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Lau-Barraco C, Stamates AL, Ehlke SJ, Glenn DJ. Differential Pathways of Risky Drinking via Coping Motives in College and Noncollege Young Adults. ADDICTION RESEARCH & THEORY 2022; 31:127-136. [PMID: 37200537 PMCID: PMC10187969 DOI: 10.1080/16066359.2022.2127693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 09/15/2022] [Accepted: 09/20/2022] [Indexed: 05/20/2023]
Abstract
The current study tested a mediation model of psychological functioning (i.e., perceived stressors, psychological distress, and self-regulation) and risky drinking through a drinking to cope pathway comparing college and noncollege young adults. Participants were 623 young adult drinkers (M age = 21.46) who completed an online survey. Multigroup analyses examined the proposed mediation model for college students and nonstudents. For nonstudents, the indirect effects of psychological distress to alcohol use outcomes (i.e., alcohol quantity, binge drinking frequency, and alcohol-related problems) via coping motives was significant. Further, coping motives significantly mediated the positive effects of self-regulation on alcohol quantity, binge drinking frequency, and alcohol-related problems. For students, greater psychological distress was associated with greater coping motives, which in turn, related to greater alcohol-related problems. Coping motives significantly mediated the positive effect of self-regulation on binge drinking frequency. Findings highlight the different pathways that may result in risky drinking and alcohol problems based on young adult's educational attainment. These results have important clinical implications, particularly for those who have not attended college.
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Affiliation(s)
- Cathy Lau-Barraco
- Old Dominion University
- Virginia Consortium Program in Clinical Psychology
| | | | - Sarah J. Ehlke
- Old Dominion University
- TSET Health Promotion Research Center, University of Oklahoma Health Sciences Center
| | - Douglas J. Glenn
- Old Dominion University
- Virginia Consortium Program in Clinical Psychology
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2
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Chartier KG, Bares CB, Prom-Wormley EC, Blondino C, Miles K, Lee AG, Karriker-Jaffe KJ. Effects of family history of alcohol problems on alcohol consumption: Stronger for medically underserved men. Prev Med 2022; 161:107093. [PMID: 35597304 DOI: 10.1016/j.ypmed.2022.107093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 03/22/2022] [Accepted: 05/13/2022] [Indexed: 11/28/2022]
Abstract
Family history (FH), informed by genetics and family environment, can be used by practitioners for risk prediction. This study compares the associations of FH with alcohol outcomes for medically underserved (MUS) men and women with the associations for non-underserved individuals to assess the utility of FH as a screening tool for this high-priority group. Data were from 29,993 adult lifetime drinkers in the Wave 1 (2001-2002) and Wave 2 (2004-2005) National Epidemiologic Survey on Alcohol and Related Conditions. All variables except FH were measured at Wave 2. Dependent variables were 12-month alcohol consumption and alcohol use disorder (AUD). FH scores (FH-SCORE) measured the proportion of first- and second-degree biological relatives with alcohol problems. MUS status was defined by household income at or below 100% of the federal poverty line and participants reporting no usual source of health care. Multivariate linear and logistic regression models tested main and interaction effects. Models showed a significant interaction of FH-SCORE with MUS status (p < .01), with a stronger effect of FH on alcohol consumption for the MUS group. This moderating effect was weaker for women than for men (FH-SCORE x MUS x Sex three-way interaction: p < .01). AUD models showed a significant positive association with FH-SCORE (p < .001) but no association with MUS status and no significant interaction effects. In this sample of lifetime drinkers, FH was associated with higher alcohol consumption, especially for MUS men. These results encourage additional validation of FH scores to prioritize MUS adults at high risk for alcohol problems to receive preventive interventions.
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Affiliation(s)
- Karen G Chartier
- School of Social Work and Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, United States of America.
| | - Cristina B Bares
- School of Social Work, The University of Michigan, Ann Arbor, MI, United States of America
| | - Elizabeth C Prom-Wormley
- School of Medicine, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Courtney Blondino
- School of Medicine, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Kia Miles
- School of Medicine, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Anna G Lee
- School of Medicine, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Katherine J Karriker-Jaffe
- Center for Behavioral Health Epidemiology, Implementation & Evaluation Research, RTI International, Berkeley, CA, United States of America
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Santora L, Byrne D, Klöckner C. Clusters of older adults with and without experience of alcohol-related harms based on affective motivations for drinking. NORDIC STUDIES ON ALCOHOL AND DRUGS 2022; 39:379-405. [PMID: 36003125 PMCID: PMC9379293 DOI: 10.1177/14550725211073006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 12/22/2021] [Indexed: 11/17/2022] Open
Abstract
Aim: This cross-sectional study explores profiles of community-residing Norwegian older adults (aged 62–95 years) in relation to their personally expressed motives for alcohol use. It specifically investigates drinking motives as they uniquely characterise alcohol consumers reporting problem and non-problem drinking assessed using the Drinking Problem Index (DPI). Methods: Two-step cluster analysis was used to delineate subgroups of alcohol consumers on seven drinking motivation variables, together with DPI score. The clusters were evaluated by gender, physical health and psychological health status. Results: Four clusters of alcohol consumers were identified in relation to drinking motives: Low motivated drinkers, Ambivalent drinkers, Enhancement drinkers, and Coping drinkers. For one subgroup, a strong reliance on alcohol to cope with negative feelings was most relevant to both non-problem and problem drinkers. For another subgroup, enjoying the effects of alcohol, but non-reliance on alcohol to cope with negative mood were associated with reporting drinking problems. Ambivalent drinkers reported overall low satisfaction with mental health. Very poor physical and mental health were more prevalent in men than in women characterised as Coping drinkers. Predominantly mental health status supported distinctiveness of delineated clusters. Conclusion: This study demonstrates that the classification approach to profiling of characteristics of alcohol consumers based on their motivations to drink may have a potential utility in human care settings to identify individuals who incur or may be at risk of developing alcohol-related problems in later life, and those who are not.
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Affiliation(s)
- Lidia Santora
- Norwegian University of Science and Technology, Trondheim, Norway; and Australian National University, Canberra, Australia
| | - Don Byrne
- Australian National University, Canberra, Australia
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Stevens AK, Drohan MM, Boyle HK, White HR, Jackson KM. More Reasons, More Use and Problems? Examining the Influence of Number of Motives on Consumption and Consequences Across Alcohol-Only, Cannabis-Only, and Simultaneous-Use Days. J Stud Alcohol Drugs 2021; 82:782-791. [PMID: 34762038 PMCID: PMC8819619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 04/12/2021] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE Alcohol and cannabis use as well as their simultaneous use are common among U.S. college students. Reasons for use are proximal predictors of consumption and consequences. Little research has examined possible adverse effects of endorsing multiple motives on a given use day. We examined the effects of the number of motives on consumption and negative consequences for alcohol-only, cannabis-only, and simultaneous-use days. METHOD College students (N = 341; 53% women; mean age = 19.79 years) who reported past-month simultaneous alcohol and cannabis use completed 54 days of data collection. We used generalized linear mixed-effects models to examine the effects of endorsing multiple motives on consumption and consequences. RESULTS Across models, endorsing more motives than typical on a given use day (within person) and more motives in general (between person) was related to greater alcohol and cannabis consumption. Endorsing more alcohol-only motives and cannabis-only motives than typical resulted in greater odds of experiencing a negative consequence when accounting for consumption. This within-person effect was not statistically significant for simultaneous-use motives/consequences. Endorsing a greater number of motives across the study (i.e., between person) was not significantly related to consequences beyond consumption. CONCLUSIONS Research has documented the robust effects of specific motives on substance use outcomes. Our novel findings extend this work by demonstrating the risks associated with endorsing multiple motives on a given use day. In addition to motive type, we recommend that the number of motives endorsed on a given day be considered as a potential risk factor to be targeted to reduce harms associated with substance use.
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Affiliation(s)
- Angela K. Stevens
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
| | - Megan M. Drohan
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island
| | - Holly K. Boyle
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
| | - Helene R. White
- Center of Alcohol and Substance Use Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Kristina M. Jackson
- Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
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Waddell JT, Sher KJ, Piasecki TM. Coping motives and negative affect: An ecological study of the antecedents of alcohol craving and alcohol use. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2021; 35:565-576. [PMID: 33507786 PMCID: PMC8316487 DOI: 10.1037/adb0000696] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
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).
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Karriker-Jaffe KJ, Chartier KG, Bares CB, Kendler KS, Greenfield TK. Intersection of familial risk and environmental social control on high-risk drinking and alcohol dependence in a US national sample of adults. Addict Behav 2021; 113:106668. [PMID: 33045642 PMCID: PMC7524522 DOI: 10.1016/j.addbeh.2020.106668] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Effects of a family history of alcoholism may be moderated by area-level social control factors. We examine whether increased neighborhood alcohol availability (low social control environment) or increased presence of religious adherents in the county (high social control environment) interact with family history in relation to alcohol outcomes. METHODS Weighted data from 12,686 adult drinkers (51% male; mean age 44; 80% White, 9% Black, 11% Hispanic) in three US National Alcohol Surveys were linked with data on area-level off-premise alcohol availability and adherence to religions with strong prohibitions against drinking. Family history density had four levels (family history negative, extended family only, first-degree relative(s) only, high family density). Dichotomous outcomes were past-year high-risk drinking and alcohol dependence. Logistic regression models with interaction terms assessed whether associations of family history with alcohol outcomes differed significantly by area-level social control. Stratified models assessed differences by sex and by race/ethnicity. RESULTS In the full sample, effects of first-degree relatives and high family density on high-risk drinking strengthened as alcohol availability increased. This was replicated in the subsample of women and suggested in relation to dependence among men and Black drinkers. For White drinkers, higher religious social control reduced effects of first-degree relatives on high-risk drinking. CONCLUSIONS Low social control-in particular, greater density of off-premise alcohol outlets-appears to exacerbate effects of a family history of alcoholism on high-risk drinking. Policy makers should consider differential benefits of decreasing alcohol availability for people from high-risk families to reduce high-risk drinking and alcohol problems.
