Affect relative to day-level drinking initiation: Analyzing ecological momentary assessment data with multilevel spline modeling

Affective dynamics surrounding craving, non-heavy alcohol use and binge drinking in female patients with alcohol use disorder and controls: An experience sampling method study

BACKGROUND AND AIMS

Studies show that higher levels of positive affect (PA) and lower levels of negative affect (NA) are related to craving and alcohol consumption at a daily level in men, but little is known on these associations at a momentary level, and whether they are present in women. This study measured the dynamics of within-person NA and PA surrounding craving, non-heavy alcohol use and binge drinking in women with alcohol use disorder (AUD) and female controls without AUD.

METHODS

53 female patients with AUD and 75 female controls, all recruited in Belgium, were included in an experience sampling study where they reported on momentary NA, PA, craving and alcohol use in daily life over a period of 12 months. Assessments occurred eight times a day on Thursdays, Fridays and Saturdays in seven bursts of three weeks.

RESULTS

Within-person NA at a previous assessment (t-1) predicted craving at the current assessment (t0) in patients with AUD in a positive linear [β = 0.043; 95% confidence interval (CI) = 0.002, 0.057; P = 0.041] and quadratic fashion (β = 0.034; CI = 0.011, 0.057; P = 0.004). Within-person PA at t-1 predicted craving at t0 in patients with AUD with a positive quadratic relation (β = 0.042; CI = 0.08, 0.065; P < 0.001). Within-person NA at t-1 negatively predicted non-heavy alcohol use at t0 in a linear fashion in controls (β = -0.495; CI = -0.677, -0.312; P < 0.001) and patients with AUD (β = -0.276; CI = -0.421, -0.132; P < 0.001). Within-person PA at t-1 significantly predicted non-heavy alcohol use at t0 with a positive linear term (β = 0.470; CI = 0.329, 0.610; P < 0.001) in controls, but with a positive linear term (β = 0.399; CI = 0.260, 0.454; P < 0.001) and a positive quadratic term (β = 0.203; CI = 0.060, 0.347; P = 0.003) in patients with AUD. Within-person NA at t-1 predicted binge drinking at t0 in patients with AUD with a significant quadratic term (β = 0.236; CI = 0.060, 0.412; P = 0.008), but not for controls. Within-person PA at t-1 predicted binge drinking at t0 in patients with AUD with a significant quadratic term (β = 0.378; CI = 0.215, 0.542; P < 0.001), and this was also the case for controls (β = 0.487; CI = 0.158, 0.770; P < 0.001). Non-heavy alcohol use at t0 predicted lower levels of NA at t+1 in both patients with AUD (β = -0.161; SE = 0.044; CI = -0.248, 0.074; P = 0.001) and controls (β = -0.114; CI = -0.198, -0.029; P = 0.010). Non-heavy alcohol use at t0 also predicted higher levels of PA at t+1 in both patients with AUD (β = 0.181; CI = 0.088, 0.274; P < 0.001) and controls (β = 0.189; CI = 0.101, 0.278; P < 0.001).

CONCLUSIONS

The momentary relation between affect and craving or alcohol use seems to be non-linear in female patients with alcohol use disorder, whereby a worse mood predicts subsequent alcohol use, though more for binge drinking than for non-heavy alcohol use.

Involuntary social isolation and alcohol consumption: an ecological momentary assessment in Germany amid the COVID-19 pandemic

AIMS

Alcohol consumption often occurs in a social setting, which was affected by social distancing measures amid the coronavirus disease-2019 (COVID-19) pandemic. In this study, we examine how involuntary social isolation (i.e. comparing a no-lockdown stage with a lockdown stage) affects the association between loneliness, social activities, and drinking behavior.

METHOD

We performed an ecological momentary assessment eight times per day for 7 days amid the COVID-19 pandemic in Germany. We recruited 280 participants and assessed their trait loneliness, daily state loneliness, social activities, and drinking behaviors.

