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Participants were randomly assigned to an experimentally induced negative or neutral mood condition with questionnaire batteries completed pre- and postinduction. Primary results were based on participants reporting exposure to at least one traumatic event (n 134). Findings indicated that participants in the negative compared to the neutral mood condition reported heightened tension reduction expectancies; this was particularly salient as exposure to child/adolescent sexual abuse increased. A trend (p .08) suggested that tension reduction expectancies were higher for participants in the negative mood condi- tion, as reports of sexual abuse and emotion regulation difficulties increased, and after accounting for posttraumatic stress symptoms. Tension reduction expectancies as a risk factor for problem drinking following trauma exposure are discussed, and further, indications that risk for problem drinking following sexual abuse is associated with difficulties managing typical, rather than extreme levels of negative affect are emphasized. Clinical implications include the potential modification of brief alcohol interventions.

Keywords:child/adolescent trauma, college, mood induction, tension reduction expectancies Research indicates that approximately 60% of college students consumed alcohol within the past month. Of college students who consumed alcohol, nearly 40% engaged in high-risk or binge drinking (Johnston, O’Malley, Bachman, Schulenberg, & Miech, 2015;National Institute on Alcohol Abuse and Alcoholism [NIAAA], 2015). Well-documented associations exist between high-risk drinking and academic problems, alcohol use disorders, sexual and physical assaults, injury, and even death (Grant et al., 2015;NIAAA, 2015;World Health Organization [WHO], 2014).

High-risk drinking in college and its consequences continue to be such a significant concern that the American College Health As- sociation (ACHA) identified the reduction of high-risk drinkingand driving while intoxicated as two primary, national objectives to be achieved by 2020 (ACHA, 2012). In efforts to better under- stand high-risk or problem drinking and reduce the related conse- quences, a substantial amount of research has focused on drinking to help manage negative affective experiences.

The experience of negative affect has been positively correlated with alcohol consumption, drinking to intoxication and positive alcohol expectancies in college samples (Bardone-Cone, Brown- stone, Higgins, Harney, & Fitzsimmons-Craft, 2012;Carmack & Lewis, 2016;Goldsmith, Tran, Smith, & Howe, 2009;Holt et al., 2013;Howard, Patrick, & Maggs, 2015).Hufford (2001)found positive alcohol expectancies including tension reduction to be both correlated with negative affect and caused by negative mood induction procedures. However, other research is more mixed when utilizing mood induction paradigms to examine the relations between negative affect and alcohol-related behaviors. While some studies have found no relationship between induced-negative mood and alcohol-related variables (Ralston, Palfai, & Rinck, 2013;Treloar & McCarthy, 2012;Wardell, Read, Curtin, & Mer- rill, 2012), others reported that induced negative mood increased positive alcohol expectancies (Grant & Stewart, 2007;Ralston & Palfai, 2010), craving (Hartwell & Ray, 2013), alcohol seeking behavior (Hogarth, Hardy, Mathew, & Hitsman, 2018), and con- sumption at a trend level (Kelly & Masterman, 2008). Significant findings between induced negative mood and alcohol-related vari- ables support theories grounded in negative reinforcement, where This article was published Online First January 31, 2019.

Alicia K. Klanecky, Erika J. Ruhnke, and Rylie M. Meyer, Department of Psychological Science, Creighton University.

Rylie M. Meyer is now at Anschutz Medical Campus, University of Colorado, Aurora.

The current manuscript was previously presented as a research poster at the 2017 American Psychological Association Convention, Washington, D.C. We acknowledge Pallavi Aurora for her contribution to data collec- tion.

Correspondence concerning this article should be addressed to Alicia K.

Klanecky, Department of Psychological Science, Creighton University, Hixson-Lied Science Building, 2500 California Plaza, Omaha, NE 68178.

E-mail:[email protected] This document is copyrighted by the American Psychological Association or one of its allied publishers.

This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. Psychology of Addictive Behaviors © 2019 American Psychological Association2019, Vol. 33, No. 3, 274 –284 0893-164X/19/$12.00http://dx.doi.org/10.1037/adb0000448 274 alcohol is used to alleviate negative mood (see review bySher, Grekin, & Williams, 2005). However, it is less clear which stu- dents may be more susceptible to drinking for negative reinforce- ment purposes.

Not all (e.g.,Simpson, 2003; see review byTonmyr, Thornton, Draca, & Wekerle, 2010), but considerable research has found that the experience of child/adolescent trauma is associated with in- creased positive alcohol expectancies (Blumenthal, Leen-Feldner, Knapp, Badour, & Boals, 2015), alcohol use (e.g.,Harrison, Fulk- erson, & Beebe, 1997) and problem drinking (La Flair et al., 2013; Miron, Orcutt, Hannan, & Thompson, 2014). Particularly, child/ adolescent sexual abuse is associated with an increased risk for alcohol use including earlier initiation, problem drinking, and alcohol-related disorders (see reviews byLangdon et al., 2017; Sartor, Agrawal, McCutcheon, Duncan, & Lynskey, 2008;Tonmyr et al., 2010). For example, college women with histories of child/ adolescent sexual abuse are significantly more likely to drink to intoxication (Rodriguez-Srednicki, 2002) and meet alcohol use disorder criteria than are women who had not been exposed to sexual abuse (prevalence rates of 43.5% and 7.9%, respectively; Silverman, Reinherz, & Giaconia, 1996). In addition, people with a history of childhood trauma (Glaser, van Os, Portegijs, & Myin- Germeys, 2006;Infurna, Rivers, Reich, & Zautra, 2015) including sexual abuse (Smith, Smith, & Grekin, 2014;Weltz, Armeli, Ford, & Tennen, 2016) have increased mean levels of negative affect.

