Cognitive Therapy and Research, Vol. 21, No. 4, 1997, pp.

421-442

Outcome Expectancies and Risk-Taking Behavior1

Kim Fromme,2,4 Elizabeth C. Katz,2 and Kathy Rivet3

One explanation for risk-taking behavior despite warnings about the dangers
is that anticipated positive consequences outweigh possible negative outcomes.
In a five-part investigation, a new questionnaire was developed to assess
outcome expectancies for the potential consequences of involvement in a
variety of risky activities. Conceptual and methodological limitations of
previously available questionnaires were addressed and content, construct, and
criterion validity were demonstrated. The new questionnaire measures
respondents' beliefs about the consequences of 30 risky activities, as well as
their expected and actual involvement in those activities. Consistent with a
large body of alcohol expectancy research, beliefs about potential benefits were
found to be more reliably associated with risk-taking than were beliefs about
potential negative consequences. Implications for cognitive approaches to harm
reduction are discussed.
KEY WORDS: risk taking; outcome expectancies; harm reduction.

Injury and death among young adults are largely attributable to voluntary
participation in activities which are known to be harmful. Engs and Hanson
(1988), for example, found that almost 50% of college students reported
driving while intoxicated. In 1988, 30% of all the drinking drivers involved
in fatal motor vehicle accidents were between the ages of 16 and 24 years
1

This research was supported by a FIRST award 1R29AA09135 from the National Institute
on Alcohol Abuse and Alcoholism (NIAAA) to Kim Fromme and by NIAAA training grant
5T32-AA07471 which provides support to Elizabeth Katz. The authors express their
appreciation to Marianne Kernander and Charles Collier for their help with the pilot study,
and to Marvin Zuckerman and David Kaplan for their consultations on this project.
2
Department of Psychology, The University of Texas at Austin, Austin, Texas 78712.
3
Department of Educational Psychology, State University of New York, Albany, New York
12222.
4
Address all correspondence to Dr. Kim Fromme, Department of Psychology, 330 Mezes Hall,
The University of Texas at Austin, Austin, Texas 78712.

421
0147-5916/97/0800-0421$1250/0 C 1997 Plenum Publishing Corporation

422

Fromme, Katz, and Rivet

(U.S. Bureau of the Census, 1990). Increased concern has also been raised
about young adults' continued involvement in unsafe sexual activities which
put them at risk for human immunodeficiency virus (HIV) infection. For
college students who are sexually active, a recent survey found that 44%
reported two or more partners and 75% had not always used condoms
during sexual intercourse (Fisher & Fisher, cited by Williams et al., 1992).
Of all diagnosed cases of acquired immune deficiency syndrome (AIDS)
from August 1988 through July 1990, greater than 49% were young adults
(U.S. Department of Health and Human Services, Centers for Disease
Control, 1991). Sixty-five percent of 13- to 25-year-olds diagnosed with
AIDS contracted the disease through sexual contacts.
One explanation for young adults' continued involvement in risky activities despite warnings about the dangers is that these activities typically
provide the potential for positive or beneficial outcomes. Driving while intoxicated may provide the young driver with a thrilling experience or admiration from peers and sexual intercourse without a condom is perhaps
more spontaneous or pleasurable. Particularly in the area of alcohol and
drug use, positive outcome expectanciesbeliefs about the beneficial consequences of one's actionshave been shown to be reliable predictors of
subsequent behavior (e.g., Fromme, Stroot, & Kaplan, 1993; Goldman,
Brown, & Christiansen, 1987). Expectations of pleasurable experiences may
similarly guide decisions to engage in risky activities.
A number of single-problem outcome expectancy scales are currently
available to assess beliefs about the consequences of drug and alcohol use.
At least six alcohol expectancy questionnaires have been developed (e.g.,
Brown, Goldman, Inn, & Anderson, 1981; Fromme et al., 1993) and these
measures have proven extremely useful for predicting quantity and frequency of alcohol use (Mooney, Fromme, Kivlahan, & Marlatt, 1986), onset
of problem drinking (Christiansen, Smith, Roehling, & Goldman, 1989),
and relapse following treatment for alcoholism (Brown, 1985). Outcome
expectancy scales for marijuana and cocaine (e.g., Schafer & Brown, 1991)
have also enhanced our understanding of the reasons people use these substances. Similarly, it seems important to understand individuals' beliefs
about the positive and negative consequences of participation in other risky
activities. Beliefs about the potential risks and benefits of condom use and
driving after drinking, for example, have been reliably associated with participation in these activities. Among intravenous drug users, prostitutes, and
prostitute's clients, the benefits of enhanced sexual pleasure for self or
other were found to outweigh the risk for contracting AIDS when deciding
not to use a condom during sexual intercourse (Plant, Plant, Peck, & Setters, 1989). For drinking and driving, Wilson and Jonah (1985) found that
individuals who said that they have driven after drinking alcohol reported