RESULTS

We found that a lockdown condition moderates the association between trait and daily state loneliness and alcohol consumption. During a lockdown stage, trait loneliness was positively associated, whereas state loneliness was negatively associated with alcohol consumption. During a no-lockdown stage, trait and state loneliness were both negatively associated with alcohol consumption. For both no-lockdown and lockdown stages, duration of social interaction, male gender, and weekends was positively associated with alcohol consumption.

CONCLUSION

Our study suggests that an involuntary social isolation condition (i.e. a lockdown stage) changes how trait loneliness is associated with alcohol consumption.

Daily level examination indicates that positive affect, but not negative affect, is associated with alcohol and marijuana use among adolescents and young adults

OBJECTIVE

Although there is growing evidence that alcohol use at the daily level is associated with positive but not negative affect, results are mixed when examining marijuana use and simultaneous alcohol and marijuana (SAM) use (i.e., use with overlapping effects). In addition, less is known about these daily level associations among diverse samples of adolescents and young adults. The present study will address these gaps.

METHOD

Participants (N = 1,006; 57.3% female, 43.1% White, Non-Hispanic, ages 15-25; Mage = 20.0) were part of a study on substance use that consisted of a 3-week ecological momentary assessment (EMA) burst design (eight surveys per week, up to 2×/day) that was repeated quarterly over a 12-month period.

RESULTS

Within-person results indicated that on days with elevated positive affect, participants reported consuming more drinks, whereas positive affect was not significant for hours high from marijuana. In addition, on days with elevated negative affect, participants reported fewer hours high from marijuana. No association was found between negative affect and number of drinks. Finally, within-person results indicated that on alcohol or marijuana days with elevated positive affect, individuals were more likely to report SAM use. There was no association found between negative affect and SAM use.

CONCLUSIONS

Results have implications such that in-the-moment interventions for alcohol and SAM use may be more salient when individuals have higher positive affect than average, whereas such interventions may be more relevant for marijuana use when negative affect is lower compared to average levels. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Examining Differences in Emotion Dysregulation Between Emerging Adult Alcohol-Only Users, Abstainers, and Simultaneous Users

Objective

Simultaneous use of alcohol and cannabis is associated with more negative consequences than use of either substance alone. Research suggests that emotion dysregulation is linked to alcohol, cannabis, and polysubstance use. However, no previous research has examined whether emotion dysregulation scores differ among individuals without past month substance use (abstainers), individuals who report past-month alcohol use only (no past month cannabis or simultaneous use; alcohol-only users), and individuals who engage in past-month simultaneous alcohol and cannabis use (simultaneous users). Our aim was to examine differences in overall levels of emotion dysregulation and emotion dysregulation subscales between these groups.

Methods

The sample included 468 college students. Participants completed an online survey assessing demographics, emotion dysregulation, average number of drinks per week, days of monthly cannabis use, and simultaneous use of alcohol and cannabis.

Results

A one-way ANOVA showed significant differences in emotion dysregulation between alcohol-only users, abstainers, and simultaneous users. A Bonferroni post hoc analysis revealed significant differences in emotion dysregulation for simultaneous users (p = .004) compared to alcohol-only users and abstainers. A series of ANOVAs were run to examine emotion dysregulation subscale scores and significant differences were found for impulse control difficulties (p = .003) and limited access to emotion regulation strategies (p = .005) for simultaneous users compared to alcohol-only users and abstainers, and for non-acceptance of emotional responses (p = .018) for simultaneous users compared to and alcohol-only users.

Conclusion

These findings indicate that simultaneous users have higher levels of emotion dysregulation, higher levels of impulse control difficulties, greater non-acceptance of emotions, and greater lack of access to emotion regulation strategies compared to abstainers and alcohol-only users.

