Caffeinated Alcoholic Beverages Research Articles

Differential consumption of alcohol, caffeine, and caffeinated alcohol by adolescent rats, and effects on post-adolescent gene expression signatures in the nucleus accumbens and orbitofrontal cortex

Caffeinated alcoholic beverages (CABs) are widely consumed despite little known about their behavioral and biological effects. Furthermore, CABs are also popular among adolescents, a particularly vulnerable and maturing demographic. In this preliminary study, we compared levels of daily adolescent voluntary consumption of caffeine (0.03%), alcohol (10%), caffeinated alcohol (0.03% + 10%), or vehicle and evaluated the effects of this on mRNA expression in brain regions associated with addiction and known to be affected by each drug. Beginning on postnatal day 30, rats were allowed unrestricted access to gelatin combined with one, both, or neither drug for twenty days. Compared to vehicle-consuming animals, consumption of gelatin was significantly attenuated when alcohol was included. The addition of caffeine to alcohol increased alcohol consumption in the early days of access compared to alcohol alone; however, after two weeks, alcohol consumption between these groups reached comparable levels. Compared to animals consuming caffeine alone, combining caffeine with alcohol significantly reduced caffeine intake. Targeted mRNA analysis of tissue collected from the nucleus accumbens and orbitofrontal cortex after the consumption period identified unique patterns of differentially expressed genes between treatment groups, across a broad array of neurotransmitter systems. Of particular note were genes related to a number of solute transporters and serotonergic functions. This preliminary work suggests unique pharmacological and behavioral effects from consuming caffeinated alcohol during adolescence. Since CABs are widely consumed by adolescents, these results suggest that more research into the pharmacological and behavioral effects elicited by CABs is warranted.

Development and psychometric evaluation of the Caffeinated Alcoholic Beverages Motives Questionnaire.

Caffeinated alcoholic beverage (CAB) consumption is a risky drinking practice for young people. The purpose of the current set of studies was to develop and psychometrically evaluate a theory-based CAB motives measure to understand what drives CAB consumption and its ensuing consequences. Using 4 different samples, we pilot tested the items of the Caffeinated Alcohol Beverages Motives Questionnaire (CABMQ) and then evaluated its factor structure and its convergent, concurrent, and discriminant validity. Factor analyses supported a 5-factor structure. The coping and conformity subscales assessed negative reinforcement from internal and external sources, respectively. The social subscale assessed positive reinforcement derived from external sources, whereas the intoxication and energy enhancement subscales assessed positive reinforcement derived from internal sources. Differential relationships between the intoxication and energy enhancement subscales and existing motives measures provided compelling support for their individual distinctiveness. Greater endorsement of all subscales was related to experiencing more adverse alcohol-related consequences, whereas all subscales but the conformity subscale were related to greater CAB consumption. After controlling for general drinking motives, coping motives, energy enhancement motives, intoxication enhancement motives, and social motives were significantly correlated with CAB use, whereas only energy enhancement motives were significantly correlated with alcohol-related consequences. In sum, these results show that the CABMQ helps us understand CAB use and its consequences, with the energy enhancement subscale being particularly helpful. Future research should examine if energy enhancement motives explain why CABs pose more risk than drinking alcohol on its own. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Why are caffeinated alcoholic beverages especially risky?

PurposeEvidence suggests that people drink more alcohol and experience more adverse alcohol-related consequences (ARCs) on occasions when they also consume caffeine. The current study examined whether this increase in risk is a result of caffeine attenuating the subjective effects of alcohol intoxication (i.e., the masking hypothesis). MethodsUndergraduate students (n = 148) reported their drinking patterns using a modified Timeline Followback approach. For each recalled drinking occasion, alcohol consumption, caffeine consumption, perceived blood alcohol concentration, and ARCs were assessed. Generalized linear mixed models were used to examine the influence that alcohol and caffeine consumption had on perceived intoxication and the experience of ARCs. ResultsAt the occasion level, greater caffeine consumption was associated with increased consumption of alcohol and increased ARCs. There was also a significant curvilinear relationship between the amount of alcohol consumed and perceived intoxication, such that the more alcohol was consumed on each occasion the less each additional drink increased perceived intoxication. Increased caffeine consumption weakened the association between alcohol consumption and perceived intoxication and it also weakened the association between alcohol consumption and ARCs. Specifically, the weakest relationship between ARCs and alcohol consumption existed at the highest level of caffeine consumption (240+ mg). Caffeine increased subjective intoxication. ConclusionsThese findings do not support the masking hypothesis. Caffeine was strongly associated with ARCs when consumed at high doses and this effect does not appear to be the result of drinking more alcohol or underestimating one's blood alcohol content. Efforts to reduce caffeinated alcohol beverage use are greatly needed.