Thus, research provides correlational evidence for relations among trauma, negative affect, and alcohol consumption in college stu- dents. The first aim of the current study sought to examine these relationships utilizing a mood induction paradigm, which to our knowledge is absent in the literature. It was hypothesized that child/adolescent sexual abuse would moderate the relations be- tween mood condition and tension reduction expectancies of al- cohol such that students with increased trauma exposure would report increased tension reduction expectancies in the negative compared to neutral mood induction condition. Building on the first aim, the current study was also interested in examining the plausible role of emotion regulation difficulties among these con- structs.

Those who have experienced childhood abuse (Messman- Moore, Walsh, & DiLillo, 2010;Teisl & Cicchetti, 2008), partic- ularly sexual abuse, tend to experience more difficulties in emotion regulation (Gratz, Paulson, Jakupcak, & Tull, 2009;Kim & Cic- chetti, 2010;Séguin-Lemire, Hébert, Cossette, & Langevin, 2017).

For example, girls with sexual maltreatment reported increased emotional lability and negativity, as well as lower emotional understanding regardless of emotion type (e.g., sadness or anger) compared with peers without maltreatment histories (Shipman, Zeman, Penza, & Champion, 2000). In a sample of young adults, college women with child/adolescent sexual abuse showed less facial emotion and used fewer negative emotional words compared with their nonabused peers when viewing four film clips intended to elicit emotional responses (Luterek, Orsillo, & Marx, 2005). A meta-analysis of brain scan studies showed that childhood mal- treatment iscorrelated with an increase in bilateral amygdala, supe- rior temporal gyrus, and insula activation, among other brain areas, many of which are associated with emotions and emotion regulation (Hein & Monk, 2017). Whereas adaptive inhibition of emotion during abuse may later become maladaptive emotion regulation difficulties (Shipman et al., 2000), emotion regulation difficulties, in turn, arepositively associated with alcohol expectancies (Obasi, Brooks, & Cavanagh, 2016) and problem drinking including within college sam- ples (Aurora & Klanecky, 2016;Veilleux, Skinner, Reese, & Shaver, 2014). It follows that students with a history of abuse and emotion regulation difficulties may be more susceptible to alcohol consump- tion for negative affect reduction.

Supporting this notion, as exposure to childhood/adolescent sexual abuse increased, problem drinking was greatest for those who potentially lack insight into their emotion regulation dif- ficulties (Klanecky, Woolman, & Becker, 2015). Notably, other research has focused on the link between alcohol variables and posttraumatic stress disorder (PTSD). Some research indicates that PTSD symptoms are a more proximate predictor of alcohol use compared with early trauma (e.g.,Epstein, Saunders, Kil- patrick, & Resnick, 1998;Simpson, 2003), and in clinical samples with comorbid PTSD and alcohol use disorders, trauma-related negative emotions (elicited by personalized trauma-oriented scripts) yielded increased alcohol-related crav- ing (Coffey et al., 2002, 2010;Saladin et al., 2003). However, Ullman and colleagues (2005)found that trauma exposure, more than PTSD symptoms, was indicative of drinking prob- lems in community women (Ullman, Filipas, Townsend, & Starzynski, 2005). In addition, emotion regulation difficulties have been found to mediate the relations between trauma and PTSD symptoms (Cloitre et al., 2019) including within prospec- tive analyses (Bardeen, Kumpula, & Orcutt, 2013), as well as PTSD and alcohol-related consequences. Affect modulation difficulties persisted even after PTSD remitted (Tripp, McDevitt-Murphy, Avery, & Bracken, 2015;Wolfsdorf & Zlot- nick, 2001). This suggests that it may be emotion regulation difficulties during negative affect (more so than PTSD symp- toms) linking trauma and alcohol use. The second aim of the current study tested the hypothesis that students endorsing increased child/adolescent sexual abuse and emotion regulation difficulties would report increased tension reduction expectan- cies of alcohol when in a negative mood induction condition and after accounting for PTSD symptoms.

To our knowledge, the current study is the first to examine the associations among childhood trauma, emotion- and alcohol- related variables using a mood induction procedure in college students. The ability to investigate such constructs within an ex- perimental paradigm offers enhanced methodological rigor and control in the experience, reporting, and comparison of affective conditions. It was hypothesized that students with increased sexual trauma exposure would report heightened tension reduction expec- tancies in the negative compared with neutral mood induction condition. Further, it was hypothesized that this pattern would be particularly apparent for trauma-exposed participants reporting increased emotion regulation difficulties and after accounting for PTSD symptoms. The dependent variable of alcohol-related ten- sion reduction expectancies was selected given that it is predictive of alcohol consumption (e.g.,Hufford, 2001;Wardell et al., 2012), is emphasized in previous mood induction literature (e.g.,Birch et al., 2004;Grant & Stewart, 2007;Hufford, 2001;Treloar & McCarthy, 2012;Wardell et al., 2012), and is particularly relevant to negative reinforcement theories of alcohol (i.e., expectations that alcohol will reduce tension). For example, in a study exam- ining individuals who drink to manage sadness, expectations of alcohol consumption were as powerful as actual alcohol consump- This document is copyrighted by the American Psychological Association or one of its allied publishers.