Time-varying effect modeling with intensive longitudinal data: Examining dynamic links among craving, affect, self-efficacy and substance use during addiction recovery

Time-varying effect modeling (TVEM), a statistical technique for modeling dynamic patterns of change, presents new opportunities to study biobehavioral health processes. TVEM is particularly useful when applied to intensive longitudinal data (ILD) because it permits highly flexible modeling of outcomes over continuous time, as well as of associations between variables and moderation effects. TVEM coupled with ILD is ideal for the study of addiction. This article provides a general overview of using TVEM, particularly when applied to ILD, to better enable addiction scientists to conduct novel analyses that are important to realizing the dynamics of addiction-related processes. It presents an empirical example using ecological momentary assessment data from participants throughout their first 90 days of addiction recovery to estimate the (1) associations between morning craving and same-day recovery outcomes, (2) association between morning positive and negative affect and same-day recovery outcomes and (3) time-varying moderation effects of affect on the association between morning craving and recovery outcomes. We provide a didactic overview in implementing and interpreting the aims and results, including equations, computer syntax and reference resources. Our results highlight how affect operates as both a time-varying risk and protective factor on recovery outcomes, particularly when considered in combination with experiences of craving (i.e. dynamic moderation). We conclude by discussing our results, recent innovations and future directions of TVEM for advancing addiction science, including how 'time' can be operationalized to probe new research questions.

The role of impulsivity in the relationship between affect and alcohol consumption in young adults

BACKGROUND

Theoretical models of alcohol use posit that individuals consume alcohol to ameliorate negative affect or to heighten positive affect. It is important, however, to consider the influence of factors that may determine an individual's tendency to consume excessive amounts of alcohol under positive and negative circumstances. Thus, the current study examined a large sample of young adults to clarify whether positive and negative affect predict total alcohol consumption on drinking days and whether facets of impulsivity moderate these relationships.

METHODS

Six-hundred ninety-three young adults (Mage  = 19.71 years, SD = 2.04; female = 62.9%) completed the Behavioral Inhibition System/Behavioral Activation System (BIS/BAS) scales at baseline followed by daily measures of positive and negative affect and self-reported alcohol use for 13 days. Generalized linear mixed models were specified to assess the role of pre-consumption affect on total drinks consumed across drinking days and to determine the moderating effect of each BIS/BAS subscale.

RESULTS

Participants were significantly more likely to drink in greater quantities on occasions preceded by higher positive affect but not negative affect. While fun-seeking positively predicted total drinks consumed, there were no significant interaction effects between the BIS/BAS subscales and affect on total drinks consumed.

CONCLUSIONS

These findings challenge existing affect regulation models and have implications for ecological momentary interventions aimed at addressing hazardous drinking behaviors.

Disaggregating within- and between-person effects of affect on drinking behavior in a clinical sample with alcohol use disorder

OBJECTIVE

The goal of the current study was to better understand affect-drinking relations among those diagnosed with an alcohol use disorder (AUD), as recent meta-analytic work suggests that daily negative affect may not universally predict subsequent alcohol consumption in those nondependent on alcohol. Specifically, we investigated the between- and within-person effects of positive and negative affects on drinking.

METHOD

Participants (n = 92) who met AUD diagnostic criteria completed a 90-day daily assessment of drinking behavior and positive and negative affects.

RESULTS

Time-lagged multilevel modeling revealed that within-person elevations in negative affect predicted increased odds and quantity of drinking later in the day. Relations between positive affect and drinking were nonsignificant.

CONCLUSIONS

These findings are in contrast to recent meta-analytic findings and highlight the complexity of affect-drinking relations among those diagnosed with AUD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

To Drink or Not to Drink: Is That the Question? Examining Correspondence and Predictive Validity of Morning Drinking Intentions for Young Adults' Drinking Behaviors and Consequences