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Affiliation(s)
| | - Karen G Chartier
- Virginia Commonwealth University, School of Social Work and Department of Psychiatry, Richmond, VA 23284, USA
| | - Cristina B Bares
- University of Michigan, School of Social Work, Ann Arbor, MI 48109, USA
| | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry and Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Thomas K Greenfield
- Alcohol Research Group, Public Health Institute, Emeryville, CA 94608-1010, USA
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7
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Gonzalez VM, Halvorsen KAS. Mediational Role of Drinking to Cope in the Associations of Depression and Suicidal Ideation with Solitary Drinking in Adults Seeking Alcohol Treatment. Subst Use Misuse 2021; 56:588-597. [PMID: 33673785 DOI: 10.1080/10826084.2021.1883661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
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.
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Affiliation(s)
- Vivian M Gonzalez
- Department of Psychology, University of Alaska Anchorage, Anchorage, Alaska, USA
| | - Kevin A S Halvorsen
- Department of Psychology, University of Alaska Anchorage, Anchorage, Alaska, USA
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8
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Karriker-Jaffe KJ, Drabble L, Trocki KF, Hughes TL, Greenfield TK. Harm from Others' Drinking Among Sexual Minority Adults in the United States. LGBT Health 2020; 8:50-59. [PMID: 33337273 DOI: 10.1089/lgbt.2020.0011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose: Due to discrimination and stigma, sexual minority adults may be more likely than their heterosexual counterparts to experience harms from other people's drinking. We compared prevalence of second-hand alcohol harms for sexual minority and heterosexual adults in the United States. Methods: Data from the 2014-15 U.S. National Alcohol Survey (n = 5516; 10.2% sexual minority adults) were analyzed using logistic regression with survey weights to account for sampling and nonresponse. Multivariable models included simple main effects of sexual identity on the past-year harm outcomes, as well as interactions of drinker status with sexual identity. Results: In bivariate results stratified by sex, bisexual women were significantly more likely than heterosexual women to report all five types of harms. Lesbian respondents had greater odds relative to heterosexual women of reporting harm by a friend/coworker and assault or physical harm by a drinker. Bisexual identity among men was associated with greater odds of reporting assault/physical harm relative to heterosexual men in bivariate models. In adjusted models, differences by sexual identity were substantially reduced, with significance remaining only for friend/coworker-perpetrated harms and assault/physical harm among lesbian respondents compared with heterosexual women. For assault/physical harm, an interaction of sexual identity with the respondent's own drinking showed that the increased odds of harm associated with heavy drinking was even greater among sexual minority respondents (both bisexual and lesbian/gay respondents) than among heterosexual respondents. Conclusion: These findings underscore the importance of preventive interventions that consider disparities in risk for alcohol-related harms, particularly interpersonal violence, among sexual minority adults in the United States.
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Affiliation(s)
| | - Laurie Drabble
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA.,College of Health and Human Sciences, San Jose State University, San Jose, California, USA
| | - Karen F Trocki
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Tonda L Hughes
- School of Nursing and Department of Psychiatry, Columbia University, New York, New York, USA
| | - Thomas K Greenfield
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
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9
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Grant JE, Chamberlain SR. Family history of substance use disorders: Significance for mental health in young adults who gamble. J Behav Addict 2020; 9:289-297. [PMID: 32516117 PMCID: PMC7115917 DOI: 10.1556/2006.2020.00017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 04/18/2020] [Accepted: 04/22/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Although family history of psychiatric disorders has often been considered potentially useful in understanding clinical presentations in patients, it is less clear what a positive family history means for people who gamble in the general community. We sought to understand the clinical and cognitive impact of having a first-degree relative with a substance use disorder (SUD) in a sample of non-treatment seeking young adults. METHODS 576 participants (aged 18-29 years) who gambled at least five times in the preceding year undertook clinical and neurocognitive evaluations. Those with a first-degree relative with a SUD were compared to those without on a number of demographic, clinical and cognitive measures. We used Partial Least Squares (PLS) regression to identify which variables (if any) were significantly associated with family history of SUDs, controlling for the influence of other variables on each other. RESULTS 180 (31.3%) participants had a first-degree family member with a SUD. In terms of clinical variables, family history of SUD was significantly associated with higher rates of substance use (alcohol, nicotine), higher rates of problem gambling, and higher occurrence of mental health disorders. Family history of SUD was also associated with more set-shifting problems (plus higher rates of obsessive-compulsive tendencies), lower quality of decision-making, and more spatial working memory errors. CONCLUSIONS These results indicate that gamblers with a first-degree family member with a SUD may have a unique clinical and cognition presentation. Understanding these differences may be relevant to developing more individualized treatment approaches for disordered gambling. Compulsivity may be important as a proxy of vulnerability towards addiction.
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Affiliation(s)
- Jon E. Grant
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, IL, USA,Corresponding author. Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Pritzker School of Medicine, 5841 S. Maryland Avenue, MC-3077, Chicago, IL, 60637, USA. Tel.: +1 773 834 1325; fax: +1 773 834 6761 E-mail:
| | - Samuel R. Chamberlain
- Department of Psychiatry, University of Cambridge, Cambridge, UK,Cambridge and Peterborough NHS Foundation Trust (CPFT), Cambridge, UK
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Moitra E, Anderson BJ, Herman DS, Hayaki J, Pinkston MM, Kim HN, Stein MD. Examination of using alcohol to cope, depressive symptoms, and perceived social support in persons with HIV and Hepatitis C. AIDS Care 2020; 32:1238-1245. [PMID: 32098484 DOI: 10.1080/09540121.2020.1734177] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Depression is common among people living with HIV (PLWH) and some likely turn to alcohol to cope with this emotional distress. Using alcohol to cope is associated with increased alcohol use, persistent longitudinal alcohol use, and alcohol-related problems. This association is particularly concerning among PLWH who are co-infected with Hepatitis C (HCV) because alcohol adds to the damage already caused by HCV. Despite data showing the associated risks of using alcohol to cope, scant research has examined factors that might contribute to coping-based alcohol use in HIV-HCV patients, such as limited social support. Baseline data from a randomized trial of strategies to reduce alcohol use in co-infected HIV and HCV adult patients (n=110) were analyzed. Multiple linear regression models were used to estimate the association between using alcohol to cope, depression, and four aspects of social support, controlling for demographic variables. Results showed that using alcohol to cope was not significantly correlated with social support but was significantly correlated with depressive symptoms. In fact, depressive symptoms and severity of alcohol consumption accounted for nearly 45% of the variance related to coping-based alcohol use. These data highlight the central role of depression in the coping motives-alcohol use relationship among co-infected patients.
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Affiliation(s)
- Ethan Moitra
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence RI, USA
| | - Bradley J Anderson
- Behavioral Medicine and Addictions Research Unit, Butler Hospital, Providence RI, USA
| | - Debra S Herman
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence RI, USA.,Behavioral Medicine and Addictions Research Unit, Butler Hospital, Providence RI, USA
| | - Jumi Hayaki
- Department of Psychology, College of the Holy Cross, Worcester MA, USA
| | - Megan M Pinkston
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence RI, USA.,Lifespan Physicians Group, Providence RI, USA
| | - H Nina Kim
- Department of Global Health, University of Washington, Seattle WA, USA.,Department of Medicine, University of Washington, Seattle WA, USA
| | - Michael D Stein
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston MA, USA
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Straka BC, Gaither SE, Acheson SK, Swartzwelder HS. “Mixed” Drinking Motivations: A Comparison of Majority, Multiracial, and Minority College Students. SOCIAL PSYCHOLOGICAL AND PERSONALITY SCIENCE 2019. [DOI: 10.1177/1948550619883294] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Social exclusion is associated with substance use, but the specific link between majority and minority racial group membership and substance use is unknown. We examined how social exclusion among racial majority (White), Multiracial, and racial minority (Native American, Latino, Asian, and Black) college students relates to self-reported alcohol use and motivations. Using the AlcoholEdu for College™ survey, Study 1a reports five factors related to motives for initiating or inhibiting alcohol use. Study 1b analyzes majority, Multiracial, and minority college students’ comparative endorsement of these motivations. Study 2 compares these factors with established belonging scales using a separate undergraduate sample. White, Multiracial, Native American, and Latino students displayed the highest proportion of problematic alcohol use. White students endorsed belonging-based drinking motivations, while Multiracial and Asian students endorsed motivations similar to both majority and minority groups. Native American, Latino, and Black students endorsed abstaining motivations more than other groups.