This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. 275 TENSION REDUCTION ALCOHOL EXPECTANCIES tion in reducing induced negative affect (Sitharthan, Sitharthan, & Hough, 2009). All analyses with child/adolescent sexual abuse were replicated examining cumulative childhood/adolescent trauma to account for research indicating that alternative forms of childhood trauma are related to increased alcohol use (La Flair et al., 2013; Miron et al., 2014; See review byKonkolÿ et al., 2017) and emotion regulation difficulties (e.g., child physical abuse;Messman-Moore et al., 2010;Teisl & Cicchetti, 2008). Method Participants Undergraduate students (N 157) from a private Midwestern university were recruited via the Department of Psychological Sci- ence’s online research recruitment system to complete an experimen- tal study examining factors including induced mood that affect alco- hol use variables. All students were eligible to self-select into the study and received credit toward their Psychology course for study completion. Men were oversampled in efforts to obtain a more equiv- alent ratio of male to female participants. On average, participants were 18.94 (SD .83) years old and included 53.5% men and 46.5% women. Just over half of the sample were first-year students (54.1%), 32.5% were sophomores, and 13.3% were juniors and seniors. Sixty- five percent of the sample was White, with 14.0% Asian American, 9.6% Hispanic, 1.9% African American, 1.3% Middle Eastern, 0.6% Pacific Islander, and 7.6% “other” or “not applicable.” Measures Alcohol Use Disorders Identification Test (AUDIT;Saun- ders, Aasland, Babor, de la Fuente, & Grant, 1993).The AUDIT is a brief 10-item questionnaire that was developed to measure severity of hazardous or problematic alcohol consump- tion. Utilizing a 5-point Likert scale, the measure includes ques- tions regarding amount and frequency of drinking, symptoms of alcohol dependence, and alcohol-related problems. Example items include “How often during the last year have you been unable to remember what happened the night before because of your drink- ing?” Higher scores are indicative of more severe alcohol use. The AUDIT has evidenced reliability and validity across a variety of populations and has been described as “especially useful” in col- lege students in a publication by the National Institute of AlcoholAbuse and Alcoholism (NIAAA, 2003). Cronbach’s alpha in the current study was .82.

Difficulties in Emotion Regulation Scale (DERS;Gratz & Roemer, 2004).The DERS was designed to provide a com- prehensive measure of emotion regulation, assessed across six domains (i.e., nonacceptance, goals, impulse, awareness, strat- egies and clarity). With a total of 36 items, participants are asked to rate each question on a 1- (almost never) to 5-point (almost always) Likert scale. Questions include, “I experience my emotions as overwhelming and out of control” and “When I’m upset, I have difficulty getting work done.” Higher scores are interpreted as greater difficulties in emotion regulation. The DERS has evidenced high construct validity and good test– retest reliability in college student samples (Gratz & Roemer, 2004). Internal consistency has ranged from .93 to .94 across different genders and ethnicities (Gratz & Roemer, 2004; Ritschel, Tone, Schoemann, & Lim, 2015). Cronbach’s alpha for the current study was .86.

Drinking Expectancy Questionnaire—Revised (DEQ-R; Lee, Oei, Greeley, & Baglioni, 2003).The DEQ-R is a 37-item questionnaire designed to measure expectations toward alcohol consumption across five factors (i.e., negative consequences of drinking, increased confidence, increased sexual interest, cognitive enhancement, and tension reduction). The current study utilized the tension reduction subscale, which was administered pre- and postmood induction. Items include, “When I am anxious or tense I do not feel a need for alcohol” and “Drinking does not help to relieve any tension I feel about recent concerns and interests.” Participants rate items from 1 (strongly disagree)to5(strongly agree). Tension reduction items are reverse-coded, and higher scores are indicative of higher alcohol-related expectancies. The DEQ-R has evidenced a more robust factor structure compared with the original DEQ (Lee et al., 2003), and evidenced construct validity with measures of alcohol consumption (Young, Connor, Ricciardelli, & Saunders, 2006). Cronbach’s alphas for the tension reduction subscale were low, ranging from .48 to .47 for measure- ments pre- and postmood induction, respectively. This is very likely attributable to the small number of items (i.e., 3 items); the fewer the number of items, the lower the Cronbach’s alpha esti- mate (Agbo, 2010;Vaske, Beaman, & Sponarski, 2017). Despite the small number of items, the subscale behaved as expected. The subscale correlated as anticipated with other constructs (seeTable 1for descriptive and bivariate statistics), and a principal compo- Table 1 Descriptive and Bivariate Statistics Variable1234567M(SD) Range 1. Problem drinking —7.37 (5.59) 0–25 2. Sexual abuse .242 —0.50 (0.98) 0–6 3. Trauma .153 † .553 — 5.44 (3.73) 0–18 4. DERS .117 .243 .455 — 81.66 (23.11) 38–148 5. PTSD symptoms .210 .307 .516 .702 — 34.39 (12.47) 17–69 6. Pre TRE .358 .180 † .118 .281 .306 — 7.74 (2.45) 3–13 7. Post TRE .384 .176 † .214 .376 .313 .654 — 7.82 (2.40) 3–14 Note. DERS Difficulties in Emotion Regulation Scale; TRE Tension reduction expectancies as measured by the DEQ-R; TRE means/SDs do not reflect differences by condition. †p .10. p .05. p .01. This document is copyrighted by the American Psychological Association or one of its allied publishers.

