Depressive symptoms and the implicit evaluation of alcohol: the moderating role of coping motives

The Role of Depressive Symptoms in Substance Use Among African American Boys Exposed to Community Violence

Adolescents exposed to community violence (CV) are at increased risk for alcohol, marijuana, and tobacco use. The disproportionate exposure to CV among African American boys heightens their susceptibility to substance use and related problems. Depressive symptoms are linked to both CV exposure and adolescent substance use; however, their role in the link between CV exposure and substance use in African American male adolescents has received little attention. The current study examined whether depressive symptoms mediate or moderate the associations between CV exposure and substance use among African American male adolescents. Participants were 225 African American adolescent boys in Baltimore, Maryland who completed measures of CV exposure and depressive symptoms in 10th grade and measures of substance use in 10th and 11th grades. Hierarchal linear regression analyses indicated that depressive symptoms moderated associations between violent victimization and alcohol and tobacco use, R² = .21-.30, ps < .001. There was a positive association between CV victimization and alcohol and tobacco use among those who reported high levels of depressive symptoms but not low levels. Depressive symptoms also moderated the link between witnessing CV and alcohol use such that witnessing CV was negatively related to alcohol use among those who reported high levels of depressive symptoms only. The findings suggest that depressive symptoms may play an important role in differentiating alcohol and tobacco use outcomes in CV-exposed African American boys. Prevention efforts should assess for depressive symptoms to identify adolescent boys with the highest risk of substance use.

Cognitive risk, coping-oriented substance use, and increased avoidance tendencies among depressed outpatients: A prospective investigation

OBJECTIVE

The present study was designed to assess the interplay between depressive cognition, coping-oriented substance use, and future behavioral disengagement tendencies. Cognitive risk subtypes examined include brooding rumination, attributional bias (internal/stable/global), and dysfunctional attitudes.

METHOD

Individuals were recruited from outpatient treatment settings and met criteria for a unipolar depressive disorder (N = 70; 66% female; 81% White; M_age  = 31; SD_age  = 13.2). Participants completed self-report measures of brooding rumination, attributional style, dysfunctional attitudes, coping-oriented substance use, and behavioral disengagement tendencies following a 3-week period.

RESULTS

Brooding rumination, stable attributional style, and dysfunctional attitudes were positively associated with later behavioral disengagement tendencies. Coping-oriented substance use moderated associations between both internal attributional style, as well as dysfunctional attitudes onto later behavioral disengagement.

CONCLUSIONS

With regard to stress-related avoidance, subsyndromal substance use may play a detrimental role among cognitively vulnerable, depressed outpatients when said drug or alcohol use serves as a means of coping.

Understanding Relations Among Drinking and Hookup Motives, Consequences, and Depressive Symptoms in College Students

In this longitudinal study (N = 98), we examined whether drinking for suppression reasons moderated the relation between depressive symptoms and hooking up for self-affirmation reasons and negative hookup consequences. No moderation was found for hooking up for self-affirmation reasons, but the effect for negative hookup consequences approached significance. When drinking for suppression reasons is low, participants with fewer depressive symptoms reported more negative consequences, and participants with more depressive symptoms reported fewer negative consequences 2 months later. Results are discussed within the context of sex education and mental health programming for young adults.

Examination of using alcohol to cope, depressive symptoms, and perceived social support in persons with HIV and Hepatitis C

Depression is common among people living with HIV (PLWH) and some likely turn to alcohol to cope with this emotional distress. Using alcohol to cope is associated with increased alcohol use, persistent longitudinal alcohol use, and alcohol-related problems. This association is particularly concerning among PLWH who are co-infected with Hepatitis C (HCV) because alcohol adds to the damage already caused by HCV. Despite data showing the associated risks of using alcohol to cope, scant research has examined factors that might contribute to coping-based alcohol use in HIV-HCV patients, such as limited social support. Baseline data from a randomized trial of strategies to reduce alcohol use in co-infected HIV and HCV adult patients (n=110) were analyzed. Multiple linear regression models were used to estimate the association between using alcohol to cope, depression, and four aspects of social support, controlling for demographic variables. Results showed that using alcohol to cope was not significantly correlated with social support but was significantly correlated with depressive symptoms. In fact, depressive symptoms and severity of alcohol consumption accounted for nearly 45% of the variance related to coping-based alcohol use. These data highlight the central role of depression in the coping motives-alcohol use relationship among co-infected patients.

Prevalence and correlates of probable depression diagnosis and suicidal ideation among patients receiving HIV care in Lilongwe, Malawi

Background

Depression and suicide ideation among people living with HIV (PLHIV) can threaten the success of HIV care and treatment programs, particularly within high HIV prevalence settings. We describe the prevalence and correlates associated with depression and suicidal ideation among PLHIV receiving HIV care in Lilongwe, Malawi.