The association between caffeinated alcoholic beverages and the perpetration of intimate partner violence

ABSTRACTBackground: Problematic alcohol use is a recognized risk factor for intimate partner violence (IPV) perpetration.Objective: The use of caffeinated alcoholic beverages (CAB) appears to be associated with high-risk drinking behavior but the relationship between CAB use and IPV has yet to be explored.Methods: Sixty male and 40 female married or dating participants responded to an online survey including measures of past-year alcohol use and partner violence.Results: Logistic regression analyses revealed that CAB users were significantly more likely to perpetrate physical assault and partner injury after controlling for age, sex, ethnicity, income, and heavy alcohol use. The relationship between CAB use and perpetration of sexual coercion was better accounted for by heavy alcohol use.Conclusion: Results from the current study suggest that there exists an independent link between CAB use and partner violence perpetration.

Caffeinated Alcoholic Beverages and Intimate Partner Violence Victimization.

Background: Caffeinated alcoholic beverage (CAB) use is associated with general victimization beyond the use of alcohol alone. Materials and Methods: No prior research has evaluated the association between CAB use and intimate partner violence (IPV) victimization. This study evaluated the CAB-IPV victimization relationship using the responses of 100 (40 female) respondents to an online survey. Results: Results of logistic regression analyses indicated that CAB use was associated with IPV physical and sexual victimization after adjusting for demographics and heavy alcohol use. Exploratory analyses detected little evidence of sex differences in the strength of the relationship between CAB use and IPV victimization. Conclusions: The current results provide initial evidence that CAB use may place males and females at greater risk of IPV victimization.

The Timeline Followback Reliably Assesses Caffeinated Alcohol Beverage Consumption and Outcomes: Caffeinated Alcoholic Beverages Increase Risk

Background: Daily diary studies have shown that caffeinated alcoholic beverages (CABs) are associated with more risk than consuming alcohol alone; however, daily diary studies are time intensive. T...

Alcopops: a global perspective on the new category of alcoholic beverage

Purpose The purpose of this paper is to explore the history, classification, regulation, the current market and consumer trends and health effects of alcopops. Design/methodology/approach The articles reviewed were selected based on the following key descriptors such as alcopop, history, classification, types, production and consumption trend, health benefits and adverse effect. Findings “Alcopop” is a collective term used to refer to flavored alcoholic beverages (FAB), also known as malt alcoholic beverage; ready-to-drink beverage (RTD); pre-packaged spirit or premium packaged spirit; high-strength (HS) pre-mixed beverage; pre-mixed caffeinated alcoholic beverage or alcoholic energy drink, etc. Alcopops were introduced into the market in 1990s. Starting with the introduction of FAB in the form of wine coolers, a large number of alcoholic beverages have been introduced. FAB are sweet, containing relatively low alcohol content and especially designed for the young drinkers also called the “entry-level” drinkers. They are popular among young and underage drinkers, teenage girls particularly, and the industries use packaging materials and marketing strategies that appear to target the youth. These products are now marketed globally, and their production, classification and marketing vary by country based on national regulatory restrictions. In countries such as USA and Australia, the industry represents that the products were malt beverages for regulatory purpose which were found to be false as other products were derived from distilled spirits. The product has no health benefits so far, the government need to reform their regulations and include new definitions of alcopops with available restrictions that would be practice at both national and state levels until and unless there have been another scientifically approved method of production through which the beverage could be beneficial for human consumption. Originality/value This is a unique and comprehensive review that will provide a brief overview of alcopops, i.e., a global perspective on the new category of alcoholic beverage.

