Ecological evidence that affect and perceptions of drink effects depend on alcohol expectancies

The influence of negative urgency and mood inductions on alcohol cognitions

BACKGROUND

Negative urgency (NU), the tendency to act rashly during negative emotional states, is a robust risk factor for alcohol misuse that is posited to function in part through alcohol-related cognitions. Nonetheless, relatively little research has examined mood-based fluctuations in such cognitions, which could help to explain how the trait of NU translates to impulsive alcohol-related behaviors. We examined how NU impacted several alcohol cognitions (positive/negative alcohol expectancies, positive/negative alcohol valuations, and alcohol craving for positive/negative emotional reinforcement) before and after negative, neutral, or positive mood inductions. We hypothesized that NU would predict greater and more favorable endorsement of alcohol and its effects following negative (vs. positive or neutral) mood induction.

METHODS

Participants (N = 428) were southern-midwestern college students recruited for an online experiment. Following the provision of consent, participants rated NU and preinduction alcohol cognitions, and were then randomly assigned to one of three (negative, neutral, or positive) mood inductions; subsequently, postinduction alcohol-cognition ratings were immediately obtained. We conducted six robust multilevel linear models (one per DV) examining NU's influence on within-person changes in alcohol cognitions across each mood induction.

RESULTS

No three-way interactions were identified and only one two-way interaction involving NU was identified. There were main effects across mood induction conditions and time points for NU predicting greater endorsement of positive and negative alcohol outcome expectancies, and greater alcohol craving for positive and negative emotional reinforcement.

CONCLUSIONS

Greater NU predicts greater perceived likelihood of alcohol's effects, alongside greater desire for mood improvement from alcohol. The absence of three-way interactive effects indicates NU's influence on mood-dependent fluctuations in alcohol cognitions may manifest over longer timescales (e.g., months and years), involve alternative cognitive processes (e.g., drinking motives and implicit alcohol cognitions), and apply more broadly to desires for mood improvement than purely negative emotional reinforcement.

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.

Self-management with alcohol over lifespan: psychological mechanisms, neurobiological underpinnings, and risk assessment

Self-management includes all behavioural measures and cognitive activities aimed at coping with challenges arising throughout the lifespan. While virtually all of these challenges can be met without pharmacological means, alcohol consumption has long been instrumentalized as a supporting tool to help coping with problems arising selectively at adolescence, adulthood, and ageing. Here, we present, to our knowledge, the first systematic review of alcohol instrumentalization throughout lifespan. We searched MEDLINE, Google Scholar, PsycINFO and CINAHL (from Jan, 1990, to Dec, 2022) and analysed consumption patterns, goals and potential neurobiological mechanisms. Evidence shows a regular non-addictive use of alcohol to self-manage developmental issues during adolescence, adulthood, and ageing. Alcohol is selectively used to overcome problems arising from dysfunctional personality traits, which manifest in adolescence. A large range of psychiatric disorders gives rise to alcohol use for the self-management of distinct symptoms starting mainly in adulthood. We identify those neuropharmacological effects of alcohol that selectively serve self-management under specific conditions. Finally, we discuss the adverse effects and associated risks that arise from the use of alcohol for self-management. Even well-controlled alcohol use adversely impacts health. Based on these findings, we suggest the implementation of an entirely new view. Health policy action may actively embrace both sides of the phenomenon through a personalized informed use that allows for harm-controlled self-management with alcohol.

Feasibility and Acceptability of Using Ecological Momentary Assessment to Evaluate Alcohol Use with American Indian Women

BACKGROUND

Ecological momentary assessments (EMA) are one way to collect timely and accurate alcohol use data, as they involve signaling participants via cell phones to report on daily behaviors in real-time and in a participant's natural environment. EMA has never been used with American Indian populations to evaluate alcohol consumption. The purpose of this project was to determine the feasibility and acceptability of EMA for American Indian women.

METHODS

Eligible participants were American Indian women between the ages of 18 and 44 who were not pregnant and had consumed more than one drink within the past month. All participants received a TracFone and weekly automated messages. Self-reported measures of daily quantity and frequency of alcohol consumption, alcohol type, and context were assessed once per week for four weeks. Baseline measurements also included the Drinking Motives Questionnaire-Revised (DMQ-R) and the Interpersonal Support Evaluation List (ISEL).

RESULTS

Fifteen participants were enrolled in the study. All but one participant completed all data collection time points, and drinking patterns were consistent across the study period. A total of 420 records were completed across 86 drinking days and 334 non-drinking days. Participants reported drinking an average of 5.7 days over the 30-day period and typically consumed 3.99 drinks per drinking occasion. Sixty-six percent of participants met gender-specific cut-points for heavy episodic drinking, with an average of 2.46 binge drinking occasions across the four week study period.

CONCLUSIONS

This proof-of-concept project showed that EMA was both feasible and acceptable for collecting alcohol data from American Indian women. Additional studies are necessary to fully implement EMA with American Indian women to better understand the drinking motives, contexts, patterns, and risk factors in this population.

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.

Alcohol craving in the natural environment: Moderating roles of cue exposure, drinking, and alcohol sensitivity

Effects of cue exposure and alcohol consumption (e.g., priming doses) on craving for alcohol have been examined in largely separate literature, limiting what is known about their potential interaction. Individuals with low alcohol sensitivity, a known risk factor for alcohol use disorder (AUD), exhibit stronger cue-elicited craving than their higher-sensitivity (HS) peers in both laboratory and real-world contexts. Here, underage drinkers (N = 155) completed a 21-day ecological momentary assessment (EMA) protocol in which they recorded exposure to alcohol cues and levels of craving during both nondrinking and postdrinking moments. Multilevel modeling detected a significant interaction of cue exposure and postdrinking status on craving. Cue-induced craving was increased in postdrinking moments compared to nondrinking moments. Contrary to prediction, cue-elicited increase in craving during nondrinking moments was stronger in participants reporting higher sensitivity to alcohol. In the presence of cues, lower sensitivity was robustly related to craving intensity in the postdrinking state but unrelated to craving during nondrinking moments. Craving during drinking episodes in the natural environment is magnified by the presence of alcohol cues, potentially contributing to the maintenance or acceleration of drinking episodes. Moreover, lower-sensitivity drinkers may be particularly susceptible to the combined effects of cue exposure and postdrinking status on alcohol craving. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Elixir of love or venom of violence: When does a drinking event result in couple intimacy or couple conflict?

The short-term consequences of drinking events may be positive or negative. Most studies have considered only one outcome, but people may experience different alcohol outcomes on different occasions, depending on the circumstances. The present study sought to identify predictors of drinking events that resulted in couple intimacy, conflict, or neither outcome using existing data from a 30-day ecological momentary assessment (EMA) study. Participants were a community sample of partnered, moderately drinking adults with a recent history of verbal or physical partner aggression (N = 249 couples). They provided reports of drinking events, intimacy and conflict events, and ratings of relationship harmony and discord in three randomly signaled reports each day. Mixed-effects multinomial analyses were used to compare predictors of drinking events that, within three hours, resulted in intimacy, conflict, or neither outcome. Consistent with previous research, characteristics of the drinker (individual tendencies to experience intimacy or conflict) and characteristics of the drinking event (alcohol quantity, drinking companions) both predicted drinking outcomes. Moreover, the pre-drinking relationship context predicted post-drinking relationship outcomes, consistent with the idea that alcohol focuses attention on salient contextual cues. Specifically, greater pre-drinking relationship harmony predicted greater likelihood of experiencing intimacy after drinking, whereas greater pre-drinking relationship discord predicted greater likelihood of experiencing conflict after drinking. In summary, characteristics of the drinker, the drinking event, and the pre-drinking relationship context contribute to the likelihood that a given drinking event will have short-term positive or negative relationship outcomes.

