Regret Me Not: Examining the Relationship between Alcohol Consumption and Regrettable Experiences

Associations between emotional reactivity to stress and adolescent substance use: Differences by sex and valence

Although stress is often related to substance use, it remains unclear whether substance use is related to individual differences in how adolescents respond to stress. Therefore the present study examined associations between substance use and daily emotional reactivity to stress within a year across adolescence. Adolescents (N = 330; Mage = 16.40, SD = 0.74 at study entry; n = 186 female; n = 138 Latine; n = 101 European American; n = 72 Asian American; n = 19 identifying as another ethnicity including African American and Middle Eastern) completed a longitudinal study, including three assessments between the 10th grade and 3-years post-high school. At each assessment, participants reported frequency of alcohol and cannabis use and the number of substances they had ever used. They also completed 15 daily checklists, in which they reported the number of daily arguments and their daily emotion. Multilevel models suggested that more frequent alcohol and cannabis use were related to attenuated positive emotional reactivity to daily stress (i.e., smaller declines in positive emotion on days when they experienced more arguments) for both male and female adolescents. Associations for negative emotional reactivity to stress varied by sex; more frequent alcohol use and use of more substances in one's lifetime were related to greater anxious emotional reactivity to stress among female adolescents, whereas more frequent alcohol and cannabis use and higher lifetime substance use were related to attenuated depressive emotional reactivity to stress among male adolescents. Taken together, substance use was related to emotional reactivity to daily stress within the same year during adolescence, although associations differed by valence and adolescent sex.

Two online randomised controlled trials examining effects of alcohol calorie labelling on hypothetical ordering of calories from alcohol and food

BACKGROUND

Providing calorie information for alcoholic beverages is a potential public-health intervention which may serve to reduce alcohol use but also prevalence of overweight/obesity. Equivocal evidence has been found for the effectiveness of alcohol calorie information at reducing drinking intentions as well as purchasing and consumption. However, the extent at which calorie information 'on-trade' will impact consumer behaviour for both alcohol and food consumption has not been investigated.

AIMS

(1) To examine the presence of alcohol calorie labelling for hypothetical purchasing of alcohol and food in typical UK restaurant scenarios. (2) To determine the characteristics of individuals who will be likely to choose to view alcohol calorie labels.

METHODS

Two online randomised control trials using a hypothetical menu selection. In experiment one (N = 325) participants were randomised to the presence or absence of alcohol calorie labels. In experiment two (N = 1081) individuals were randomised to alcohol calorie labels absent or the choice to view alcohol calorie labels. The primary outcome for each study was calories ordered from alcoholic beverages.

RESULTS

There was no evidence that the presence of alcohol calorie information on restaurant menus impacted the number of calories ordered from alcoholic beverages or from food and soft drinks. Younger individuals and individuals who exhibit greater motives for good health were more likely to choose to view alcohol calorie labels.

CONCLUSIONS

In two online, hypothetical experiments there is no evidence for alcohol calorie labelling impacting consumer decisions to order alcohol or food. Given the choice, a self-selecting group of individuals who are more motivated by health concerns will view alcohol calorie labels, and in turn may be less likely to order alcohol.

Individualized treatment effects of a digital alcohol intervention and their associations with participant characteristics and engagement

AIMS

Conditional average treatment effects are often reported in intervention studies, in which assumptions are made regarding how effects are similar across a heterogeneous sample. Nonetheless, differing factors, such as genetics, age, and sex, can impact an intervention's effect on outcomes. The study aimed to estimate the individualized effects of a digital alcohol intervention among individuals looking online to reduce their drinking.

METHODS

We used data from a randomized controlled trial (RCT), including 2129 adults from the Swedish general population. The RCT concerned a text message-based alcohol intervention that sought to engender change through increasing knowledge on how to change and instilling confidence in changing behaviour. Outcomes were total weekly alcohol consumption and monthly heavy episodic drinking. Individualized treatment effects were modelled using baseline characteristics (age, gender, alcohol consumption, and psychosocial variables) and engagement with the intervention content.

RESULTS

We found evidence that the effects of the digital alcohol intervention were heterogeneous concerning participants' age, baseline alcohol consumption, confidence, and importance. For heavy episodic drinking, there was evidence that effects were heterogeneous concerning age, sex, and baseline alcohol consumption. Overall, women, older individuals, and heavier drinkers benefitted more from the intervention in terms of effect size. In addition, participants who engaged more with the goal-setting and screening content reported better outcomes.