Effects of caffeinated alcoholic beverages with low alcohol and high caffeine content on cognitive and motor functions.

In Taiwan, caffeinated alcoholic beverages (CABs), with high caffeine but low alcohol concentrations compared to those sold in Western countries, are commonly consumed at work and have been associated with work-related injuries. However, the effects on cognitive and motor functions and self-perception have not been examined. Twenty-eight healthy male volunteers (mean age: 32.6±2.7) participated in the study. Each participant visited our laboratory 4 times at intervals of at least 1week and was assigned to one of 4 trials in a counterbalanced order at each visit: placebo, alcohol, caffeinated energy drink, and CAB. They completed the subjective perception ratings, go/no-go tasks, Stroop color-word tests, Purdue pegboard tests, and the standardized field sobriety test. We used analysis of variance to examine the intraindividual differences in the performance. Consuming alcohol of 0.23g/kg typically consumed by Taiwanese CAB drinkers caused significant impairments in fine and crude motor functions; caffeine (1.5mg/kg) did not antagonize these effects but led to an improvement in response speed in the go/no-go task. The subjective perceptions produced by alcohol were not masked by caffeine. CABs that contains a higher ratio of caffeine to alcohol did not counteract the motor function impairments induced by alcohol.

A daily diary examination of caffeine mixed with alcohol among college students.

Caffeinated alcoholic beverage (CAB) use is associated with a range of substance-related problems. The majority of prior research on CABs is based on cross-sectional and retrospective reports, which do not account for intraindividual differences in use and may be subject to recall biases. The current research used a daily diary, within-subjects design to compare days where individuals simultaneously mixed alcohol with caffeine (CAB days) and days where individuals drank other types of alcohol (non-CAB days) on alcohol use outcomes. These relationships were tested further by examining the impact of the type of mixer (i.e., energy drink or cola-caffeinated). Participants were 122 (73.8% women) heavy drinking, college student CAB users. Mean age was 20.39 (SD = 2.08) years. Students completed a baseline questionnaire and up to 14 consecutive daily surveys about the previous night's drinking behavior. Multilevel modeling results indicated that CAB days were associated with heavier alcohol use, regardless of mixer type. In addition, beyond amount of alcohol consumed the previous night and trait impulsivity, CAB days were linked with more alcohol-related problems, but only when the mixer was an energy drink. CAB days did not differ from non-CAB days on driving or sex after drinking. This study was the first to demonstrate the unique risks posed by simultaneously consuming caffeine and alcohol in a within-subjects, daily diary design. Future research investigating use patterns may benefit from the use of fine-grained approaches in order to provide information relevant for CAB prevention and intervention efforts. (PsycINFO Database Record

Elevated Consumption of Ethanol and Caffeine in Adolescent Rodents During Acquisition: The Role of Ethanol Concentration

Background: Naturalistic studies of bar patrons suggest that caffeinated alcoholic beverages contribute to excessive alcohol consumption, in comparison to individuals consuming alcohol alone. This study was designed as a rodent model of adolescent caffeinated alcoholic beverage consumption. ETOH acquisition occurred during the adolescent period, postnatal day (PND) 28–39. Method: Male Sprague-Dawley rats (N = 32) were randomly assigned to receive either alcohol (ETOH) or alcohol+caffeine (ETOH+Caffeine) in vehicle “supersac” solution (3% sucrose +0.125% saccharin). Rodents were given free access using a two-bottle choice procedure. Results: During acquisition (PND 31–39), ETOH+Caffeine animals consumed more fluid (mL/kg) at the 6% (v/v) compared to ETOH-only animals (p = 0.014). In addition, ETOH+Caffeine animals had greater fluid preference at the 6% (v/v) compared to ETOH only animals (p = 0.005). Discussion: These results suggest that ETOH+Caffeine may contribute to excessive alcohol consumption during acquisition. They further support continued study of ETOH+Caffeine in rodent models of adolescent alcohol consumption.