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.

Quantifying heterogeneity in mood-alcohol relationships with idiographic causal models

BACKGROUND

Ecological momentary assessment (EMA) studies have provided conflicting evidence for the mood regulation tenet that people drink in response to positive and negative moods. The current study examined mood-to-alcohol relationships idiographically to quantify the prevalence and intensity of relationships between positive and negative moods and drinking across individuals.

METHOD

We used two EMA samples: 96 heavy drinking college students (sample 1) and 19 young adults completing an ecological momentary intervention (EMI) for drinking to cope (sample 2). Mood and alcohol use were measured multiple times per day for 4-6 weeks. Mood-alcohol relationships were examined using three different analytic approaches: standard multilevel modeling, group causal modeling, and idiographic causal modeling.

RESULTS

Both multilevel modeling and group causal modeling showed that participants in both samples drank in response to positive moods only. However, idiographic causal analyses revealed that only 63% and 21% of subjects (in samples 1 and 2, respectively) drank following any positive mood. Many subjects (24% and 58%) did not drink in response to either positive or negative mood in their daily lives, and very few (5% and 16%) drank in response to negative moods throughout the EMA protocol, despite sample 2 being selected specifically because they endorse drinking to cope with negative mood.

CONCLUSION

Traditional group-level analyses and corresponding population-wide theories assume relative homogeneity within populations in mood-alcohol relationships, but this nomothetic approach failed to characterize accurately the relationship between mood and alcohol use in approximately half of the subjects in two samples that were demographically and clinically homogeneous. Given inconsistent findings in the mood-alcohol relationships to date, we conclude that idiographic causal analyses can provide a foundation for more accurate theories of mood and alcohol use. In addition, idiographic causal models may also help improve psychosocial treatments through direct use in clinical settings.

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.

The Mood Boost from Tobacco Cigarettes is More Erratic with the Additions of Cannabis and Alcohol

INTRODUCTION

A large body of literature indicates that nicotine results in an acute mood "boost," including increased positive affect and decreased negative affect. Young adults frequently engage in polysubstance use of cigarettes with cannabis and alcohol-a trend that is likely to accelerate with the expanding legalization of cannabis. However, little is known about whether polysubstance use, defined here as combustible tobacco cigarette use within the same hour as cannabis and alcohol, is associated with changes in the nicotine mood boost. The present study aimed to address this gap.

METHODS

Young adults (N = 202, 52% female, mean age = 21 years at time 1) provided ecological moments assessment (EMA) reports of cigarette use over two 7-day bursts spaced 1 year apart. In each report, participants rated mood levels before and after smoking, and indicated cannabis and alcohol use. Mixed-effects location-scale modeling simultaneously tested changes in mood levels and variability related to smoking events with cannabis and/or alcohol compared with smoking-only events.

RESULTS

From before to after smoking, positive affect increased and negative affect decreased, on average. Overall, the additions of cannabis and/or alcohol had nonsignificant associations with these mean changes. However, polysubstance use, as well as cigarette-cannabis co-use, were each associated with significantly greater within-person variability in the positive and negative affect changes related to smoking.

CONCLUSIONS

The mood benefits associated with smoking were more erratic in the contexts of polysubstance use and cigarette-cannabis co-use. Potential implications for young adults' long-term nicotine use trajectories are discussed.

IMPLICATIONS

Among young adults who smoke cigarettes, the mood "boost" from smoking may be more erratic-which is to say, more likely to be either amplified or attenuated-with the additions of cannabis and alcohol together, or cannabis alone. On occasions when young adults seek out cannabis and alcohol to enhance their smoking mood boost, but instead experience a dampening effect, they might consume more nicotine, contributing over time to greater dependence. Future investigation is warranted, with particular attention to nicotine-cannabis co-use.

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

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

Daily impulsivity is associated with alcohol use and problems via coping motives, but not enhancement motives

BACKGROUND

The present study sought to determine daily associations between impulsivity, coping and enhancement motives, alcohol use, and alcohol problems in the natural environment.

METHODS

Participants were 89 (47 women) heavy drinking, college students from a university in the southeastern U.S. who completed a 14-day ecological momentary assessment study. Each day, participants completed three random reports of momentary impulsivity and indicators of drinking motives and two additional reports at the beginning and end of any drinking occasions.

RESULTS

A series of multilevel mediation models were tested to examine indirect effects from impulsivity to alcohol use and alcohol problems through coping and enhancement motives. At the within-person level, results revealed that greater than usual impulsivity experienced prior to drinking was associated with greater coping motives, and this in turn was associated with greater number of drinks consumed that day (all p values <0.001). A similar indirect effect was revealed when impulsivity predicted alcohol problems that day through coping motives (p values range: <0.001 to .01). Greater enhancement motives than usual were associated with greater number of drinks consumed and alcohol problems experienced that day (p values range: <0.001 to.001), but associations with impulsivity were nonsignificant.

CONCLUSIONS

Findings supported daily fluctuations in drinking to cope motives as a salient mechanism explaining the link between daily impulsivity and level of alcohol use and alcohol problems. Fluctuations in daily impulsivity were associated with changes in motivations to drink which may benefit efforts aimed at reducing alcohol harms among young adults.

Effects of couple drinking events on short-term relationship harmony and discord: An ecological momentary assessment study

OBJECTIVE

Couples with concordant drinking patterns have higher relationship satisfaction and greater relationship stability over time. Emerging evidence suggests that episodes of drinking with one's intimate partner can have positive immediate consequences for relationship functioning, whereas drinking episodes without partner do not. The present ecological momentary assessment (EMA) study examined the impact of drinking with partner (DWP) and drinking without partner (DWOP) events on immediate and next-day self-reported relationship harmony and discord.

METHOD

Heterosexual, cohabiting community couples with congruent drinking patterns, ages 21-35 (N = 191), made three random reports each day for 30 days. Multilevel modeling was used to examine the impact of DWP and DWOP events on momentary relationship functioning, controlling for quantity of alcohol consumed and for functioning at the previous report.

RESULTS

As hypothesized, harmony increased immediately after DWP (but not after DWOP) compared with no drinking for men and women. There were no immediate effects of drinking on discord. There were also positive effects of DWP on next morning harmony, but these were specific to women's drinking reports. Women's DWP and DWOP predicted reduced next morning discord for men; however, men's and women's discord increased as women consumed more drinks the previous evening.

