Effects of depressive symptoms and coping motives on naturalistic trends in negative and positive alcohol-related consequences

Happy Hour: The association between trait hedonic capacity and motivation to drink alcohol

The (over)consumption of alcohol and other addictive substances is often conceptualized as a problem of low self-control (i.e., people's inability to inhibit unwanted impulses). According to that view, people drink because they cannot resist. In the present studies, we approached this from a different perspective and tested whether alcohol consumption might also be a problem of low hedonic capacity (i.e., people's inability to experience pleasure and relaxation, often due to intrusive thoughts). According to that view, people drink because it helps them enjoy or cope with negative thoughts or emotions. In two studies among individuals at low risk of harmful alcohol use (e.g., AUDIT < 7) we consistently found that trait hedonic capacity was unrelated to alcohol consumption but negatively related to coping motivation (drinking alcohol to cope with negative thoughts and feelings; Study 1: N = 348; Study 2: N = 302, preregistered). Exploratory analyses in study 2 (conducted during the COVID-19 pandemic) also showed that people with low, but not high, trait hedonic capacity drank more alcohol in response to stress. Our findings are in line with the notion that people's drinking motivation and behavior might not only be a problem of poor self-control but also of low trait hedonic capacity. They align with a new direction in addiction prevention and treatment research, which explores ways to help people to seek out and savor hedonic experiences from non-drug related reinforcers (e.g., engaging in leisure activities).

Protective behavioral strategies as a protective factor against suicidal ideation among college student drinkers

Objective: Research shows that alcohol use is linked to suicidal ideation (SI), while depression is strongly associated with SI. Protective behavioral strategies (PBS) are safe drinking strategies. PBS are broadly protective across alcohol-related problems; however, it is unclear if these effects extend to those at risk for SI. We hypothesized that alcohol use and depressive symptoms would be risk factors for SI, and that these factors would moderate the effects of PBS. PBS was hypothesized to be protective for individuals with elevated depressive symptoms and alcohol use. Participants: College student drinkers (n = 990; M age = 19.97, SD = 3.75) from a Southeastern University. Methods: Participants completed an online survey inquiring about demographics, depressive symptoms, SI, alcohol use, and PBS use. Results: Depressive symptoms were associated with an increased likelihood of SI; however, alcohol use was not. PBS were most protective for individuals with high levels of alcohol use and/or depressive symptoms. Conclusions: PBS may be protective for heavier drinkers who are at heightened risk for SI.

A latent profile analysis of social anxiety, depression, and pregaming motives among heavy-drinking college students

BACKGROUND

Pregaming is a high-risk drinking behavior that is associated with heavy drinking and negative alcohol-related consequences. College students may engage in pregaming for several reasons, including to enhance social experiences or cope with negative affect. Research shows that associations between drinking, social anxiety, and depression are multifaceted. However, our understanding of the complex associations of mental health symptoms with pregaming motives and behaviors remains limited.

METHODS

This study examined heterogeneity in how pregaming motives, social anxiety, and depression associate with past 30-day pregaming variables (quantity, frequency, and negative consequences). We used latent profile analysis (LPA) in a sample of heavy-drinking university students (N = 479).

RESULTS

LPA results indicated four profiles: mild/moderate social anxiety and depression symptoms, moderate motives (n = 285), minimal social anxiety and depression symptoms, low motives (n = 61), subclinical/elevated social anxiety and depression symptoms, high motives (n = 75), and clinically elevated social anxiety and depression symptoms, moderate motives (n = 58). The subclinical/elevated symptoms, high motives profile reported the highest pregaming frequency and consequences, including blackouts. Individuals in the clinically elevated symptoms, moderate motives profile reported more consequences than those in the minimal symptoms, low motives and mild/moderate symptoms, moderate motives profiles. Individuals in the minimal symptoms, low motives profile reported the fewest consequences.

CONCLUSIONS

Among these students, social anxiety and pregaming motives were associated with more frequent pregaming and social anxiety and depression were associated with greater negative consequences. Interventions that target pregaming-specific motives among students with mental health symptoms may be warranted to reduce this risky behavior and associated drinking-related harm.