Testing a model of caffeinated alcohol-specific expectancies

IntroductionThe present study sought to further understand the association between caffeinated alcoholic beverage (CAB) use and alcohol-related risks. In particular, we focused on the role of two identified expectancies specific to CAB use: intoxication enhancement and avoidance of negative consequences. Although outcome expectancies are consistent predictors of substance use, limited research has examined expectancies related to CAB use and their association with alcohol-related behaviors, such as protecting themselves from alcohol-related harms. Consequently, the present study examined CAB-specific expectancies and protective behavioral strategies (PBS) as mediators of CAB use and negative consequences. MethodsParticipants were 322 (219 women) college drinkers who completed self-report measures of typical CAB and alcohol use, CAB-specific expectancies, PBS use, and alcohol-related harms. ResultsStructural equation modeling revealed, after controlling for typical non-CAB heavy alcohol use, a significant indirect effect of CAB use to alcohol-related problems through avoidance of negative consequences CAB expectancies and PBS use. However, intoxication enhancement expectancies did not mediate this association. ConclusionsOur findings indicate that heavier CAB use was associated with stronger expectations that drinking CABs can help avoid negative consequences. These beliefs were related to using fewer PBS when drinking and a greater likelihood of experiencing problems. Given that these expectancies may be underlying mechanisms of CAB use, their inclusion in existing alcohol interventions may be beneficial.

The Role of Caffeine in the Alcohol Consumption Behaviors of College Students

ABSTRACTBackground: Evidence suggests that alcohol mixed with caffeine in any form may spur risky drinking behavior among young adults; however, most studies have only examined drinking behavior related to alcohol mixed with energy drinks (AmEDs) compared with alcohol alone. This survey assessed the consumption patterns and reasons for use of alcohol mixed with any caffeinated beverages (alcohol-caffeine) versus alcohol-only beverages among current users. Methods: Students (N = 1174) at a large, urban university completed a Web-based survey in October–December of 2010. Predictors of alcohol-caffeine use versus alcohol-only use were examined, as were drinking characteristics and reasons for alcohol-caffeine consumption as a function of type of alcohol-caffeine beverage usually consumed. Results: Past-30-day prevalence was 34% for any alcohol-caffeine beverages and 36% for alcohol-only. The most frequent alcohol-caffeine beverages usually consumed were manufactured ready-to-drink AmED products (no longer sold in the United States; 50.3%), followed by self-mixed alcoholic beverages containing caffeinated sodas (26.4%) and energy drinks (18.5%). Users of alcohol-caffeine displayed a riskier drinking profile than alcohol-only users; however, there were few differences in overall alcohol drinking behaviors between consumers of AmEDs (manufactured or self-mixed) versus other caffeinated alcoholic beverages (e.g., alcohol mixed with caffeinated sodas). Conclusions: Although alcohol-caffeine consumption was associated with heavier drinking characteristics compared with alcohol-only consumption, overall alcohol consumption patterns were similar between users of various alcohol-caffeine combinations. Future examinations should assess alcohol in combination with a variety of caffeine sources to determine whether energy drinks present a unique risk.

Caffeinated Alcohol Use and Expectancies for Caffeine Versus Alcohol

Background: Caffeinated alcoholic beverage (CAB) use is related to alcohol-related risk. Limited research has examined outcome expectancies and CAB consumption. Objectives: This study tested the predictive utility of caffeine and alcohol expectancies in CAB use outcomes (i.e. quantity, frequency, and alcohol-related harms). Methods: Participants were 419 (302 women) alcohol and caffeine users from a mid-sized urban university. Data collection occurred between August 2010 and December 2011. Participants completed measures of caffeine and alcohol expectancies, alcohol problems, alcohol use, and CAB use. Results: Caffeine and alcohol expectancies contributed uniquely to approximately 12% of the variability in quantity, 8% in frequency, and 16% in problems. When examined separately, alcohol expectancies explained approximately 10% to 11% of the variance, whereas caffeine expectancies accounted for 6% of the variance in CAB use quantity. For CAB use frequency, alcohol and caffeine expectancies accounted for about 8% and 4%, respectively. Alcohol expectancies accounted for 12% to 14% of variance, whereas caffeine expectancies accounted for 4% to 6% in alcohol-related harms. Conclusions/ Importance: The present study sought to address a gap in the literature regarding the contributions of expectancies in the prediction of CAB use. Our findings provide support for the predictive utility of both caffeine and alcohol expectancies in accounting for individual variability in CAB use but alcohol expectancies may exert greater impact on use patterns. Inclusion of both types of expectancies in larger theoretical frameworks may be beneficial in gaining a more complete and deeper conceptualization of this risky behavior.

