Do Drinking Motives and Drinking Contexts Mediate the Relationship Between Social Avoidance and Alcohol Problems? Evidence from Two Studies of Undergraduate Drinkers

Cognitive inflexibility moderates the relationship between relief-driven drinking motives and alcohol use

Introduction

Drinking motives and neurocognition play significant roles in predicting alcohol use. There is limited research examining how relief-driven drinking motives interact with neurocognition in alcohol use, which would help to elucidate the neurocognitive-motivational profiles most susceptible to harmful drinking. This study investigated the interactions between neurocognition (response inhibition and cognitive flexibility) and relief-driven drinking, in predicting problem drinking.

Methods

Participants completed the Alcohol Use Disorders Identification Test - Consumption items (AUDIT-C) to measure drinking behaviour, and online cognitive tasks, including the Value-Modulated Attentional Capture and Reversal Task (VMAC-R) and the Stop Signal Task (SST). The sample (N = 368) were individuals who drink alcohol, which included a subsample (N = 52) with problematic drinking, as defined by self-identifying as having a primary drinking problem. Drinking motives were assessed using a binary coping question in the overall sample, and the Habit, Reward, and Fear Scale (HRFS) in the subsample. Moderation analyses were conducted to investigate whether cognitive flexibility and response inhibition moderated relationships between relief-driven motives and drinking.

Results

Cognitive flexibility moderated the relationship between relief-driven motives and drinking (overall sample: β = 13.69, p = 0.017; subsample: β = 1.45, p = 0.013). Greater relief-driven motives were associated with heavier drinking for individuals with low cognitive flexibility. There was no significant interaction between response inhibition and relief-driven motives.

Conclusions

Relief-driven drinking motives interact with cognitive inflexibility to drive heavier drinking. Greater understanding of these neurocognitive-motivational mechanisms may help to develop more targeted and effective interventions for reducing harmful drinking.

An Analysis of Drinking Motives in the Maintenance of Co-Occurring Obsessive-Compulsive Symptoms and Alcohol Misuse

Objective: Despite the commonly observed co-occurrence of obsessive-compulsive symptoms (OCS) and substance use in clinical populations, few researchers have examined potential mechanisms which contribute to this relationship. This study assessed the mediating role of drinking motives in the relationship between OCS, alcohol consumption, and its resulting health risks among U.S. adults. Methods: Adult participants (n = 1966; Mage = 47.72, SD = 17.91; 76.30% female; 86.10% non-Hispanic White) sourced from Research Match answered an online questionnaire containing measures related to substance use and anxiety-related symptoms. Results: As hypothesized, there was a significant positive indirect path between OCS and both alcohol consumption and risky alcohol use through coping motives. However, there were also small indirect effects of OCS through social motivations for consumption and conformity motivations for risky alcohol use. Conclusions: These results add evidence that coping motives play a role in OCS and alcohol misuse and highlights the need to also consider drinking motives related to social facilitation and conformity in those with co-occurring OCS and alcohol misuse.

Motives and Consequences of Alcohol Use in People With Social Anxiety Disorder: A Daily Diary Study

People with social anxiety disorder (SAD) are at increased risk for alcohol-related problems. Most research exploring social anxiety and alcohol use has examined negative drinking consequences, with less consideration of positive consequences-namely positive social experiences-that may reinforce alcohol use. In this daily diary study, we examined how adults diagnosed with SAD (N = 26) and a psychologically healthy control group (N = 28) experienced positive drinking consequences in naturally occurring drinking episodes during the study period. For 14 consecutive days, participants answered questions about alcohol use, motives for drinking, and positive consequences of drinking. On days when participants drank, those with SAD were more likely than healthy controls to perceive a reduction in anxiety, but the two groups did not differ in their likelihood of experiencing positive social drinking consequences. For both groups, on days when they were more motivated to drink to enhance social experiences (affiliation motives) or cope with distress (coping motives), they were more likely to obtain positive consequences from drinking. Compared to controls, participants with SAD endorsed stronger trait and daily coping motives (anxiety-coping, social anxiety-coping, and depression-coping). Results are discussed in the context of reinforcement mechanisms that may maintain social anxiety and alcohol use.