This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. 276 KLANECKY, RUHNKE, AND MEYER nents analysis using the Kaiser criterion (eigenvalues 1) pro- duced a one factor solution that accounted for 49.77% of the variance. All subscale items loaded on the single factor, with an average loading of .704. Such additional analyses provide evi- dence for construct validity and work to alleviate concerns related to the Cronbach’s alpha values.

Early Trauma Inventory—Self Report—Short Form (ETI- SR-SF;Bremner, Bolus, & Mayer, 2007).The ETI-SR-SF is a 29-item questionnaire developed as a self-report, shortened version of the semistructured interview, the Early Trauma Inventory (ETI; Bremner, Vermetten, & Mazure, 2000), and the Early Trauma Inventory—Self Report (62 items; ETI-SR;Bremner et al., 2007).

The ETI-SR-SF measures four domains of childhood/adolescent trauma including physical trauma, emotional trauma, general trau- matic events, and sexual trauma prior to 18. Six items constitute the sexual trauma subscale, and reflect a continuum of severity including “Were you ever forced or coerced to touch another person in an intimate or private part of their body?,” and “Were you ever touched in an intimate or private part of your body (e.g., breast, thighs, genitals) in a way that surprised you or made you feel uncomfortable?” Participant responses to each item are coded 0(no)or1(yes). Items from the sexual trauma subscale are summed to provide the child/adolescent sexual abuse measure, whereas the total sum provided the cumulative trauma exposure measure. The ETI-SR-SF evidenced reliability, good internal con- sistency, and construct validity with the Clinician Administered PTSD Scale. Internal consistency ratings ranged from .70 to .87 (Bremner et al., 2007), with Cronbach’s alpha in the current study equal to .80.

PTSD Checklist—Civilian (PCL-C;Weathers, Litz, Her- man, Huska, & Keane, 1993).The PCL-C is a 17-item self- report instrument designed to measure severity of non-military- related PTSD symptoms including reexperiencing, avoidance, and hyperarousal clusters as outlined by theDiagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM–IV). Respon- dents provided severity ratings indicative of how much they have been bothered by the stressful experience over the last month.

Responses ranged from 1 (not at all)to5(extremely). Questions include “Loss of interest in activities that you used to enjoy?” and “Avoiding activities or situations because they reminded you of a stressful experience?” Total PCL-C score was utilized as a cova- riate in the current study; higher scores are indicative of greater PTSD symptoms. The PCL-C has evidenced sound psychometric properties (superior to alternative self-report instruments) among college students including test–retest reliability and internal reli- ability (Adkins, Weathers, McDevitt-Murphy, & Daniels, 2008).

Cronbach’s alpha in the current study was .91.

Visual Analogue Scale (VAS).The VAS is a widely used survey designed to measure state affect (e.g.,Birch et al., 2004; Grant & Stewart, 2007;Kelly & Masterman, 2008;Treloar & McCarthy, 2012). Participants rated their current affect across four positive mood adjectives (i.e., cheerful, happy, glad, and pleased) and three negative mood adjectives (i.e., sad, depressed, and blue) ona0(not at all) to 100 (extremely) scale. For each iteration of the VAS, ratings across the four positive mood adjectives, as well as three negative mood adjectives were averaged to reflect total positive and negative affect, respectively. The VAS provided the primary manipulation check in assessing affective ratings pre- andpostmood induction. Cronbach’s alphas for VAS ratings ranged from .89 to .95. Procedure All study procedures were approved by the University’s Insti- tutional Review Board, and study completion was voluntary. Fol- lowing arrival to the research lab, students completed informed consent procedures followed by a baseline (or premood induction) survey battery using Qualtrics, an online survey platform, which took approximately 30 – 45 min. Questionnaires emphasized topics such as alcohol use behaviors and related problems, history of trauma exposure and related symptoms, regulatory abilities, and alcohol expectancies. All participants completed an initial affec- tive rating during the baseline survey using the VAS, and then received a randomly assigned negative or neutral mood induction.

Mood induction procedures included a simultaneous presenta- tion of music and pictures, consistent with prior studies sampling college students (e.g.,Birch et al., 2004;Goodwin & Sher, 1993; Hufford, 2001;Treloar & McCarthy, 2012;Wardell et al., 2012).