Outcome Expectancies and Involvement in Risky Activities

423

a lower perceived risk of arrest than individuals who did not drink and
drive. Research documenting the covariation among these various behaviors
(Jessor, 1991) also suggests that similar cognitive processes may motivate
involvement in otherwise dissimilar activities. A single-outcome expectancy
questionnaire could be useful for assessing people's beliefs about the consequences of involvement in a broad array of risky activities.
To date, one published measure is available to examine the association between cognitive appraisals and risk-taking across a variety of activities. Horvath and Zuckerman (1992) developed the General Risk Appraisal
Scale (GRAS) which prompts respondents to estimate the likelihood that
specific negative consequences would occur (e.g., getting arrested) if they
were to engage in certain activities (e.g., driving after drinking). Path analyses indicated that past risk-taking behavior was significantly inversely associated with GRAS likelihood ratings for negative consequences. Because
involvement in risky activities is clearly influenced by a variety of potential
consequences, however, specification of a single negative outcome for each
measured activity limits the utility of this questionnaire. For example, fear
of contracting cancer might discourage smoking for some people, whereas
social disapproval might be the most salient deterrent for others. Only when
personally salient consequences are considered should outcome expectancies predict an individual's involvement in that behavior (Leigh & Stacy,
1994).
Slovic (1991) and his colleagues have also employed the psychometric
paradigm of risk perception to study voluntary participation in personally
dangerous activities. Using an unpublished questionnaire (Severson, Hampson, Schrader, & Slovic, 1990), their research has shown that individuals
who engage in risky activities report greater perceived benefits relative to
risks, and greater perceived control over associated consequences, than
those individuals who do not participate in risky activities (Benthin, Slovic,
& Severson, 1993). Unlike the GRAS, the Slovic measure did not specify
particular consequences, but rather prompted respondents to evaluate the
likelihood that any negative or positive consequences would result if they
were to engage in the specified activities. Thus, Slovic and his colleagues
have begun to demonstrate that outcome expectancies regarding potential
positive and negative consequences are reliably related to participation in
a variety of risky activities. Their measure is limited, however, by focusing
on behaviors specific to adolescents (e.g., having a drink of alcohol) and
by the fact that psychometric properties have not been established.
The current investigation, comprising five studies, was therefore conducted to develop a brief, but broad-based, measure of outcome expectancies and risk-taking among young adults. Consistent with a growing interest
in harm reduction, the new expectancy questionnaire would assess not only

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Fromme, Katz, and Rivet

substance use, but also involvement in unsafe sexual practices and aggressive behavior. It could serve as a brief, but comprehensive assessment tool.
In an effort to capture the full domain of hazardous activities in which
people voluntarily engage, risky activities were defined broadly as those
activities which could result in both negative and positive consequences
(U.S. Department of Health and Human Services, [USDHHS], 1992). We
focused on behaviors with relatively immediate potential consequences
(e.g., drug use) rather than those behaviors which could have substantial,
but significantly delayed, outcomes (e.g., choosing a marital partner). This
approach allowed us to assess "traditional" risk behaviors (e.g., substance
use, unsafe sex) as well as more socially acceptable behaviors which also
involve potential negative consequences (e.g., rock climbing, skipping class).
In addition, particular outcomes were not specified, but rather potential
negative and positive consequences of risk-taking were defined generally.
Negative outcomes included being hurt, embarrassed, or arrested, whereas
positive outcomes included experiencing pleasure or feeling good about
oneself. In employing a general approach to assessing outcome expectancies, we believe that respondents will provide appraisals for those consequences which are most personally salient (Leigh & Stacy, 1994).
As college students constitute a sizeable proportion of young adult
risk-takers (Larimer & Marlatt, 1991), the new measure was developed
within this population. Content validity was established by asking college
students to monitor their risk-taking, with typical risk behaviors selected
for inclusion in the initial item pool. Construct validity of the measure was
tested through factor-analytic techniques and by examining the association
between risk-taking outcome expectancies and trait measures of sensation
seeking/impulsivity and social conformity (previously associated with seeking or avoiding risky behavior, respectively). Criterion validity of the questionnaire was tested by relating outcome expectancies of risk and benefit
to individual's recent risk-taking, measured during a 10-day follow up to
expectancy questionnaire completion.
PILOT STUDY

Potential items for the new measure were generated by asking 113
undergraduate students (46% female) to keep a written record of the most
risky activities in which they engaged for each of 10 days. A risky activity
was defined as any activity for which both negative and positive consequences could result (USDHHS, 1992), and participants rated the amount
of perceived risk associated with each behavior (1 = none, 1 = extreme).
A return rate of 96% yielded 1,008 instances of risky activities.

Outcome Expectancies and Involvement in Risky Activities

425

Equal numbers of male and female raters (12 psychology faculty, 12

graduate students, 12 undergraduate students) were then asked to identify
those monitored behaviors which unambiguously represented a range of
risky activities. Using a Q-sorting procedure, activities which had face validity and could be reliably identified as representing meaningful forms of
risk-taking (i.e., those with perceived risk ratings > 3) were selected for
subsequent measurement development. Ambiguous and duplicate responses were eliminated, leaving 165 unique behaviors. Forty-nine of those
most frequently reported responses were selected to form the item pool
for our preliminary expectancy questionnaire. These items represented substance use (e.g., alcohol and marijuana), aggressive behaviors (e.g., shouting
at someone), illegal activities (e.g., driving after drinking), gambling (e.g.,
playing poker), irresponsible academic behaviors (e.g., skipping class), sexual behaviors (e.g., having sex with a casual partner), interpersonal behaviors (e.g., going on a blind date), and sports (e.g., rock climbing, team
sports).5 Together the monitoring and sorting procedures served to characterize the domain of risky activities in which college students reported that
they engaged. Because of the short monitoring period and the low base
rates of occurrence for nonconsenting sex and physical aggression, seven
activities were added to the item pool which were not reported by pilot
subjects: Two items concerned nonconsenting sex (Koss, Gidycz, & Wisniewski, 1987) and four items represented physical aggression (Pernanen,
1991). Requests by college administrators led to the inclusion of one item
for academic dishonesty. A total of 56 items therefore comprised the initial
item pool for the measure.

