Alcohol effects on cognitive & affective mediation of women’s decision making

Thesis Abstract

This project is a competing renewal of R01AA014512 and continues a program of research concerned with alcohol’s effects on women’s sexual decision making. The original project applied a cognitive mediation model to understanding alcohol’s effects, in conjunction with other contextual and background factors, on women’s risky sexual decisions in the context of consensual sex with a first-time or former male partner. Alcohol consumption puts women at risk for both sexual coercion and unprotected consensual sex, especially in new and casual relationships. Being sexually coerced and having unprotected sex can share characteristics, particularly when a male partner resists using a condom. Men may use a variety of coercive tactics to obtain sex, ranging from verbal and psychological pressure to physical force, and may use similar tactics to obtain unprotected sex. These are cognitively and emotionally complex situations, and the ability to judge them and respond effectively can be especially difficult if a woman is intoxicated. Understanding in-the-moment processes affecting women’s decisions while intoxicated is critical to informing prevention efforts. This project examines relationships among alcohol consumption, a partner’s pressure or coercion to obtain unprotected sex, and women’s sexual decisions, focusing on new and casual partners. It draws on four theoretical lines 1) the Cognitive Mediation Model of Sexual Decision Making (Norris et al., 2004), which examines the extent to which cognitive appraisals mediate the influence of background and situational factors on emotional responses and sexual outcomes; 2) Alcohol Myopia Theory (Taylor & Leonard, 1983), which explicates the influence of alcohol-related cognitive impairment on behavior; 3) the Appraisal-Disruption Model (Sayette, 1993), which addresses alcohol’s cognitive impairment effects on emotional responding; and 4) Alcohol Expectancy Theory (Goldman, 1999; MacAndrew & Edgerton, 1969), which describes how alcohol influences behavior through cultural and individual expectations about alcohol’s effects. This research includes a laboratory-based alcohol administration experiment to establish causal connections between manipulated situational factors, including alcohol consumption, and cognitive appraisals, emotional responses, and in-the-moment sexual decisions. It also employs a longitudinal survey to examine how these in-the-moment sexual decisions translate to actual sexual situations. Structural equation modeling is used to examine background and situational factors, as well as situation-based cognitive and emotional mediators, as predictors of in-the-moment sexual decisions. Background and situational models are examined using longitudinal data analytic techniques, including survival analysis, latent transition analysis, and growth curve modeling.