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Affiliation(s)
- Brenda C. Straka
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
| | - Sarah E. Gaither
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Samuel DuBois Cook Center on Social Equity, Center on Health and Society, Duke University, Durham, NC, USA
| | - Shawn K. Acheson
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - H. S. Swartzwelder
- Department of Psychology & Neuroscience, Duke University, Durham, NC, USA
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
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Stapinski LA, Prior K, Newton NC, Deady M, Kelly E, Lees B, Teesson M, Baillie AJ. Protocol for the Inroads Study: A Randomized Controlled Trial of an Internet-Delivered, Cognitive Behavioral Therapy-Based Early Intervention to Reduce Anxiety and Hazardous Alcohol Use Among Young People. JMIR Res Protoc 2019; 8:e12370. [PMID: 30977742 PMCID: PMC6484258 DOI: 10.2196/12370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 01/09/2019] [Accepted: 01/09/2019] [Indexed: 11/13/2022] Open
Abstract
Background The transition to adulthood is a unique developmental period characterized by numerous personal and social role changes and increased opportunities for alcohol consumption. Using alcohol to cope with anxiety symptoms is commonly reported, and young people with anxiety are at a greater risk of hazardous alcohol use and progression to alcohol use disorder. Anxiety and alcohol use tend to fuel each other in an exacerbating feed-forward cycle, leading to difficult-to-treat chronic problems. The peak in onset of anxiety and alcohol disorders suggests this developmental window represents a promising opportunity for early intervention before these problems become entrenched. Objective This study aims to evaluate the efficacy of the Inroads program, a therapist-supported, internet-delivered early intervention for young adults that targets alcohol use, anxiety symptoms, and the interconnections between these problems. Methods A randomized controlled trial will be conducted nationally among young Australians (aged 17-24 years) who experience anxiety symptoms and drink alcohol at hazardous or harmful levels. Participants will be individually randomized on a 1:1 basis to receive the Inroads intervention or assessment plus alcohol guidelines. Participants randomized to the Inroads intervention will receive access to 5 Web-based cognitive behavioral therapy (CBT) modules and weekly therapist support via email and/or phone. The primary outcome assessment will be 8 weeks post baseline, with follow-up assessment 6 months post baseline to determine the sustainability of the intervention effects. Primary outcomes will be the total number of standard drinks consumed in the past month (assessed by the Timeline Follow-Back procedure), severity of alcohol-related harms (assessed by the Brief Young Adult Alcohol Consequences Questionnaire), and anxiety symptoms across multiple disorders (assessed by the Generalized Anxiety Disorder-7). Secondary outcomes will include alcohol outcome expectancies; functional impairment and quality of life; and symptoms of social anxiety, anxious arousal, and depression. Results will be analyzed by intention-to-treat using multilevel mixed effects analysis for repeated measures. Results The study is funded from 2017 to 2020 by Australian Rotary Health. Recruitment is expected to be complete by late-2018, with the 6-month follow-ups to be completed by mid-2019. Results are expected to be published in 2020. Conclusions The study will be the first to evaluate the benefits of a youth-focused early intervention that simultaneously targets anxiety and hazardous alcohol use. By explicitly addressing the interconnections between anxiety and alcohol use and enhancing CBT coping skills, the Inroads program has the potential to interrupt the trajectory toward co-occurring anxiety and alcohol use disorders. The Web-based format of the program combined with minimal therapist support means that if effective, the program could be widely disseminated to reach young people who are not currently able or willing to access face-to-face treatment. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12617001609347; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372748&isReview=true (Archived by WebCite at http://www.webcitation.org/77Au19jmf) International Registered Report Identifier (IRRID) DERR1-10.2196/12370
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Affiliation(s)
- Lexine A Stapinski
- Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia.,The Matilda Centre, University of Sydney, Sydney, Australia
| | - Katrina Prior
- Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia.,The Matilda Centre, University of Sydney, Sydney, Australia
| | - Nicola C Newton
- Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia.,The Matilda Centre, University of Sydney, Sydney, Australia
| | - Mark Deady
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Erin Kelly
- Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia.,The Matilda Centre, University of Sydney, Sydney, Australia
| | - Briana Lees
- Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia.,The Matilda Centre, University of Sydney, Sydney, Australia
| | - Maree Teesson
- Centre of Research Excellence in Mental Health and Substance Use, National Drug & Alcohol Research Centre, University of New South Wales, Sydney, Australia.,The Matilda Centre, University of Sydney, Sydney, Australia
| | - Andrew J Baillie
- The Matilda Centre, University of Sydney, Sydney, Australia.,Faculty of Health Sciences, University of Sydney, Sydney, Australia
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Risi MM, Forkus SR, Roy A, Laforge RG, Rossi JS, Weiss NH. The Mediating Role of Impulsivity Between Psychological Distress and Alcohol Misuse Among College Students at a Historically Black University. J Dual Diagn 2019; 15:95-104. [PMID: 31007151 PMCID: PMC6541518 DOI: 10.1080/15504263.2019.1583398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Objective: Alcohol misuse is prevalent and clinically significant among college students. Psychological distress is one factor that has been found to predict alcohol misuse in this population. However, relatively few investigations examined the association of psychological distress to alcohol misuse or its underlying mechanisms among students attending historically Black colleges and universities (HBCUs). The present study examined whether impulsivity explains the relation between psychological distress and alcohol misuse in this population using structural equation modeling. Methods: Participants were 287 undergraduate students attending an HBCU in the southern United States (Mage = 22.5, 66.3% female, 93.7% Black). Results: Impulsivity was found to significantly mediate the association of psychological distress to alcohol misuse, such that higher levels of psychological distress were associated with greater impulsivity which, in turn, was related to more alcohol misuse. Further analyses indicated that attentional impulsivity significantly mediated the association of psychological distress to alcohol misuse. Conclusions: These findings suggest the utility of targeting impulsivity in interventions aimed at preventing and reducing alcohol misuse among college students attending HBCUs who experience psychological distress.
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Affiliation(s)
- Megan M Risi
- a Department of Psychology , University of Rhode Island , Kingston , RI , USA
| | - Shannon R Forkus
- a Department of Psychology , University of Rhode Island , Kingston , RI , USA
| | - Amanda Roy
- a Department of Psychology , University of Rhode Island , Kingston , RI , USA
| | - Robert G Laforge
- a Department of Psychology , University of Rhode Island , Kingston , RI , USA
| | - Joseph S Rossi
- a Department of Psychology , University of Rhode Island , Kingston , RI , USA
| | - Nicole H Weiss
- a Department of Psychology , University of Rhode Island , Kingston , RI , USA
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Lannoy S, Dormal V, Billieux J, Maurage P. Enhancement motivation to drink predicts binge drinking in adolescence: a longitudinal study in a community sample. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2019; 45:304-312. [PMID: 30601035 DOI: 10.1080/00952990.2018.1550089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Binge drinking, characterized by alternations between intense alcohol intakes and abstinence periods, is the most frequent alcohol-consumption pattern among adolescents and is associated with cognitive impairments. OBJECTIVES It appears crucial to disentangle the psychological factors involved in the emergence of binge drinking in adolescence, and centrally the role played by drinking motives, which are related to binge drinking. METHODS This longitudinal study explored the role of drinking motives (i.e., social order, conformity, enhancement, coping) in the emergence of binge drinking among 144 adolescents (56.3% girls) from the community, who were assessed for alcohol consumption and drinking motives at two times (T1/T2), with a 1-year interval. After data checking, 101 adolescents (12-15 years old; 56.4% girls) constituted the final sample. RESULTS Strong relationships were found between drinking motives and binge drinking. Regression analyses were computed to determine how drinking motives at T1 predicted binge drinking at T2, while controlling for global alcohol use. The statistical model explained 60% of the binge-drinking variance. In particular, enhancement motivation (i.e., the search for the enjoyable sensations felt when drinking) constituted the unique predictor of future binge drinking. Conversely, social motives did not predict binge drinking. CONCLUSION These findings highlight the central role of enhancement motivation (e.g., focusing on the positive expectancies towards alcohol) in youths' alcohol consumption and call for the development of preventive interventions. The previously reported relationship between social motives and college drinking does not seem to play a key role in the early steps of binge drinking.
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Affiliation(s)
- Séverine Lannoy
- a Laboratory for Experimental Psychopathology, Psychological Science Research Institute , Université catholique de Louvain , Louvain-la-Neuve , Belgium
| | - Valérie Dormal
- a Laboratory for Experimental Psychopathology, Psychological Science Research Institute , Université catholique de Louvain , Louvain-la-Neuve , Belgium
| | - Joël Billieux
- b Addictive and Compulsive Behaviours Lab, Institute for Health and Behaviour , University of Luxembourg , Esch-sur-Alzette , Luxembourg
| | - Pierre Maurage
- a Laboratory for Experimental Psychopathology, Psychological Science Research Institute , Université catholique de Louvain , Louvain-la-Neuve , Belgium
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Posttraumatic stress, alcohol use, and alcohol use reasons in firefighters: The role of sleep disturbance. Compr Psychiatry 2018; 87:64-71. [PMID: 30219373 DOI: 10.1016/j.comppsych.2018.09.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/28/2018] [Accepted: 09/04/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Firefighters are at elevated risk for posttraumatic stress and alcohol use, with research indicating that individuals with posttraumatic stress are likely to use alcohol as a coping strategy. A behavioral mechanism of clinical relevance to these associations is sleep disturbance. Thus, it was hypothesized that higher posttraumatic stress and sleep disturbance would be associated with higher alcohol use and alcohol use coping reasons; and sleep disturbance would moderate the association between posttraumatic stress and alcohol use and alcohol use coping reasons. PROCEDURE Participants included 639 urban career firefighters (93.6% male; 77.9% White; Mage = 38.5). Covariates included fire department years and occupational stress. Structural equation models were tested. RESULTS Posttraumatic stress severity was significantly, positively associated with alcohol use severity and alcohol use coping reasons. Similarly, sleep disturbance severity was significantly, positively associated with alcohol use severity and alcohol use coping reasons. After accounting for covariates and main effects, the interaction of PTSD severity and sleep disturbance was significantly associated with alcohol use severity, with the model accounting for 23.6% of variance, and alcohol use coping reasons, with the model accounting for 37.6% of variance. As predicted, the interaction of posttraumatic stress severity and sleep disturbance was not significantly associated with alcohol use enhancement, conformity, or social reasons. CONCLUSION These findings indicate that posttraumatic stress severity is related to heightened alcohol use severity and alcohol use coping reasons, and this association is markedly stronger when firefighters' levels of sleep disturbance are heightened. Clinical and research implications are to be discussed.