A qualitative review of psychosocial risk factors associated with caffeinated alcohol use.

Caffeinated alcoholic beverages (CABs) are increasingly popular among young adults. The use of such beverages is associated with negative consequences including heavy alcohol use, risky sexual and driving behaviors, as well as other drug use. The prevalence of CAB use and their related harms warrants greater focus into the factors that may explain why use is associated with negative outcomes or what factors may impact their association. Consequently, the present study reviewed existing research on CABs and highlighted constructs (i.e., drinking motives, substance expectancies, perceived drinking norms, risk-taking propensity) that could act as mediators or moderators of CAB use and consequences. We proposed implications for practice and future research.

Impulsivity and alcohol demand in relation to combined alcohol and caffeine use.

Problematic alcohol use among college students continues to be a prominent concern in the United States, including the growing trend of consuming caffeinated alcoholic beverages (CABs). Epidemiologically, CAB use is associated with incremental risks from drinking, although these relationships could be due to common predisposing factors rather than specifically due to CABs. This study investigated the relationship between CAB use, alcohol misuse, and person-level characteristics, including impulsive personality traits, delayed reward discounting, and behavioral economic demand for alcohol use. Participants were 273 regularly drinking undergraduate students. Frequency of CAB use was assessed over the past month. A multidimensional assessment of impulsivity included the UPPS-P questionnaire, which measures positive and negative urgency, premeditation (lack thereof), perseverance (lack thereof), and sensation seeking (Lynam, Smith, Whiteside, & Cyders, 2007), and a validated questionnaire-based measure of delayed reward discounting. Demand was assessed via a hypothetical alcohol purchase task. Frequency of CAB consumption was significantly higher in men than in women and was also associated with higher impulsivity on the majority of the UPPS-P subscales, steeper delayed reward discounting, and greater demand for alcohol. Significant correlations between CAB use and both alcohol demand and lack of premeditation remained present after including level of alcohol misuse in partial correlations. In a hierarchical linear regression incorporating demographic, demand, and impulsivity variables, CAB frequency continued to be a significant predictor of hazardous alcohol use. These results suggest that although there are significant associations between CAB consumption and gender, impulsivity, and alcohol demand, CAB use continues to be associated with alcohol misuse after controlling for these variables.

Caffeinated alcohol consumption profiles and associations with use severity and outcome expectancies

Growing evidence suggests that the consumption of caffeinated alcoholic beverages (CAB) may be riskier than alcohol alone. Efforts to identify patterns of CAB use and the correlates of such drinking patterns could further our conceptualization of and intervention for this health issue. Consequently, the current study aimed to (1) identify distinct classes of CAB users, (2) examine differences between classes on measures of alcohol and caffeine problems, and (3) compare distinct classes of CAB users on caffeine and alcohol outcome expectancies. Participants were 583 (31% men) undergraduate students from a psychology research pool. Latent profile analysis models were derived using four indicators: CAB use quantity, CAB use frequency, alcohol use quantity, and alcohol use frequency. Finding revealed four classes of drinkers: High Alcohol/High CAB (6.00%), High Alcohol/Moderate CAB (5.15%), High Alcohol/Low CAB (22.99%), and Low Alcohol/Low CAB (65.87%). The Low Alcohol/Low CAB class reported the lowest relative levels of caffeine dependence symptoms, caffeine withdrawal, alcohol use problems, and heavy episodic drinking frequency. Further, results indicated differential expectancy endorsement based on use profiles. CAB users in the High Alcohol/Low CAB class endorsed more positive alcohol expectancies than the Low Alcohol/Low CAB group. Those in the High Alcohol/High CAB class endorsed stronger withdrawal symptom caffeine expectancies than all other classes. Inclusion of substance-specific expectancies into larger theoretical frameworks in future work of CAB use may be beneficial. Findings may inform intervention efforts for those at greatest risk related to CAB consumption.