Methods

From July to September 2013, 206 HIV clinic patients, who were ≥18 years of age and either pre-antiretroviral therapy (ART) or established on ART for ≥6 months prior to study, participated in a survey to assess the prevalence of a likely depressive disorder and suicidal ideation using the Patient Health Questionnaire-9. We explored factors associated with depression using bivariable linear regression and suicidal ideation using bivariable log-binomial regression.

Results

The prevalence of a likely depressive disorder and suicidal ideation was 12% (95% CI: 8%, 17%) and 16% (95% CI: 11%, 21%), respectively. Pre-ART patients (β=1.17, 95% CI: 0.03, 2.30, p-value=0.04) and those with problematic alcohol use (β=0.49, 95% CI: 0.07, 0.92, p-value=0.02) were associated with a higher depression severity. Suicidal ideation was relatively common (8%, 95% CI: 5%, 13%) among those without a likely depressive disorder and significantly correlated with having no primary, secondary, or tertiary education (β=-1.52, 95% CI: -2.46, -0.59, p-value<0.01).

Conclusions

Interventions that enhance identification and management of depressive disorders and suicidal ideation should be integrated within HIV care clinics in Malawi.

Different pathways explain alcohol-related problems in female and male college students

OBJECTIVES

Comprehensive models elucidating the intricate associations of depressive symptoms, coping motives, alcohol use, alcohol-related problems (ARPs), and gender among young adults have been scarcely examined. This study investigated relationships among these variables and the effect of gender on these pathways.

METHODS

College students (N = 163; 49.7% female) completed self-report measures on alcohol consumption, depressive symptoms, coping motives, and ARPs.

RESULTS

Structural equation modeling showed that the association between depressive symptoms and ARPs was mediated by coping motives in both females and males. However, frequency of heavy alcohol use mediated the association between depressive symptoms and ARPs in females but not in males.

CONCLUSIONS

Different models explain the association between depressive symptoms and ARPs in male and female college students. Prevention programs aimed at reducing ARPs should focus on increasing alcohol screening among students with depressive symptoms, teaching coping skills, and emphasizing moderation in alcohol consumption.

Multisubstance Use Among Treatment-Seeking Smokers: Synergistic Effects of Coping Motives for Cannabis and Alcohol Use and Social Anxiety/Depressive Symptoms

OBJECTIVE

This study examined the impact of coping motives for cannabis and alcohol use on the relation between social anxiety/depressive symptoms and severity of substance use for alcohol, tobacco, and cannabis among treatment-seeking smokers who also use cannabis and alcohol.

METHODS

The sample included 197 daily cigarette smokers (MAge 34.81 years, SD = 13.43) who reported using cannabis and alcohol.

RESULTS

Hierarchical multiple regression analyses were conducted wherein separate models were constructed for each dependent variable. Among individuals with higher social anxiety, alcohol coping motives were associated with heavier drinking, and this was more pronounced among those low in depressive symptoms. Similarly, those at greater risk for nicotine dependence were anxious individuals with lower depressive symptoms who endorse coping-oriented motives for using cannabis. Further, among those with higher social anxiety, cannabis coping motives were associated with marginally greater drinking, particularly for those high in depressive symptoms.

CONCLUSIONS

The present findings support the perspective that among multisubstance users, the interplay between social anxiety, depressive symptoms, and coping-oriented motives for using one substance (e.g., cannabis or alcohol) may pose difficulties in refraining from other substances (e.g., tobacco). This observation highlights the importance of tailoring multisubstance treatments to specific needs of multiusers for whom single-substance interventions may be less effective. Findings also support previous work exploring the benefits of concurrently treating co-occurring substance use and lend credence to the perspective that motivation to use substances for coping reasons is of central theoretical and clinical relevance.

Understanding differences in alcohol consumption and depressed mood between U.S.- and foreign-born Asian and Caucasian college students

The number and proportion of foreign-born individuals in the U.S. population has increased in recent decades. From 1970 to 2007, the foreign-born population more than tripled to approximately 37 million (U.S. Census Bureau, 1997 , 2008 ). Foreign-born students are a key subpopulation of college students. About 23% of U.S. undergraduate college students in 2007-2008 were either born outside of the United States (10%) or were children of at least one first-generation immigrant parent (13%; National Center for Education Statistics, U.S. Department of Education [NCES], 2012 ). Asian students constitute the majority (30%) of foreign-born undergraduates. Although foreign-born Asian students compose nearly one-quarter of the college population, limited research has examined how rates of alcohol use and depression differ between foreign-born and U.S.-born Asian college students (Gonzalez, Reynolds, & Skewes, 2011 ; Ralston & Palfai, 2012 ). The limited research is worrisome given their increasing rates of college enrollment (U.S. Census Bureau, 2011 ), alcohol consumption (Aud, Fox, & KewalRamani, 2010 ), alcohol abuse and dependence (Grant et al., 2004 ), and underutilization of mental health services (U.S. Department of Health and Human Services, 2001 ). Collectively, these factors point to the need for further research tailored to Asian college drinkers.

