Different drinking motives, different adverse consequences? Evidence among adolescents from 10 European countries

Perceived psychological control relates to coping-related drinking motives via social anxiety among adolescents: A cross-sectional mediation analysis

Accumulating evidence suggests that particular parenting behaviors (e.g., elevated psychological control) may increase risk for both problematic social anxiety and alcohol use among youth; however, no work has yet examined these factors together in a single model. Building developmentally sensitive models of problematic alcohol use trajectories is key to developing effective prevention and intervention strategies. The present study includes 94 adolescents (ages 14-17 years; 53.3% girls; 89.2% White) entering a treatment facility for a variety of internalizing and externalizing forms of psychological distress. Levels of perceived parental psychological control, social anxiety, and coping-related drinking motives were assessed. Higher levels of perceived psychological control were associated with a greater endorsement of coping-related drinking motives; however, a significant proportion of that association was accounted for by elevated social anxiety symptoms. These data extend the existing literature and lay groundwork for more sophisticated experimental and longitudinal designs to corroborate the findings. Moreover, personality-targeted drinking interventions for adolescents may benefit from identifying elevated perceived psychological control as a developmentally relevant risk factor for social anxiety and problematic drinking motives and administering relevant interventions (e.g., personality-targeted coping skills training, parent-involved care) before drinking patterns are established.

Development and Validation of the Maternal Drinking Motives Scale (M-DMS)

BACKGROUND

Alcohol use is a gendered behavior and motherhood is a life stage which may influence drinking motives. However, there are no drinking motive scales uniquely tailored to maternal populations. This work developed a new maternal drinking motives scale (M-DMS) and determined associations between the M-DMS and alcohol-related behavior.

METHODS

An online observational survey (n = 534) and online test-retest survey (n = 164) were conducted with adult, UK mothers. From the observational study, data on drinking motives was extracted to determine M-DMS items and factor loading. This was split into two data sets for exploratory and confirmatory factor analyses. Alcohol Use Disorders Identification Test (AUDIT) and Timeline Follow back data, taken from both surveys, were combined to determine the M-DMS's predictive validity.

RESULTS

Following a parallel analysis and exploratory factor analysis, a two-factor model (positive reinforcement motives, negative reinforcement motives) was deemed the best fit. Probability functional analysis identified items with problematic responses. These were removed before confirmatory factor analysis (on the second dataset) demonstrated a good fit for the two-factor model. All factor loadings were significant and positive (βs > 0.56). Reliability of the two subscales was excellent: negative reinforcement (ωT = 0.95), positive reinforcement (ωT = 0.89). Test-retest reliability was good for both negative (ICC = 0.84, 95%CI = 0.80-0.88) and positive (ICC = 0.77, 95% CI = 0.71-0.82) subscales. Both subscales predicted AUDIT and quantity of alcohol consumption (ps < 0.001).

CONCLUSION

The first tailored Maternal Drinking Motives Scale (M-DMS) provides a more valid research tool for assessing psychological mechanisms of alcohol use in mothers.

Coping motives as a mediator of the relationship between child maltreatment and substance use problems in south African adolescents

BACKGROUND

Evidence suggests that adults with a history of child maltreatment (CM) engage in substance misuse driven by 'coping motives': maladaptive beliefs that substances help them cope with negative emotions. However, the specificity of this risk pathway is under-researched in younger and non-Western cohorts.

OBJECTIVE

The present study aimed to determine whether coping motives play a distinct role compared to other motives for substance use in mediating the relationship between CM and problematic alcohol and marijuana use in a sample of South African adolescents.

PARTICIPANTS AND SETTING

A sample of 688 high school students (M age = 15.03 years; 62.5 % female) in Cape Town, South Africa, completed a cross sectional survey.

METHODS

Participants completed self-report measures of CM exposure, motives for using alcohol and marijuana (coping, enhancement, social and conformity), and alcohol and marijuana related problems. Participants who endorsed using alcohol (N = 180) or marijuana (N = 136) were included in analysis. A parallel mediation model was conducted for each substance (alcohol and marijuana, respectively) to assess which motives mediated the relationship between CM exposure and substance-related problems.