The Theory of Planned Behavior suggests that intentions are significant and proximal determinants of behavior. The purpose of this study was to test the predictive validity of drinking intentions for subsequent same-day drinking behaviors and negative consequences. Regularly drinking young adults (N = 222, 21-29 years, 84% undergraduates) completed an ecological momentary assessment (EMA) protocol and wore an alcohol monitor for five consecutive 24-h periods spanning 6 days (Wednesday-Monday). Each morning, participants reported their drinking intentions for the day and their previous day's alcohol consumption and the number of negative drinking consequences. Multilevel models showed that, at the within-person level, on days when people reported intending to drink, to get drunk, or to drink more than usual, they had higher odds of drinking, consumed more drinks, and had higher peak transdermal alcohol concentrations later that day. However, drinking occurred on 28% of days without drinking intentions, suggesting intentions were an imperfect signal for future drinking behavior. Morning drinking intentions also predicted experiencing more negative consequences, even after controlling for alcohol consumption. On average, young adults' morning-reported drinking-related intentions predicted increased odds of same-day drinking behavior and alcohol-related consequences. However, drinking frequently occurred on days participants did not intend to drink, suggesting that focusing only on drinking intention days will result in many missed prevention opportunities. Together, these results suggest the need for additional research to increase the predictive value of drinking intention assessments and for prevention interventions aimed at helping individuals follow through on their intentions not to drink.

The daily association between affect and alcohol use: A meta-analysis of individual participant data

Influential psychological theories hypothesize that people consume alcohol in response to the experience of both negative and positive emotions. Despite two decades of daily diary and ecological momentary assessment research, it remains unclear whether people consume more alcohol on days they experience higher negative and positive affect in everyday life. In this preregistered meta-analysis, we synthesized the evidence for these daily associations between affect and alcohol use. We included individual participant data from 69 studies (N = 12,394), which used daily and momentary surveys to assess affect and the number of alcoholic drinks consumed. Results indicate that people are not more likely to drink on days they experience high negative affect, but are more likely to drink and drink heavily on days high in positive affect. People self-reporting a motivational tendency to drink-to-cope and drink-to-enhance consumed more alcohol, but not on days they experienced higher negative and positive affect. Results were robust across different operationalizations of affect, study designs, study populations, and individual characteristics. These findings challenge the long-held belief that people drink more alcohol following increases in negative affect. Integrating these findings under different theoretical models and limitations of this field of research, we collectively propose an agenda for future research to explore open questions surrounding affect and alcohol use.

Attention bias and alcohol craving: Differential effects via biological sex and mood

BACKGROUND

Attentional bias (AB) has been linked to alcohol use, mood, and alcohol craving, with key differences across different types of mood and biological sex. However, further exploration of the role of AB across these alcohol variables is needed. The current study examined the relationship between mood and AB as predictors of alcohol craving using ecological momentary assessment (EMA). Exploratory analysis examined these effects as a function of biological sex.

METHODS

Participants (n = 69) from a Midwestern University carried a mobile device for 15 days and provided ratings of momentary mood (positive mood, anxious mood, and sad mood), alcohol craving, and AB. Data were analyzed using a two-level multilevel regression model, with associations between craving, mood, and AB examined at both the momentary and between-subjects levels.

RESULTS

Across assessments, positive and negative moods were positively associated with momentary craving, with AB found to operate differently between men and women. At the within-subjects level, increases in positive mood among men strengthened the AB-craving association, while women showed stronger AB-craving associations when positive mood decreased. At the between-subjects level, trait-like sadness led to positive AB-craving associations for men, however, this was the opposite for women. Similarly, AB-craving associations were positive and robust for men with trait-like positive mood but again the opposite was observed for women.

CONCLUSIONS

The findings highlight the importance and nuances of biological sex in the context of mood, AB, and craving. Interventions targeting AB and/or emotion regulation may yield different outcomes for men and women.

Transdermal sensor features correlate with ecological momentary assessment drinking reports and predict alcohol-related consequences in young adults' natural settings

BACKGROUND

Wearable transdermal alcohol concentration (TAC) sensors allow passive monitoring of alcohol concentration in natural settings and measurement of multiple features from drinking episodes, including peak intoxication level, speed of intoxication (absorption rate) and elimination, and duration. These passively collected features extend commonly used self-reported drink counts and may facilitate the prediction of alcohol-related consequences in natural settings, aiding risk stratification and prevention efforts.