CONCLUSIONS

Findings suggest that concordant drinking couples may achieve immediate benefits for couple harmony from drinking together. Women's drinking seems to be more impactful than men's on next-day harmony and discord, with greater harmony following women's evening DWP but increased discord associated with heavier evening drinking by women. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Positive Urgency, Drinking Preoccupation, and Alcohol Problems in College Students

OBJECTIVE

Individuals high in positive urgency (i.e., impulsiveness stemming from high positive mood) may be more preoccupied with alcohol-related cognitions. Our aim was to examine how positive urgency, drinking preoccupation, and consumption patterns concurrently influence the endorsement of alcohol-related problems.

METHOD

We sampled 756 students enrolled in a large, public U.S. university, who completed a cross-sectional survey online. Their mean age was 19.6 (SD = 1.72), 71.3% identified as female, and participants largely identified as Caucasian (65.5%) and Hispanic/Latinx (22.1%). Self-report measurements of trait positive urgency and drinking preoccupation and retrospective data of alcohol use and alcohol-related problems were collected. A series of linear regressions tested for a hypothesized indirect effect between variables.

RESULTS

We discovered an indirect effect in the relationship between positive urgency and alcohol-related problems via drinking preoccupation. A significant conditional effect showed that this relationship was influenced by past 30-day alcohol consumption, with the effect gaining strength as consumption days increased.

CONCLUSIONS

Students with high positive urgency may be more engrossed with alcohol-related drinking cognitions, leading to negative consequences as their alcohol consumption increases. This potential association can inform tailored intervention plans for college student alcohol control, such as successfully managing intense positive moods and alcohol-related cognitions and triggers.

Co-use of medication and alcohol: The influence on subjective effects of intoxication and affect

Co-use of alcohol and medication can have serious negative health effects (e.g., overdose risk, liver damage). Research has primarily focused on older adults or the pharmacokinetics of specific medication-alcohol combinations. Little work has focused on the subjective experience of persons who take alcohol-interactive (AI) medications and also drink alcohol, particularly in psychiatric samples at high risk for problematic alcohol use and high rates of prescription medication use, such as individuals with borderline personality disorder (BPD). Data from a larger ecological momentary assessment study of alcohol use in 52 persons diagnosed with BPD (83% women; Mage = 26 years) were used to examine the influence of alcohol intoxication (i.e., estimated blood alcohol concentration [eBAC]) and medication co-use on momentary subjective experience while drinking. Participants reported AI medication use at baseline and completed multiple ecological momentary assessment reports per day over 21 days, which included reports of alcohol use, subjective effects of alcohol (e.g., pleasure, feeling worse), and negative and positive affect. AI medications significantly moderated the association between eBAC and pleasurable effects of alcohol, such that at higher levels of eBAC, those taking AI medications experienced blunted subjective pleasure compared with those not taking AI medications. AI medications did not moderate the associations between eBAC and subjective relief, feeling worse, positive affect, or negative affect. Attenuated pleasure during drinking could lead to increased drinking in an attempt to achieve a desirable state among individuals who co-use psychiatric medications and alcohol, and therefore may represent a useful target for prevention and intervention. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

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.

The paradoxical association between tension-reduction alcohol outcome expectancies and tension following alcohol consumption

BACKGROUND

Behavioral models suggest that strong tension-reduction alcohol-outcome expectancies (TREs) among drinkers should be associated with greater tension reduction after drinking. Yet, the few studies investigating this have found either no relationship or the opposite relationship.

OBJECTIVES

We sought to explore this relationship by building upon the limitations of past studies and employing a placebo-controlled, within-subject experimental design.

METHODS

Sixty social drinkers (26 M, 34 F) visited the lab on two occasions spaced one week apart. Each participant was randomly assigned to receive alcoholic drinks targeting a BAC of 0.05% on one testing day and placebo drinks on the other, with the order counter-balanced. On both testing days, participants completed measures of state anxiety and fear both before drinking and following a drinking/absorption period. While completing the self-report measures, participants were anticipating an impending, mildly stressful heartbeat perception task.

RESULTS

Multilevel modeling revealed that the more strongly individuals believed that alcohol reduces tension, the less the pharmacologic properties of alcohol did so (p = .02 for the state anxiety outcome measure; p = .001 for the fear outcome measure). This was the case even with anxiety sensitivity - a known predictor of stress-response dampening - controlled for.

CONCLUSIONS

These results provide further evidence for the paradoxical association of TREs and the dampening of anxiety. Additionally, the findings are consistent with the basis of expectancy challenges that aim to reframe inaccurate TREs among drinkers.

The effect of alcohol on mood among males drinking with a platonic friend

BACKGROUND

Despite the social nature of most drinking experiences, prior work has largely failed to incorporate social context into the study of alcohol's effects on emotion. The present study provides an initial test of the effect of alcohol on mood among platonic friends drinking together in a non-stress setting. We hypothesized that subjects would report more positive postdrink mood after consuming alcohol than after consuming a nonalcoholic control beverage.

METHODS

Dyads of platonic male friends (n = 36; 55.55% White, 38.88% Asian, 5.55% Black) attended two laboratory-based experimental sessions, wherein their drink conditions (alcohol vs. no alcohol control) were randomized by dyad and counter-balanced across sessions. They reported their mood before and after consuming their beverages together, using the Positive and Negative Affect Schedule and an 8-item mood measure.

RESULTS

As hypothesized, alcohol enhanced positive mood ( β  = 0.26, p < 0.01). Although in the expected direction, the effect of alcohol on negative mood was not significant ( β  = -0.12, p = 0.17). Post hoc analyses revealed that alcohol yielded greater increases in both stimulation ( β = 0.26 , p = 0.00) and sedation ( β = 0.40 , p = 0.00) as compared to the control condition.

CONCLUSION

This study highlights the positive mood-enhancing and broader subjective effects of alcohol when drinking with a platonic friend and encourages further consideration of friendship contexts in the examination of alcohol's effects when developing models of the etiology of alcohol use disorder.

Real-time reports of drinking to cope: Associations with subjective relief from alcohol and changes in negative affect

Many individuals report drinking alcohol to cope or relieve negative affective states, but existing evidence is inconsistent regarding whether individuals experience negatively reinforcing effects after drinking to cope (DTC). We used ecological momentary assessment to examine the effects of DTC during daily-life drinking episodes in a sample of current drinkers (N = 110; 52 individuals with borderline personality disorder and 58 community individuals). Multilevel models were used to test whether momentary and episode-level endorsement of DTC-depression and DTC-anxiety motives would be related to increased subjective drinking-contingent relief and decreased depression and anxiety during drinking episodes. Momentary DTC-anxiety predicted greater subsequent drinking-contingent relief, and greater episode-level DTC-anxiety and DTC-depression predicted greater drinking-contingent relief during the episode. However, we did not find decreased depression and anxiety following endorsement of DTC-depression and DTC-anxiety. Instead, we found that greater episode-level DTC-depression was associated with increased depression. Thus, findings suggest that individuals' negative affective states may not improve during DTC despite endorsing drinking-contingent relief. This discrepancy warrants further attention because subjective relief likely reinforces DTC, whereas awareness of one's change (or lack of change) in affect may provide valuable counterevidence for whether alcohol use is an effective coping strategy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Coping motives and negative affect: An ecological study of the antecedents of alcohol craving and alcohol use

OBJECTIVE

Negative affect (NA) is presumed to be an important trigger for drinking, particularly among coping-motivated drinkers. However, diary studies attempting to predict alcohol use from interactions between state NA and coping motives have proved inconsistent. Craving or momentary desire for alcohol may be a more proximal and robust consequence of NA in coping-motivated drinkers.