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Weiss NH, Risi MM, Bold KW, Sullivan TP, Dixon-Gordon KL. Daily relationship between positive affect and drinking to cope: the moderating role of difficulties regulating positive emotions. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2018; 45:189-198. [PMID: 30136859 DOI: 10.1080/00952990.2018.1508470] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Alcohol use is highly prevalent and linked to a wide range of negative outcomes among college students. Although emotion dysregulation has been theoretically and empirically linked to alcohol use, few studies have examined emotion dysregulation stemming from positive emotions. OBJECTIVE The goal of the current study was to extend extant research by using daily diary methods to examine the potentially moderating role of difficulties regulating positive emotions in the daily relation between positive affect and alcohol use to cope with social and non-social stressors. METHODS Participants were 165 college students (M age = 20.04; 55.2% male) who completed a baseline questionnaire assessing difficulties regulating positive emotions. Participants then responded to questions regarding state positive emotions and alcohol use once a day for 14 days. RESULTS Difficulties regulating positive emotions moderated the daily relation between positive affect stemming from social stressors and alcohol use to cope with social stressors. Positive affect stemming from social stressors predicted alcohol use to cope with social stressors with high (but not low) levels of difficulties regulating positive emotions. CONCLUSIONS Findings underscore the potential utility of targeting difficulties regulating positive emotions in treatments aimed at reducing alcohol use to cope with social stressors among college students.
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Affiliation(s)
- Nicole H Weiss
- a Department of Psychology , University of Rhode Island , Kingston , RI , USA
| | - Megan M Risi
- a Department of Psychology , University of Rhode Island , Kingston , RI , USA
| | - Krysten W Bold
- b Department of Psychiatry , Yale University School of Medicine , New Haven , CT , USA
| | - Tami P Sullivan
- b Department of Psychiatry , Yale University School of Medicine , New Haven , CT , USA
| | - Katherine L Dixon-Gordon
- c Department of Psychological and Brain Sciences , University of Massachusetts Amherst , Amherst , MA , USA
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Risk of alcohol use disorder among South African university students: The role of drinking motives. Addict Behav 2018; 82:44-49. [PMID: 29486329 DOI: 10.1016/j.addbeh.2018.02.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 02/08/2018] [Accepted: 02/09/2018] [Indexed: 11/23/2022]
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Kelley ML, Ehlke SJ, Lewis RJ, Braitman AL, Bostwick W, Heron KE, Lau-Barraco C. Sexual Coercion, Drinking to Cope Motives, and Alcohol-Related Consequences among Self-Identified Bisexual Women. Subst Use Misuse 2018; 53:1146-1157. [PMID: 29278972 PMCID: PMC5935574 DOI: 10.1080/10826084.2017.1400565] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Given higher sexual victimization and greater alcohol use among bisexual women, a critical public health challenge is to understand within-group variation that may heighten or explain these associations in bisexual women. OBJECTIVES The present study tested a moderated-mediation model in which sexual coercion was hypothesized to be associated with alcohol-related consequences via drinking to cope motives in self-identified bisexual women who reported at least occasional binge drinking. Negative affect was hypothesized to moderate the sexual coercion-drinking to cope motives association. METHODS Participants were a community sample of 107 self-identified bisexual women (age M = 20.97, SD = 2.11) who completed an online survey and reported at least one binge drinking episode as well as engaging in sexual activity in the past 30 days. RESULTS Of these participants, 57 (53.3%) reported one or more experiences of sexual coercion in the past 30 days. Sexual coercion was associated with negative alcohol-related consequences via drinking to cope motives. Negative affect moderated the association between sexual coercion and drinking to cope motives such that the association was stronger among women with greater negative affect. Conclusions/Importance: Methods of addressing vulnerability to sexual coercion and educating young bisexual women about the association between sexual coercion and potentially problematic affective coping through alcohol use are needed.
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Affiliation(s)
- Michelle L. Kelley
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Sarah J. Ehlke
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Robin J. Lewis
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Abby L. Braitman
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Wendy Bostwick
- Health Systems Science, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kristin E. Heron
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
| | - Cathy Lau-Barraco
- Department of Psychology, Old Dominion University, Norfolk, Virginia, USA
- Virginia Consortium Program in Clinical Psychology, Norfolk, Virginia, USA
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Ertl V, Preuße M, Neuner F. Are Drinking Motives Universal? Characteristics of Motive Types in Alcohol-Dependent Men from Two Diverse Populations. Front Psychiatry 2018; 9:38. [PMID: 29487544 PMCID: PMC5816937 DOI: 10.3389/fpsyt.2018.00038] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 01/29/2018] [Indexed: 12/16/2022] Open
Abstract
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.
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Affiliation(s)
- Verena Ertl
- Clinical Psychology and Psychotherapy, Department of Psychology, Bielefeld University, Bielefeld, Germany
- vivo international, Konstanz, Germany
| | - Melissa Preuße
- Clinical Psychology and Psychotherapy, Department of Psychology, Bielefeld University, Bielefeld, Germany
- vivo international, Konstanz, Germany
| | - Frank Neuner
- Clinical Psychology and Psychotherapy, Department of Psychology, Bielefeld University, Bielefeld, Germany
- vivo international, Konstanz, Germany
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Hogarth L, Hardy L. Depressive statements prime goal-directed alcohol-seeking in individuals who report drinking to cope with negative affect. Psychopharmacology (Berl) 2018; 235:269-279. [PMID: 29082424 PMCID: PMC5748391 DOI: 10.1007/s00213-017-4765-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 10/13/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND Most variants of negative reinforcement theory predict that acute depressed mood can promote alcohol-seeking behaviour, but the precise mechanisms underpinning this effect remain contested. One possibility is that mood-induced alcohol-seeking is due to the formation of a stimulus-response (S-R) association, enabling depressed mood to elicit alcohol-seeking automatically. A second possibility is that depressed mood undergoes incentive learning, enabling it to enhance the expected value of alcohol and thus promote goal-directed alcohol-seeking. OBJECTIVES These two explanations were distinguished using a human outcome-revaluation procedure. METHODS One hundred and twenty-eight alcohol drinkers completed questionnaires of alcohol use disorder, drinking to cope with negative affect and depression symptoms. Participants then learned that two responses earned alcohol and food points respectively (baseline) in two alternative forced choice trials. At test, participants rated the valence of randomly sampled negative and positive mood statements and, after each statement, chose between the alcohol- and food-seeking responses in extinction. RESULTS The percentage of alcohol- versus food-seeking responses was increased significantly in trials containing negative statements compared to baseline and positive statement trials, in individuals who reported drinking to cope with negative affect (p = .004), but there was no such interaction with indices of alcohol use disorder (p = .87) or depression symptoms (p = .58). CONCLUSIONS Individuals who drink to cope with negative affect are more sensitive to the motivational impact of acute depressed mood statements priming goal-directed alcohol-seeking. Negative copers' vulnerability to alcohol dependence may be better explained by excessive affective incentive learning than by S-R habit formation.
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Affiliation(s)
- Lee Hogarth
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG, UK.
| | - Lorna Hardy
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter, EX4 4QG, UK
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Drinking to Cope: a Latent Class Analysis of Coping Motives for Alcohol Use in a Large Cohort of Adolescents. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2017; 17:584-94. [PMID: 27129479 DOI: 10.1007/s11121-016-0652-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Alcohol consumption during adolescence is widespread, although there is considerable variation in patterns of use. The aim of this study was to identify patterns of coping-motivated alcohol use in a UK birth cohort and examine individual and family characteristics associated with the resulting drinker profiles. At age 17, participants (n = 3957; 56 % female) reported their alcohol and drug use, internalising symptoms and use of alcohol to cope with a range of emotions. Socio-demographic data were collected via maternal report. Latent class analysis identified drinker subtypes based on the coping motives reported. Association between these profiles and socio-demographic characteristics and internalising disorders was examined. The vast majority (92 %) of adolescents reported alcohol consumption in the past year, and 26 % of those drank weekly or more often. Four distinct motive profiles were identified. These profiles were associated with different socio-demographic characteristics: adolescents from higher socio-economic backgrounds drank primarily for increased confidence, whereas adolescents from low socio-economic backgrounds were more likely to drink to cope with low mood. Adolescents with an anxiety or depressive disorder were six times more likely to fall within the high-risk subtype, characterised by a generalised pattern of drinking to cope with emotions across the board. Coping motives for drinking vary with individual and family factors. Adolescents from low versus high socio-economic backgrounds were characterised by distinct drinking profiles; thus, prevention messages may need to be tailored accordingly. Internalising disorders were strongly associated with a high-risk profile of coping-motivated drinking.
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Jiang H, Callinan S, Laslett AM, Room R. Measuring Time Spent Caring For Drinkers and Their Dependents. Alcohol Alcohol 2016; 52:112-118. [DOI: 10.1093/alcalc/agw070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 08/08/2016] [Accepted: 09/09/2016] [Indexed: 01/28/2023] Open
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Haeny AM, Littlefield AK, Sher KJ. Limitations of lifetime alcohol use disorder assessments: A criterion-validation study. Addict Behav 2016; 59:95-9. [PMID: 27082748 DOI: 10.1016/j.addbeh.2016.03.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 02/01/2016] [Accepted: 03/29/2016] [Indexed: 11/30/2022]
Abstract
The goal of the present study was to compare etiologically and clinically relevant correlates of lifetime AUD (e.g., alcohol consumption, personality traits, psychiatric disorders) based on a single assessment compared to a cumulative, prospective assessment of lifetime AUD. Data were drawn from the Alcohol, Health and Behavior (AHB; baseline N=489) study, which consisted of a prospective cohort of college students assessed seven times over a 16-year period ([M(SD) age at baseline=18.56 (.97)] and [M(SD) age at final assessment=34.33 (.82)]). The participants were assessed using the Diagnostic Interview Schedule (DIS) for DSM-III at Waves 1-7 and for DSM-IV at Waves 6-7. A single assessment and cumulative assessments of DSM-III lifetime AUD at Wave 6 (M[SD] age=28.98 [1.03]) were used to predict past-year alcohol related variables (e.g., alcohol consumption, drinking motives, drinking expectancies), personality variables, general functioning, lifetime substance use, and lifetime psychiatric disorders at Wave 7. Significantly larger correlations were found between the cumulative assessment and eight of the 25 etiologically relevant correlates of AUD compared to the single assessment. Further, significant incremental validity of cumulative assessment over single, retrospective assessment was observed for 16 of the 25 covariates. Overall, this study provides further support for the value of using prospective data with multiple assessments when determining lifetime history of disorder.