RESULTS

CM exposure predicted both alcohol-and marijuana related problems. The relationship between CM exposure and alcohol-related problems was partially mediated by coping motives (p < .001, 95%CI 0.028, 0.115) and, to a lesser extent, conformity motives (p < .01, 95%CI 0.001, 0.041), but not by social motives or enhancement motives. The relationship between CM exposure and marijuana-related problems was partially mediated by coping motives (p < .001, 95%CI 0.004, 0.037), but not by conformity, social or enhancement motives.

CONCLUSIONS

The findings support the importance of coping motives as a mediator between CM and problematic substance use across different substances of abuse in South African adolescents, and the role of conformity motives in problematic alcohol use. Future research should explore whether these findings hold across other sociocultural contexts, and the utility of interventions to address coping motives for substance use in adolescence.

Genetic associations between alcohol phenotypes and life satisfaction: a genomic structural equation modelling approach

Alcohol use (i.e., quantity, frequency) and alcohol use disorder (AUD) are common, associated with adverse outcomes, and genetically-influenced. Genome-wide association studies (GWAS) identified genetic loci associated with both. AUD is positively genetically associated with psychopathology, while alcohol use (e.g., drinks per week) is negatively associated or NS related to psychopathology. We wanted to test if these genetic associations extended to life satisfaction, as there is an interest in understanding the associations between psychopathology-related traits and constructs that are not just the absence of psychopathology, but positive outcomes (e.g., well-being variables). Thus, we used Genomic Structural Equation Modeling (gSEM) to analyze summary-level genomic data (i.e., effects of genetic variants on constructs of interest) from large-scale GWAS of European ancestry individuals. Results suggest that the best-fitting model is a Bifactor Model, in which unique alcohol use, unique AUD, and common alcohol factors are extracted. The genetic correlation (rg) between life satisfaction-AUD specific factor was near zero, the rg with the alcohol use specific factor was positive and significant, and the rg with the common alcohol factor was negative and significant. Findings indicate that life satisfaction shares genetic etiology with typical alcohol use and life dissatisfaction shares genetic etiology with heavy alcohol use.

Drinking motives as a predictor of readiness to change alcohol use

Drinking motives have been identified as important predictors of alcohol consumption. Similarly, the degree of readiness to change (RTC) can predict behavioral changes when drinking alcohol. However, the link between drinking motives and RTC has not been explored in previous research. The aim of this study is to investigate whether the four drinking motives (coping, enhancement, social, conformity) can predict the three stages of RTC (precontemplation, contemplation and action) in relation to alcohol consumption. Two hundred and fifty-two undergraduates’ students completed an online self-assessment survey on Qualtrics that assessed motives for alcohol use, drinking behavior, and RTC. Hierarchical regressions showed that among the four specific drinking motives, coping motives significantly predicted all three stages of RTC; conformity motives positively predicted the action stage of change; social motives negatively predicted the precontemplation and action stages of change; enhancement motives were not significant in predicting RTC stages. These results indicate that the three RTC levels can be predicted by coping, social, and conformity motives, but not by enhancement motives. Additionally, given the importance of coping motives, it might be useful to address and include healthier coping mechanisms as part of clinical interventions and prevention methods to circumvent unsafe drinking behaviors independent of a single RTC stage.

Genetic and environmental etiology of drinking motives in college students

BACKGROUND

Drinking motives are robust proximal predictors of alcohol use behaviors and may mediate distinct etiological pathways in the development of alcohol misuse. However, little is known about the genetic and environmental etiology of drinking motives themselves and their potential utility as endophenotypes.

METHODS

Here, we leverage a longitudinal study of college students from diverse racial/ethnic backgrounds (phenotypic N = 9889, genotypic N = 4855) to investigate the temporal stability and demographic and environmental predictors of four types of drinking motives (enhancement, social, coping, and conformity). Using genome-wide association study (GWAS) and in silico tools, we characterize their associated genes and genetic variants (single nucleotide polymorphisms or SNPs).

RESULTS

Drinking motives were stable across four years of college (ICC >0.74). Some robust environmental predictors of alcohol misuse (parental autonomy granting and peer deviance) were broadly associated with multiple types of drinking motives, while others (e.g., trauma exposure) were type specific. Genome-wide analyses indicated modest SNP-based heritability (14-22%, n.s.) and several suggestive genomic loci that corroborate findings from previous molecular genetic studies (e.g., PECR and SIRT4 genes), indicating possible differences in the genetic etiology of positive versus negative reinforcement drinking motives that align with an internalizing/externalizing typology of alcohol misuse. Coping motives were significantly genetically correlated with alcohol use disorder diagnoses (r_g  = 0.71, p = 0.001). However, results from the genetic analyses were largely underpowered to detect significant associations.