Distress symptoms and alcohol consumption: anxiety differentially mediates drinking across gender

Introduction

The consumption of alcohol remains a significant health concern and represents a prevalent form of substance use worldwide. Previous research has identified sex differences in the consumption of alcohol. This study explores the relationship between drinking and the presence of distress symptoms across gender. Based on previous research, it was hypothesized that presence of distress symptoms, defined as increases in anxiety and depression, would be prominent features associated with alcohol consumption among women compared to men.

Methods

A sample of undergraduate students (N = 448) participated in an online-based questionnaire (71% female; M age = 22.1; 42.9% Hispanic/Latino). The questionnaire contained assessments related to demographic information and alcohol consumption over the past 30 days. Anxiety and depression symptoms were assessed using the Hospital Anxiety and Depression Scale.

Results

Gender differences were observed with men consuming more alcoholic drinks than women. However, women who consumed alcohol reported having more distress symptoms relative to their male counterparts. A logistic regression revealed that this gender difference was moderated by anxiety, such that greater anxiety scores associates with whether women consumed alcohol. However, an ordinary least squares regression revealed that for men, anxiety scores significantly related to the amount of drinks consumed. Gender differences were not detected in relation to alcohol consumption and depression.

Conclusion

Our findings contribute to the literature by indicating that the mere presence of distress symptoms reveals distinctive gender-specific differences in relation to alcohol consumption in a non-clinical population. Identifying the distinct associations linked with alcohol use for men and women can aid in reducing drinking disparities among young adults.

Mediational Role of Drinking to Cope in the Associations of Depression and Suicidal Ideation with Solitary Drinking in Adults Seeking Alcohol Treatment

BACKGROUND

Little research on solitary drinking has focused on clinical samples. Previous research in college students has found that depression, suicidal ideation, and drinking to cope with negative affect are associated with drinking in solitary, but not social, contexts. These associations have not been examined among individuals with alcohol use disorder, despite their high rates of depression and suicidal behavior.

METHOD

To fill this gap in knowledge, the associations of depression and suicidal ideation with solitary and social drinking were examined among 96 individuals seeking alcohol treatment, the majority of whom had alcohol use disorder (97.9%). Multiple mediation models were conducted to examine the mediating effects of two drinking to cope variables (drinking excessively to cope and coping motives) on the associations of depression and suicidal ideation with drinks per month and heavy episodic drinking in social and solitary contexts.

RESULTS

Significant indirect effects were found for depression and suicidal ideation with solitary drinking variables through greater drinking excessively to cope. No significant indirect effects were found for social drinking variables. However, a positive direct association was found between suicidal ideation and greater social drinks per month that was not mediated by drinking to cope.

CONCLUSIONS

These findings suggest that greater depression or suicidal ideation, through their effect on greater drinking to cope, are associated with greater solitary drinking in a treatment seeking sample. Drinking context should perhaps be considered in alcohol interventions, particularly when treating individuals suffering from depression or suicidal ideation.

The Mediated Moderation Model of Depressive Symptoms, Alcohol Use, and Consequences: The Protective Role of Executive Function

Heavy episodic drinking (HED) and negative drinking consequences represent prevalent and serious health concerns for college students. Depressive symptoms may elevate students' risk for engaging in HED and experiencing negative consequences, but levels of risk may vary by executive function (EF) capabilities. Growing evidence suggests that EF deficits are associated with comorbid depressive symptoms and alcohol misuse. Nevertheless, little is known about unique and shared risks that depressive symptoms and EF may interactively pose for HED and negative drinking consequences. Methods: To address these gaps, the study assessed depressive symptoms, multiple domains of EF via multimethod approach, HED, and negative drinking consequences in a sample of 446 undergraduate students. Mediated moderation models were conducted to examine associations between depressive symptoms and alcohol use behaviors and modulating roles of EF. Results: Depressive symptoms, poor planning, and self-reported executive dysfunction were significantly associated with HED and negative drinking consequences. HED mediated the effect of depressive symptoms and executive dysfunction on negative consequences. A significant interaction indicated that better EF (i.e. low or average self-reported executive dysfunction) may buffer the risk depressive symptoms present for negative drinking consequences. Conclusions: The current findings suggest that among college students, risk and resilience factors for HED and negative drinking consequences may vary. Effective EF capabilities may be especially helpful for reducing students' risk for more serious drinking consequences.