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Affiliation(s)
- Angela M Haeny
- Department of Psychological Sciences, University of Missouri, and The Midwest Alcohol Research Center, United States.
| | - Andrew K Littlefield
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, United States
| | - Kenneth J Sher
- Department of Psychological Sciences, University of Missouri, and The Midwest Alcohol Research Center, United States
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Abstract
PURPOSE OF REVIEW Illicit drugs, alcohol, and tobacco use disorders contribute substantially to the global burden of disease. Knowledge about the major elements of the natural history of substance use disorders (incidence, remission, persistence, and relapse) is crucial to a broader understanding of the course and outcomes of substance use disorders. RECENT FINDINGS Prospective cohort studies in nonclinical samples indicate that externalizing psychopathology in earlier life, including early disordered substance use, delinquency, and personality disorders, are related to substance use disorders later in life and chronic course. Externalizing psychopathology may be initiated by early adverse experiences, for example, childhood maltreatment and stressful life events. After controlling for confounders, 'age at first use' as a causal factor for alcohol use disorder later in life and the 'drug substitution' hypothesis are not supported in general population data. SUMMARY Future research should focus on elaborating the causal framework that leads to the development and persistence of severe substance use disorders, with an emphasis on identifying modifiable factors for intervention by policy makers or health professionals. More research is needed on the natural history of substance use disorders in low-income and middle-income countries.
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Watkins LE, Franz MR, DiLillo D, Gratz KL, Messman-Moore TL. Does drinking to cope explain links between emotion-driven impulse control difficulties and hazardous drinking? A longitudinal test. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2015; 29:875-84. [PMID: 26502334 DOI: 10.1037/adb0000127] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Difficulty controlling impulsive behaviors when experiencing negative emotions is a prominent risk factor for hazardous alcohol use, and prior research suggests that drinking to cope may mediate this association. The present study examines this possibility prospectively in a sample of 490 young adult women between the ages of 18 and 25. Participants completed measures of emotion-driven impulse control difficulties, drinking to cope, and hazardous alcohol use at 6 time points over the course of approximately 20 months (i.e., 1 assessment every 4 months). Multilevel structural equation modeling revealed that drinking to cope fully mediated the relationship between emotion-driven impulse control difficulties and hazardous alcohol use when examining these relationships between individuals and partially mediated this relation when examining these relationships within individuals. These findings suggest that drinking to cope is a key mechanism in the relationship between emotion-driven impulse control difficulties and hazardous drinking. Results highlight the importance of targeting both emotion dysregulation and drinking to cope when treating young women for alcohol use problems.
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Affiliation(s)
| | - Molly R Franz
- Department of Psychology, University of Nebraska-Lincoln
| | - David DiLillo
- Department of Psychology, University of Nebraska-Lincoln
| | - Kim L Gratz
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center
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Dvorak RD, Kuvaas NJ, Lamis DA, Pearson MR, Stevenson BL. Emotionally Up and Down, Behaviorally To and Fro: Drinking Motives Mediate the Synergistic Effects of Urgency and Emotional Instability on Alcohol Outcomes. JOURNAL OF DRUG EDUCATION 2015; 45:156-84. [PMID: 27075609 PMCID: PMC5238711 DOI: 10.1177/0047237916639030] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Emotional and behavioral regulation has been linked to coping and enhancement motives and associated with different patterns of alcohol use and problems. The current studies examined emotional instability, urgency, and internal drinking motives as predictors of alcohol dependence symptoms as well as the likelihood and severity of Diagnostic and Statistical Manual of Mental Disorders-5th editionAlcohol Use Disorder (AUD). In Study 1, college drinkers (n = 621) completed alcohol involvement and behavioral/emotional functioning assessments. There was an indirect association between emotional instability and dependence symptoms via both coping and enhancement drinking motives which was potentiated by trait urgency. In Study 2, college drinkers (n = 510) completed alcohol involvement, behavioral/emotional functioning, and AUD criteria assessments. A significant indirect effect from emotional instability to the likelihood of meeting AUD criteria, via drinking to cope was found, again potentiated by urgency.
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Affiliation(s)
| | | | | | - Matthew R Pearson
- Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, Albuquerque, NM, USA
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Clinkinbeard SS, Rhodes TN. Propensity, Social Ties, Friend Behavior, and Heavy Drinking Among College Students. JOURNAL OF CHILD & ADOLESCENT SUBSTANCE ABUSE 2014. [DOI: 10.1080/1067828x.2012.732547] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
Conventional wisdom and survey data indicate that alcohol is a social lubricant and is consumed for its social effects. In contrast, the experimental literature examining alcohol's effects within a social context reveals that alcohol does not consistently enhance social-emotional experience. We identify a methodological factor that might explain inconsistent alcohol-administration findings, distinguishing between studies featuring unscripted interactions among naïve participants (k = 18) and those featuring scripted social interactions with individuals identified as study confederates (k = 18). While 89% of naïve-participant studies find positive effects of alcohol on mood (d = 0.5), only 11% of confederate studies find evidence of significant alcohol-related mood enhancement (d = -0.01). The naïve-participant versus confederate distinction remains robust after controlling for various moderators including stress manipulations, gender, group size, anxiety outcome measure, and within-group consistency of beverage assignment. Based on the findings of our review, we propose a multidimensional, social-attributional framework for understanding alcohol-related reward. Borrowing organizing principles from attribution theory, the social-attributional approach predicts that alcohol will enhance mood when negative outcomes are perceived to be unstable and/or self-relevant. Our framework proposes that alcohol's effects within a social context are largely explained by its tendency to free individuals from preoccupation with social rejection, allowing them to access social rewards. The social-attributional approach represents a novel framework for integrating distinct, well-validated concepts derived from several theories of alcohol's effects. It further presents promising lines of inquiry for future research examining the role of social factors in alcohol reward and addiction susceptibility.
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Dvorak RD, Pearson MR, Day AM. Ecological momentary assessment of acute alcohol use disorder symptoms: associations with mood, motives, and use on planned drinking days. Exp Clin Psychopharmacol 2014; 22:285-97. [PMID: 24932896 PMCID: PMC4631409 DOI: 10.1037/a0037157] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Several theories posit that alcohol is consumed both in relation to one's mood and in relation to different motives for drinking. However, there are mixed findings regarding the role of mood and motives in predicting drinking. Ecological momentary assessment (EMA) methods provide an opportunity to evaluate near real-time changes in mood and motives within individuals to predict alcohol use. In addition, endorsement of criteria of an alcohol use disorder (AUD) may also be sensitive to changes within subjects. The current study used EMA with 74 moderate drinkers who responded to fixed and random mood, motive, alcohol use, and AUD criteria prompts over a 21-day assessment period. A temporal pattern of daytime mood, evening drinking motivation, and nighttime alcohol use and acute AUD symptoms on planned drinking days was modeled to examine how these associations unfold throughout the day. The results suggest considerable heterogeneity in drinking motivation across drinking days. Additionally, an affect regulation model of drinking to cope with negative mood was observed. Specifically, on planned drinking days, the temporal association between daytime negative mood and the experience of acute AUD symptoms was mediated via coping motives and alcohol use. The current study found that motives are dynamic, and that changes in motives may predict differential drinking patterns across days. Further, the study provides evidence that emotion-regulation-driven alcohol involvement may need to be examined at the event level to fully capture the ebb and flow of negative affect motivated drinking.
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Elliott JC, Aharonovich E, O’Leary A, Wainberg M, Hasin DS. Drinking motives among HIV primary care patients. AIDS Behav 2014; 18:1315-23. [PMID: 24165984 DOI: 10.1007/s10461-013-0644-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Heavy drinking among individuals with HIV is associated with poor medication adherence and other health problems. Understanding reasons for drinking (drinking motives) in this population is therefore important and could inform intervention. Using concepts of drinking motives from previous alcohol research, we assessed these motives and drinking in 254 HIV-positive primary care patients (78.0 % male; 94.5 % African American or Hispanic) prior to their participation in an alcohol intervention trial. Three motives had good factor structure and internal consistency: "drinking to cope with negative affect", "drinking for social facilitation" (both associated with heavier drinking), and "drinking due to social pressure" (associated with less drinking). Drinking motives may provide important content for alcohol intervention; clinical trials could indicate whether inclusion of such content improves intervention efficacy. Discussing motives in session could help providers assist clients in better managing psychological and social aspects of their lives without reliance on alcohol.
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Lijffijt M, Hu K, Swann AC. Stress modulates illness-course of substance use disorders: a translational review. Front Psychiatry 2014; 5:83. [PMID: 25101007 PMCID: PMC4101973 DOI: 10.3389/fpsyt.2014.00083] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 06/30/2014] [Indexed: 11/21/2022] Open
Abstract
Childhood trauma and post-childhood chronic/repeated stress could increase the risk of a substance use disorder by affecting five stages of addiction illness-course: (a) initial experimentation with substances; (b) shifting from experimental to regular use; (c) escalation from regular use to abuse or dependence; (d) motivation to quit; and (e) risk of (re-)lapse. We reviewed the human literature on relationships between stress and addiction illness-course. We explored per illness-course stage: (i) whether childhood trauma and post-childhood chronic/repeated stress have comparable effects and (ii) whether effects cut across classes of substances of abuse. We further discuss potential underlying mechanisms by which stressors may affect illness-course stages for which we relied on evidence from studies in animals and humans. Stress and substances of abuse both activate stress and dopaminergic motivation systems, and childhood trauma and post-childhood stressful events are more chronic and occur more frequently in people who use substances. Stressors increase risk to initiate early use potentially by affecting trait-like factors of risk-taking, decision making, and behavioral control. Stressors also accelerate transition to regular use potentially due to prior effects of stress on sensitization of dopaminergic motivation systems, cross-sensitizing with substances of abuse, especially in people with high trait impulsivity who are more prone to sensitization. Finally, stressors increase risk for abuse and dependence, attenuate motivation to quit, and increase relapse risk potentially by intensified sensitization of motivational systems, by a shift from positive to negative reinforcement due to sensitization of the amygdala by corticotropin releasing factor, and by increased sensitization of noradrenergic systems. Stress generally affects addiction illness-course across stressor types and across classes of substances of abuse.