CONCLUSIONS

Drinking motives show promise as endophenotypes but require further investigation in larger samples to further our understanding of the etiology of alcohol misuse.

Differences and Similarities in Motives to Decrease Drinking, and to Drink in General Between Former and Current Heavy Drinkers-Implications for Changing Own Drinking Behaviour

The evidence on why people initiate or cease drinking is vast; however, little is known regarding why people change their frequency and amount of drinking from intense (heavy or dependent drinking) to recreational (with little risk). Therefore, the purpose of this study was to investigate how drinking motives and motives to decrease drinking differ between former heavy drinkers (problematic and dependent), current dependent, and current recreational drinkers. Data were obtained from four groups of individuals (n = 263) using alcohol with different severity. The participants were Polish young adults aged between 18 and 35 years. About 53% of the sample were women. The Alcohol Use Disorder Identification Test (AUDIT) was used to assess the level of drinking; the Drinking Motive Questionnaire-Revised Short Form (DMQ-R SF) was used to assess drinking motives (social, coping, enhancement, and conformity). The reasons for abstaining and limiting drinking (RALD) instrument was used to assess the RALD. Additionally, a set of questions regarding motives to decrease drinking were analysed. The results show that differences were observed between the investigated groups: the current dependent group scored significantly higher on all the dimensions of drinking motives than the current low-risk group and significantly higher on coping, social, and enhancement motives than former heavy drinkers (both groups). The two groups of former heavy drinkers did not differ from each other on drinking motives. The investigated groups differed on the motives to reduce drinking-low-risk users scored the lowest on all the motives, whereas current dependent-the highest. The differences in motives to decrease drinking between current-depended and former heavy drinkers indicate which motives can be associated with the prevention strategies, programmes, and therapeutic approaches.

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

BACKGROUND

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

Development of emotion regulation across the first two years of college

INTRODUCTION

Emotion regulation is thought to develop substantially from late adolescence into early adulthood; further, the rate of development purportedly varies based on personal and contextual characteristics. However, little research has explicitly documented this maturation in young adulthood or identified its determinants. We aimed to (1) characterize how adaptive (positive reappraisal, emotional social support-seeking) and maladaptive (suppression, substance use coping) emotion regulation strategies changed over time and (2) predict change in each strategy based on baseline personal, social, and motivational characteristics.

METHODS

We followed a sample of 1578 students entering university in the northeastern United States across their first two years, assessing them four times.

RESULTS

As expected, social support-seeking increased and suppression decreased. However, contrary to expectations, cognitive reappraisal declined over time while substance use coping increased. Women generally used more adaptive emotion regulation strategies than did men; social engagement and connection and eudaimonic well-being were generally predictive of using more adaptive coping over time.

CONCLUSIONS

Overall, students did not consistently demonstrate maturation to more adaptive emotion regulation and in fact exhibited decrements over the first two years of college. Students' baseline characteristics accounted for substantial degrees of change in emotion regulation. These findings suggest potentially fruitful directions for interventions to assist college students in developing more adaptive emotion regulation skills.

Copattern of depression and alcohol use in medical care patients: cross-sectional study in Germany

OBJECTIVE

To predict depressive symptom severity and presence of major depression along the full alcohol use continuum.

DESIGN

Cross-sectional study.

SETTING

Ambulatory practices and general hospitals from three sites in Germany.

PARTICIPANTS

Consecutive patients aged 18-64 years were proactively approached for an anonymous health screening (participation rate=87%, N=12 828). Four continuous alcohol use measures were derived from an expanded Alcohol Use Disorder Identification Test (AUDIT): alcohol consumption in grams per day and occasion, excessive consumption in days per months and the AUDIT sum score. Depressive symptoms were assessed for the worst 2-week period in the last 12 months using the Patient Health Questionnaire (PHQ-8). Negative binomial and logistic regression analyses were used to predict depressive symptom severity (PHQ-8 sum score) and presence of major depression (PHQ-8 sum score≥10) by the alcohol use measures.