The Relationship between Negative Affect and Alcohol and Marijuana Use Outcomes among Dual Users

Background: Past research with college students has found that substance use motives, particularly coping motives, mediate the relationship between negative affect and alcohol- and marijuana-related outcomes. Objectives: This study aimed to investigate substance use motives of dual users of both substances (past 30-day use; not necessarily simultaneous use) and identify any mediation effects that are either common to both substances or substance-specific. Methods: The majority of dual users (n = 2,034) identified as being White, non-Hispanic (63.8%), female (69.08%), and reported a mean age of 20.24 (SD = 3.16) years. To test study aims, path models were conducted such that negative affect (stress, depressive and anxiety symptoms) were independently modeled as predictors of substance use outcomes (i.e. quantity and consequences) via substance use motives. Results: All three negative affect symptoms were indirectly related to both alcohol and marijuana consequences via coping motives, such that higher negative affect was associated with higher coping motives; which in turn were positively associated with consequences. Substance-specific effects were also found: (a) stress was indirectly related to both alcohol and marijuana use quantity via enhancement motives, (b) depressive/anxiety symptoms were indirectly related to alcohol use quantity via enhancement motives, and (c) all three negative affect symptoms were indirectly related to both marijuana use quantity and negative consequences via expansion motives. Conclusions: Findings suggests that dual users of alcohol and marijuana with negative affect symptoms engage in substance use for similar reasons as single substance users with negative affect symptoms. Intervention efforts should examine ways to replace substance-related coping and expansion methods with non-substance-related methods.

Temporal precedence of self-regulation over depression and alcohol problems: Support for a model of self-regulatory failure

Alcohol use is highly comorbid with depression, especially among college students, whose rates of both phenomena are higher than in the general population. The self-medication hypothesis (i.e., alcohol use is negatively reinforced via the alleviation of negative affect) has dominated explanatory models of comorbidity. However, self-regulation has also demonstrated cross-sectional relationships with both depression and alcohol problems and may contribute to the development of alternative comorbidity models. Self-regulation introduces three alternative models that can be tested empirically: (a) a depressed regulation model, (b) a central nervous system depressant model, and (c) a self-regulatory failure model. The purpose of this study was to test the utility of these models (in addition to the self-medication hypothesis) by examining the temporal precedence in the relations between self-regulation, depressive symptoms, and alcohol problems among heavy-drinking college students (N = 393) over 5 assessment points (baseline, 1 month, 6 months, 12 months, and 16 months) using an autoregressive cross-lagged model. Lower self-regulation, and higher alcohol problems and depressive symptoms, prospectively predicted higher depressive symptoms. Higher alcohol problems and lower self-regulation prospectively predicted higher alcohol problems. Only self-regulation prospectively predicted self-regulation. These results were consistent across multiple time points. Findings are consistent with a self-regulatory failure model of depressive symptoms and alcohol problems. Therefore, self-regulation may be an important etiological variable and potential intervention target to reduce both alcohol problems and depressive symptoms among college students. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A randomized clinical trial evaluating the efficacy of a brief alcohol intervention supplemented with a substance-free activity session or relaxation training

OBJECTIVE

Behavioral economic theory suggests that a reduction in alcohol use is most likely when there is an increase in rewarding substance-free activities. Anxiety has also been linked to heavy drinking, and strategies to reduce anxiety may enhance alcohol interventions. The goal of this 2-site randomized controlled clinical trial was to evaluate the efficacy of a brief alcohol intervention that was supplemented with either a behavioral economic substance-free activity session (SFAS) or a relaxation training (Relaxation training [RT]) session.

METHOD

Participants were 393 college students (61% female, mean age = 18.77 years) who reported 2 or more past-month heavy drinking episodes. Participants were randomized to 1 of 3 conditions: (a) assessment; (b) alcohol brief motivational intervention (BMI) plus SFAS; or (c) BMI plus RT. Both treatment conditions included 2 in-person sessions plus a phone booster session. Outcomes were evaluated 1-, 6-, 12-, and 16-months postintervention.