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Affiliation(s)
- Marijn Lijffijt
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine , Houston, TX , USA
| | - Kesong Hu
- Human Neuroscience Institute, Department of Human Development, Cornell University , Ithaca, NY , USA
| | - Alan C Swann
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine , Houston, TX , USA ; Mental Health Care Line, Michael E. DeBakey VA Medical Center , Houston, TX , USA
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Elliott JC, Aharonovich E, O’Leary A, Wainberg M, Hasin D. Drinking motives as prospective predictors of outcome in an intervention trial with heavily drinking HIV patients. Drug Alcohol Depend 2014; 134:290-295. [PMID: 24286967 PMCID: PMC3908664 DOI: 10.1016/j.drugalcdep.2013.10.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 10/22/2013] [Accepted: 10/22/2013] [Indexed: 12/25/2022]
Abstract
BACKGROUND Heavy alcohol consumption in HIV patients is an increasing health concern. Applying the drinking motivational model to HIV primary care patients, drinking motives (drinking to cope with negative affect, for social facilitation, and in response to social pressure) were associated with alcohol consumption at a baseline interview. However, whether these motives predict continued heavy drinking or alcohol dependence in this population is unknown. METHODS Participants were 254 heavy-drinking urban HIV primary care patients (78.0% male; 94.5% African American or Hispanic) participating in a randomized trial of brief drinking-reduction interventions. Drinking motive scales, as well as measures of alcohol consumption and alcohol dependence, were administered at baseline. Consumption and dependence measures were re-administered at the end of treatment two months later. Regression analyses tested whether baseline drinking motive scale scores predicted continued heavy drinking and alcohol dependence status at the end of treatment, and whether motives interacted with treatment condition. RESULTS Baseline drinking to cope with negative affect predicted continued heavy drinking (p<0.05) and alcohol dependence, the latter in both in the full sample (adjusted odds ratio [AOR]=2.14) and among those with baseline dependence (AOR=2.52). Motives did not interact with treatment condition in predicting alcohol outcomes. CONCLUSIONS Drinking to cope with negative affect may identify HIV patients needing targeted intervention to reduce drinking, and may inform development of more effective interventions addressing ways other than heavy drinking to cope with negative affect.
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Affiliation(s)
- Jennifer C. Elliott
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032
| | - Efrat Aharonovich
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 180 Ft. Washington Avenue, New York, NY 10032,New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
| | - Ann O’Leary
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333
| | - Milton Wainberg
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 180 Ft. Washington Avenue, New York, NY 10032,New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
| | - Deborah Hasin
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032,Department of Psychiatry, College of Physicians and Surgeons, Columbia University, 180 Ft. Washington Avenue, New York, NY 10032,New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
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Foster DW, Zvolensky MJ, Garey L, Ditre JW, Schmidt NB. Relationships between drinking motives and smoking expectancies among daily smokers who are also problem drinkers. J Dual Diagn 2014; 10:118-29. [PMID: 25392285 PMCID: PMC4231525 DOI: 10.1080/15504263.2014.926759] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE There is a high co-occurrence of problem drinking and regular cigarette smoking, and cognitive processes (e.g., motivation to use, expectations about the consequences of use) related to each are positively associated with one another. We explored drinking motives in relation to cognitive-based smoking processes among smokers with problematic drinking. We expected that drinking coping motives would be associated with smoking consequences related to negative reinforcement and negative personal outcomes and inflexibility of smoking behavior; observed effects for coping motives would be unique from shared variance with other motives and incrementally evident beyond the variance accounted for by tobacco-related health problems, smoking rate, negative affectivity, cannabis use, and gender. METHODS The sample included 195 individuals recruited into a larger study of smoking cessation treatments (i.e., they were interested in quitting), who were heavy drinkers and smoked daily. Participants were primarily male (n = 122, 63%), fairly young (Mage = 30.3 years; SD = 12.46), and predominantly White/Caucasian (n = 175, 80%). Roughly 57% (n = 111) had at least one comorbid Axis I disorder, the most common being social anxiety (n = 21, 11%) and generalized anxiety disorder (n = 12, 6%). RESULTS Coping drinking motives predicted negative smoking consequences, negative reinforcement, and smoking inflexibility. Enhancement drinking motives marginally predicted positive reinforcement. Conformity drinking motives predicted smoking consequences related to appetite/weight control. Social drinking motives predicted negative reinforcement and barriers to cessation and marginally predicted positive reinforcement. CONCLUSIONS Theoretical models and clinical activities focused on smoking cessation among problem drinkers may benefit from considering the role of drinking motives, particularly coping-oriented motives, to better understanding cognitive-based smoking processes.
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Affiliation(s)
- Dawn W Foster
- a Harvard University , Harvard School of Public Health , Boston , Massachusetts , USA
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Lombardo S, Perera B, Beaudry L, Grad J, Maselko J, Østbye T. Use of and attitudes toward tobacco and alcohol among adults in southern Sri Lanka. THE SOUTHEAST ASIAN JOURNAL OF TROPICAL MEDICINE AND PUBLIC HEALTH 2013; 44:880-899. [PMID: 24437324 PMCID: PMC4169263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The adverse health effects of tobacco and alcohol are well known. Alcohol consumption is increasing in Sri Lanka, but few population studies have been conducted. The objective of this study was to document tobacco and alcohol consumption levels among adults in southern Sri Lanka and to identify the main reasons for using or refraining from alcohol and tobacco products. Tobacco and alcohol use within Sri Lanka is relatively common, particularly among adult males. Reasons given for smoking and drinking frequently relate to social and image-based motivators. Women may be especially susceptible to the influence of peer pressure in social situations. Public health efforts should consider the use of demographic-specific anti-tobacco and anti-alcohol messages, as the motivators driving behavior appear to differ across gender and age groups.
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Affiliation(s)
- Sarah Lombardo
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Bilesha Perera
- Department of Community Medicine, University of Ruhuna, Galle, Sri Lanka
| | - Lauren Beaudry
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Jennifer Grad
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Joanna Maselko
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Truls Østbye
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
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Schuckit MA, Smith TL, Trim RS, Kuperman S, Kramer J, Hesselbrock V, Bucholz KK, Nurnberger JI, Hesselbrock M, Saunders G. Sex differences in how a low sensitivity to alcohol relates to later heavy drinking. Drug Alcohol Rev 2012; 31:871-80. [PMID: 22708705 DOI: 10.1111/j.1465-3362.2012.00469.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND AIMS A low level of response (LR), or low sensitivity, to alcohol is a genetically influenced characteristic that predicts future heavy drinking and alcohol problems. While previous analyses of how LR relates to heavier drinking reported the process is similar in males and females, some potential sex differences have been identified. This difference is further explored in these analyses. DESIGN AND METHODS Prospective structural equation models (SEMs) were evaluated for 183 young adult females and 162 males, none of Asian background, from the Collaborative Study on the Genetics of Alcoholism. Invariance analyses and SEM evaluations by sex were used to compare across females and males for these primarily Caucasian (75%), non-Asian young (mean age 19) subjects. RESULTS The prospective SEM for the full set of 345 subjects had good fit characteristics and explained 37% of the variance. While the initial invariance analyses identified few sex differences, comparisons of correlations and direct evaluations of path coefficients across males and females indicated that only females showed a link between a low LR and future alcohol problems that was partially mediated by more positive alcohol expectancies and drinking to cope. These sex differences were reflected in the different structures of the SEM results for female versus male subjects. DISCUSSION AND CONCLUSIONS These prospective results indicate that there might be some important sex differences regarding how a lower LR relates to alcohol outcomes that should be considered in protocols focusing on preventing the impact of LR on future drinking problems.
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Affiliation(s)
- Marc A Schuckit
- Department of Psychiatry, University of California, San Diego, La Jolla, USA.
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Creswell KG, Sayette MA, Manuck SB, Ferrell RE, Hill SY, Dimoff JD. DRD4 polymorphism moderates the effect of alcohol consumption on social bonding. PLoS One 2012; 7:e28914. [PMID: 22347363 PMCID: PMC3275561 DOI: 10.1371/journal.pone.0028914] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Accepted: 11/17/2011] [Indexed: 11/26/2022] Open
Abstract
Development of interpersonal relationships is a fundamental human motivation, and behaviors facilitating social bonding are prized. Some individuals experience enhanced reward from alcohol in social contexts and may be at heightened risk for developing and maintaining problematic drinking. We employed a 3 (group beverage condition) ×2 (genotype) design (N = 422) to test the moderating influence of the dopamine D4 receptor gene (DRD4 VNTR) polymorphism on the effects of alcohol on social bonding. A significant gene x environment interaction showed that carriers of at least one copy of the 7-repeat allele reported higher social bonding in the alcohol, relative to placebo or control conditions, whereas alcohol did not affect ratings of 7-absent allele carriers. Carriers of the 7-repeat allele were especially sensitive to alcohol's effects on social bonding. These data converge with other recent gene-environment interaction findings implicating the DRD4 polymorphism in the development of alcohol use disorders, and results suggest a specific pathway by which social factors may increase risk for problematic drinking among 7-repeat carriers. More generally, our findings highlight the potential utility of employing transdisciplinary methods that integrate genetic methodologies, social psychology, and addiction theory to improve theories of alcohol use and abuse.
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Affiliation(s)
- Kasey G Creswell
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America.