Each condition viewed 20 photographs selected from the Interna- tional Affective Pictures System (IAPS;Lang, Bradley, & Cuth- bert, 2008). The IAPS rates pictures on two dimensions: valence is rated from 1 (unpleasant)to9(pleasant), and arousal rated from 1(calm)to9(excited). Pictures selected for the neutral mood induction had a mean valence rating of 5.61 and included items such as a ship, street, pole vaulter, and a man in the snow. Pictures selected for the negative mood induction had a significantly lower mean valence of 2.81,t(38) 19.63,p .01, and included items such as a memorial, a boxer, individuals crying, and individuals in the hospital. Pictures across negative and neutral mood conditions were matched on arousal, with mean ratings of 5.13 and 4.96, respectively,t(38) 1.39,p .17 (Goodwin & Sher, 1993; Hufford, 2001;Treloar & McCarthy, 2012). Each picture was shown for 30 seconds. The negative mood condition also listened to music selections shown to induce dysphoric mood including “Russia Under the Mongolian Yoke” by Prokfiev and Sibelius’ “Swan of Tuonela” (Goodwin & Sher, 1993;Hufford, 2001;Kelly & Masterman, 2008;Klanecky & McChargue, 2009;Treloar & McCarthy, 2012). Those in the neutral mood induction did not receive music, which has been shown to be mood altering (e.g., Västfjäll, 2002). Each mood induction lasted 10 min.

Directly following the mood induction, participants provided a second affective rating using the VAS and answered a brief ques- tionnaire addressing perceived interest in the pictures and music, as well as their ability to attract attention. The questionnaire helped provide manipulation check information and distract from study goals (Goodwin & Sher, 1993;Grant & Stewart, 2007;Mongrain & Trambakoulos, 2007). A postmood induction survey battery, which represented a shortened version of the baseline survey, took approximately 15 min to complete. Except for VAS measures pre- and directly postmood induction, the order of survey presentation was randomized to minimize effects of response bias on the data.

Study debriefing procedures included a positive mood induction for all students in the negative mood induction condition to ensure return to normative mood levels (e.g.,Westermann, Spies, Stahl, & Hesse, 1996). The positive mood induction included music, spe- cifically, Handel’s “Water Music” and Bach’s “Brandenburg Con- certo” (Goodwin & Sher, 1993;Hufford, 2001), as well as 10 IAPS This document is copyrighted by the American Psychological Association or one of its allied publishers.

This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. 277 TENSION REDUCTION ALCOHOL EXPECTANCIES photographs with an average valence rating of 7.83. All partici- pants identified normative mood levels via a final VAS rating prior to leaving the lab. In total, the experimental session took approx- imately 90 min.

Analytic Plan Data were cleaned, and covariates were chosen based on their potential impact on the dependent (i.e., postmood induction ten- sion reduction expectancies) and independent variables (Tabach- nick & Fidell, 2001). Based on previous literature, gender was included as a covariate given reports that men and women may be differentially impacted by mood induction procedures (e.g., Hartwell & Ray, 2013), as well as report differences in tension reduction expectancies (Wardell et al., 2012). Baseline ratings of tension reduction expectancies were included as a covariate given the high correlation between pre- and posttension reduction rat- ings,r .68,p .01, and to best ensure that expectancy ratings postinduction reflected the impact of affective experience, rather than preexisting baseline measures. Last, self-reported PTSD symptoms were included as a covariate to be comprehensive in the examination of factors that may influence tension reduction ex- pectancies following abuse, but also investigate the unique role of emotion regulation difficulties in addition to PTSD symptoms (e.g.,Tripp et al., 2015;Wolfsdorf & Zlotnick, 2001).

Approximately 88% (n 134) of the sample reported exposure to at least one traumatic event, consistent with previous research (e.g.,Fortson, Scotti, Del Ben, & Chen, 2006). To best ensure that reports of PTSD symptoms were linked to a traumatic event(s), all following analyses were conducted with the portion of the sample reporting at least one trauma. Hierarchical regression analyses were utilized to examine the study hypotheses. Specifically, cova- riates were entered on Step 1, and the independent variables on Step 2 (i.e., sexual abuse, condition, and emotion regulation dif- ficulties). All two-way interactions were entered on Step 3 (i.e., Sexual Abuse Condition, Sexual Abuse Emotion Regulation Difficulties, and Condition Emotion Regulation Difficulties), and Step 4 included the three-way interaction (i.e., Sexual Abuse Emotion Regulation Difficulties Condition). Analyses were replicated substituting sexual abuse with cumulative child- hood/adolescent trauma, and all variables were centered or dummy coded to facilitate interpretation of model coefficients (Dawson, 2014). Interaction patterns were examined using a simple slopes analysis where the relations between the continuous variable(s) and tension reduction expectancies were plotted at different levels of the mood condition (i.e., negative and neutral;Aiken & West, 1991;Dawson, 2014). Results Manipulation Check A manipulation check using the VAS confirmed that there were no significant differences in reported negative or positive affect between the two mood conditions at baseline (ps .98 and .35, respectively). Following the mood induction, participants in the negative condition experienced significantly increased negative, F(1, 131) 30.37,p .01, 2 .19, and decreased positive affect,F(1, 131) 14.25,p .01, 2 .10, compared with thosein the neutral condition (seeFigure 1). Further, participants were asked to rate their perceptions of the pictures as a secondary manipulation check. Participants in the negative mood induction rated pictures as significantly less pleasant compared with partic- ipants in the neutral condition,F(1, 131) 318.88,p .01, 2 .71. There were no significant differences in participants’ gender, age, race/ethnicity, or alcohol-related variables including problem drinking scores and alcohol-related expectancies between the neg- ative and neutral conditions (ps .05). Preliminary Results On average, students reported drinking in the problematic range (M 7.37,SD 5.59;Reinert & Allen, 2007). From those reporting exposure to at least one trauma, 29% of students reported some exposure to child/adolescent sexual abuse, which is consis- tent with previous rates reported in college samples (e.g.,Klanecky et al., 2015;Ullman & Filipas, 2005). Frequency of item endorse- ment included: experiencing “someone rubbing their genitals against you” (20.1%), “touched in an intimate or private part of your body (e.g., breast, thigh, genitals) in a way that surprised you or made you feel uncomfortable” (11.9%), “ever forced or coerced to kiss someone in a sexual rather than affectionate way” (6.7%), “ever forced or coerced to touch another person in an intimate or private part of their body” (4.5%), “ever forced or coerced to perform oral sex on someone against your will” (4.5%), and “ever have genital sex with you against your will” (2.2%). Refer back to Table 1for additional descriptive and bivariate statistics.

