Potenza, M. N. (2012). Hazardous
drinking and dimensions of impulsivity, behavioural approach
and inhibition in adult men and women. Alcoholism: Clinical
and Experimental Research, 36, 958–966. doi:10.1111/j.15300277.2011.01708.x
Hasking, P. A. (2006). Reinforcement sensitivity, coping,
disordered eating and drinking behavior among adolescents. Personality and Individual Differences, 40, 677–688.
doi:10.1016/j.paid.2005.07.017
Hasking, P. A., & Oei, T. P. S. (2002). The differential role of alcohol expectancies, drinking refusal self-eficacy and coping resources in predicting alcohol consumption in community and
clinical samples. Addiction Research & Theory, 10, 465–494.
doi:10.1080/1606635021000034049
Hasking, P. A., & Oei, T. P. S. (2004). The complexity of drinking: Interactions between the cognitive and behavioural determinants of alcohol consumption. Addiction, Research & Theory,
12, 469–488. doi:10.1080/16066350410001713240
Hasking, P. A., & Oei, T. P. S. (2008). Incorporating coping into an
expectancy framework for explaining drinking behaviour. Current Drug Abuse Reviews, 1, 20–35.
Hu, L., & Bentler, P. M. (1999). Cutoff criteria for it indexes
in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modelling, 6, 1–55.
doi:10.1080/10705519909540118
Hundt, N. E., Williams, A. M., Mendelson, J., & NelsonGraym R. O. (2013). Coping mediates the relationship between reinforcement sensitivity and symptoms of psychopathology. Personality and Individual Differences, 54, 726–731.
http://dx.doi.org/10.1016/j.paid.2012.11.028
Ivory, N. J., & Kambouropoulos, N. (2012). Coping mediates the
relationships between revised reinforcement sensitivity theory
and alcohol use. Personality and Individual Differences, 52,
822–827. doi:10.1016/j.paid.2012.01.013
Jackson, C. J. (2009). Jackson-5 scales of revised Reinforcement
Sensitivity Theory (r-RST) and their application to dysfunctional real world outcomes. Journal of Research in Personality,
43, 556–569. doi:10.1016/j.jrp.2009.02.007
Johnson, S. L., Turner, R. J., & Iwata, N. (2003). BIS/BAS levels and psychiatric disorder: An epidemiological study. Journal of Psychopathology and Behavioral Assessment, 25, 25–36.
doi:0882-2689/03/0300-0025/0
Jones, B. T., Corbin, W., & Fromme, K. (2001). A review of expectancy theory and alcohol consumption. Addiction, 96, 57–72.
http://dx.doi.org/10.1046/j.1360-0443.2001.961575.x
Jones, B. T., & McMahon, J. (1992). Negative and positive expectancies in lone and group problem drinkers. British Journal
of Addiction, 87, 929–930.
Kambouropoulos, N., & Staiger, P. K. (2001). The inluence of sensitivity to reward on reactivity to alcohol-related cues. Addiction,
96, 1175–1185.
Kline, R. B. (2010). Principles and practice of structural equation
modeling (3rd ed.). New York: Guilford Press.
Lee, N. K., Oei, T. P. S., Greeley, J. D., & Baglioni, A. J.
(2003). Psychometric properties of the Drinking Expectancy
Questionnaire: A review of the factor structure and a proposed new scoring method. Journal of Studies on Alcohol, 64,
432–436.
Loxton, N. J, & Dawe, S. (2001). Alcohol abuse and dysfunctional eating in adolescent girls: The inluence of individual differences in sensitivity to reward and punishment. International
Journal of Eating Disorders, 29, 455–462. doi: 0.1002/eat.1042
Loxton, N. J., & Dawe, S. (2006). Reward and punishment sensitivity in dysfunctional eating and hazardous drinking women:
Associations with family risk. Appetite, 47, 361–371. doi:
10.1016/j.appet.2006.05.014
Loxton, N. J., & Dawe, S. (2007). How do dysfunctional
eating and hazardous drinking women perform on behavioural measures of reward and punishment sensitivity?
Personality and Individual Differences, 42, 1163–1172.
http://dx.doi.org/10.1016/j.paid.2006.09.031
Lyvers, M., Hasking, P. A., Albrecht, B., & Thorberg, F. (2012).