METHOD

Data were drawn from an ecological momentary assessment investigation. Frequent drinkers (N = 403) carried electronic diaries for 21 consecutive days, recording their drinking behavior, and rating cravings for alcohol and NA.

RESULTS

Outside of active drinking episodes, within-person elevations of momentary NA were associated with increased craving intensity, and this effect was more prominent among drinkers with higher dispositional coping motives. There was no significant interaction between coping motives and momentary NA in predicting the occurrence and amount of same-day alcohol use. Significant conditional indirect effects indicated that NA promoted drinking through increases in craving. These indirect effects were stronger among drinkers reporting higher coping motives.

CONCLUSIONS

Coping motives and within-person fluctuations in NA interactively predict alcohol craving. NA promotes drinking indirectly via increased craving, particularly among coping-motivated drinkers. Alcohol craving may be a proximal and sensitive response channel for investigating interactions between affective distress and coping motives. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Positive emotional intensity and substance use: the underlying role of positive emotional avoidance in a community sample of military veterans

Background: Military veterans are at greater risk for substance misuse. Positive emotional intensity is one well-established antecedent of substance misuse in this population. Positive emotional avoidance, or attempts to alter the form, frequency, or context of positive emotions, may help to explain this association. While clinical practice typically aims to increase positive emotions, such approaches may have iatrogenic effects, as high-intensity positive emotions may be experienced as distressing and prompt avoidance for some populations. This suggests a need to better understand responses to positive emotions to inform clinical practice.Objectives: The goal of the current study was to advance theory, research, and clinical practice by exploring the role of positive emotional avoidance in the associations between positive emotional intensity and both alcohol and drug misuse. We hypothesized that positive emotional intensity would indirectly influence alcohol and drug misuse through positive emotional avoidance.Methods: Participants were a community sample of United States military veterans recruited through Amazon's Mechanical Turk (n = 535, Mage = 37.45, 71.8% male, 69.5% White).Results: Correlations among positive emotional intensity, positive emotional avoidance, and alcohol and drug misuse were significant and positive (rs range from.13 to.41). Further, positive emotional avoidance was found to account for the relations of positive emotional intensity to alcohol (indirect effect: b =.04, 95%CI [.01,.08]) and drug misuse (indirect effect: b =.01, 95%CI [.01,.02]).Conclusions: Results provide preliminary support for the potential clinical utility of targeting avoidance responses to positive emotions in interventions targeting alcohol and drug misuse among military veterans.

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.

Drinking motives moderate daily-life associations between affect and alcohol use in individuals with borderline personality disorder

People often report drinking to cope with negative affect (NA) or to enhance positive affect (PA). However, findings from daily life studies examining the interaction of motives and affect to predict alcohol use are mixed. Individuals with borderline personality disorder (BPD) may be particularly susceptible to drinking for the purpose of changing affective states, representing a population in which these patterns may be more readily identifiable in daily life. We tested whether drinking motives moderate daily life associations between affect and drinking in individuals with BPD. Regular drinkers with BPD (N = 54; 81.5% female) completed ecological momentary assessments approximately 6-10 times daily for 21 days. We tested whether the interactions between (a) person-level coping motives and NA so far that day (i.e., cumulative-average NA), and (b) person-level enhancement and cumulative-average PA were associated with subsequent drinking. We also tested whether effects differed for the initiation versus continuation of a drinking episode. Using generalized estimating equations, the interaction between coping and cumulative-average NA was positively associated with momentary drinking, with some evidence for a stronger relation during the continuation of drinking. The interaction between enhancement motives and cumulative-average PA was positively associated with initiation but negatively associated with continuation of drinking. Our novel approach of using cumulative-average affect and distinguishing initiation and continuation of drinking allowed us to examine differential momentary patterns across the drinking episode, and results suggest that awareness of motives as well as affect leading up to and during drinking may be a useful intervention target. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

A multimodal, longitudinal investigation of alcohol's emotional rewards and drinking over time in young adults

Theories of alcohol use disorder (AUD) have long suggested that alcohol's emotional rewards play a key role in reinforcing problematic drinking. Studies employing survey methods, in which participants recall and aggregate their experiences with alcohol in a single questionnaire, indicate that self-reported expectancies and motivations surrounding alcohol's emotional rewards predict problematic drinking trajectories over time. The current study is the first to combine laboratory alcohol-administration, ambulatory methods, and longitudinal follow-ups to assess whether alcohol's ability to enhance positive mood and reduce negative mood predicts later drinking problems. Sixty young heavy social drinkers (50% female) participated in laboratory-based alcohol-administration, attending both alcohol (target blood alcohol concentration [BAC] .08%) and no-alcohol laboratory sessions. Forty-eight of these participants also wore transdermal alcohol monitors and completed mood surveys outside the laboratory for 7 days. Participants reported on their drinking at 18-month follow-up (90% compliance). Controlling for baseline drinking, greater negative mood reduction from alcohol at baseline predicted more drinking problems at follow-up, an effect that emerged as consistent across methods capturing alcohol's emotional rewards in the laboratory, b = -.24, p = .02, as well as via ambulatory methods, b = -3.14, p = .01. Greater positive mood enhancement from alcohol, captured via laboratory methods, also predicted drinking problems, b = .16, p = .03, and binge drinking, b = 3.22, p = .02, at follow-up. Models examining drinking frequency/quantity were nonsignificant. Results provide support for emotional reward as a potential factor in the development of problematic drinking. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

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

Affect regulation models state that affect both motivates and reinforces alcohol use. We aimed to examine whether affect levels and rates of change differed across drinking versus nondrinking days in a manner consistent with affect regulation models. Four hundred four regularly drinking adults, aged 18-70 years, completed ecological momentary assessments over 3 weeks. Participants provided positive affect (PA; enthusiastic, excited, happy) and negative affect (NA; distressed, sad) reports during all prompts; alcohol consumption reports were also provided. Multilevel spline models revealed that on drinking days, PA was higher and NA was lower both before and after drinking compared to matched times on nondrinking days. PA and NA were also higher and lower, respectively, both before and after drinking, when heavy drinking days were compared to moderate drinking days. Examination of affect rates of change revealed that (a) accelerating increases in PA and accelerating decreases in NA preceded drinking initiation, (b) PA increases and NA decreases were seen up to 2 hr after drinking initiation, and (c) pre- and postdrinking PA increases were larger on heavy versus moderate drinking days, whereas only postdrinking NA decreases were larger on heavy drinking days. Results supported affect regulation models while adding nuance, showing accelerating changes in predrinking affect on drinking days and pre- and postdrinking differences in affect levels and rates of change across days of varying drinking intensity. Beyond theory, our results suggest that accelerating changes in affect may provide a clue to future commencement of heavy drinking, which may aid momentary intervention development. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Self-fulfilling prophecies: Documentation of real-world daily alcohol expectancy effects on the experience of specific positive and negative alcohol-related consequences