STUDY 1
Study 1 was conducted to finalize item content and assess construct
validity of the new Cognitive Appraisal of Risky Events (CARE) questionnaire.
Method
Subjects. Students (N = 240; 50.2% male) enrolled in general psychology courses participated. Participants were predominately white (90%), sin5

Details on item generation and selection procedures, as well as complete lists of the 165
unique behaviors and the 49 most frequently reported behaviors, are available from the
authors.

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Fromme, Katz, and Rivet

gle (99%), middle class ($50,000 average family income), and averaged 19
years of age. They received course research credit for their participation.
Measures. Demographic information, including gender, ethnicity, age,
and socioeconomic status, was collected. For the CARE questionnaire, 7point Likert response scales (1 = not at all likely, 1 = extremely likely) were
used to rate three types of outcome expectancies: expected risk, expected
benefit, and expected involvement.
For expected risk (ER), respondents rated the likelihood that a negative consequence would occur, with a negative consequence being defined
as one in which the individual might become sick, injured, embarrassed,
or that he or she might lose money, suffer legal consequences, fail a class,
or feel bad about him or herself. Likewise for expected benefit (EB), a
positive consequence was defined as one in which the individual would experience pleasure, win money, feel good about him or herself, etc. For expected involvement (EI), respondents rated their likelihood of engaging in
each activity during the subsequent 6 months.
Procedures. For economy of time purposes, subjects provided EI ratings
(along with other questionnaires not relevant to the current study) during
a Department of Psychology group questionnaire administration. Subjects
were subsequently scheduled for small group sessions where they provided
informed consent, ER, and EB ratings for the CARE.
Results Study 1
Exploratory Factor Analyses. Because risk, benefit, and expected involvement have been shown to represent distinct, but correlated, constructs
(Benthin et al., 1993; Slovic, 1991), separate exploratory factor analyses
were conducted for the ER, EB, and EI ratings. Three unconstrained exploratory factor analyses with principal axis factoring and oblique rotation
were conducted.6 Examination of the scree plots, eigenvalues (>1.0), and
amount of trace variance explained by each successive factor suggested
seven factor solutions for all three analyses. The ER, EB, and EI ratings
were then reanalyzed, constraining each analysis to seven factors. Items
were deleted if they loaded below .40 for at least two of the three analyses
or if they loaded equally well on more than one factor within an analysis.
Eleven items were deleted.7
6

Consistent with the literature on alcohol outcome expectancies, we expected these risk-taking
expectancies to be modestly intercorrelated. Therefore, oblique rotation was selected to allow
for such covariation. Similar factor structures were obtained, however, when varimax
orthogonal rotations were used.
7
Factor loadings and internal reliabilities for exploratory analyses are available from the
authors.

Outcome Expectancies and Involvement in Risky Activities

427

Substantial similarity in factor structure for ER, EB, and EI ratings

was found for six of the seven factors. Eight items from a seventh uninterpretable factor were dropped and three were retained. "Leaving a social
event with someone I just met" and "Sex with someone I just met or do
not know well" were added to the Risky Sexual Activities factor and "Rock
or mountain climbing" was added to the High Risk Sports factor. The six
remaining factors could be described as: (a) Drug and Illegal Alcohol Use,
(b) Aggressive/Illegal Behaviors, (c) Risky Sexual Activities, (d) Heavy
Drinking, (e) High Risk Sports, and (f) Academic/Work Behaviors.
Cronbach's alpha coefficients were examined to determine the internal
reliabilities for the six factors. Items were dropped when their deletion resulted in a .10 increase in the alpha coefficients for a given factor. Based
on this criterion, one item from the Sports factor was deleted.
With the reduced item pool of 36 CARE items, the data were reanalyzed and the factor analyses were constrained to six factors. Again, items
which loaded above .40 in at least two of the three analyses and loaded
above .40 on only one factor within an analysis were retained. Although
one item concerning nonconsenting sex failed to meet these criteria, it was
retained because of its potential application in future studies. Three final
items were dropped, leaving 33 items.

STUDY 2
Using confirmatory factor analytic (CFA) techniques, Study 2 was conducted to examine the stability of the CARE factor structure through a
two-phase process. In Phase 1, six- and one-factor models were tested. The
six-factor solution was based on the exploratory factor analysis and a onefactor solution represented a parsimonious model, consistent with the existence of a problem behavior syndrome and covariation among risk
behaviors (Jessor, 1991). Relative goodness of fit for these two models was
evaluated through statistical comparison of chi-square tests. In Phase 2, a
second subject sample was recruited and CFA was again used for scale
score analysis of ER, EB, and EI ratings.
Method and Procedures
Members of sororities (n = 123) and fraternities (n = 114), who were
participating in an unrelated study (Fromme & Wendel, 1995), provided
data for Phase 1 and completed questionnaires during their organizations'
weekly membership meetings. Undergraduate students (n = 224; 53% fe-

