Alcohol-related cognitive mechanisms underlying adolescent alcohol use and alcohol problems: Outcome expectancy, self-schema, and self-efficacy

• Published in: Addictive behaviors 2020-06, Vol.105, p.106349, Article 106349
• Main Authors: Lee, Chia-Kuei, Corte, Colleen, Stein, Karen F., Feng, Jui-Ying, Liao, Li-Ling
• Format: Article
• Language: English
• Subjects: Adolescent; Alcohol Abstinence - psychology; Alcohol-Related Disorders - psychology; Cognition; Cognitive mechanism; Cognitive vulnerability; Female; Humans; Identity; Male; Middle school students; Models, Theoretical; Motivation; Prospective Studies; Schools; Self Concept; Self Efficacy; Self-cognition; Students - psychology; Students - statistics & numerical data; Surveys and Questionnaires; Taiwan - epidemiology; Underage drinking; Underage Drinking - psychology
• ISSN: 0306-4603; 1873-6327
• DOI: 10.1016/j.addbeh.2020.106349

•Theoretical model for the functional relationship among the alcohol-related cognitions were supported.•Alcohol-related cognitive constructs predicted adolescent alcohol use and problems.•Alcohol-related self-schema and self-efficacy mediated alcohol expectancy effects. The objective of this study was to empirically test a theoretical model to determine the cognitive mechanisms that are associated with adolescent alcohol use and alcohol problems. We posited that alcohol outcome expectancies would affect alcohol-refusal self-efficacy through the drinker self-schema. We also posited that alcohol outcome expectancies and the drinker self-schema would affect alcohol use and problems through alcohol-refusal self-efficacy. A survey was administered to 225 adolescents in a public junior high school in Taiwan at two-time points, six months apart. Path analysis was used to determine the mechanisms underlying the alcohol-related cognitive constructs on the alcohol use and alcohol problems separately, controlling for appropriate alcohol-related personal and environmental factors. Indirect effects were estimated using the bootstrapping method. Higher positive alcohol outcome expectancies and lower negative alcohol outcome expectancies predicted higher drinker self-schema scores. Higher positive alcohol outcome expectancies and drinker self-schema scores predicted lower alcohol-refusal self-efficacy. Lower alcohol-refusal self-efficacy was associated with a history of drinking and alcohol problems in the past six months. Effects of alcohol outcome expectancies on alcohol use and alcohol problems were partially mediated through the drinker self-schema and alcohol-refusal self-efficacy. Findings support the proposed theoretical cognitive mechanisms underlying alcohol use and alcohol problems in a sample of Taiwanese adolescents. Given that alcohol-related cognitive constructs are modifiable, the findings also provide a foundation to suggest that interventions to reduce positive alcohol outcome expectations and prevent the formation of a drinker self-schema may facilitate alcohol-refusal self-efficacy and mitigate drinking behaviors in this adolescent population.