Primary Results Regression analyses examining the study hypotheses are shown inTable 2. After accounting for gender, baseline tension reduction expectancies, and PTSD symptoms, the main effect of condition was significant (p .02) with participants in the negative mood condition reporting higher tension reduction expectancies com- pared with the neutral mood condition. Further, the main effect for emotion regulation difficulties was significant (p .02), such that those with increased emotion regulation difficulties reported higher tension reduction expectancies. Consistent with study hy- potheses, the two-way interaction between condition and child/ adolescent sexual abuse was significant (p .04; seeFigure 2).

0 10 20 30 40 50 60 Negative Affect Positive Affect Negative ConditionNeutral Condition ** ** Affect Rating Figure 1.Postmood induction, participants in the negative mood condi- tion reported significantly increased negative and decreased positive affect compared with those in the neutral condition. Error bars represent 95% confidence intervals. p .01. This document is copyrighted by the American Psychological Association or one of its allied publishers.

This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. 278 KLANECKY, RUHNKE, AND MEYER For participants one standard deviation above the mean on sexual abuse exposure, tension reduction expectancy scores were 1.62 points higher (a difference amounting to 15% across the range of the scale) for those in the negative compared with the neutral mood condition. The two-way interaction between condition and emo- tion regulation difficulties showed a trend (p .09), suggesting that tension reduction expectancies were higher for students in the negative mood condition, as emotion regulation difficulties in- creased. Contrary to the study hypotheses, the three-way interac- tion among condition, sexual abuse, and emotion regulation was not statistically significant (p .08); instead, a trend suggested that tension reduction expectancies were higher for participants in the negative mood condition, as emotion regulation difficulties and reports of sexual abuse increased.Findings were partially replicated with cumulative child/adoles- cent trauma. After accounting for the previously named covariates, the main effects of condition ( .18,p .01,sr 2 .032) and emotion regulation difficulties ( .23,p .02,sr2 .027) were again significant (R 2 .49, R 2 .06, F(1, 105) 4.21,p .01). Participants in the negative mood condition and those with increased emotion regulation difficulties endorsed higher tension reduction expectancies. The two-way interaction between cumu- lative trauma and condition was in the same direction although only suggested a trend ( .21,p .08,sr 2 .014), and the three-way interaction among mood condition, cumulative trauma, and emotion regulation difficulties was not significant ( .13, p .24,sr 2 .006). Discussion Results from the current study indicated that participants in the negative mood condition reported heightened alcohol-related ten- sion reduction expectancies compared with those in the neutral mood condition. Findings are consistent with previous reports linking induced-negative mood to positive alcohol expectancies (Grant & Stewart, 2007), as well as negative reinforcement theo- ries of alcohol use (Sher et al., 2005). While nearly half of college students report alcohol helps them manage stress (Southern Illinois University Core Institute, 2013), current results indicated that students generally endorse the negatively reinforcing effects of alcohol when experiencing acute negative affect. Such endorse- ments, to an extent, likely normalize drinking patterns where alcohol is used to alleviate negative emotional experiences. Find- ings relevant to our first aim indicated that the negatively rein- forcing effects of alcohol are particularly salient to individuals with histories of child/adolescent sexual abuse.

Results of the First Aim: The Interaction Between Sexual Abuse and Mood Condition Results showed that tension reduction expectancies of alcohol use were heightened for students in the negative mood condition as Table 2 Regression Results for the Three-Way Interaction Among Child/Adolescent Sexual Abuse, Emotion Regulation Difficulties, and Condition Predicting Tension Reduction Expectancies Predictorb(SE) sr 2 R2 R 2 F Step 1.43 .43 27.45 Gender .17 (.35) .04 .001 PTSD symptoms .02 (.02) .11 .012 Preinduction tension reduction expectancies .60 (.07) .61 .340 Step 2.49 .06 3.75 DERS .03 (.01) .24 .030 Condition .83 (.34) .17 .029 Sexual abuse .03 (.19) .01 .001 Step 3.54 .05 3.67 DERS Condition .03 (.02) .16 .014 † DERS Sexual Abuse .00 (.01) .03 .001 Condition Sexual Abuse .73 (.34) .21 .020 Step 4.55 .01 3.16 † DERS Sexual Abuse Condition .04 (.02) .20 .014† Note.sr 2is the squared semi-partial correlation; Condition Mood induction condition; DERS Difficulties in Emotion Regulation Scale. †p .10. p .05. p .01. 0 2 4 6 8 10 12 Low Sexual Abuse High Sexual Abuse s e i c n a t c e p x E n o i t c u d e R n o i s n e T Low Condition High Condition Neutral Condition Negative Condition Figure 2.Significant two-way interaction results (p .04) obtained in Step 3 of the hierarchical regression model. “Low” and “high” sexual abuse labels represent 1SDfrom the mean (Dawson, 2014). For participants 1SDabove the mean on sexual abuse exposure, tension reduction expec- tancy scores were 1.62 points higher (a difference amounting to 15% across the range of the scale) for those in the negative compared with the neutral mood condition. Simple slopes analyses indicated that the slope for the negative mood condition was significantly different than zero (gradient .76,p .01); however, the slope for the neutral mood condition did not differ from zero (gradient .03,p .92). This document is copyrighted by the American Psychological Association or one of its allied publishers.