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Fromme, Katz, and Rivet

male) participated in Phase 2 of the current study and completed questionnaires during small-group administrations. Payments for Phase 1 were
made to each fraternity or sorority organization and subjects for Phase 2
received research credit in partial fulfillment of a class requirement.
Results
Item CFA. Using the LISREL VII statistical program (Joreskog & Sorbom, 1989), chi-square statistic indicated that the six-factor model did not
precisely fit the data. Because chi square is known to be affected by a
variety of factors (see Fromme et al., 1993), however, it has become common practice to examine practical residual fit indices (Loehlin, 1992) as
additional measures of the adequacy of model fit (e.g., Earleywine, 1994;
Stacy, Bentler, & Flay, 1994). In addition, an examination of modification
indices (MI) and the expected change (EC) statistic (Kaplan, 1989; Saris,
Satorra, & Sorbom, 1987) was used to point out areas of model misfit. The
results indicated that two errors were large, theoretically defensible, and
consistent across all three scales. Consequently two items were dropped
from the measure. One item (driving after drinking alcohol) loaded more
highly on the Aggressive and Illegal Behaviors than on the Illicit Drug Use
factor, so it was freed to load on the former factor. Finally, one item
(tried/used cigarettes) was deleted because it artificially inflated the frequency of reported drug use.
After modifying the model, ER had X2 (390) = 1220.4, p < .001, adjusted goodness of fit (AGFI) = .70, root mean square residual (RMSR)
= .09, ratio of chi square to degrees of freedom (RATIO) = 3.12; EB had
X2 (390) = 901.6, p < .001, AGFI = .77, RMSR = .07, RATIO = 2.31;
and EI had x2 (390) = 856.0, p < .001, AGFI = .78, RMSR = .07, RATIO
= 2.20. Modification indices (Mis) for items on EB and EI were less than
20 whereas ER had seven Mis > 20. Expected change statistics for ER,
EB, and EI were all less than .40, however, suggesting that other factors,
such as nonnormality (see Kaplan, 1990) were contributing to model misfit.
The AGFI, RMSR, and RATIO statistics suggested that the six-factor
model provided an adequate fit for item analysis of the data (see Table I).
Also indicated in Table I, chi-square difference tests indicated that a sixfactor model provided a better fit for the data than a one-factor model.
Internal reliability and correlations among items and factors were examined. Cronbach alpha coefficients indicated adequate internal reliability
which ranged from .64 to .90 (see Table II). Item-total correlations, also
shown in Table II, provided further support for an internally reliable measure.

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Outcome Expectancies and Involvement in Risky Activities

Table I. Goodness-of-Fit Indices for Alternative Measurement
Modelsa
Model

Chi square

df

AGFI

RMSR

RATIO

.09
.13

3.13
6.24

.07
.11
-

2.31
5.35

.07
.11
-

2.20
5.56

Expected risk
Six factor
One factor
Difference

1220.4
2527.1
1306.7

Six factor
One factor
Difference

901.6
2166.8
1265.2

Six factor
One factor
Difference

856.0
2251.6
1395.6

390
405
15

.70
.45

Expected benefit

390
405
15

.77
.52

Expected involvement

390
405
15

.78
.53

All chi-square analyses were statistically significant at p < .001.

AGFI = adjusted goodness of fit index; RMSR = root mean
square residual; RATIO = ratio of chi square to degrees of
freedom.

Pearson correlation coefficients were used to examine the covariation

among ER, EB, and EI ratings for each factor. Intercorrelations ranged
from r = .02 (ER for Sex and Sports) to r = .68 (ER for Aggression and
Academic/Work behaviors).
Scale Score CFA. Using confirmatory factor analysis with LISREL VII
(Joreskog & Sorbom, 1989) on derived scale scores, the stability of a threefactor ER, EB, and EI structure was examined among another independent
subject sample. Chi-square statistics indicated that the three-factor solution
did not fit the data, f = 564.0, p < .001; AGFI = .66, RMSR = .10;
RATIO = 4.27. An examination of the modification indices, however, suggested that the imprecise model fit did not stem from specification errors
as there was only one MI > 20 and two ECs > .40. Thus, other factors,
such as nonnormality of the data, may account for the lack of model fit.
Summary of Study 2
CFA supported the reliability of the observed six-factor structure of
the CARE. Although chi-square statistics indicated model misfit, additional
fit indices suggested that the six-factor solution adequately described the
obtained data. Model comparison procedures using difference chi-square
tests also indicated that a six-factor model demonstrated an improvement

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Fromme, Katz, and Rivet

Table II. Item-Total Correlations and Cronbach's Alpha Coefficients
Expected
risk (ER)

Factors

Expected
Expected
involvement
benefit (EB)
(EI)

I. Illicit Drug Use

1. Trying/using drugs other than alcohol or
marijuana
22. Smoking marijuana
25. Mixing drugs and alcohol
Coefficient alpha Factor I

.58
.70
.73
.81

.58
.72
.71
.82

.49
.75
.78
.81

.71
.38
.62
.62
.58
.50
.60
.68
.53
.86

.69
.40
.66
.65
.64
.49
.59
.70
.41
.85

.42
.64

.59
.60

.56
.62

.61

.55

.36

.52
.73

.39
.70

.40
.73

.69
.83

.71
.82

.68
.78

.66
.79
.68
.84

.70
.72
.62
.83

.59
.57
.62
.64
.79

.31
.42
.40
.57
.64

II. Aggressive and Illegal Behaviors

3.
5.
6.
10.
11.
14.
19.
21.
16.