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Kuntsche E, Müller S. Why do young people start drinking? Motives for first-time alcohol consumption and links to risky drinking in early adolescence. Eur Addict Res 2012; 18:34-9. [PMID: 22142752 DOI: 10.1159/000333036] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2011] [Accepted: 09/08/2011] [Indexed: 11/19/2022]
Abstract
AIMS To investigate which motives young adolescents indicate for first-time alcohol consumption and whether these motives are linked to risky drinking. METHODS Logistic regressions were used based on a nationally representative sample of 1,654 11- to 14-year-olds who had consumed alcohol at least once. RESULTS 'To toast' (42.5%), 'to find out what effect it would have' (36.4%), and 'to have more fun at a party' (31.0%) were most frequently indicated as motives. Boys indicated curiosity about the effect more often than girls who instead more frequently indicated coping motives. Those who had their first drink 'to have more fun at a party' or 'because it was exciting' had a higher likelihood of risky drinking. Moreover, those who indicated depression as a motive were three times more likely to have 5 or more drinks on a single occasion. CONCLUSIONS Information on young people's motives for first-time drinking appears to play a significant role in primary prevention, e.g. to prevent risky drinking or alcohol-related problems later in life by postponing alcohol use.
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Affiliation(s)
- Emmanuel Kuntsche
- Addiction Info Switzerland, Research Institute, Lausanne, Switzerland.
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Patrick ME, Schulenberg JE, O'Malley PM, Maggs JL, Kloska DD, Johnston LD, Bachman JG. Age-related changes in reasons for using alcohol and marijuana from ages 18 to 30 in a national sample. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2011; 25:330-9. [PMID: 21417516 DOI: 10.1037/a0022445] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study used up to seven waves of data from 32 consecutive cohorts of participants in the national longitudinal Monitoring the Future study to model changes in self-reported reasons for using alcohol and marijuana by age (18 to 30), gender, and recent substance use. The majority of stated reasons for use decreased in prevalence across young adulthood (e.g., social/recreational and coping with negative affect reasons); exceptions included age-related increases in using to relax (alcohol and marijuana), to sleep (alcohol), because it tastes good (alcohol), and to get high (marijuana). Women were more likely than men to report drinking for reasons involving distress (i.e., to get away from problems), while men were more likely than women to endorse all other reasons. Greater substance use at age 18 was associated with greater likelihood of all reasons except to experiment and to fit in. A better understanding of developmental changes in reasons for use is important for understanding normative changes in substance use behaviors and for informing intervention efforts involving underlying reasons for use.
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Affiliation(s)
- Megan E Patrick
- Institute for Social Research, University of Michigan, 426 Thompson St., Ann Arbor, MI 48106-1248, USA.
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Schuckit MA, Smith TL, Heron J, Hickman M, Macleod J, Lewis G, Davis JM, Hibbeln JR, Brown S, Zuccolo L, Miller LL, Davey-Smith G. Testing a level of response to alcohol-based model of heavy drinking and alcohol problems in 1,905 17-year-olds. Alcohol Clin Exp Res 2011; 35:1897-904. [PMID: 21762180 PMCID: PMC3183150 DOI: 10.1111/j.1530-0277.2011.01536.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The low level of response (LR) to alcohol is one of several genetically influenced characteristics that increase the risk for heavy drinking and alcohol problems. Efforts to understand how LR operates through additional life influences have been carried out primarily in modest-sized U.S.-based samples with limited statistical power, raising questions about generalizability and about the importance of components with smaller effects. This study evaluates a full LR-based model of risk in a large sample of adolescents from the United Kingdom. METHODS Cross-sectional structural equation models were used for the approximate first half of the age 17 subjects assessed by the Avon Longitudinal Study of Parents and Children, generating data on 1,905 adolescents (mean age 17.8 years, 44.2% boys). LR was measured with the Self-Rating of the Effects of Alcohol Questionnaire, outcomes were based on drinking quantities and problems, and standardized questionnaires were used to evaluate peer substance use, alcohol expectancies, and using alcohol to cope with stress. RESULTS In this young and large U.K. sample, a low LR related to more adverse alcohol outcomes both directly and through partial mediation by all 3 additional key variables (peer substance use, expectancies, and coping). The models were similar in boys and girls. CONCLUSIONS These results confirm key elements of the hypothesized LR-based model in a large U.K. sample, supporting some generalizability beyond U.S. groups. They also indicate that with enough statistical power, multiple elements contribute to how LR relates to alcohol outcomes and reinforce the applicability of the model to both genders.
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Affiliation(s)
- Marc A Schuckit
- Department of Psychiatry, University of California, San Diego, La Jolla, California 92037, USA.
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Patrick ME, Schulenberg JE, O'Malley PM, Johnston LD, Bachman JG. Adolescents' reported reasons for alcohol and marijuana use as predictors of substance use and problems in adulthood. J Stud Alcohol Drugs 2011; 72:106-16. [PMID: 21138717 DOI: 10.15288/jsad.2011.72.106] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The aim of this study was to examine how reasons for substance use at age 18 relate to alcohol and marijuana use at ages 18 and 35 and to symptoms of alcohol use disorder and marijuana use disorder at age 35. METHOD Bivariate correlation and multivariate regression analyses were conducted to examine the prediction of substance use and misuse by social/recreational, coping with negative affect, compulsive, and drug effect reasons for alcohol and marijuana use. Control variables included gender, race/ethnicity, parent education, and previous substance use (for age 35 outcomes). RESULTS Social/recreational, coping, and drug effect reasons for drinking predicted symptoms of alcohol use disorder 17 years later. Reasons for marijuana use were generally associated only with concurrent marijuana use; an exception was that drug effect reasons predicted marijuana use disorder at age 35. CONCLUSIONS The long-term longitudinal predictive power of reasons for alcohol use (and, to a lesser extent, for marijuana use) suggests that adolescents' self-reported reasons, in particular those involving regulating emotions and experiences, may be early risk factors for continued use and misuse of substances into adulthood.
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Affiliation(s)
- Megan E Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan 48106-1248, USA.
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Beseler CL, Aharonovich E, Hasin DS. The enduring influence of drinking motives on alcohol consumption after fateful trauma. Alcohol Clin Exp Res 2011; 35:1004-10. [PMID: 21314697 DOI: 10.1111/j.1530-0277.2010.01431.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Drinking motives predict later levels of alcohol consumption and development of alcohol dependence, but their effects on stress-related drinking are less clear. Proximity to the terrorist attack on the World Trade Center (WTC) on 9/11/01 was significantly associated with alcohol consumption 1 and 16 weeks after 9/11/01. We investigated the relationship between drinking motives measured a decade earlier, proximity to the WTC, and drinking after 9/11/01. This event constitutes a natural experiment for studying the effects of previously measured drinking motives on alcohol consumption after fateful trauma. METHODS Adult drinkers (N = 644) residing in a New Jersey county were evaluated for four drinking motives: coping with negative affect, for enjoyment, for social facilitation and social pressure. After 9/11/01, their exposure to the WTC attack and subsequent drinking were assessed. Poisson regression was used to assess the relationships between proximity to the WTC, drinking motives and post-9/11/01 drinking; models were adjusted for alcohol dependence, age, gender and race. RESULTS Drinking to cope with negative affect predicted alcohol consumption 1 week after 9/11/01 (p = 0.04) and drinking for enjoyment predicted drinking 1 and 16 weeks after 9/11/01 (p = 0.001 and 0.01, respectively). The associations were independent of proximity to the WTC. No interactions were observed between drinking motives, proximity to the WTC or lifetime alcohol dependence. CONCLUSION Drinking motives a decade earlier predicted higher alcohol consumption after fateful trauma independently from proximity to the WTC on 9/11/01. Results suggest that drinking motives constitute a robust, enduring influence on drinking behavior, including after traumatic experiences.
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van der Zwaluw CS, Kuntsche E, Engels RCME. Risky alcohol use in adolescence: the role of genetics (DRD2, SLC6A4) and coping motives. Alcohol Clin Exp Res 2011; 35:756-64. [PMID: 21244440 DOI: 10.1111/j.1530-0277.2010.01393.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Drinking to cope (i.e., drinking to forget or alleviate negative feelings) has been found to be associated with adolescents' heavy drinking and alcohol-related problems. Additionally, it is widely accepted that genetic factors are involved in alcohol use and dependence. Studies are only beginning to reveal, however, which specific genotypes are related to drinking behaviors, and it is unknown whether they may interact with coping motives in predicting adolescents' risky drinking. The aim of this study was to examine relationships between the dopamine D2 receptor gene (DRD2) Taq1A polymorphism (rs1800497), a serotonin transporter gene (SLC6A4) polymorphism (5-HTTLPR), coping motives, and adolescents' binge drinking and alcohol-related problems. METHODS Participants in this cross-sectional study were 282 Dutch adolescents (mean age 17.4, 47% men) who had consumed alcohol at least once in their life. RESULTS Coping motives were positively related to both binge drinking and alcohol-related problems, while DRD2 and SLC6A4 genotypes were not. DRD2, but not the SLC6A4 genotype, interacted with coping motives. The link between coping motives and alcohol outcomes was stronger among those carrying the DRD2 risk (A1) allele. CONCLUSIONS This study extends the present literature by providing additional insight into the etiological factors of adolescent drinking behavior. An interaction between a vulnerability gene (DRD2) and a cognitive factor (coping drinking) was found to be related to adolescents' binge drinking and alcohol-related problems.
