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- MATERIALS AND METHODS
Results showed that the studied group of FN people appeared to fall in between the LCC and MCC groups with respect to their expectations for access to fundamentally important life reinforcers, with the LCC group perceiving less access and the MCC group perceiving greater access. It is also important to note that while the unadjusted means for how heavy drinking would influence access to reinforcers appear similar, regression analyses show that after adjusting for age and gender, the LCC and MCC groups both expect less access to all reinforcers than the FN group with 1 exception: The LCC and FN groups did not differ in their expectation for how heavy drinking would influence their access to family relationships.
Taking baseline differences in perceived SLR access into account, as hypothesized, the FN group reported that heavy drinking would be less apt to cost them access to these important reinforcers than was true for the MCC group. Perhaps, FN people who reside on reserves are at higher risk for problem drinking than MCCs in part, because they perceive the negative consequences of excessive consumption to be less pronounced. We anticipated that FN individuals would be similar in this regard to less financially fortunate, LCC individuals. In part, they were, but counter to our hypothesis, the LCC group did expect drinking to have less of an impact on their access to jobs and friendships than the FN group.
It was striking that an unselected sample of members of an FN reserve were similar to a highly selected group of Caucasians—those at homeless shelters and soup kitchens. It thus seems that the normative experience, at least on the reserve we studied, with respect to SLR access is more similar to that of destitute Caucasians than of Caucasians in general.
These findings have important treatment and prevention implications. Consider the effective treatment for alcoholism that is known as the community reinforcement approach (CRA; Sisson and Azrin, 1989). Many serious alcoholics in the United States have lost access to many sources of reinforcement and thus have reduced incentive not to drink. In the CRA treatment, providers reintroduce access to many reinforcers, and access to them is only removed upon a return to alcohol consumption. A key step in the intervention is to make reinforcers available, to reintroduce contingency between sobriety and reinforcer access. Thus, for the treatment to work, SLRs need to be available. To the degree that reserves are characterized by reduced access to SLRs, this useful treatment is difficult to implement. However, while CRA would be difficult to implement using these SLRs as reinforcers, it would not be impossible. Through some form of external support or some new, entrepreneurial initiative, reserves could increase the number and quality of positions available. Doing work that is important to the individual may make employees more invested in their positions and less likely to drink problematically for fear of losing their jobs. Indeed, our results suggest that expecting that problematic or heavy drinking will cost access to SLRs is negatively associated with problem drinking.
An easier approach to using CRA would include finding other possible reinforcers that may be less costly to implement within the CRA framework. Reinforcers that compete with substance use may prove fruitful to use. For example, increasing the number of community events may be a useful reinforcer that could be contingent upon sobriety. Providing sufficient access to the SLRs, we studied to implement community reinforcement that would involve a significant change to life on the reserve we studied. However, finding smaller-scale, easily controlled reinforcers may prove more feasible and still fruitful.
The findings suggest promise to the Spillane and Smith (2007) model, and they also suggest the value of attempts to apply behavioral principles to understand important differences in context experienced by different groups. Researchers can rely on what appear to be universal psychological processes, such as those of behavioral theory, to better understand important contextual factors that contribute to different behaviors by different groups (Smith et al., 2006).
Interestingly, our hypothesis that FN individuals would perceive less loss of family support from drinking heavily than the LCC group was not supported; in fact, the opposite finding emerged. We cannot know the reason for this outcome, and it should be replicated. We can offer 1 speculation. Perhaps a combination of the more individualistic focus of Caucasian culture (Smith et al., 2006) and a lack of LCC family cohesiveness because of the effects of poverty, psychopathology, or both reduces the degree to which LCC individuals rely on family support in comparison to FN individuals. It is possible that FN individuals rely on family support more consistently on a daily basis and so have more to lose from drinking heavily in this respect. This possibility merits investigation. Should this finding be replicated, it would have important treatment implications for using the family unit as a motivation for treatment and/or to include the family into the treatment of the individual.
It is also important to appreciate what this study did not show. First and foremost, this study was not an investigation of individual differences in FN members' drinking and risk. We tested 1 component of a risk model, and that component pertained to group, contextual risk. It is by no means true that all FN engage in problem drinking, or even drinking at all. In fact, Spillane and Smith (2007) reviewed evidence for high rates of abstinence from alcohol in Indian Nation. Group-level, contextual risk processes influence the risk matrix, but they of course operate in the context of profound variability among people. In another study, we reported the findings from a risk model to help explain individual differences in problem drinking among FN members (Spillane and Smith, 2010).
Second, we did not test whether there are, in fact, differences in contingency between sobriety and SLR access for the groups we compared. Spillane and Smith (2007) argue for that position, but the aim of this study was different. We sought to test what we considered the more proximal aspect of the risk process: whether FN and MCCs/LCCs perceived the contingencies differently. Our perspective was that differences in the perception of the contingencies would be associated with differences in behavior, and they were.
Third, this study does not describe a risk process that applies to all FN people. We have only provided evidence that it may apply in contexts where the relative lack of contingency between sobriety and SLR access exists. Reserves vary a great deal from each other. Although there are reserves where the unemployment rate is nearly 80% (Beauvais, 1998; Costello et al., 1997; Ramasamy, 1996; US Census Bureau, 2006), Beals and colleagues (2009) correctly noted that 2000 U.S. Census data indicated an overall reserve unemployment rate of 14%. Although unconscionably high, that figure obviously represents an average of very different rates on different reserves. Access to a sample of relatively affluent reserve-dwelling FN members would shed further light on the degree to which the effects we observed were specific to nonaffluent reserve-dwelling individuals.
Fourth, we do not know, in detail, how members of the FN group are similar to, or different from, members of the LCC group. For example, information on the medical and psychiatric status of members of each group, as well as information on the degree and chronicity of homelessness among the LCC group, could shed further light on the nature of their perceived access to SLRs.
Fifth, the Spillane and Smith (2007) model describes 1 possible risk process. No doubt, many other factors contribute to risk for FN people. Concerning FN, the profoundly tragic history of Indigenous groups in North America, including the nature of early Caucasian–Indigenous interactions around alcohol (Beauvais, 1998), and Indigenous perceptions of discrimination (Whitbeck et al., 2001) all likely played a role in creating a risk context, along with other factors (see review by Spillane and Smith, 2007). This empirical report does not address those important possibilities.
Sixth, we did not study non-reserve-dwelling FN people. The differences and similarities in the challenges, possibilities, and risk factors faced between non-reserve-dwelling and reserve-dwelling FN people were beyond the scope of this study.
It is important that researchers study all aspects of Indigenous life, including both the many profound strengths of FN culture and the difficulties some members from FN face. One of those difficulties, for some FN people, is problem drinking. We hope that this empirical test, along with tests of alternative, competing theories, will lead to successful efforts to ameliorate this problem.