METHOD

A total of 222 young adults aged 21-29 (M age = 22.3, 64% female, 79% non-Hispanic white, 84% undergraduates) who regularly drink heavily participated in a 5-day study that included the ecological momentary assessment (EMA) of alcohol consumption (daily morning reports and participant-initiated episodic EMA sequences) and the wearing of TAC sensors (SCRAM-CAM anklets). The analytic sample contained 218 participants and 1274 days (including 554 self-reported drinking days). Five features-area under the curve (AUC), peak TAC, rise rate (rate of absorption), fall rate (rate of elimination), and duration-were extracted from TAC-positive trajectories for each drinking day. Day- and person-level associations of TAC features with drink counts (morning and episodic EMA) and alcohol-related consequences were tested using multilevel modeling.

RESULTS

TAC features were strongly associated with morning drink reports (r = 0.6-0.7) but only moderately associated with episodic EMA drink counts (r = 0.3-0.5) at both day and person levels. Higher peaks, larger AUCs, faster rise rates, and faster fall rates were significantly predictive of day-level alcohol-related consequences after adjusting for both morning and episodic EMA drink counts in separate models. Person means of TAC features added little above daily scores to the prediction of alcohol-related consequences.

CONCLUSIONS

These results support the utility of TAC sensors in studies of alcohol misuse among young adults in natural settings and outline the specific TAC features that contribute to the day-level prediction of alcohol-related consequences. TAC sensors provide a passive option for obtaining valid and unique information predictive of drinking risk in natural settings.

No evidence for trait- and state-level urgency moderating the daily association between negative affect and subsequent alcohol use in two college samples

It remains unclear whether the negative reinforcement pathway to problematic drinking exists, and if so, for whom. One idea that has received some support recently is that people who tend to act impulsively in response to negative emotions (i.e. people high in negative urgency) may specifically respond to negative affect with increased alcohol consumption. We tested this idea in a preregistered secondary data analysis of two ecological momentary assessment studies using college samples. Participants (N = 226) reported on their current affective state multiple times per day and also the following morning reported alcohol use of the previous night. We assessed urgency both at baseline and during the momentary affect assessments. Results from our Bayesian model comparison procedure, which penalises increasing model complexity, indicate that no combination of the variables of interest (negative affect, urgency, and the respective interactions) outperformed a baseline model that included two known demographic predictors of alcohol use. A non-preregistered exploratory analysis provided some evidence for the effect of daily positive affect, positive urgency, as well as their interaction on subsequent alcohol use. Taken together, our results suggest that college students' drinking may be better described by a positive rather than negative reinforcement cycle.

Associations between simultaneous alcohol and cannabis use and next-day negative affect among young adults: The role of sex and trait anxiety

BACKGROUND AND AIMS

The simultaneous use of alcohol and cannabis ("simultaneous alcohol and marijuana [SAM] use") is common among young adults and associated with negative substance-related consequences. SAM use may be tied to fluctuating mood states such as negative affect and individual characteristics including trait level of anxiety and sex. However, little is understood about their collective role. In this study, we sought to understand the daily link between SAM use and negative affect and whether this link might differ by both trait anxiety and sex.

METHOD

Participants were 154 young adults (57.8% female, 72.7% White, M age = 20.2) who completed baseline surveys on trait anxiety symptoms and up to 14 consecutive daily surveys on their substance use and affective states.

RESULTS

Multilevel models tested for associations of type of substance use day (i.e., alcohol-only days, cannabis-only days, and no use days relative to SAM use days) with next-day negative affect. Three-way and lower order interactions were tested for substance use day type, anxiety, and sex. Two three-way interactions between cannabis-only days, anxiety, and sex and between alcohol-only days, anxiety, and sex emerged such that SAM use was associated with greater next-day negative affect relative to single substance use days particularly among female participants with elevated anxiety.

CONCLUSIONS

Anxiety and sex are salient factors in the link between SAM use relative to single-substance use and daily negative affect. Study findings reinforce the need to account for all of these factors in order to develop maximally efficacious substance use interventions.