The use of caffeinated alcoholic beverages among underage drinkers: Results of a national survey

ObjectiveThe mixing of alcoholic beverages with caffeine has been identified as a public health problem among college students; however, little is known about the consumption of such drinks among younger adolescents. We estimated the prevalence of caffeinated alcoholic beverage (CAB) use among a wide age range of underage drinkers, examined differences in traditional (i.e. self-mixed alcoholic beverages with soda, coffee and tea) and non-traditional CAB use (pre-mixed caffeinated alcoholic beverages or self-mixed alcoholic beverages with energy drinks or energy shots) among underage drinkers by age and other demographic characteristics, and examined differences in hazardous drinking behavior between CAB and non-CAB users. MethodsWe used an existing Internet panel maintained by Knowledge Networks, Inc. to assess the use of pre-mixed and self-mixed CABs in the past 30days among a national sample of 1031 youth drinkers age 13–20. We conducted logistic regression analyses to estimate the relationship between traditional and non-traditional CAB use and risky drinking behavior as well as adverse outcomes of drinking, while controlling for age, gender, race/ethnicity, income, and general risk-taking (seat belt use). ResultsThe overall prevalence of CAB use in the sample of underage drinkers was 52.4% (95% confidence interval [CI], 47.4%–57.4%). CAB prevalence was 48.4% among 13–15year-old drinkers, 45.3% among 16–18year-old drinkers, and 58.4% among 19–20year-old drinkers. After controlling for other variables, we found a continuum of risk with non-traditional CAB use most significantly associated with binge drinking (odds ratio [OR]=6.3), fighting (OR=4.4), and alcohol-related injuries (OR=5.6). ConclusionsThe problem of caffeinated alcoholic beverage use is not restricted to college-aged youth. The prevalence of CAB use among underage drinkers is higher than previously thought and begins in early adolescence. Adolescents who consume CABs, and particularly non-traditional CABs, are at increased risk of adverse outcomes.

Energy Drinks: What Teenagers (and Their Doctors) Should Know

1. Kwabena L. Blankson, MD* 2. Amy M. Thompson, DO† 3. Dale M. Ahrendt, MD‡ 4. Vijayalakshmy Patrick, MD§ 1. *Maj, US Air Force, Adolescent Medicine, Naval Medical Center, Portsmouth, VA. 2. †Maj, US Army, Adolescent Medicine Fellow, San Antonio Uniformed Services Health Education Consortium (SAUSHEC), San Antonio, TX. 3. ‡Lt Col, US Air Force, Program Director, Adolescent Medicine, Fellowship, SAUSHEC, San Antonio, TX. 4. §Psychiatrist, Brooke Army Medical Center Associate Professor, University of Texas Health Science Center, San Antonio, TX. Hundreds of different energy drinks are available and are marketed to adolescents, carrying the potential for substance abuse that involves caffeine and alcohol. Clinicians must be educated to deal with their patients’ use of these products. After reading this article, readers should be able to: 1. Understand the size and scope of the energy drink market and recognize common energy drink brands. 2. Know that adolescents are high consumers of energy drinks and use them as performance enhancers. 3. Know the contents of energy drinks and their adverse effects and safety concerns. 4. Know that energy drinks can be a cause of tachycardia, hypertension, obesity, and other medical problems in adolescents. 5. Know the dangers of mixing energy drinks with alcohol. 6. Understand the relationship between caffeine tolerance/dependence and alcohol tolerance/dependence. 7. Understand the importance of screening teenagers for energy drink use in the office setting and offering appropriate counseling. Energy drinks are caffeinated beverages advertised as boosting the immune system, enhancing performance, and creating a “buzz” or a “high.” Some of these drinks contain alcohol, and sometimes consumers mix them with alcoholic beverages. This article reviews current information about the content, benefits, and risks of the use of these energy drinks by adolescents. Adolescents are no strangers to energy drinks, and over the past 2 years, media reports have heightened the awareness of doctors, parents, and lawmakers. In 2010, nine university students in Washington State were hospitalized and one almost died; their illness was attributed to a fruit-flavored, caffeinated alcoholic drink. A month earlier, on a college campus in New Jersey, 23 students were hospitalized after becoming intoxicated, again reportedly after drinking the same …