Alcohol expectancies are consistently associated with alcohol use in cross-sectional and longitudinal studies. However, little research has examined whether alcohol expectancies on specific drinking occasions are associated with reported consequences on those days, particularly when controlling for the amount of alcohol consumed, thus differentiating the extent to which reported consequences may have resulted from alcohol or an "expectancy effect." This study examined consequence-specific daily expectancy effects. College students (N = 342; mean age 19.7 [standard deviation (SD) = 1.25], 52.9% female) participated in a longitudinal measurement burst study. During four 2-week intervals, participants used mobile phones to respond to 3 surveys per day via automated telephone interviews. The results showed that on days when college students had higher-than-average expectancies for specific subjective positive consequences (e.g., feeling more relaxed, being in a better mood), they were more likely to report experiencing those same consequences as a result of their alcohol use that day, even after controlling for how much they actually drank on that day. The same held true for subjective interpersonal negative consequences (e.g., becoming aggressive, rude, or obnoxious; embarrassing oneself), but not for less subjective physical/cognitive negative consequences (e.g., having a hangover, vomiting, getting hurt/injured, forgetting). The results suggest that one's expectations about the particular effects of alcohol tend to be self-fulfilling for subjective effects of alcohol even when they are not directly tied to the physiological effects of alcohol. The findings underscore the important role of alcohol expectancies, particularly the expectation of subjective positive social and tension-reduction/relaxation effects, in understanding problematic alcohol use. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

The Association Between Negative and Positive Affect and Alcohol Use: An Ambulatory Study

OBJECTIVE

Negative and positive affect are proposed to play a crucial role in alcohol use and the development of alcohol use disorder. Results from ambulatory studies that measure momentary affect and subsequent alcohol use have been mixed, particularly regarding negative affect. We attempted to identify within-person moderators (i.e., time between assessments, prior blood alcohol content) that might explain mixed results.

METHOD

We examined the association between self-reported affect and an objective measure of alcohol consumption (measured via a transdermal ankle bracelet) in a sample of heavy social drinkers across 7 days of ambulatory assessment.

RESULTS

Our results showed that negative affect was negatively related to later drinking, whereas positive affect was positively related to later drinking. The results showed that these effects were stronger for amount consumed when affect was assessed closer rather than farther in time.

CONCLUSIONS

These findings are important for understanding affect as an antecedent to alcohol use, which may ultimately have implications for the development of alcohol use disorder.

Understanding profiles of student binge drinking and eating: The importance of motives

Binge drinking and binge eating occur frequently in undergraduates; however, the mechanism driving their co-occurrence is not well-understood. Several theories support the role of motives in driving drinking and eating behavior, especially motivations related to affect regulation (i.e., enhancement/pleasure and coping). This study used a person-centered approach to identify classes of students based on eating and drinking motives and past-month binge behavior and examined class differences in psychopathology, emotion regulation, and impulsivity. Undergraduates (N = 776) completed a drinking timeline follow-back and surveys assessing motives, binge eating, psychopathology, emotion regulation, impulsivity, and quality of life. Mixture modeling was used to group students based on presence/absence of past-month binge eating, binge drinking, and motives for eating and drinking. The analysis resulted in 4 classes: Binge Drinking (with relatively high social and enhancement drinking motives), Binge Eating (with overall high eating motives), Both Bingeing (with high drinking motives, especially coping, and high eating motives), and Low Bingeing (with low motives for both behaviors). ANOVA and post-hoc analyses suggested that the Binge Eating and Both Bingeing groups were most impaired, while the Binge Drinking class rarely differed from the Low Bingeing group across measures of psychological distress. Notably, classes with high eating/drinking motives displayed significant impairment despite not all class members endorsing binge behavior. Findings suggest that binge drinking in addition to binge eating may not imply more psychological impairment and support the importance of assessing motives for eating/drinking among undergraduates and potentially trying to challenge these motives through early intervention.

Effects of alcohol intoxication on self-reported drinking patterns, expectancies, motives and personality: a randomized controlled experimental study

Alcohol intoxication may affect self-reports of alcohol use and related constructs, such as impulsivity and dependence symptoms. Improved knowledge about potential systematic reporting biases induced by alcohol, e.g. through disinhibition, may be relevant for the assessment of intoxicated individuals both in clinical routine and research. We therefore randomly assigned 54 socially drinking males aged 18 to 19 without lifetime diagnosis of DSM-IV alcohol dependence to one of two experimental arms: either placebo infusion at day 1 and alcohol infusion at day 2, or vice versa. The lab-based intravenous alcohol infusion produced a constant blood alcohol level of 0.08 percent. On each day, participants completed the Alcohol Use Disorders Identification Test, as well as other questionnaires on alcohol expectancies, drinking motives and substance use-related temperament traits. We found that alcohol significantly increased self-reported expectancies (tension reduction) and motives (conformity; η²  = .16-.23), but we observed no effect of sequence, i.e. alcohol first versus placebo first (P_corr  ≥ .118). High baseline alcohol expectancies did not moderate alcohol effects (P_corr  ≥ .462). We conclude that moderate alcohol intoxication might not generally affect the reliability of self-reported alcohol use, alcohol use problems and psychological concepts related to drinking behavior in young males without alcohol dependence. Future studies could examine larger, less selective and clinical samples for possible alcohol effects on self-report measures related to alcohol consumption.

Neighborhood alcohol outlet density and genetic influences on alcohol use: evidence for gene-environment interaction

BACKGROUND

Genetic influences on alcohol involvement are likely to vary as a function of the 'alcohol environment,' given that exposure to alcohol is a necessary precondition for genetic risk to be expressed. However, few gene-environment interaction studies of alcohol involvement have focused on characteristics of the community-level alcohol environment. The goal of this study was to examine whether living in a community with more alcohol outlets would facilitate the expression of the genetic propensity to drink in a genetically-informed national survey of United States young adults.

METHODS

The participants were 2434 18-26-year-old twin, full-, and half-sibling pairs from Wave III of the National Longitudinal Study of Adolescent to Adult Health. Participants completed in-home interviews in which alcohol use was assessed. Alcohol outlet densities were extracted from state-level liquor license databases aggregated at the census tract level to derive the density of outlets.

RESULTS

There was evidence that the estimates of genetic and environmental influences on alcohol use varied as a function of the density of alcohol outlets in the community. For example, the heritability of the frequency of alcohol use for those residing in a neighborhood with ten or more outlets was 74% (95% confidence limits = 55-94%), compared with 16% (95% confidence limits = 0-34%) for those in a neighborhood with zero outlets. This moderating effect of alcohol outlet density was not explained by the state of residence, population density, or neighborhood sociodemographic characteristics.

CONCLUSIONS

The results suggest that living in a neighborhood with many alcohol outlets may be especially high-risk for those individuals who are genetically predisposed to frequently drink.