To drink, or to exercise: That is (not) the question! Daily effects of alcohol consumption and exercise on well-being

Drinking alcohol and exercising are two of the most popular ways of dealing with stress. Despite the fact that they often co-occur, few studies have examined the role of the two activities together in everyday well-being. The current research aimed to investigate the dynamics between these two daily activities and various indices of well-being in a natural environment by using a daily diary method and ecological momentary assessment. We asked 478 adults to record their alcohol intake, exercising activity, and momentary well-being, three times a day for 2 weeks. Significant detrimental effects of drinking alcohol and beneficial effects of exercising on well-being were observed on the next day, whereas no significant effect of well-being was found on the likelihood of drinking and exercising on the second day. Furthermore, sleep quality was identified as one of the factors influencing the changes of well-being induced by the drinking and exercising engaged in the previous day. The present research allows us to deepen our understanding of the lagged relationship between the daily activities of drinking alcohol/exercising and well-being and demonstrates the underlying mechanism for the observed effects. Theoretical and practical implications are discussed.

Stress and Affect as Daily Risk Factors for Substance Use Patterns: an Application of Latent Class Analysis for Daily Diary Data

At the population level, use of multiple substances (or "co-use") is prevalent in young adulthood and linked with increased risk for experiencing substance-related harms. Less understood is the heterogeneity of substance use behaviors within individuals and across days, as well as the proximal predictors of these daily use patterns. The present study applied latent class analysis to daily diary data to identify daily substance use patterns and compare day-level class membership based on day-level stress and positive and negative affect among a higher-risk sample of young adult substance users. Participants (n = 152) completed up to 13 daily assessments of stress, affect, and substance use behavior. Among substance use days, five classes of days were identified: cannabis (some alcohol; 43% of days), alcohol-only (26%), vaping (some alcohol, cannabis; 24%), stimulant + alcohol (some cannabis, vaping; 4%), and cigarette-only (3%) days. Days with lower levels of perceived stress were significantly more likely to be alcohol-only Days relative to being days characterized by cigarette use, cannabis use, or multiple drug combinations. Days with higher levels of stress and negative affect were more likely to be cigarette-only days relative to cannabis and vaping days. Study findings document the wide range of substance use and co-use behaviors exhibited among young adults in daily life and highlight the importance of considering risk factors that correspond to days of problematic use patterns.

Unplanned vs. planned drinking: Event-level influences of drinking motives and affect

OBJECTIVE

Problematic alcohol involvement in college students remains a public health concern and identifying factors that promote this consequential behavior as it occurs in daily life is critical. Recent work has found that whether a drinking event is unplanned vs. planned has implications for the risk of negative consequences, though less work has identified fine-grained predictors of these two types of drinking occasions.

METHOD

The present study examined drinking motives and positive and negative affect as predictors of unplanned vs. planned drinking in a sample of college students who completed 28 days of ecological momentary assessment (N = 96; 72% White; 52% female). We examined drinking motives reported at two points: (1) in real-time upon initiating drinking and (2) after one day of retrospection (collected at the daily diary report assessing the prior day). Positive and negative affect were both assessed in real-time. Generalized linear mixed-effects models disentangling within- and between-person effects were leveraged.

RESULTS

Drinking "to get high, buzzed, or drunk" - when retrospectively reported for prior-day drinking - exhibited within-person associations with planned drinking, relative to unplanned drinking. This same effect was marginally significant when ascertained in real-time. Individuals with more frequent retrospective endorsement of the motive "to make the day/night more fun" reported more planned drinking. Higher real-time positive affect, but not negative affect, was marginally associated with planned drinking.

CONCLUSIONS

Our findings provide preliminary support that enhancement motives and higher positive affect are related to planned drinking, which may inform the development of momentary interventions.

How much and how fast: Alcohol consumption patterns, drinking-episode affect, and next-day consequences in the daily life of underage heavy drinkers

BACKGROUND

Understanding how alcohol consumption patterns are associated with negative and positive outcomes can inform efforts to reduce negative consequences through modification of those patterns. This is important in underage drinkers, many of whom drink heavily despite negative consequences. Most work has focused on the amount of alcohol consumed, but amount provides limited information about consumption patterns compared to rate of consumption, or how fast individuals drink. We therefore examined associations of both amount and rate of consumption with negative and positive outcomes (immediate affective states and next-morning consequences) in daily life.