Biopsychosocial Model Social Anxiety and Substance Use Revised

PURPOSE OF REVIEW

To review data published in the past 5 years to evaluate the utility of our biopsychosocial model of social anxiety's relation to substance misuse to evaluate the model's utility and update it.

RECENT FINDINGS

Data support the utility of our revised model-e.g., socially anxious persons report using substances to manage subjective anxiety, despite evidence that some substances may not have a direct effect on physiological responding. Other factors with promise include social influence, cognitive processes (e.g., post-event processing), and avoidance. Data highlight the importance of context as socially anxious persons use some substances more in some high-risk situations, despite lack of relation between social anxiety and use generally. Sociocultural factors remain understudied. This updated model is a theory- and data-driven model of the relations between social anxiety and substance misuse that can inform future work to improve substance-related outcomes among this especially vulnerable group.

Context Matters for the Socially Anxious: Moderating Role of Drinking Context on Alcohol Outcome Expectancies

Background: Moderating effects of alcohol outcome expectancies (AOE) on the social anxiety (SA)-alcohol misuse relationship are mixed. This may be explained by differential relationships between SA and context-specific AOE. Gender may further moderate these associations, as it influences SA, AOE, and drinking behaviors. Objectives: To examine the moderating role of drinking context (i.e. convivial, negative coping, or personal-intimate) and gender on the relationships between SA and three AOE (i.e. tension reduction, sociability, and sexuality). Methods: Participants (n = 436, M_age=19.32, 72% female, 85.8% White) were 218 undergraduates with elevated SA (high SA group) and a gender-matched low SA group (n = 218) drawn from a larger undergraduate sample (N = 1,015). Participants completed three versions of an AOE measure, differing by drinking context considered. Results: A significant SA group x context x gender interaction was found for tension reduction AOE; compared to men, women in the low SA group reported greater tension reduction AOE in negative coping contexts. Significant SA group and context main effects suggest that sociability and sexuality AOE are endorsed more in the high (vs. low) SA group, and in convivial and personal-intimate compared to negative coping contexts. Conclusions/Importance: Tension reduction AOE vary depending on the drinking context, SA, and gender. Assessment of AOE in specific drinking contexts may help to identify which individuals may be at greatest risk for alcohol misuse and help inform treatment of SA-related problem drinking.

Drinking Problems and Social Anxiety among Young Adults: The Roles of Drinking to Manage Negative and Positive Affect in Social Situations

Background: Socially anxious individuals seem to be at a high risk for alcohol-related problems because they drink to cope. Yet social anxiety is unique among the anxiety conditions in that it is characterized by lower positive affect (PA). It is unclear whether drinking to cope is related to drinking to decrease negative affect (NA) or increase PA. Objectives: We tested whether social anxiety was related to more drinking problems via the sequential relations between affect (NA or PA), drinking to change affect (decrease NA or increase PA), and drinking quantity. We also tested whether the indirect effect of drinking to increase PA was significantly less than that of drinking to decrease NA. Methods: Past-month drinkers with clinically elevated social anxiety (n = 174) and those with more normative or lower social anxiety (n = 362) completed an online survey. Results: Social anxiety was indirectly related to drinking problems via the sequential effect of NA, drinking to decrease NA, and drinking quantity. Social anxiety was indirectly related to drinking problems via the sequential relations of PA and drinking quantity and of drinking to increase PA and drinking quantity. The indirect effect of drinking to increase PA did not significantly differ from drinking to decrease NA. Conclusions/Importance: Socially anxious drinkers may drink not only to decrease NA but also to increase PA in social situations. Both of these drinking motives appear to play important roles in socially anxious drinkers' experience of drinking-related problems.