Measurement of Mood States Following Light Alcohol Consumption: Evidence from the Implicit Association Test

As the problems of mood measurements during alcohol consumption of alcoholic beverages do not necessarily evoke interpretable physiological responses, explicit reports may be contaminated by various cognitive biases or expectations. The present study examined whether emotional responses induced by the consumption of beverages containing low concentrations of alcohol can be measured using the Implicit Association Test (IAT). The IAT can detect the estimates of internal proximity between bipolar target concepts (e.g., cheerfulness and fatigue). Participants (N = 30) received three IAT sessions, followed by drinking a beverage containing 0% (control), 1%, or 3% alcohol by volume, and three IATs (at 0, 30, and 60 min after the time of consumption). We also recorded the explicit responses regarding the extent of drunkenness. The analyses of variance with alcohol concentration and time reveal dissociation between implicit and explicit measures. The IAT scores under the alcohol conditions reflect a more cheerful mood state relative to the baseline test. This effect of enhanced cheerfulness was not observed under the non-alcohol control condition. These results demonstrate that the impact of the consumption of low-alcohol beverages on mood can be measured using the IAT.

Before and after: craving, mood, and background stress in the hours surrounding drug use and stressful events in patients with opioid-use disorder

RATIONALE

Ecological momentary assessment (EMA) of specific events usually focuses more on antecedents and concomitants than on aftermaths.

OBJECTIVES

To examine mental state both before and after discrete episodes of stress and drug use.

METHODS

For up to 16 weeks, outpatients on opioid-agonist treatment carried smartphones on which they initiated entries for stressful events (SEs) or lapses to drug use (DUs), and thrice daily when randomly prompted (RPs). Participants rated their stress, opioid craving, cocaine craving, and moods. RP entries within 5 h of an event were analyzed and compared to other RPs.

RESULTS

Stress, negative mood, and craving were generally higher before and after DUs and SEs compared to background levels in participants with at least one DU (n = 149) or SE (n = 158). Before DUs, there were increases in negative mood, opioid craving, and cocaine craving, but not background stress. Before SEs, there were increases in background stress, opioid craving, and cocaine craving, but not negative mood. These changes were more variable after events than before. Neither DUs nor SEs were significantly related to positive mood.

CONCLUSIONS

Stress increased before stressful-event entries, but was less evident before drug use. Craving increased in the hours before drug use and stressful events-and remained elevated in the hours after either event. These results suggest a stronger link between drug use and craving than between drug use and stress. Lapses to drug use did not improve mood or reduce stress, at least not at our 1-h-bin time resolution, suggesting that if such benefits exist, they are brief.

Moderation of alcohol craving reactivity to drinking-related contexts by individual differences in alcohol sensitivity: An ecological investigation

Laboratory cue exposure investigations have demonstrated that, relative to drinkers who report a high sensitivity to the pharmacologic effects of alcohol, low-sensitivity (LS) drinkers show exaggerated neurocognitive and behavioral reactivity to alcohol-related stimuli. The current study extends this line of work by testing whether LS drinkers report stronger cravings for alcohol in daily life. Data were from an ecological momentary assessment study in which participants (N = 403 frequent drinkers) carried a palmtop computer for 21 days and responded to questions regarding drinking behavior, alcohol craving, mood states, and situational context. Initial analyses identified subjective states (positive and negative mood, cigarette craving) and contextual factors (bar-restaurant location, weekend, time of day, presence of friend, recent smoking) associated with elevated craving states during nondrinking moments. Effects for nearly all these craving correlates were moderated by individual differences in alcohol sensitivity, such that the associations between situational factors and current alcohol craving were larger among LS individuals (as determined by a questionnaire completed at baseline). Complementary idiographic analyses indicated that self-reported craving increased when the constellation of situational factors more closely resembled individuals' observed drinking situations. Again, this effect was moderated by alcohol sensitivity, with greater craving response increases among LS drinkers. The findings align with predictions generated from theory and laboratory cue exposure investigations and should encourage further study of craving and incentive processes in LS drinkers. (PsycINFO Database Record

Tension reduction and affect regulation: An examination of mood indices on drinking and non-drinking days among university student drinkers

Several theories posit problematic alcohol use develops through mechanisms of positive and negative reinforcement. However, the literature on these mechanisms remains inconsistent. This may be due to a number of issues including a failure to disaggregate negative mood or a failure to account for mood functioning (i.e., stability in mood). Alternatively, there may be differences in typical postdrinking/evening mood on drinking and nondrinking days, however, this has yet to be fully explored. We examined multiple indices of distinct mood states prior to and after typical drinking onset times on drinking and nondrinking days using ecological momentary assessment. College student drinkers (n = 102) carried personal data devices for 15 days. They reported on mood and alcohol use several times per day. Tonic positive mood was higher on drinking days than nondrinking days prior to typical drinking initiation. After typical drinking times, positive mood was higher on drinking days than nondrinking days. Similarly, negative moods (anxiety, stress, anger, and stress instability) indicated a pattern of lower levels relative to both predrinking mood on drinking days, and matched mood time-points on nondrinking days; though, not all of these differences were statistically different. Results suggest positive and negative reinforcing mechanisms may be at play-though the negative reinforcement effects may manifest through subjectively "better" mood on drinking versus nondrinking days. (PsycINFO Database Record

Advancing statistical analysis of ambulatory assessment data in the study of addictive behavior: A primer on three person-oriented techniques

Ambulatory assessment (AA) methodologies have the potential to increase understanding and treatment of addictive behavior in seemingly unprecedented ways, due in part, to their emphasis on intensive repeated assessments of an individual's addictive behavior in context. But, many analytic techniques traditionally applied to AA data - techniques that average across people and time - do not fully leverage this potential. In an effort to take advantage of the individualized, temporal nature of AA data on addictive behavior, the current paper considers three underutilized person-oriented analytic techniques: multilevel modeling, p-technique, and group iterative multiple model estimation. After reviewing prevailing analytic techniques, each person-oriented technique is presented, AA data specifications are mentioned, an example analysis using generated data is provided, and advantages and limitations are discussed; the paper closes with a brief comparison across techniques. Increasing use of person-oriented techniques will substantially enhance inferences that can be drawn from AA data on addictive behavior and has implications for the development of individualized interventions.

The effect of laboratory manipulations of negative affect on alcohol craving and use: A meta-analysis

Scientific and lay theories propose that negative affect plays a causal role in problematic alcohol use. Despite this common belief, supporting experimental evidence has been mixed. Thus, the goals of this study were to (a) meta-analytically quantify the degree to which experimentally manipulated negative affect influenced alcohol use and craving in the laboratory, (b) examine whether the size of this effect depended on key manipulation characteristics (i.e., self-relevance of the stressor, timing of the end of the stressor, and strength of negative affect induction) or sample characteristics (i.e., substance use history). Across 41 studies (N = 2,403), we found small-to-medium effects for more use (d_av = .31, 95% confidence interval; CI [.11, .50]) and craving (d_av = .39, 95% CI [.04, .74]) following a negative affect manipulation than a control manipulation. We also found a significant increase in craving from pre- to postaffect induction (d_av = .36, 95% CI [.14, .58]). This suggests the mixed results from the prior literature were likely because of statistically underpowered studies. The moderator hypotheses received weak support, with few significant results in the predicted direction. Our meta-analysis provides clarity about a previously inconclusive set of results and highlights the need for more ecologically valid manipulations of affect in future work. (PsycINFO Database Record

Mood and restrained eating moderate food-associated response inhibition in obese individuals with binge eating disorder

Recent research suggests that obese individuals with binge eating disorder (BED) show deficits in response inhibition, but findings are not consistent, especially when food-associated stimuli are presented. The aim of the present study was to assess the role of moderating factors by taking into account restrained eating and mood. Seventeen obese women with BED, 20 obese women without BED and 20 normal-weight controls (NW) were recruited. A go/no-go task with food-associated and control stimuli and questionnaires were administered. Obese BED showed less impairment of response inhibition to food-associated than to control stimuli, while this pattern was reversed in NW; no differences were observed for obese participants. Interestingly, group differences were moderated by the interaction of restrained eating and mood, and obese BED made the most commission errors to food-associated stimuli when they were restrained eaters and in a very positive mood at the time of testing. Our results might explain why some studies did not observe deficits in response inhibition to food-associated cues in BED.