METHOD

Ninety-five college students aged 18-20 years completed ecological momentary assessment over 28 days. Participants reported number of standard drinks consumed and positive and negative affect hourly within drinking episodes. Estimated blood alcohol concentration (eBAC) values were used to create amount and rate of consumption indicators. Each morning after drinking, participants reported negative (e.g., blackout, hangover) and positive (e.g., new friend, making others laugh) consequences.

RESULTS

Within drinking episodes, multilevel models showed faster consumption was associated with reduced negative affect and both larger amount and faster consumption were associated with greater positive affect. Further, amount and rate were both associated with greater likelihood of a negative consequence the next morning. Rate, but not amount, was associated with more positive consequences.

CONCLUSIONS

Not only how much but also how fast individuals drink may be important for the positive and negative outcomes they experience. Interventions to reduce negative alcohol-related outcomes should consider not only amount, but also rate of consumption.

Daily associations between affect and alcohol use among adults: The importance of affective arousal

OBJECTIVE

Little is known about whether level of affective arousal (i.e., high vs. low) is associated with alcohol use and whether this relationship differs by valence (i.e., positive vs. negative affect) among adults.

METHODS

Participants were n = 93 self-reported current drinkers (ages 25-65) who reported positive (PA) and negative affect (NA) seven times a day and alcohol use once a day for seven consecutive days. For each individual, mean levels of high arousal PA (e.g., excited), low arousal PA (e.g., satisfied), high arousal NA (e.g., frustrated), and low arousal NA (e.g., sad) were computed for each day.

RESULTS

Alcohol use was reported on 30% of person-days, with an average of 2.3 drinks consumed on drinking days. Heavy episodic drinking (4+/5+ drinks for women/men) occurred on 4% of days. After covarying for age, gender, and weekday, days with higher-than-usual levels of high arousal PA were associated with a 52% increase in the odds of consuming any alcohol and a 105% increase in the odds of engaging in heavy episodic drinking. Individuals reporting more low arousal PA on average had a 77% increase in the odds of heavy episodic drinking. No significant associations between high or low arousal NA and alcohol use were found.

CONCLUSIONS

Greater PA, but not NA, was associated with heavy alcohol use at both the within- and between-person levels, perhaps attributable to social and enhancement drinking motives. Results differed by arousal, highlighting the importance of considering a wide range of affective states when examining alcohol use behavior.

Daily Patterns of Emotional Functioning on Drinking and Nondrinking Days

BACKGROUND

Alcohol misuse continues to be a significant public health problem. Understanding the factors that may contribute to the harmful progression in drinking is an important aspect of public health. Previous research has shown that affect regulation is associated with problematic alcohol use. Additionally, emotion instability has been found as a predictor of alcohol-related problems and may be linked to reinforcement mechanisms.

METHODS

The current study examined positive mood, negative mood, and mood instability in real time across drinking and nondrinking days utilizing ecological momentary assessment (EMA). Current drinkers (n = 74) were recruited for a 21-day EMA study. Participants completed up to 10 random assessments of positive mood, negative mood, and alcohol use per day. Mood instability was assessed as the squared difference in current mood from mood in the previous assessment. Data were analyzed using piecewise multilevel regression to examine mood trajectories across drinking and nondrinking days.

RESULTS

Positive emotion across the day was higher on drinking days than nondrinking days and continued to increase after drinking initiation. In contrast, negative emotion across the day was lower on drinking days than nondrinking days and continued to decrease after drinking initiation. Emotional functioning was stable across the day on nondrinking days. However, on drinking days there was a steady increase in emotional instability leading up to drinking initiation, followed by a rapid stabilization after initiation.

CONCLUSIONS

This study highlights the potentially reinforcing impact of alcohol via emotional stability. Overall, these findings highlight the importance of mood dynamics when examining the reinforcing effects of alcohol consumption.