This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. 279 TENSION REDUCTION ALCOHOL EXPECTANCIES exposure to early sexual abuse increased. Findings with cumula- tive trauma exposure suggested a trend in the same direction.

Results coincide with the large amount of research linking early sexual abuse to increased risk for problem drinking and alcohol use disorders. Results also add to the existing literature, given the limited number of studies and mixed findings specifically exam- ining positive alcohol expectancies. To our knowledge, no studies have tested the direct relationship between child/adolescent sexual abuse and tension reduction expectancies in a college sample.

However, studies utilizing samples of children and adolescents have concluded that increased trauma exposure including sexual abuse leads to increased tension reduction expectancies in cross- sectional (Blumenthal et al., 2015) and longitudinal designs (Jester, Steinberg, Heitzeg, & Zucker, 2015). Expectations that alcohol would reduce negative affect after childhood exposure to violence predicted peak alcohol use, as well as heavy drinking days when participants were 18 to 20 years old (Jester et al., 2015).

In contrast, tension reduction expectancies seem to play a minimal role in differentiating those with and without childhood trauma including sexual abuse in samples with substance dependence.

Simpson (2003)reported that child/adolescent sexual abuse history in women with substance abuse was not associated with alcohol- related expectancies or drinking effects.Wall, Wekerle, and Bis- sonnette (2000)reported no difference in tension reduction expec- tancies in individuals who have experienced substance abuse and either high or low sexual abuse, although differences were appar- ent in expectancies associated with liquid courage, sociability, and sexuality. Such findings suggest that the role of tension reduction expectancies may change across time, serving as a more prominent risk factor for problem alcohol use and potential alcohol use disorder development earlier on, namely during adolescence and young adulthood.

Results of the Second Aim: Three-Way Interaction Among Sexual Abuse, Mood Condition, and Emotion Regulation Difficulties The second aim of the current study tested the hypothesis that students endorsing increased child/adolescent sexual abuse and emotion regulation difficulties would report increased tension re- duction expectancies of alcohol when in a negative mood induc- tion condition and after accounting for PTSD symptoms. Although there was a significant main effect for emotion regulation difficul- ties, results for this aim were not statistically significant. There were trends such that tension reduction expectancies were higher for participants in the negative mood condition, as emotion regu- lation difficulties increased. Further, there was also a trend such that tension reduction expectancies were higher for participants in the negative mood condition, as emotion regulation difficulties and reports of sexual abuse increased. As opposed to PTSD symptoms, which did not reach statistical significance in the model, our second aim tentatively suggests evidence for the role of emotion regulation difficulties as a mechanism increasing the risk of prob- lem drinking for tension reduction purposes in trauma-exposed students.

Consistent with previous work (Klanecky & McChargue, 2009), results following the mood induction suggest that it may not be extreme levels of negative affect that are associated with problem drinking risk. Rather, individuals with increasing exposure tosexual abuse cope with typical levels of negative affect less adap- tively. After accounting for baseline negative affect, sexual abuse exposure severity wasnotassociated with negative affect follow- ing the mood induction conditions (ps .05). To corroborate these findings and when examining trauma as a dichotomous variable, those with sexual trauma exposure were no more susceptible to negative affect (M 31.00,SD 21.76) compared to peers without sexual abuse histories (M 29.50,SD 21.96) following the negative mood induction (p .05). Although results indicated that those with increasing sexual abuse exposure endorse higher tension reduction expectancies when experiencing negative affect, results were not attributable to disparate affective ratings post- mood induction. Accordingly, rather than extreme levels of neg- ative affect, findings suggest that risk for problem drinking in those with sexual abuse histories may relate to difficulties man- aging typical levels of negative affect.

Notably, although postmood induction affective ratings did not differ by sexual abuse, premood induction negative affective rat- ings were associated with sexual abuse exposure. Bivariate statis- tics identified positive correlations between sexual abuse exposure and baseline ratings of negative affect,r .19,p .05. As sexual trauma exposure increased, participants reported increased levels of negative affect at baseline—at study entry and prior to any mood induction. Following the mood induction, correlations be- tween trauma exposure variables and negative affect were no longer significant, and correlations between positive affect and trauma exposure (pre- or postmood induction) were not significant (ps .05). Again, after accounting for baseline negative affect, trauma exposure severity was not associated with differential in- creases in negative affect following the mood inductions (ps .05), and manipulation check results maintained in those with and without sexual abuse.