CONCLUSIONS

The results highlight how different individuals respond differently to a digital alcohol intervention. This allows insight into who benefits the most and least from the intervention and highlights the potential merit of designing interventions adapted to different individuals' needs.

I can't believe I missed that! How the fear of missing out impacts on alcohol behaviours

BACKGROUND

The Fear of Missing Out (FoMO), which is often experienced over missing opportunities for social gains associated with drinking, has been linked to heavy episodic drinking and experiencing negative consequences. The UK Coronavirus (COVID-19)-related lockdown provided a unique context to study FoMO's ability to predict of alcohol consumption. The aim of the current study was to test if FoMO predicted alcohol consumption during a time of social restrictions.

METHODS

One hundred and five UK adults (aged 18-30, 61% female) participated in a study using an ecological momentary assessment design. Surveys were completed on smartphones and assessed FoMO and drinking intentions, three time a day (morning, afternoon, evening) over three consecutive weekends (Friday, Saturday, Sunday). Alcohol consumption was recorded once per day, based on previous day consumption.

RESULTS

Repeated mixed model analyses found FoMO significantly predicted quantity of alcohol consumption (b =.05, p =.01) and drinking intentions (b =.47, p <.001), but did not predict frequency of consumption. Being male (b = 2.93, p =.02) and higher intentions (b = 0.5, p <.001) predicted higher quantity of consumption. Drinking intentions was the only variable to predict frequency of consumption (b =.004, p <.001).

CONCLUSIONS

The study showed FoMO can predict quantity of alcohol consumption and drinking intentions, which are linked to increased negative consequences. Future studies should assess FoMO against other predictive factors. Results provide an insight into how a social predictor influenced alcohol consumption during a time of restrictions.

The Associations among Perceived Courtesy Stigma, Health and Social Behaviours in Family Members and Friends of People Who Use Substances: An Ecological Momentary Assessment Study

Background: The stigma and discrimination experienced by individuals with an alcohol/substance use disorder often extends to the family members and friends who provide care, which is known as courtesy stigma. This courtesy stigma can lead to isolation, poor mental health and might impact the quality-of-care these individuals provide. The aim of this study was to examine the frequency of experienced courtesy stigma/discrimination in individuals in a family support service for a loved one's substance use, and to examine any cross-sectional associations with changes in mood, health- and social-related outcomes. Methods: Thirty-six individuals (25 female) with a mean age of 51.91 years took part in an ecological momentary assessment study in which the experience of courtesy stigma/discrimination and measures of mood, health (e.g. alcohol use, nicotine use, healthy eating, sleep, physical activity) and social connections were taken 3 times per day for fourteen days. Results: Across 1029 competed assessments (compliance ∼68%), there were 122 (∼11%) reports of courtesy stigma/discrimination. The most common sources of stigma/discrimination were from family members (∼43% of occurrences) and friends (∼31% of occurrences). Experiencing this stigma/discrimination was associated with increases in alcohol and nicotine use, as well as reductions in healthy eating, physical activity, sleep, social connections, and mood. Conclusions: The experience of courtesy stigma/discrimination was common in a sample of individual's who support a loved one with alcohol or substance use disorder. These experiences are associated with changes in health and social behaviors and may lead to a poorer quality of care.

Regrets, I've Had a Few: Exploring Factors Associated with Getting Drunk and Regret in an International Study of People Who Drink Alcohol

BACKGROUND

Excessive alcohol consumption is often followed by feelings of regret. This study aimed to explore country differences in experiences of drunkenness and regrets and predictors of experiencing a greater number of regrettable drinking occasions.

METHODS

This study draws on a sample of 82,821 respondents from 31 countries who completed the 2020 Global Drug Survey. Respondents were asked to report how many times in the last year they had been drunk, how many of those times they felt regret afterwards and to complete a range of sociodemographic measures.