Alexithymia and alcohol: The roles of punishment sensitivity and drinking motives. Addiction, Research and Theory, 20,
348–357. doi:10.3109/16066359.2011.636494
Lyvers, M., Hasking, P. A., Hani, R., Rhodes, M., & Trew, E.
(2010). Drinking motives, drinking restraint and drinking behaviour among young adults. Addictive Behaviors, 35, 116–122.
doi:10.1016/j.addbeh.2009.09.011
MacKinnon, D. P., Lockwood, C. M., & Williams, J. (2004). Conidence limits for the indirect effect: Distribution of the product
and resampling methods. Multivariate Behavioral Research, 39,
199–128.
McNaughton, N., & Corr, P. J. (2004). A two-dimensional
neuropsychology of defense: fear/anxiety and defensive distance. Neuroscience & Biobehavioral Reviews, 28, 285–305.
doi:10.1016/j.neubiorev.2004.03.005
Miller, P. M., Smith, G. T., & Goldman, M. S. (1990).
Emergence of alcohol expectancies in childhood: A possible critical period. Journal of Studies on Alcohol, 51,
343–349.
Oei, T. P. S., & Baldwin, A. R. (1994). Expectancy theory: A twoprocess model of alcohol use and abuse. Journal of Studies on
Alcohol, 55, 525–534.
Oei, T. P. S., Fergusson, S., & Lee, N. K. (1998). The differential role of alcohol expectancies and DRSE in problem
and nonproblem drinkers. Journal of Studies on Alcohol, 59,
704–711.
Oei, T. P. S., Hasking, P. A., & Phillips, L. (2007). A comparison
of general self-eficacy and drinking refusal self-eficacy in predicting drinking behaviour. The American Journal of Drug and
Alcohol Abuse, 33, 833–841. doi:10.1080/00952990701653818
Oei, T. P. S., Hasking, P. A., & Young, RMcD. (2005). Drinking refusal self-eficacy questionnaire - revised (DRSEQR): A new factor structure with conirmatory factor
analysis. Drug and Alcohol Dependence, 78, 297–307.
doi:10.1016/j.drugalcdep.2004.11.010
Oei, T. P., & Morawska, A. (2004). A cognitive model of binge
drinking: The inluence of alcohol expectancies and drinking refusal self-eficacy. Addictive Behaviors, 29, 159–179.
doi:10.1016/S0306-4603(03)00076-5
Perry, R. I., Krmpotich, T., Thompson, L. L., Mikulich-Gilbertson,
S. K., Banich, M. T., & Tanabe, J. (2013). Sex modulates
REWARD AND COGNITION
Subst Use Misuse Downloaded from informahealthcare.com by Curtin University of Technology on 02/23/15
For personal use only.
approach systems and impulsivity in substance dependence. Drug and Alcohol Dependence, 133, 222–227.
doi:10.1016/j.drugalcdep.2013.04.032
Reinert, D. F., & Allen, J. P. (2007). The alcohol use disorders identiication test: An update of research indings. Alcoholism: Clinical and Experimental Research, 31, 185–199.
doi:10.1111/j.1530-0277.2006.00295.x
Smillie, L. D., Pickering, A. D., & Jackson, C. J. (2006). The new
Reinforcement Sensitivity Theory: Implications for personality
measurement. Personality and Social Psychology Review, 10,
320–335.
Torrubia, R., Avila, C., Molto, J., & Caseras, X. (2001). The
Sensitivity to Punishment and Sensitivity to Reward Questionnaire (SPSRQ) as a measure of Gray’s anxiety and impul-
9
sivity dimensions. Personality and Individual Differences, 31,
837–862.
World Health Organisation. (2014). Global status report on alcohol
and health 2014. Geneva: WHO Press.
Yarosh, H. L., Hyatt, C. J., Meda, S. A., Jiantonio-Kelly, R.,
Potenza, M. N., Assaf, M., & Pearlson, G. D. (2014).
Relationships between reward sensitivity, risk-taking, and
family history of alcoholism during an interactive competitive fMRI task. PLOSOne, 9. doi:10.1371/journal.pone.0088188
Young, R. McD., & Oei, T. P. S. (1993) Grape expectations: The
role of alcohol expectancies in the understanding and treatment
of problem drinking. International Journal of Psychology, 28,
337–364.