Grabbing, pushing, or shoving someone

Driving after drinking alcohol
Making a scene in public
Disturbing the peace
Damaging/destroying public property
Hitting someone with a weapon or object
Slapping someone
Punching or hitting someone with fist
Getting into a fight or argument
Coefficient alpha Factor II

.69
.59
.58
.68
.72
.72
.72
.75
.55
.90

III. Risky Sexual Activities

4. Leaving a social event with someone I
have just met
12. Sex without protection against pregnancy
16. Sex without protection against sexually
transmitted diseases
27. Involvement in sexual activities without
my consent
23. Sex with multiple partners
29. Sex with someone I have just met or
don't know well
Coefficient alpha Factor III

IV. Heavy Drinking

9. Drinking alcohol too quickly
7. Drinking more than 5 alcoholic beverages
28. Playing drinking games
Coefficient alpha Factor IV

.60
.71
.67
.81

V. High Risk Sports

15.
17.
24.
30.

Rock or mountain climbing

Playing non-contact team sports
Snow or water skiing
Playing individual sports
Coefficient alpha Factor V

.44
.56
.68
.66
.77

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Outcome Expectancies and Involvement In Risky Activities

Table II. Continued
Expected
benefit (EB)

Expected
involvement
(EI)

.61
.77

.48
.60

.61
.69

.68
.75
.74
.88

.59
.62
.58
.78

.68
.67
.77
.86

Expected
risk (ER)

Factors

VI. Academic/Work Behaviors

2. Missing class or work

8. Not studying for exam or quiz
13. Leaving tasks or assignments for the last
minute

18. Failing to do assignments

20. Not studying or working hard enough
Coefficient alpha Factor VI

Note. Scoring is accomplished by averaging item scores, within each factor, for ER, EB, and EI.

over a one-factor model for each of the ER, EB, and EI analyses. Because
we were attempting to maximize model fit across factor structures for three
separate constructs (i.e., expected risk, benefit, and involvement), these results were taken as satisfactory evidence that items in the CARE adequately
represent outcome expectancies for a variety of risky activities.
Scale score CFAs from a second independent sample additionally provided modest support for the reliability of overall ER, EB, and EI scales.
Thus the final CARE questionnaire consists of 30 items for which a total
of 90 ratings (ER, EB, EI) can be made.8 The results further indicate that
outcome expectancies can be measured for each of the six domains of risky
activities and that average ER, EB, and EI scores can be computed across
the six CARE factors.

STUDY 3
Study 3 was conducted to establish the test-retest reliability and the
construct and criterion validity of the CARE. Construct validity was tested
by correlating CARE scores with trait measures of sensation-seeking, impulsivity, and social conformity. Previous research suggests that EB, EI,
and frequency of risk-taking scores should be positively associated with
sensation seeking and impulsivity, and negatively associated with social
conformity. Conversely, ER scores should be negatively correlated with
sensation seeking and impulsivity, and positively correlated with social
conformity.
8

Factor loadings for the final 30-item CARE questionnaire are available from the authors.

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Fromme, Katz, and Rivet

Criterion validity of the CARE was examined by testing the association

between respondents' current self-reported risk-taking and their ER, EB,
and EI ratings, with past risk-taking statistically controlled. Current risktaking behavior should be positively associated with expected positive outcomes and negatively associated with expected negative outcomes.
Expected involvement scores should be positively associated with reported
risk-taking.
Method
Subjects. Ninety-eight undergraduate students (58% female) were paid
$5.00 to complete questionnaires and to return to the laboratory 10 days
later to provide follow-up information on their risk-taking.
Measures. The CARE questionnaire was used to assess outcome expectancies for 30 risky activities. A Frequency of Involvement form was
also used to assess the number of times participants engaged in each of
these activities during the 10 days following initial questionnaire completion. Trait characteristics previously associated with risk-taking behavior
were measured by the Social Conformity Questionnaire (SCQ; Newcomb
& Rentier, 1989) and the Impulsive Unsocialized Sensation Seeking (IMPUSS) scale. The IMPUSS scale is part of the new Zuckerman-Kuhlman
Personality QuestionnaireIII (Zuckerman, Kuhlman, Joireman, Teta, &
Kraft, 1993) and is thought to be an improved measure of trait sensation
seeking as it does not include the specific risk-taking items that were included in the original Sensation Seeking Scale (Zuckerman, 1979).
Procedures. The subjects completed all measures except the Frequency
of Involvement form during small group sessions. They returned 10 days
later to complete ER and EB ratings (for test-retest analyses) and the Frequency of Involvement form (to assess criterion validity).

Results
Test-Retest Reliability. Pearson correlation coefficients were computed
between scores for the first and second administrations of the ER and EB
measures.9 With all alpha levels at p < .001, test-retest correlations ranged
from r = .51 to .65 for ER, and from r = .58 to .79 for EB.
Construct Validity. As seen in Table III, the pattern of correlations between trait measures and CARE scores revealed significant associations in
9

Test-retest was not examined for the EI scale, as the temporal element of instructions (i.e.,
expected involvement during the next 6 months) would attenuate results.