RESULTS

Analyses revealed that depressive symptom severity and presence of major depression were significantly predicted by all alcohol use measures after controlling for sociodemographics and health behaviours (p<0.05). The relationships were curvilinear: lowest depressive symptom severity and odds of major depression were found for alcohol consumptions of 1.1 g/day, 10.5 g/occasion, 1 excessive consumption day/month, and those with an AUDIT score of 2. Higher depressive symptom severity and odds of major depression were found for both abstinence from and higher levels of alcohol consumption. Interaction analyses revealed steeper risk increases in women and younger individuals for most alcohol use measures.

CONCLUSION

Findings indicate that alcohol use and depression in medical care patients are associated in a curvilinear manner and that moderation by gender and age is present.

Adolescents who experienced negative alcohol-related consequences are willing to experience these consequences again in the future

Alcohol use and risky single occasion drinking are common among adolescents and are associated with a higher risk of various negative social, physical, academic, or sexual consequences. Studies have shown that among college students, willingness to experience negative consequences is associated with a higher likelihood of experiencing these consequences in the future. However, it remains unclear how experiencing negative consequences influences adolescents' willingness to experience them again. Based on a representative sample of 1,333 alcohol-using 14- to 15-year-olds (47.9% female), a path model was used to examine the associations between risky drinking, negative social and physical consequences, and willingness to experience the specific consequence in the future. As hypothesized, more frequent risky drinking was positively associated with experiencing negative consequences (i.e., saying or doing embarrassing things, regretted sexual experiences, impairment of schoolwork, problems with parents/friends, accident or injury, hangover, vomiting, memory lapses). Contrary to our second hypothesis, adolescents who experienced a negative consequence were also consistently willing to experience it in the future. Findings suggest that adolescents may see the experience of negative consequences as a necessary evil to attain the positive consequences. Prevention efforts may benefit from focusing on ways of attaining positive consequences by promoting alternatives to engaging in risky drinking practices, as well as reducing negative consequences (e.g., by promoting protective behavioral strategies). (PsycINFO Database Record

Are Drinking Motives Universal? Characteristics of Motive Types in Alcohol-Dependent Men from Two Diverse Populations

BACKGROUND AND AIMS

Since alcohol use disorders are among the most prevalent and destructive mental disorders, it is critical to address factors contributing to their development and maintenance. Drinking motives are relevant driving factors for consumption. Identifying groups of drinkers with similar motivations may help to specialize intervention components and make treatment more effective and efficient. We aimed to identify and describe distinct motive types of drinkers in dependent males from two diverse cultures (Uganda and Germany) and to explore potential differences and similarities in addiction-related measures. Moreover, we investigated specific links between motive types and childhood maltreatment, traumatic experiences, and symptoms of comorbid psychopathologies.

METHODS

To determine distinct drinking motive types, we conducted latent class analyses concerning drinking motives (Drinking Motive Scale) in samples of treatment-seeking alcohol-dependent men (N = 75). Subsequently we compared the identified motive types concerning their alcohol consumption and alcohol-related symptoms (Alcohol Use Disorders Identification Test), history of childhood maltreatment (Childhood Trauma Questionnaire), trauma exposure (Violence, War and Abduction Exposure Scale), psychopathology (Posttraumatic Stress Diagnostic Scale, Depression-section of the Hopkins Symptom Checklist, and Brief Symptom Inventory) and deficits in emotion regulation (Difficulties in Emotion Regulation Scale).

RESULTS

We found two congruent drinking motive types in both contexts. Reward-oriented drinking motives like the generation of positive feelings and enhancing performance were endorsed almost equally by both motive types, whereas high relief motive endorsement characterized one group, but not the other. The relief motive type drank to overcome aversive feelings, withdrawal, and daily hassles and was characterized by higher adversity in general. Emotional maltreatment in childhood and psychopathological symptoms were reported to a significantly greater extent by relief drinkers (effect sizes of comparisons ranging from r = 0.25 to r = 0.48). However, the motive types did not differ significantly on alcohol consumption or alcohol-related symptoms and traumatic experiences apart from childhood maltreatment.

CONCLUSION

The chronology of addiction development and patterns of drinking motivation seem to be similar across cultures, i.e., that motive targeting interventions might be applicable cross-culturally. Addressing comorbid symptomatology should be a key treatment component for relief drinkers, whereas finding alternatives for the creation of positive feelings and ways to counteract boredom and inactivity should be a general treatment element.