Intra- and Interindividual Variability in the Behavioral, Affective, and Perceptual Effects of Alcohol Consumption in a Social Context

BACKGROUND

We examined the influence of interindividual differences in alcohol use on the intraindividual associations of drinking occurrence with interpersonal behaviors, affect, and perceptions of others during naturally occurring social interactions.

METHODS

For 14 consecutive days, 219 psychology freshmen (55% female; M_age  = 20.7 years, SD = 2.18) recorded their behaviors, affect, and perceptions in social interactions soon after an interpersonal event occurred. Interpersonal behaviors and perceptions were assessed in terms of dominance-submissiveness and agreeableness-quarrelsomeness. Participants also reported the number of alcoholic drinks consumed within 3 hours of each interaction. We considered the intraindividual associations of (i) having a drinking episode and (ii) the number of drinks during an episode with behaviors, affect, and perceptions and examined interindividual differences in drinking frequency and intensity during social interactions as potential moderators of these associations.

RESULTS

Social drinking frequency and intensity moderated the associations between drinking episode and behaviors, affect, and perceptions in social interactions. During a drinking episode, more frequent social drinkers perceived others as more dominant than less frequent social drinkers. During a drinking episode in which more alcohol was consumed than usual, more frequent social drinkers also reported behaving more dominantly and experiencing less pleasant affect.

CONCLUSIONS

As more frequent social drinkers had different interpersonal responses to drinking than less frequent social drinkers, including when they had consumed larger amounts of alcohol than usual, our results suggest a differential susceptibility to the effects of alcohol during naturally occurring social interactions among drinkers with varying drinking frequency.

WISDM Primary and Secondary Dependence Motives: Associations With Smoking Rate, Craving, and Cigarette Effects in the Natural Environment

Introduction

The Wisconsin Inventory of Smoking Dependence Motives (WISDM) is a multidimensional measure of smoking motives that was developed to facilitate research aiming to refine the nomological network surrounding tobacco dependence. Recent evidence suggests that a composite of four subscales, termed the Primary Dependence Motives (PDM), may represent core features of advanced addiction, while the remaining nine subscales (Secondary Dependence Motives; SDM) represent instrumental motives for cigarette use that may be relevant at any stage of smoking.

Methods

A sample of 255 smokers (all regular alcohol users) participated in an ecological momentary assessment study in which they monitored smoking behavior and related experiences for 21 days. Multilevel regression analyses tested how PDM and SDM predicted daily smoking rate, cigarette craving, and appraisals of pleasure and relief of unpleasant feelings from smoking.

Results

When PDM and SDM were entered simultaneously, only PDM was related to daily cigarette count, and only SDM predicted reports of craving and relief from unpleasant feelings from smoking. SDM was associated with reports of greater pleasure from smoking and PDM was associated with lower pleasure ratings. The Fagerström Test for Nicotine Dependence (FTND) was related to daily smoking rate and craving, but WISDM composites contributed incremental prediction.

Conclusions

The findings confirm that PDM indexes heavier use that is relatively unrelated to immediate consequences of smoking. SDM is not uniquely related to smoking heaviness, but is associated with craving and reports of pleasure and relief of unpleasant feelings derived from smoking during ad lib use.

Implications

This study extends the evidence for the distinction between the WISDM PDM and SDM. PDM scores are associated with heavier smoking and are relatively unrelated to immediate consequences of smoking. SDM is more strongly related to craving and reports of smoking-derived pleasure and relief of unpleasant feelings during ongoing use in daily life.

Craving and acute effects of alcohol in youths' daily lives: Associations with alcohol use disorder severity

Identifying factors associated with the progression from recreational to pathological drinking in youth holds high clinical and theoretical importance. The present study tested cross-sectional associations of alcohol use disorder (AUD) severity with putative mechanisms of AUD progression among youth ages 15-24 years, namely acute subjective effects of alcohol and craving. Male (n = 44) and female (n = 42) youth completed ecological momentary assessments when not drinking, just before drinking, and while drinking in the natural environment via handheld wireless devices. Youth were recruited from the community and were frequent and heavy drinkers, the majority (93%) with at least 1 AUD symptom (M = 3.4, SD = 2.4). Findings from youths' daily lives suggested that how youth feel while they drink depends, in part, on their severity of AUD pathology. In support of hypotheses, youths with more progressed drinking pathology (i.e., those with more symptoms of AUD) reported greater reductions in craving and tension while drinking, relative to nondrinking times. In partial support of hypotheses, males with greater AUD symptomatology reported marginally attenuated increases in stimulatory states while drinking; however, contrary to hypotheses, females with greater AUD symptomatology reported enhanced increases in stimulation while drinking. This research leveraged ecological momentary assessment methods to study subjective responses to alcohol and craving in youths' daily lives and to cross-sectionally test putative associations with AUD etiology. This work adds to literature supporting subjective responses to alcohol in the pathogenesis of alcoholism, specifically by highlighting their importance during the period in life when alcohol problems typically first emerge. (PsycINFO Database Record

Naltrexone moderates the relationship between cue-induced craving and subjective response to methamphetamine in individuals with methamphetamine use disorder

RATIONALE

Reductions in cue-induced craving and subjective response to drugs of abuse are commonly used as initial outcome measures when testing novel medications for the treatment of addiction. Yet neither the relationship between these two measures at the individual level nor the moderating effects of pharmacotherapies on this relationship has been examined.

OBJECTIVE

This secondary data analysis sought to examine (1) the predictive relationship between cue-induced craving and subsequent acute subjective response to methamphetamine (MA) and (2) whether the opioid-receptor antagonist naltrexone moderated this association in a sample of non-treatment-seeking individuals who met DSM-IV criteria for MA use disorder (abuse or dependence).

METHODS

Participants (n = 30) completed two 4-day medication regimens (oral naltrexone 50 mg or placebo, in a randomized, counterbalanced, and double-blind fashion). On day 4 of each medication regimen, participants completed a cue-reactivity paradigm followed by intravenous MA administration. Methamphetamine craving was assessed after the cue-reactivity paradigm, and subjective response to MA was assessed during MA infusion.

RESULTS

Cue-induced craving for MA was positively associated with post-infusion subjective MA effects, including positive (i.e., stimulation, good effects, feel drug, high), negative (i.e., anxious and depressed), and craving-related (i.e., want more, would like access to drug, crave) responses. Naltrexone, vs. placebo, significantly reduced the association between cue-induced craving and positive subjective response to MA.

CONCLUSIONS

The findings indicate that naltrexone moderates the predictive relationship between cue-induced craving and positive subjective effects of MA, thereby suggesting a behavioral mechanism by which naltrexone may be efficacious in treating MA use disorder.