Outcome Expectancies and Involvement in Risky Activities

433

Table III. Correlations Between Cognitive Appraisal of Risky Events (CARE) Factors and
Social Conformity (SC) and Impulsive Unsocialized Sensation Seeking (IMPUSS)
Expected
risk

Expected
benefit

1. Illicit Drug Use

IMPUSS
SC

-.35*
.36*

.30*
-.46C

.17
-.37*

.28*
-.28*

2. Aggressive/Illegal Behaviors
IMPUSS
SC

-.23a
.19

.23a
-.28a

.49c
-.46C

.33*
-.28a

3. Risky Sexual Activities

IMPUSS
SC

-.20
.10

.41c
.42C

.51C
-.46C

.23a
-.30*

4. Heavy Drinking
IMPUSS
SC

-.19
.22a

.31*
-.44C

.32*
-.13

-.46c

5. High Risk Sports

IMPUSS
SC

.00
.00

.13
.05

-.44C

6. Academic/Work Behaviors
IMPUSS
SC

.00
.00

.14
.05

-.44C

Factors

Expected
involvement

.40c

.40c

Actual
risk-taking

.32*

.05
.09

.33*
.09

p < .05.
p < .01.
p < .001.

b
c

the expected directions. For all four of the traditional risk behaviors (i.e.,
drug and alcohol use, unsafe sex, and aggression), EB, EI, and Frequency
of Involvement ratings were significantly positively correlated with IMPUSS
scores and significantly negatively correlated with SCQ scores. The strongest pattern of associations between trait measures and outcome expectancies were demonstrated for EB and EI. ER showed the least robust
correlations with trait measures, although when significant, they were in
the expected direction.
Criterion Validity. Table IV summarizes participants' average frequency
of involvement (during the 10-day follow-up period) for activities which
comprise the six CARE factors. Except for illicit drug use and risky sexual
practices, over 50% of the sample reported some involvement in each form
of risky activity.
A measure of outcome expectancies is most useful if it yields information beyond that provided by an individual's past behavior. Consequently, hierarchical regression analyses, statistically controlling for past

Fromme, Katz, and Rivet

434

Table IV. Participation in Risky Activities During 10-Day Follow-Upa

Frequency of occurrence
None

1 to 2

3 to 5

>6

1. Illicit Drug Use (n = 93)

81.7

10.8

3.2

4.3

2. Aggressive/Illegal Behaviors (n = 93)

29.0

39.8

20.4

10.8

3. Risky Sexual Activities (n = 92)

57.6

27.2

13.0

2.2

4. Heavy Drinking (n = 89)

35.9

13.5

31.5

19.1

5. High Risk Sports (n = 93)

39.8

28.0

16.1

16.1

1.0

13.5

19.8

65.6

CARE factors

6. Academic/Work Behaviors (n = 96)

a

Numbers represent the percentage of the sample who reported participation in

activities which comprise each CARE factor. CARE = Cognitive Appraisal of Risky
Events.

risk-taking, were used to test the association between participants' outcome

expectancies and their risk-taking frequency at 10-day follow-up. Separate
analyses were conducted for the six CARE factors, each time loading frequency of past risk-taking behavior on Step 1 and ER, EB, and EI scores
on Step 2 of the model. The results, presented in Table V, indicated that
past behavior was significantly associated with current behavior in all analyses except that for Risky Sexual Activities. For all analyses, however, outcome expectancies accounted for significant incremental variance in current
risk-taking behavior, beyond that predicted by past behavior. An examination of beta estimates indicated that EB contributed the greatest amount
of variance in drug use, heavy drinking, and aggression, whereas EI conTable V. The Effect of Past Risk-Taking and Outcome
Expectancies on Current Reported Risk-Takinga
CARE factor scores

Beta

R2 change

Illicit Drug Use, F(4, 73) = 9.31, p < .001

Step 1
Past drug use
Step 2
Expected risk
Expected benefit
Expected involvement
Total R2

.09c

.16
.24d
-.02
.50d

.01

.30d

Outcome Expectancies and Involvement in Risky Activities

435

Table V. Continued
CARE factor scores

Beta

R2 change

Aggressive/Illegal Behaviors, F(4, 70) = 22.11, p < .001

Step 1
Past aggression
Step 2
Expected risk
Expected benefit
Expected involvement
Total R2
Risky Sexual Activities, F(4, 66)
Step 1
Past sexual behavior

.62d

.47d
.09c

-.03

.29c
.04

.53d

= 3.55, p = .01

.03
.11

Step 2
Expected risk
-.13
Expected benefit
.17
Expected involvement
.22
2
Total R
Heavy Drinking, F(4, 68) = 17.78, p < .001

.14b

Step 1
Past heavy drinking

.16d

.13b

.14

Step 2
.35d
Expected risk
-.15
Expected benefit
.54d
Expected involvement
.07
Total R2
.48d
High Risk Sports, F(4, 63) = 1.88, p = .12, n.s.
Step 1
Past sports behavior

.08b

.29

Step 2
.02
Expected risk
-.03
Expected benefit
.12
Expected involvement
-.08
2
Total R
.05
Irresponsible Academic/Work Behaviors, F(4, 85) = 5.48, p < .001
Step 1
Past academic/work behaviors
Step 2
Expected risk
Expected benefit
Expected involvement
Total R2
a