To better understand the current findings, including trends as- sociated with emotion regulation difficulties as well as the asso- ciations between sexual abuse and negative affect, future research may work to better tease apart self-reported emotion regulation abilities and stress reactivity. It is plausible that heightened levels of negative affect at baseline reflect sensitivity to stress for some trauma-exposed individuals (e.g., potentially attributable to the unfamiliar lab setting and study procedures, or preexisting nega- tive affect from the day’s prior events). Although not always the case (e.g.,Weltz et al., 2016), some researchers have separated the measurement of emotion regulation difficulties and stress reactiv- ity (Rellini, Zvolensky, & Rosenfield, 2012).Rellini and col- leagues (2012)reported that emotion regulation difficulties medi- ated the relations between childhood trauma and engagement in maladaptive behaviors among those with heightened stress reac- tivity. The relations between emotion regulation difficulties and trauma exposure severity may be further clarified by also consid- ering measures of stress reactivity, as suggested by baseline rela- tions between sexual abuse and negative affect. Further research may work to better understand not only intensity, but also fre- quency of negative affective experiences among those with sexual abuse exposure. As applied to the current study, it may be that those with increased sexual abuse exposure are more susceptible to heightened tension reduction expectancies in the negative mood condition as stress reactivity and emotion regulation difficulties increase. This document is copyrighted by the American Psychological Association or one of its allied publishers.

This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. 280 KLANECKY, RUHNKE, AND MEYER Limitations Although the current findings shed light on factors that increase risk of problem drinking, findings are cautioned by study limita- tions. First, post hoc power analyses for the effect of the three-way interaction indicated that the interaction term was underpowered (r .174; corresponding to just under 50% power), identifying a greater than 50% chance of Type II error (Cohen, 1988;Friedman, 1982). As such, and in addition to future research also examining stress reactivity, results specifically for the three-way interaction should be replicated utilizing a larger sample. Second, although the same or similar measures have been used in mood induction studies (e.g.,Hufford, 2001;Kelly, Masterman, & Young, 2011), the DEQ-R phrased items in a manner that reflects general ten- dencies, rather than “in the moment” or “right now” experiences.

Findings should be replicated with a measure of expectancies that more directly assesses “in the moment” experiences. Third, prior research (Hufford, 2001;Wardell et al., 2012) and current bivariate statistics provide evidence for the relations between tension reduc- tion expectancies and problem drinking (rs .36 –.38,p .01).

However, it cannot be assumed that greater tension reduction expectancies result in increased alcohol consumption for all stu- dents. Fourth, although our findings support that mood induction increased negative affect, affect in the lab may not be fully generalizable to negative affect experienced outside of a research setting. Results may be replicated using alternative data collection methods such as daily diary reports in efforts to examine how (if at all) findings differ as a result of study procedures. Finally, this study utilized college students in Psychology courses who received class credit for participating. Although other studies examining similar constructs have drawn from similar samples (Hufford, 2001;Tripp et al., 2015;Weltz et al., 2016), our results may not generalize to alternative populations (e.g., noncollege young adults) and should be replicated.

Conclusion In conclusion and to our knowledge, the current study is the first to utilize a mood induction paradigm in examining the relations among sexual trauma exposure severity, emotion regulation diffi- culties, and tension reduction expectancies in college students.

Such methods provided an opportunity to measure constructs temporally proximal to the experience of an experimentally in- duced negative mood, which may help develop a more acute, real-time understanding of the relations among variables as they present a risk for problem drinking. Findings indicated that stu- dents in the negative mood condition reported heightened tension reduction expectancies compared with those in the neutral mood condition. This effect was particularly salient as exposure to sexual abuse increased, with trends suggesting emotion regulation diffi- culties may also relate to risk for problem drinking. Future re- search should work to replicate the current findings, particularly given reduced power for the three-way interaction, and may also work to better understand emotion regulation difficulties relative to stress reactivity in efforts to enhance our understanding of sexual abuse experiences and how such experiences relate to risk for problem drinking.

Additionally, because drinking to reduce tension or negative affect is a large predictor of problem drinking and alcohol use disorders (e.g.,Kuntsche, Knibbe, Gmel, & Engels, 2005), stu-dents may be informed of the propensity to use alcohol in response to negative emotional experiences, as well as the short- and long- term risks of such drinking patterns. Such feedback may be incor- porated into brief alcohol interventions (see reviews byCronce & Larimer, 2011;Scott-Sheldon, Carey, Elliott, Garey, & Carey, 2014). The added risk of sexual trauma exposure severity may be integrated into brief interventions to further inform students of individual characteristics that place one at even greater risk for alcohol-related problems. Although there is evidence that brief alcohol interventions delivered in-person are effective for students with trauma exposure (Monahan et al., 2013), brief interventions have yet to be modified to address trauma-specific information and difficulties. For example, alternative coping skills (e.g., cognitive reappraisal and acceptance;Conklin et al., 2015) may provide students strategies for managing their emotional experiences through more adaptive means. These modifications may aid in preventing alcohol-related consequences such as sexual revictim- ization, as well as future alcohol use and mental health disorders (e.g.,Gidycz et al., 2007;Najdowski & Ullman, 2009). References Adkins, J. W., Weathers, F. W., McDevitt-Murphy, M., & Daniels, J. B.

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This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. 284 KLANECKY, RUHNKE, AND MEYER