Concurrent validity of the Alcohol Purchase Task for measuring the reinforcing efficacy of alcohol: an updated systematic review and meta-analysis

Background and aims An early meta-analysis testing the concurrent validity of the Alcohol Purchase Task (APT), a measure of alcohol's relative reinforcing value, reported mixed associations, but predated a large number of studies. This systematic review and meta-analysis sought to: (1) estimate the relationships between trait-based alcohol demand indices from the APT and multiple alcohol indicators, (2) test several moderators and (3) analyze small study effects. Methods A meta-analysis of 50 cross-sectional studies in four databases (n = 18 466, females = 43.32%). Sex, year of publication, number of APT prices and index transformations (logarithmic, square root or none) were considered as moderators. Small study effects were examined by using the Begg-Mazumdar, Egger's and Duval & Tweedie's trim-and-fill tests. Alcohol indicators were quantity of alcohol use, number of heavy drinking episodes, alcohol-related problems and hazardous drinking. APT indices were intensity (i.e. consumption at zero cost), elasticity (i.e. sensitivity to increases in costs), O-max (i.e. maximum expenditure), P-max (i.e. price associated to O-max) and breakpoint (i.e. price at which consumption ceases). Results All alcohol demand indices were significantly associated with all alcohol-related outcomes (r = 0.132-0.494), except P-max, which was significantly associated with alcohol-related problems only (r = 0.064)(.) The greatest associations were evinced between intensity in relation to alcohol use, hazardous drinking and heavy drinking and between O-max and alcohol use. All the tested moderators emerged as significant moderators. Evidence of small-study effects was limited. Conclusions The Alcohol Purchase Task appears to have concurrent validity in alcohol research. Intensity and O-max are the most relevant indices to account for alcohol involvement.

Automated summary

This systematic review and meta-analysis found that the Alcohol Purchase Task has concurrent validity in alcohol research, with intensity and O-max being the most relevant indices. All tested moderators emerged as significant moderators, with limited evidence of small-study effects.