.21b

.14C
-.18
.12
.31C

CARE = Cognitive Appraisal of Risky Events.

p < .05.
c
p < .01.
d
p < .001.
b

.06*

.17d

436

Fromme, Katz, and Rivet

tributed the most variance in academic/work behaviors. Whereas the combined expectancies were significantly associated with reported frequency of
current risky sexual behavior, the independent contributions of ER, EB,
and EI were not supported.
Summary of Study 3
The results helped establish the test-retest reliability and the construct
and criterion validity of the CARE questionnaire. The outcome expectancies were found to be reliably associated with current risk-taking, even when
past behavior was statistically controlled. Consistent with previous research
on alcohol expectancies, the expected positive consequences were more
strongly associated with risk-taking behavior than expected negative consequences. Assessments which focus exclusively on the hazards of risky activities may therefore fail to encompass a primary motivational factor for
young adult risk-taking.

STUDY 4
To provide evidence for the generalizability and external validity of
the CARE questionnaire, the measure was given to a clinical sample and
a group of high-risk sports enthusiasts.

Subjects and Procedures

The clinical sample (n = 38) averaged 37 years of age, was 53% white,
and reported long-term problems with alcohol (M = 10 years, SD = 3.9),
nicotine (M = 8.9 years, SD = 12.5), and illicit drugs (M = 8.9 years, SD
= 9). They were currently in treatment for an average of 3.9 months (SD
= 7.3) and reported an average of 2.9 previous treatment efforts (SD =
3.8).10 The sports enthusiasts (n = 58) averaged 35 years of age, were 87%
white, and reported an average of 4 years of involvement (SD = 3.2) in
high-risk sports such as rock climbing, caving, and scuba diving.
All participants provided consent and anonymous responses to a brief
demographic questionnaire and the ER, EB, and Frequency of Involvement
measures of the CARE.
10

The authors are grateful to Dr. Bruce Liese, University of Kansas Medical Center, for
providing these data.

437

Outcome Expectancies and Involvement in Risky Activities

Results
Using simultaneous regression analyses, frequency of involvement
scores were regressed onto ER and EB ratings for each of the six CARE
factors. As seen in Table VI, the outcome expectancies were significantly
associated with involvement for all six risky activities in both samples.
Summary Study 4
Despite its development with a young, middle-class college sample, the
CARE fared well with older more diverse groups. For the treatment sample,
CARE ratings accounted for approximately 15% of the variance in subjects'
illicit drug use and 19% of the variance in their aggressive behavior. Given
subjects' current treatment status, we believe these scores were attenuated.
Similar amounts of variance were explained for high-risk sports enthusiasts' drug use (10%) and aggressive behavior (34%). A lower association
between outcome expectancies and sports behavior may relate to the fact
that caving and scuba diving (primary activities of this sample) are not
measured by the CARE.

GENERAL DISCUSSION

The Cognitive Appraisal of Risky Events questionnaire was constructed to assess outcome expectancies regarding participation in risky acTable VI. Regression Analyses Showing the Association Between Outcome Expectancies and
Participation in Risky Activities for People in Treatment for Addictive Behaviors and for
High-Risk Sports Enthusiasts
Addictions treatment
Sports enthusiasts
Adjusted R2
Illicit Drug Use
Aggressive/Illegal Behavior
Risky Sexual Activities
Heavy Drinking
High Risk Sports
Academic/Work Behaviors
a
p
b

< .05.
p < .01.
c
p < .001.

F-value

Adjusted R2

F-value

.31
.58

.28
.24

6.97b

.17

6.22

.28

12.00C
33.48C
4.71a
10.76C

.13

3.31a

.11

3.44a

.28

7.15b

.08

3.31a

.39

11.16

.44

12.42

438

Fromme, Katz, and Rivet

tivities. Consistent with extensive alcohol expectancy research, outcome expectancies regarding potential positive consequences were positively and
reliably associated with participation in risky activities. Development of the
CARE addressed conceptual and methodological limitations of previously
available questionnaires, such as their exclusive focus on negative consequences and their restricted range of activities examined.
Advantages of this new expectancy measure are its brevity and breadth.
Like the 90-item Alcohol Expectancy Questionnaire (AEQ; Brown et al.,
1980), the 57-item Marijuana Effect Expectancy Questionnaire (MEEQ;
Schafer & Brown, 1991) and the 52-item Cocaine Effect Expectancy Questionnaire (CEEQ; Schafer & Brown, 1991), the CARE measures beliefs
about the consequences of alcohol and drug use. In addition, using only
60 items (for Risk and Benefit), the CARE also measures outcome expectancies for risky sex and aggression; beliefs not addressed by other outcome
expectancy questionnaires, and academic/work and sports, activities not traditionally considered "risk behaviors." This new measure will allow us to
study the association between cognitions and risk-taking for a wide variety
of risky behaviors. We might determine, for example, whether a general
expectancy set underlies all risk-taking or whether expectancies might discriminate among socially acceptable (e.g., sports) and less socially acceptable (e.g., drug use) forms of risk-taking behavior.
The key strength of this new measure is the assessment of both positive
and negative consequences of risk-taking. Though an individual may recognize the possibility of being arrested for illicit drug use, the possibilities
of peer acceptance or getting high may be more salient determinants of
that behavior. Similarly for risky sexual practices, young adults may recognize that unprotected sex with an unfamiliar partner increases their likelihood of HIV infection. Yet the anticipated pleasure of such a sexual
experience may result in dangerous behavior. A large body of research on
outcome expectancies has already shown that perceived benefits appear to
be central motivators of individuals' heavy drinking and illicit drug use
(Fromme et al., 1993; Goldman et al., 1987). Similar findings, across a
range of risky activities, were found in the current research. Perceived benefits, rather than perceived risks, may be the key to predicting young adults'
involvement in a variety of risky activities.
Prevention programs which focus exclusively on the hazards associated
with unsafe sex, drug use, and heavy drinking may be missing a crucial motivational element in young adult risk-taking. Based on the principles of operant conditioning, possible positive consequences and associated beliefs
should have a stronger association to risk-taking than potential negative consequences. Positive, as compared to negative, consequences occur more frequently (Fromme, Katz, & D'Amico, 1997) and tend to be paired more