RESULTS

Generalized linear mixed models indicated that the combination of a BMI plus either the SFAS or RT was associated with significant reductions in alcohol use and problems across the 16-month follow-up compared with assessment only. There were no significant differences between the two active treatment conditions. Changes in proportional reinforcement from substance-related activities, and protective behavioral strategies mediated treatment effects.

CONCLUSION

Two-session (plus booster) interventions that combine BMI and either substance-free activity enhancement or RT can result in enduring reductions in alcohol misuse among college drinkers. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Factors linking suicidal ideation with drinking to cope and alcohol problems in emerging adult college drinkers

There is a well-established association between suicidal behavior and alcohol misuse. However, few studies have applied relevant theory and research findings in the areas of both alcohol and suicidal behavior to aid in the understanding of why these may be linked. The current study examined whether three variables (problem-solving skills, avoidant coping, and negative urgency) suggested by theory and previous findings in both areas of study help to account for the previously found association of suicidal ideation with drinking to cope and alcohol problems. Participants were 381 college women (60.4%) and men (39.6%) between the ages of 18 and 25 who were current drinkers and had a history of (at a minimum) passive suicidal ideation. Structural equation modeling was used to examine hypothesized associations among problem-solving skills, avoidant coping, drinking to cope (DTC), impulsivity in response to negative affect (i.e., negative urgency), severity of suicidal ideation, heavy alcohol use, and alcohol problems. Model results revealed that problem-solving skills deficits, avoidant coping, and negative urgency were each directly or indirectly associated with greater severity of suicidal ideation, DTC, heavy alcohol use, and alcohol problems. The results suggest that the positive association between suicidal ideation and DTC found in this and other studies may be accounted for by shared associations of these variables with problem-solving skills deficits, avoidant coping, and negative urgency. Increasing at-risk students' use of problem-solving skills may aid in reducing avoidance and negative urgency, which in turn may aid in reducing suicidal ideation, DTC, and alcohol misuse. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Alcohol motivations and behaviors during months young adults experience social role transitions: Microtransitions in early adulthood

The study examines how young adult transitions into and out of social roles (i.e., starting or ending a job, a romantic relationship, school) are associated with drinking motives (coping, enhancement, social, and conformity) and alcohol use in a given month. A community sample of young adult drinkers (N = 767; 56.3% female; 59.3% White; Ages 18-23) completed 24 consecutive months of online surveys (N = 15,333 months of data) about the previous month's experiences, social role transitions, and alcohol use. During the 2-year data collection window, participants reported starting/ending a job (10.0%/8.2%), a relationship (2.7%/4.3%), and school (9.2%/17.4%). Between persons, those who more often started jobs were more likely to drink and those who more often ended jobs had higher enhancement motives; those who more often ended relationships were more likely to drink, have a greater number of drinks when drinking, and have higher coping and enhancement motives; and those who more often started relationships had higher conformity motives. Within persons, during months when a relationship ended, participants reported stronger coping motives, and during months when a relationship started, they reported stronger social motives for drinking. During months when a relationship started or ended, participants also reported consuming a greater number of drinks when drinking. There were no differences based on starting or ending school. Young adult social role transitions are associated with concurrent changes in both alcohol use and motives for drinking. Understanding these contextual changes and their concomitant risks is key to providing salient interventions to reduce alcohol-related harm. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Depressive symptoms as predictors of alcohol problem domains and reinforcement among heavy drinking college students