Tears in your beer: Gender differences in coping drinking motives, depressive symptoms and drinking

This study evaluates associations between coping drinking motives (CDM; drinking to regulate negative affect), depressive symptoms, and drinking behavior and extends the literature by also taking into account gender differences. Two hundred forty-three college students (Mean age = 22.93, SD = 6.29, 82% female) participated. Based on previous research, we expected that CDM would be positively associated with drinking and problems, particularly among those higher in depressive symptoms, as individuals experiencing higher levels of negative affect (i.e. depressive symptoms) and who drink to cope are likely to drink more and experience more alcohol-related problems. Lastly, based on established gender differences, we expected that CDM would be positively associated with drinking and problems, especially among females higher in depressive symptoms. Unexpectedly, findings suggested that CDMs were positively related to peak drinking, especially among those lower in depressive symptoms. Results further revealed a significant three-way interaction between CDM, depressive symptoms, and gender when predicting alcohol-related problems and drinking frequency. Specifically, we found that CDM were more strongly associated with problems among women who were lower in depressive symptoms; whereas CDM were more strongly associated with problems among men who were higher in depressive symptoms. These findings offer a more comprehensive depiction of the relationship between depressive symptoms, CDM, and drinking behavior by taking into account the importance of gender differences. These results provide additional support for considering gender when designing and implementing alcohol intervention strategies.

Sleep quality and alcohol risk in college students: examining the moderating effects of drinking motives

OBJECTIVE

Sleep problems and alcohol misuse are common issues experienced by college students that can have detrimental effects on overall health. Previous work indicates a strong relationship between poor sleep quality and alcohol risk in this population. This study explored the moderating effect of drinking motives in the relationship between global sleep quality and experience of alcohol-related negative consequences.

PARTICIPANTS

College students (N = 1,878) who reported past-month drinking.

METHODS

Participants completed online surveys assessing sleep and alcohol-related behaviors.

RESULTS

Poorer sleep quality and higher drinking motives (coping, conformity, and enhancement) predicted greater alcohol-related consequences, controlling for drinking. Further, coping motives moderated the relationship between sleep quality and consequences such that participants reporting poor sleep and high coping motives experienced heightened levels of consequences.

CONCLUSIONS

These findings advance the understanding of the relationship between sleep problems and alcohol-related risk and provide implications for targeted campus-based health promotion interventions.

The influence of depressive symptoms on alcohol use among HIV-infected Russian drinkers

BACKGROUND

Depressive symptoms have been linked to HIV progression through a number of biobehavioral mechanisms including increased alcohol use. Although research supports an association between alcohol use and depressive symptoms among HIV patients, there have been few studies that have examined whether depressive symptoms predict subsequent drinking, especially among heavy drinking HIV-infected patients.

METHOD

Heavy drinking Russian HIV-infected patients (n=700) were recruited from addiction and HIV care settings for a randomized controlled trial of a risk reduction intervention [HERMITAGE]. GEE overdispersed Poisson regression analyses were conducted to assess the association between depressive symptoms and alcohol consumption 6-months later.

RESULTS

In adjusted analyses, depressive symptom severity was significantly associated with drinks per day (global p=.02). Compared to the non-depressed category, mild depressive symptoms were significantly associated with more drinks per day [IRR=1.55, (95% CI: 1.14, 2.09)], while moderate [IRR=1.14, (95% CI: 0.83, 1.56)] and severe [IRR=1.48, (95% CI: 0.93, 2.34)] depressive symptoms were not. Associations between depressive symptom severity and heavy drinking days were not statistically significant (global p=.19). Secondary analyses using the BDI-II screening threshold (BDI-II>14) and the BDI-II cognitive subscale suggested an association between depressive symptoms and drinks per day over time but not heavy episodic drinking.

CONCLUSIONS

Among heavy drinking HIV-infected patients, elevated depressive symptoms were associated with greater subsequent alcohol use. These findings suggest that depressive symptoms may be important to address in efforts to reduce alcohol-related risks among HIV-infected populations.