RESULTS

In the last 12 months, the median times drunk was 6 and the median number of regretted occasions was 2. There was an inverse relationship between times drunk and regret. Respondents who got drunk more often regretted it a smaller percentage of the time than those who got drunk less often. Respondents from Argentina and Colombia regretted being drunk the most and Denmark the least. Being younger, in higher AUDIT categories were associated with more times drunk. Being a woman, having mental health conditions were associated with more regretted occasions.Discussion and conclusions: Country variations may reflect relative acceptability of being drunk. Those who drink more, per occasion, may become accustomed to the consequences and feel fewer regrets. Interventions promoting reduced alcohol consumption may benefit from encouraging people to consider their future regret following a drinking occasion but should account for lower levels of regret in those who get drunk more often.

Dealing with Alcohol-Related Posts on Social Media: Using a Mixed-Method Approach to Understand Young Peoples' Problem Awareness and Evaluations of Intervention Ideas

Young individuals frequently share and encounter alcohol-related content (i.e., alcohol posts) on social networking sites. The prevalence of these posts is problematic because both the sharing of and exposure to these posts can increase young individuals' alcohol (mis)use. Consequently, it is essential to develop effective intervention strategies that hinder young individuals from sharing these posts. This study aimed to develop such intervention strategies by following four steps: (1) assessing young individuals' problem awareness of alcohol posts, (2) unraveling individuals' own intervention ideas to tackle the problem of alcohol posts, (3) examining their evaluations of theory/empirical-based intervention ideas, and (4) exploring individual differences in both problem awareness and intervention evaluations. To reach these aims, a mixed-method study (i.e., focus-group interviews and surveys) among Dutch high-school and college students (N_total = 292, Age_range = 16-28 years) was conducted. According to the results, most youth did not consider alcohol posts to be a problem and were, therefore, in favor of using automated warning messages to raise awareness. However, these messages might not work for every individual, as group differences in problem awareness and intervention evaluations exist. Overall, this study puts forward potential intervention ideas to reduce alcohol posts in digital spheres and can therefore serve as a steppingstone to test the actual effects of the ideas.

Hangover-Related Internet Searches Before and During the COVID-19 Pandemic in England: Observational Study

BACKGROUND

It is unclear whether heavy alcohol use and associated hangover symptoms changed as a result of the COVID-19 pandemic. Due to a lack of available accurate and nonretrospective self-reported data, it is difficult to directly assess hangover symptoms during the COVID-19 pandemic.

OBJECTIVE

This study aimed to examine whether alcohol-induced hangover-related internet searches (eg, "how to cure a hangover?") increased, decreased, or remained the same in England before versus during the COVID-19 pandemic (2020-2021) and during periods of national lockdown. Secondary aims were to examine if hangover-related internet searches in England differed compared to a country that did not impose similar COVID-19 lockdown restrictions.

METHODS

Using historical data from Google Trends for England, we compared the relative search volume (RSV) of hangover-related searches in the years before (2016-2019) versus during the COVID-19 pandemic (2020-2021), as well as in periods of national lockdown versus the same periods in 2016-2019. We also compared the RSV of hangover-related searches during the same time frames in a European country that did not introduce national COVID-19 lockdowns at the beginning of the pandemic (Sweden). Hangover-related search terms were identified through consultation with a panel of alcohol researchers and a sample from the general public. Statistical analyses were preregistered prior to data collection.

RESULTS

There was no overall significant difference in the RSV of hangover-related terms in England during 2016-2019 versus 2020-2021 (P=.10; robust d=0.02, 95% CI 0.00-0.03). However, during national lockdowns, searches for hangover-related terms were lower, particularly during the first national lockdown in England (P<.001; d=.19, 95% CI 0.16-0.24; a 44% relative decrease). In a comparison country that did not introduce a national lockdown in the early stages of the pandemic (Sweden), there was no significant decrease in hangover-related searches during the same time period (P=.06). However, across both England and Sweden, during later periods of COVID-19 restrictions in 2020 and 2021, the RSV of hangover-related terms was lower than that in the same periods during 2016-2019. Exploratory analyses revealed that national monthly variation in alcohol sales both before and during the COVID-19 pandemic were positively correlated with the frequency of hangover-related searches, suggesting that changes in hangover-related searches may act as a proxy for changes in alcohol consumption.

CONCLUSIONS

Hangover-related internet searches did not differ before versus during the COVID-19 pandemic in England but did reduce during periods of national lockdown. Further research is required to confirm how changes in hangover-related search volume relate to heavy episodic alcohol use.

TRIAL REGISTRATION

Open Science Framework 2Y86E; https://osf.io/2Y86E.