Heavy drinking among college students in the United States is common and results in a wide range of problems. Symptoms of depression are also common among college students and may exacerbate problems associated with heavy drinking, but to date most studies have been cross sectional and relied on an aggregate measure of alcohol problems. Further, depressive symptoms may also predict other elements of risk among heavy drinkers, including greater experience of substance-related reinforcement, and diminished experience of substance-free reinforcement. The current study examines depressive symptoms as a prospective predictor of changes in alcohol problem domains and reward variables in a sample of heavy drinking college students. Heavy drinking college students (N = 138) completed a survey assessing depressive symptoms, alcohol problems, and reinforcement at baseline and after a 12-month follow-up period. Multiple regressions examined the utility of depressive symptoms (DASS-21) in predicting alcohol problems, substance-related reinforcement, and substance-free reinforcement at the 12-month follow-up after controlling for baseline drinking level and the baseline level of the relevant outcome variable. Baseline depressive symptoms predicted 12-month alcohol problems related to impaired control (i.e., drinking more than planned), self-perception, and self-care. Depressive symptoms also predicted lower 12-month substance-free, but not substance-related, reinforcement. Finally, change in depressive symptoms was associated with total alcohol problems, impaired control, self-perception, self-care, academic/occupational, and physiological dependence problems at 12-month follow-up. Heavy drinkers with depressive symptoms may benefit from interventions targeting alcohol problems that also increase access to and engagement in rewarding alternative activities. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Problem drinking among at-risk college students: The examination of Greek involvement, freshman status, and history of mental health problems

OBJECTIVE

Scarce research has examined the combined effect of mental health difficulties and demographic risk factors such as freshman status and Greek affiliation in understanding college problem drinking. The current study is interested in looking at the interaction among freshman status, Greek affiliation, and mental health difficulties.

PARTICIPANTS AND METHODS

Undergraduate students (N = 413) from a private and public Midwestern university completed a large online survey battery between January 2009 and April 2013. Data from both schools were aggregated for the analyses.

RESULTS

After accounting for gender, age, and school type, the three-way interaction indicated that the highest drinking levels were reported in freshman students who reported a history of mental health problems although were not involved in Greek life.

CONCLUSIONS

Findings are discussed in the context of perceived social norms, as well as alcohol-related screenings and intervention opportunities on college campuses.

Depressive Symptoms and Drinking Outcomes: The Mediating Role of Drinking Motives and Protective Behavioral Strategies Among College Students

BACKGROUND

College students with depressive symptoms tend to engage in more hazardous drinking and experience more alcohol-related consequences to cope with their symptoms. Given the perceived tension reducing effects of alcohol among these students, it is important to explore how protective factors, such as protective behavioral strategies, account for the relationships among depressive symptoms, drinking motives, and alcohol-related outcomes.

OBJECTIVE

To examine the mediating role of drinking motives and protective behavioral strategies on the associations that depressive symptoms have with typical weekly alcohol consumption, hazardous drinking, and alcohol-related negative consequences in a sample of college student drinkers.

METHODS

Traditional age college students (n = 566, 73% women; 58% White, non-Hispanic) completed measures of depression, drinking motives, protective behavioral strategies, weekly alcohol use, hazardous drinking, and alcohol-related negative consequences.

RESULTS

Coping with depression motives and controlled consumption PBS explained the association between depression and weekly alcohol consumption and hazardous drinking whereas coping with depression motives and serious harm reduction PBS explained the depression-negative consequences relationship. Conformity motives and serious harm reduction PBS explained the association between depression and hazardous drinking and alcohol-related negative consequences.

CONCLUSIONS

Findings suggest that students with more depressive symptoms would benefit from clinical interventions tailored to address negative reinforcement drinking motives and, by extension, increase student utilization of PBS related to minimizing harm. Clinical and research implications are provided.

Depressive symptoms, ruminative thinking, drinking motives, and alcohol outcomes: A multiple mediation model among college students in three countries

BACKGROUND

Recent research suggests that ruminative thinking (specifically problem-focused thoughts) may explain why individuals engage in drinking to cope (DTC) when dealing with depressive symptoms; which in turn leads to increased negative alcohol-related consequences. Cross-cultural studies addressing these phenomena are scarce.

OBJECTIVES

The present study cross-culturally tested whether four rumination facets (problem-focused thoughts, counterfactual thinking, repetitive thoughts, and anticipatory thoughts) uniquely mediate the relationships between depressive symptoms and drinking motives/alcohol outcomes in a multicultural sample of college student drinkers (n=1429) from Spain, Argentina, and the U.S.

METHOD

Structural equation modeling was conducted to test the models, controlling for sex. Further, we conducted invariance testing to determine whether our models were culturally-specific or culturally-universal.