Outcome Expectancies and Involvement in Risky Activities

439

closely in time with involvement in risky activities. For example, the likelihood of experiencing spontaneity and pleasure from unprotected sexual activities with a casual partner are reasonably certain and are temporally
contiguous with the behavior. Alternatively, the likelihood of contracting a
sexually transmitted disease is statistically lower and may not be evident until
much later. Thus, scare tactics and programs which rely on education about
the dangers of sex, drugs, and drinking seem destined for failure. Innovative
programs, based on principles of harm reduction (Marlatt & Tapert, 1993),
however, could recognize the appeal of involvement in these activities, while
still encouraging steps toward minimizing the risks.
Previous research has documented an association between personality
traits and risk-taking, but the mechanism by which personality influences
risk behavior is unknown. Research using the CARE questionnaire might
examine whether cognitive appraisals of potential consequences mediate
the association between personality characteristics (e.g., sensation-seeking,
impulsivity) and risk-taking. It may be that personality traits influence the
ways people think about risky activities, with these outcome expectancies
being the final gateway to risk-taking. Such findings would support the use
of cognitive intervention strategies for risk-reduction.
An aspect of the CARE questionnaire which may be viewed as both
a strength and a weakness, is the measurement of general (vs. specific)
consequences of risk-taking. Because specific consequences are not indicated, it is impossible to know what consequences drive a respondent's ratings on the CARE. Nevertheless, this measurement strategy is based on
the notion that it is those personally salient, idiosyncratic consequences
which contribute to an individual's beliefs and associated risk-taking. In
using a general definition of negative and positive consequences, the CARE
accommodates differences in the particular consequences which may underlie outcome expectancies and motivate individual behavior.
Although only modest test-retest correlations were found for our measure, they are on par with other expectancy questionnaires (e.g., the MEEQ
has a test-retest correlation of r = .66). Additional research is needed to
examine the role of experience in modifying people's outcome expectancies
and thereby influencing subsequent involvement in the target activities. As
previously shown with alcohol expectancies (Goldman et al., 1987), people
hold beliefs about the effects of alcohol long before they have a personal
drinking experience. Experience contributes to the modification of these
beliefs which then determines future drinking behavior. An understanding
of the reciprocal relation between beliefs and behavior may similarly prove
useful in understanding the dynamic process of risk-taking.
Analyses indicated that CARE scores were significantly associated with
risk-taking behavior during a subsequent 10-day period. Because of this

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Fromme, Katz, and Rivet

short time frame, we have interpreted these results as representing criterion, rather than predictive, validity. Further research, using longer followup periods are therefore needed to establish the predictive validity of this
new measure. Results indicating that outcome expectancies were significantly associated with current risk-taking, after statistically controlling for
past behavior, however, are promising and suggest that outcome expectancies may also be predictive of future risk-taking behavior. In addition to
the retrospective self-reports utilized in current analyses, future investigations might employ prospective monitoring and behavioral measures of risktaking to further document the criterion and predictive validity of the
CARE.
The predominately white, upper-middle-class samples used in the development of this questionnaire limit the generalizability to ethnically diverse and treatment samples. Evaluation of the CARE in a small treatment
sample in Study 4, however, yielded promising results for the measure's
clinical utility. Nevertheless, until larger studies are conducted with this
measure, caution should be taken when using the CARE in more heterogenous populations. In addition, it should be noted that risky activities
which may occur more frequently among certain groups, such as inner-city
youths (e.g., gang fights) or criminals (e.g., armed robbery), are not included in this measure. Further research might expand the content of the
CARE questionnaire, thereby increasing its usefulness in more diverse
populations.
In summary, the CARE questionnaire is a psychometrically sound
measure of outcome expectancies and risk-taking among young adults. It
may be useful for identifying individuals whose beliefs put them at risk for
engaging in potentially dangerous activities. Those young adults who anticipate more positive than negative outcomes may be good candidates for
prevention programs which teach them to either substitute less risky but
equally beneficial activities for their current behavior (e.g., sports instead
of drugs to experience a high) or to perceive safe behaviors (e.g., protected
sex) as equally beneficial as risky ones (e.g., sex without a condom). By
measuring the ways young adults think about risk-taking, we might begin
to understand why they are willing to endanger their lives by participating
in a variety of dangerous activities.

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