Are commonly used lab-based measures of food value and choice predictive of self-reported real-world snacking? An ecological momentary assessment study

OBJECTIVES

While the assessment of actual food intake is essential in the evaluation of behaviour change interventions for weight-loss, it may not always be feasible to collect this information within traditional experimental paradigms. For this reason, measures of food preference (such as measures of food value and choice) are often used as more accessible alternatives. However, the predictive validity of these measures (in relation to subsequent food consumption) has not yet been studied. Our aim was to investigate the extent to which three commonly used measures of preference for snack foods (explicit food value, unhealthy food choice and implicit preference) predicted self-reported real-world snacking occasions.

DESIGN

Ecological Momentary Assessment (EMA) design.

METHOD

Over a seven-day study period, participants (N = 49) completed three daily assessments where they reported their healthy and unhealthy snack food consumption and completed the three measures of preference (explicit food value, unhealthy food choice and implicit preference).

RESULTS

Our findings demonstrated some weak evidence that unhealthy Visual Analogue Scale scores predicted between-subject increases in unhealthy snacking frequency (OR = 1.018 [1.006, 1.030], p = .002). No other preference measures significantly predicted self-reported healthy or unhealthy snacking occasions (ps > .05).

CONCLUSIONS

These findings raise questions in relation to the association between measures of preference and self-reported real-world snack food consumption. Future research should further evaluate the predictive and construct validity of these measures in relation to food behaviours and explore the development of alternative assessment methods within eating behaviour research.

To drink or not to drink: When drinking intentions predict alcohol consumption and consequences

OBJECTIVES

We examined daily associations between drinking intentions and drinking behaviour and tested past drinking behaviour and current social environment as potential moderators of the daily intention-behaviour association. We expected both more frequent past drinking and being in a high drinking environment to weaken the intention-behaviour association. We also tested intentionality as a moderator of the association between alcohol consumption and next-day negative outcomes, expecting that less intentional alcohol consumption would be related to greater stress and regret.

DESIGN

We tested these hypotheses using two separate micro-longitudinal studies of college students (Ns = 1,641, 540).

METHODS

In two samples, participants completed bursts of data collection in which they indicated their previous alcohol consumption and then completed 30 days of diary surveys in which they reported their alcohol consumption and social environment the previous evening and their levels of stress, regret, and drinking intentions that day.

RESULT

Consistent with our predictions, drinking intentions more strongly predicted drinking behaviour among individuals with less frequent past drinking behaviour, and, in Sample 1, drinking intentions more strongly predicted drinking behaviour among individuals in a low drinking environment. Contrary to hypotheses, results indicated that individuals with low drinking intentions were more likely to experience stress the next day, particularly if they consumed less alcohol. Greater consumption, however, was related to greater odds of experiencing regret, but this was stronger among individuals with higher drinking intentions.

CONCLUSIONS

Findings are discussed in terms of the complex interplay between intentions and both social environment and contextual factors with respect to predicting drinking level and related problems.

'You see the pictures the morning after and you're like I wish I was in them': an interpretative phenomenological analysis of university student's alcohol-related regrets

OBJECTIVES

University students report experiencing regrettable health and social outcomes following excessive alcohol consumption. Students also report experiencing regret when they are unable to attend drinking events. This study explored how such experiences influence risk appraisals and decisions about future alcohol consumption.

DESIGN AND MEASURES

Thirteen university students (69% female, 18-20 years old) discussed the interplay of regret with alcohol consumption, and nonattendance at drinking events, in one of three focus groups. Transcripts were analysed using Interpretative Phenomenological Analysis (IPA).

RESULTS

IPA produced three super-ordinate themes: 'It's not something I would have done sober', 'Attitudes towards action regret' and 'Fear of Missing Out (FoMO)'. Participants reported regrettable experiences (e.g. alcohol poisoning, tattoos), and a gender difference in risk appraisals was apparent. Attitudes towards action regret affected risk appraisals and informed future drinking decisions. Participants reported experiencing FoMO when they were unable to attend drinking events.

CONCLUSION

Regrettable incidents following excessive consumption were seen as common but did not affect risk appraisals or future drinking decisions. Students' reported they preferred the regrettable experiences that follow excessive consumption than the FoMO experienced when they were unable to attend drinking events, suggesting FoMO may drive attendance at future drinking events.