The combined effects of alcohol, caffeine, and expectancies on subjective experience, impulsivity, and risk-taking.

Caffeinated alcoholic beverage (CAB) consumption is a rapidly growing phenomenon among young adults and is associated with a variety of health-risk behaviors. The current study examined whether either caffeinated alcohol or the expectation of receiving caffeinated alcohol altered affective, cognitive, and behavioral outcomes hypothesized to contribute to risk behavior. Young adult social drinkers (N = 146) participated in a single session where they received alcohol (peak Breath Alcohol Content = .088 g/dL, SD = .019; equivalent to about four standard drinks) and were randomly assigned to one of four further conditions: 1) no caffeine, no caffeine expectancy, 2) caffeine and caffeine expectancy, 3) no caffeine but caffeine expectancy, 4) caffeine but no caffeine expectancy. Participants' habitual CAB consumption was positively correlated with measures of impulsivity and risky behavior, independently of study drugs. Administration of caffeine (mean dose = 220 mg, SD = 38; equivalent to about 2.75 Red Bulls) in the study reduced subjective ratings of intoxication and reversed the decrease in desire to continue drinking, regardless of expectancy. Caffeine also reduced the effect of alcohol on inhibitory reaction time (RT) (faster incorrect responses). Participants not expecting caffeine were less attentive after alcohol, whereas participants expecting caffeine were not, regardless of caffeine administration. Alcohol decreased response accuracy in all participants except those who both expected and received caffeine. Findings suggest that CABs may elevate risk for continued drinking by reducing perceived intoxication, and by maintaining the desire to continue drinking. Simply expecting to consume caffeine may reduce the effects of alcohol on inattention, and either expecting or consuming caffeine may protect against other alcohol-related performance decrements. Caffeine, when combined with alcohol, has both beneficial and detrimental effects on mechanisms known to contribute to risky behavior.

Initial development of a measure of expectancies for combinations of alcohol and caffeine: The Caffeine + Alcohol Combined Effects Questionnaire (CACEQ).

Caffeinated alcoholic beverage (CAB) consumption is widespread among young adults in the United States and is associated with increased negative consequences from alcohol. In addition to the direct pharmacological effects of adding caffeine to alcohol, another possible risk mechanism is via socially learned expectancies, which has received very little consideration. The current study conducted an initial psychometric validation of a measure of CAB expectancies to facilitate research in this area. Participants were 409 undergraduate regular drinkers (71% female) who were assessed for alcohol and CAB use, alcohol use/misuse, and expectancies about CABs. The majority (62%) of participants reported CAB experience and 48% reported CAB use in the past month. Participants primarily consumed spontaneously-prepared as opposed to premixed-CABs. More frequent CAB use was significantly positively correlated with levels of alcohol use and misuse. For the expectancy items, exploratory factor analysis revealed two factors that were labeled "Intoxication Enhancement" and "Avoid Negative Consequences." The patterns of expectancies reflected beliefs that CABs enhanced intoxication, but did not protect against negative consequences. The measure was titled the Caffeine + Alcohol Combined Effects Questionnaire (CACEQ). Intoxication enhancement scores were significantly associated with frequency of CAB use, even after adjusting for the role of weekly drinking and alcohol misuse, supporting the convergent validity of the CACEQ. These data provide initial support for the CACEQ and suggest it may be useful for clarifying the role of expectancies in CAB use. Applications for studying the risks associated with CAB use and methodological considerations are discussed.