RESULTS

Within both proposed models, no rumination facet uniquely mediated the relationship between depressive symptoms and drinking motives. However, an exploratory model with a second-order latent factor of ruminative thinking did significantly mediate these associations (exception was conformity motives). Further, there were two significant double-mediated associations that suggested that increased depressive symptoms is associated with increased ruminative thinking, which is associated with higher DTC motives, which in turn is associated with higher alcohol consumption and negative alcohol-related consequences. All models were found to be invariant across countries and sex, suggesting that these associations may be relatively universal.

CONCLUSIONS

Rumination is relevant to understand the increased vulnerability of college drinkers to exhibit greater alcohol consumption and negative consequences via DTC motives when dealing with depressive symptoms.

In the process of drinking to cope among college students: An examination of specific vs. global coping motives for depression and anxiety symptoms

The present study sought to address an issue in the drinking to cope (DTC) motives literature, namely the inconsistent application of treating DTC motives as a single construct and splitting it into DTC-depression and DTC-anxiety motives. Specifically, we aimed to determine if the effects of anxiety and depression on alcohol-related problems are best explained via their associations with DTC with specific affects or via their associations with a more global measure of DTC by testing four distinct models: the effects of anxiety/depression on alcohol-related problems mediated by DTC-anxiety only (Model 1), these effects mediated by DTC-depression only (Model 2), these effects mediated by a combined, global DTC factor (Model 3), and these effects mediated by both DTC-anxiety and DTC-depression (Model 4). Using path analysis/structural equation modeling across two independent samples, we found that there was a significant total indirect effect of both anxiety and depressive symptoms on alcohol-related problems in every model. However, there was a slightly larger indirect effect in all models using the global DTC motives factor compared to even the model that included the two distinct DTC motives. Our results provide some preliminary evidence that at least at the between-subjects level, a global DTC motives factor may have more predictive validity than separate DTC motives. Additional research is needed to examine how to best operationalize DTC motives at different levels of analysis (e.g., within-subjects vs. between subjects) and in different populations (e.g., college students vs. individuals with alcohol use disorder).

Comparison of the Original and Short Form Drinking Motives Questionnaire-Revised With High School and Underage College Student Drinkers

Cooper developed and provided initial support for the Drinking Motives Questionnaire-Revised (DMQ-R). More recently, Kuntsche and Kuntsche introduced the briefer DMQ-R SF. Psychometric properties of the DMQ-R and the DMQ-R SF were examined in samples of high school (n = 131) and underage college student drinkers (n = 189). The original and short-form versions of the DMQ-R were similar with regard to composite score validity, concurrent validity, and internal consistency. Only the Enhancement Motives subscale showed slight decrements in reliability and validity for the short form. Confirmatory factor analysis showed that the DMQ-R SF was associated with slightly better goodness-of-fit and invariant factor loadings between the high school and college student samples. Despite its briefer form and reduced task demands for participants, the DMQ-R SF appears to provide nearly equivalent, and in some instances slightly improved, measurement of drinking motives in underage drinkers as does the original DMQ-R.

Alcohol Demand, Future Orientation, and Craving Mediate the Relation Between Depressive and Stress Symptoms and Alcohol Problems

BACKGROUND

Elevated depression and stress have been linked to greater levels of alcohol problems among young adults even after taking into account drinking level. This study attempts to elucidate variables that might mediate the relation between symptoms of depression and stress and alcohol problems, including alcohol demand, future time orientation, and craving.

METHODS

Participants were 393 undergraduates (60.8% female, 78.9% White/Caucasian) who reported at least 2 binge-drinking episodes (4/5+ drinks for women/men, respectively) in the previous month. Participants completed self-report measures of stress and depression, alcohol demand, future time orientation, craving, and alcohol problems.

RESULTS

In separate mediation models that accounted for gender, race, and weekly alcohol consumption, future orientation and craving significantly mediated the relation between depressive symptoms and alcohol problems. Alcohol demand, future orientation, and craving significantly mediated the relation between stress symptoms and alcohol problems.

CONCLUSIONS

Heavy-drinking young adults who experience stress or depression are likely to experience alcohol problems, and this is due in part to elevations in craving and alcohol demand, and less sensitivity to future outcomes. Interventions targeting alcohol misuse in young adults with elevated levels of depression and stress should attempt to increase future orientation and decrease craving and alcohol reward value.