Influence of language abilities and alcohol expectancies on the persistence of heavy drinking in youth

It has been suggested that neuropsychological functioning and cognitive factors influence substance use and treatment outcomes in youth. This study examined a model in which language skills moderate the extent to which expectancies about the positive effects of alcohol predict the persistence of alcohol involvement in youth over an 8-year period.

Participants were substance use disordered adolescents recruited from inpatient alcohol and drug treatment centers (N = 139). Exclusion criteria included major head trauma, neurological illness and psychiatric disorders. Participants were administered neuropsychological tests, expectancy questionnaires and substance involvement interviews that spanned an 8-year period from ages 16 to 24 on average. Substance involvement was assessed by self-report, collateral reports and urine toxicology screens.

Using latent class growth analysis of alcohol use over 8 years, participants were classified as abstainers, infrequent users, worse with time or frequent users. Language x Expectancy interactions were significant at all time points (p range .05 to .0001, effect size eta2 range 0.03 to 0.20). This interaction significantly predicted 8-year alcohol dependence symptoms over and above effects accounted for by covariates or main effects (F = 2.98, 5/100 df, p < .05; R2delta = 4%, beta = 0.21, p <.05).

For youths with above average language skills, positivealcohol expectancies predicted alcohol use frequency and dependence symptoms in the 8 years following treatment; expectancies were less related to outcomes for youths with poorer language scores. Results suggest that verbal skills may magnify the relationship between alcohol expectancies and drinking behavior.