Who initiates and organises situations for work-related alcohol use? The WIRUS culture study

Aims: Alcohol is one of the leading causes of ill health and premature death in the world. Several studies indicate that working life might influence employees’ alcohol consumption and drinking patterns. The aim of this study was to explore work-related drinking situations, with a special focus on answering who initiates and organises these situations. Methods: Data were collected through semi-structured group interviews in six Norwegian companies from the private ( n=4) and public sectors ( n=2), employing a total of 3850 employees. The informants ( n=43) were representatives from management and local unions, safety officers, advisers from the social insurance office and human-resource personnel, health, safety and environment personnel, and members from the occupational environment committee. Both qualitative and quantitative content analyses were applied in the analyses of the material. Results: Three different initiators and organisers were discovered: the employer, employees and external organisers. External organisers included customers, suppliers, collaborators, sponsors, subcontractors, different unions and employers’ organisations. The employer organised more than half of the situations; external organisers were responsible for more than a quarter. The differences between companies were mostly due to the extent of external organisers. Conclusions: The employer initiates and organises most situations for work-related alcohol use. However, exposure to such situations seems to depend on how many external relations the company has. These aspects should be taken into account when workplace health-promotion initiatives are planned.

Impact of alcohol use motives and internalizing symptoms on mood changes in response to drinking: An ecological momentary assessment investigation

BACKGROUND

Theory implies that individuals who use alcohol to cope with negative emotions experience the acute mood-altering effects they desire. However, no study to date has directly tested whether alcohol coping motives map onto alcohol-induced changes in mood in real-time or how co-occurring internalizing symptoms (i.e., depression and anxiety) impact the relation between coping motives and alcohol-induced changes in mood.

METHOD

The current study tested the unique and interactive effects of alcohol coping motives and internalizing symptoms on mood changes during drinking using ecological momentary assessment (EMA) in a sample of young adults (n=257). Participants completed a battery of questionnaires and a 7-day EMA assessment protocol.

RESULTS

In general, alcohol use was associated with greater positive mood and reduced negative mood while drinking. However, individuals who reported that they use alcohol to cope with anxiety, but not depression, experienced less mood benefits from alcohol relative to those without mood coping motives. In contrast, individuals with high internalizing symptoms experienced greater mood benefits while drinking relative to those with low levels of internalizing symptoms; and at high levels of anxiety, alcohol consumption was reinforcing for everyone regardless of coping motives. Only at low levels of anxiety symptoms, did coping with anxiety motives attenuate alcohol's acute reinforcing effects.

CONCLUSIONS

These results together confirm that alcohol has a robust impact on real-time mood in young adults and sheds light on the processes that may contribute to repeated alcohol use within individuals who do, and do not, use alcohol as a means of coping.

The natural expression of individual differences in self-reported level of response to alcohol during ecologically assessed drinking episodes

RATIONALE

Low sensitivity to alcohol is a well-established risk factor for alcohol use disorder (AUD). However, little is known about how the low sensitivity phenotype is expressed on a fine-grained, momentary level in drinkers' daily experience.

OBJECTIVES

The objective of the study is to evaluate individual differences in subjective states and appraisals of alcoholic beverages during the ascending limb of real-world drinking episodes.

METHODS

Social drinkers (N = 398) with varying degrees of alcohol sensitivity as indexed by the Self-Rating of the Effects of Alcohol form (SRE; Schuckit et al. in Addiction 92:979-988, 1997a) recorded diary entries over a 3-week monitoring period (2576 drinking episodes containing 6546 moments). Hierarchical linear modeling was used to evaluate whether individual differences in alcohol sensitivity predicted differing intra-episode estimated blood alcohol concentration (eBAC) trajectories, ratings of subjective states, and drink appraisals.

RESULTS

Lower self-reported alcohol sensitivity was associated with consuming "too much, too fast," as indicated by a steeper slope of ascending eBAC. In models adjusted for momentary eBAC level, participants reporting lower alcohol sensitivity at baseline showed blunted subjective intoxication and drink-contingent punishment.

CONCLUSIONS

The results suggest that low sensitivity to alcohol is associated with a blunting of some forms of subjective feedback (i.e., perceptions of intoxication and punishment) that might typically encourage drinking restraint. This may 'tip the scales' toward excess consumption and could help to explain why a low alcohol sensitivity forecasts AUD.

Emerging Pharmacologic Treatments for Adolescent Substance Use: Challenges and New Directions

Adolescence is a key period in the development of substance use and misuse. Substance use typically begins during adolescence and prevalence rates for many substance use disorders peak before age 21 years. Yet, despite clinical demand, treatments for youth rely almost entirely on psychosocial interventions that yield only modest benefit. One potential way to improve treatment effects is to augment the best available psychosocial interventions with pharmacotherapy. Although pharmacotherapy research has advanced care for adults with substance use disorders, no medication is indicated for adolescents and controlled trials with teenagers are scant. Optimizing treatments for youth will require closing this important gap in medication development research. In this paper we review the paucity of pharmacotherapy research for adolescent substance misuse, and we discuss how we can leverage human laboratory paradigms and technology to advance our understanding regarding if and how medications may improve treatment options for youths.

Developing an Internet- and Mobile-Based System to Measure Cigarette Use Among Pacific Islanders: An Ecological Momentary Assessment Study

BACKGROUND

Recent prevalence data indicates that Pacific Islanders living in the United States have disproportionately high smoking rates when compared to the general populace. However, little is known about the factors contributing to tobacco use in this at-risk population. Moreover, few studies have attempted to determine these factors utilizing technology-based assessment techniques.

OBJECTIVE

The objective was to develop a customized Internet-based Ecological Momentary Assessment (EMA) system capable of measuring cigarette use among Pacific Islanders in Southern California. This system integrated the ubiquity of text messaging, the ease of use associated with mobile phone apps, the enhanced functionality offered by Internet-based Cell phone-optimized Assessment Techniques (ICAT), and the high survey completion rates exhibited by EMA studies that used electronic diaries. These features were tested in a feasibility study designed to assess whether Pacific Islanders would respond to this method of measurement and whether the data gathered would lead to novel insights regarding the intrapersonal, social, and ecological factors associated with cigarette use.

METHODS

20 young adult smokers in Southern California who self-identified as Pacific Islanders were recruited by 5 community-based organizations to take part in a 7-day EMA study. Participants selected six consecutive two-hour time blocks per day during which they would be willing to receive a text message linking them to an online survey formatted for Web-enabled mobile phones. Both automated reminders and community coaches were used to facilitate survey completion.

RESULTS

720 surveys were completed from 840 survey time blocks, representing a completion rate of 86%. After adjusting for gender, age, and nicotine dependence, feeling happy (P=<.001) or wanting a cigarette while drinking alcohol (P=<.001) were positively associated with cigarette use. Being at home (P=.02) or being around people who are not smoking (P=.01) were negatively associated with cigarette use.

CONCLUSIONS

The results of the feasibility study indicate that customized systems can be used to conduct technology-based assessments of tobacco use among Pacific Islanders. Such systems can foster high levels of survey completion and may lead to novel insights for future research and interventions.