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Mackie CJ, Conrod PJ, Rijsdijk F, Eley TC. A systematic evaluation and validation of subtypes of adolescent alcohol use motives: genetic and environmental contributions. Alcohol Clin Exp Res 2010; 35:420-30. [PMID: 21143243 DOI: 10.1111/j.1530-0277.2010.01359.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Alcohol use motives are closely associated with specific profiles of alcohol use and reflect a subjectively derived decisional framework based on a motivational style of responding. Adult twin studies typically estimate the heritability of alcohol use motives to be between 7 and 42%, although relatively little is known about genetic and environmental influences upon alcohol use motives in adolescence. METHODS Latent class analysis (LCA) models containing 1 through 5 classes were fitted to the data derived from 1,422 adolescent twin and siblings self-reported alcohol use motives. Using twin models, we estimated the genetic, shared, and nonshared environmental influences to the class membership data derived from the LCA. RESULTS Four drinking motives classes were identified (family-oriented, social, enhancement/social, and coping/social). The coping/social and enhancement/social classes were differentiated from the social class on measures of depression, delinquency, and aggressive behavior. Analyses indicated that nonadditive genetic factors accounted for 76% of the variance in the coping/social motives class and additive genetic influences accounted for 66% of the variance in the social motives class. There was a moderate contribution of genetic factors and shared environmental factors influencing class membership of enhancement/social motivated drinkers (28 and 20% explained variance, respectively). Substantial shared environmental influences were revealed for membership of the family-oriented class (75%). CONCLUSIONS Heritable influences may predispose individuals to drink to cope with negative affect, for social reasons, and to a lesser extent for enhancement. Familial environmental influences shape family-oriented motives for drinking in adolescents.
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Affiliation(s)
- Clare J Mackie
- Division of Psychological Medicine and Psychiatry, Addictions Department, Institute of Psychiatry, Kings' College London, UK.
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Kristjansson SD, Agrawal A, Littlefield AK, Pergadia ML, Lessov-Schlaggar CN, Sartor CE, Bucholz KK, Madden PAF, Cooper ML, Sher KJ, Heath AC. Drinking motives in female smokers: factor structure, alcohol dependence, and genetic influences. Alcohol Clin Exp Res 2010; 35:345-54. [PMID: 21083669 DOI: 10.1111/j.1530-0277.2010.01350.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Alcohol and tobacco use often co-occur. Human and animal studies indicate that nicotine increases alcohol's rewarding effects and the motivation to consume it. The aims of this study were to examine whether the factorial architecture of self-reported motivations to consume alcohol differed between regular and nonregular cigarette smokers while taking into account the lifetime history of alcohol dependence and psychopathology, and to estimate the genetic and environmental influences on the motivations. METHODS Using data on 2,189 monozygotic and dizygotic female twins, we examined the factorial structure (item thresholds and factor loadings, means, and variances) of the items from the Drinking Motives Questionnaire (DMQ) in regular and nonregular smokers. Post hoc tests examined the association between the latent drinking motives factors and alcohol dependence in both groups. Twin models were fitted to the latent drinking motives factors, testing for variations in the magnitude of additive genetic, shared, and nonshared environmental influences between the groups. RESULTS The 4 DMQ factors (social, conformity, coping, and enhancement) were recovered in both groups, and their measurement structure was consistent across the groups. Regular smokers reported higher levels of coping, enhancement, and social motives while nonregular smokers reported higher conformity motives. Alcohol dependence was associated with higher scores on all motives in both groups; however, in a regression analysis that included all of the motives as predictor variables, only coping was significantly related to alcohol dependence. While twin models revealed evidence for substantially greater genetic influences on enhancement (h² = 0.40), coping (h² = 0.35) and social (h² = 0.37) drinking motives in regular compared to nonregular smokers, the power to statistically distinguish the 2 groups was low. CONCLUSIONS While the measurement structure of the drinking motive factors appears to be similar across regular and nonregular smokers, regular smokers report more motivation to drink for internal affect-related reasons and to obtain social reward. Of all the motives, coping was the most robust predictor of alcohol dependence in both the regular and the nonregular smokers. Further, genetic influences might play a larger role in drinking motives among regular smokers, which provides tentative evidence for latent genetic × smoking status interactions.
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Affiliation(s)
- Sean D Kristjansson
- Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri 63110, USA.
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Drinking to have fun and to get drunk: motives as predictors of weekend drinking over and above usual drinking habits. Drug Alcohol Depend 2010; 110:259-62. [PMID: 20363080 DOI: 10.1016/j.drugalcdep.2010.02.021] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2009] [Revised: 02/08/2010] [Accepted: 02/26/2010] [Indexed: 11/21/2022]
Abstract
Most evidence on the motives-alcohol use link has come from cross-sectional research using retrospective assessments. It remains also to be demonstrated whether motives predict drinking in particular circumstances. In the present study, drinking motives assessed 2 weeks prior to a diary study were used to predict the number of drinks on weekend days as reported via short message service (SMS). Multilevel regression models were estimated based on 391 reports from 55 participants (mean age 22.7). The results revealed that enhancement motives but not gender, age, or social, coping, or conformity motives predicted weekend drinking over and above usual consumption. Consumption and motives together explained more than three-quarters of the inter-individual variance in weekend drinking. To conclude, this study points to a heavy episodic weekend drinking culture of young people who drink large quantities on Friday and Saturday nights apparently because they are seeking fun and excitement. Preventive measures should aim to counteract young people's drinking at peak times and in high-risk situations.
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Perera B, Torabi M. Motivations for alcohol use among men aged 16-30 years in Sri Lanka. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2009; 6:2408-16. [PMID: 19826552 PMCID: PMC2760418 DOI: 10.3390/ijerph6092408] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2009] [Accepted: 09/03/2009] [Indexed: 11/16/2022]
Abstract
Psychometric properties of a new scale that measures motivations towards alcohol use were examined using a sample of 412 male alcohol users in Sri Lanka aged 16-30 years. In addition, associations between drinking motives and drinking frequency were explored. Confirmatory factor analysis showed that a 3-factor model consisting of the factors personal enjoyment, tension reduction, and social pressure fit the data well. Overall, tension-reduction motivation was found to be prominent in the context of young males' drinking behavior in Sri Lanka. Associations between stress and alcohol use among young males warrant further investigations.
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Affiliation(s)
- Bilesha Perera
- Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka; E-Mail:
| | - Mohammad Torabi
- Department of Applied Health Sciences, Indiana University, Bloomington, IN 47405, USA
- Author to whom correspondence should be addressed; E-Mail:; Tel.: +1-812-855-4808; Fax: +1-812-855-3936
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Schuckit MA, Smith TL, Danko GP, Trim R, Bucholz KK, Edenberg HJ, Hesselbrock V, Kramer JJ, Dick DM. An evaluation of the full level of response to alcohol model of heavy drinking and problems in COGA offspring. J Stud Alcohol Drugs 2009; 70:436-45. [PMID: 19371495 DOI: 10.15288/jsad.2009.70.436] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The low level of response (LR) to alcohol is an endophenotype related to heavier drinking and alcohol problems. Structural equation models (SEMs) indicate LR affects alcohol outcomes (ALCOUT) both directly and through mediation by drinking in peers (PEER), alcohol expectancies (EXPECT), and drinking to cope with stress (COPE), with some variation depending on the sample tested. This article presents the first full test of this LR-based model in young subjects from the Collaborative Study on the Genetics of Alcoholism (COGA). METHOD Data were generated from 325 12- to 22-year-old (47.4% male) drinking offspring from COGA families, using the Self-Report of the Effects of Alcohol questionnaire to determine LR early in the drinking career and a validated, structured interview for demography and alcohol use/problem patterns. Standardized questionnaires were used to measure PEER, EXPECT, and COPE, with the model tested through the maximum likelihood estimation for analyses of the variance/covariance matrix using both Amos and Mplus. RESULTS The SEM yielded good fit characteristics and explained 59% of the variance, with LR relating both directly to ALCOUT and as partially mediated by PEER and COPE. Although GENDER related to both LR and ALCOUT in the model, and AGE related to ALCOUT, the SEM results were invariant across both AGE and GENDER, with generally similar invariant results regarding the presence or absence of an alcohol-use disorder diagnosis. CONCLUSIONS The results support the applicability of the LR-based model of heavy drinking and alcohol problems in the COGA offspring, a group with different demography compared with the two other samples of adolescents tested to date. The modest differences observed across samples will be evaluated in future research to enhance understanding of how the model operates across socioeconomic groups.
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Affiliation(s)
- Marc A Schuckit
- Department of Psychiatry, University of California, San Diego, California, USA.
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Kalaydjian A, Swendsen J, Chiu WT, Dierker L, Degenhardt L, Glantz M, Merikangas KR, Sampson N, Kessler R. Sociodemographic predictors of transitions across stages of alcohol use, disorders, and remission in the National Comorbidity Survey Replication. Compr Psychiatry 2009; 50:299-306. [PMID: 19486727 PMCID: PMC2933383 DOI: 10.1016/j.comppsych.2008.09.012] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2008] [Revised: 09/23/2008] [Accepted: 09/29/2008] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Although much is known about risk factors for the initiation of alcohol use, abuse, and dependence, few population-based studies have examined the predictors of transitions across these stages. AIM The aim of this study is to examine the sociodemographic predictors of transitions across 6 stages of alcohol use in the National Comorbidity Survey Replication, a nationally representative household survey of the US population. METHODS A lifetime history of alcohol use, regular use (at least 12 drinks in a year), Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition alcohol abuse and dependence with abuse was collected in 5692 National Comorbidity Survey Replication respondents using the World Health Organization Composite International Diagnostic Interview, Version 3.0. RESULTS Lifetime prevalence estimates were 91.7% for lifetime alcohol use, 72.9% for regular use, 13.2% for abuse, and 5.4% for dependence with abuse. Male sex, young age, non-Hispanic white race/ethnicity, low education, student status, and never being married predicted the onset of alcohol use, the transition from use to regular use, and from regular use to abuse. An early age of onset of alcohol use also predicted the latter transition. The transition from abuse to dependence was associated with an early age of onset of regular alcohol use, being previously married, and student status. Remission was predicted by young age and a later age of onset of alcohol abuse. CONCLUSION The reduced number and magnitude of factors associated with transitions to dependence and remission suggest qualitatively different risk factors at these stages relative to other stages of progression. Further knowledge is needed concerning the mechanisms underlying these differences to guide selective and indicated prevention programs.
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Affiliation(s)
- Amanda Kalaydjian
- Intramural Research Program of the National Institutes of Health, National Institute of Mental Health, Bethesda, MD 20893, USA.
| | - Joel Swendsen
- National Center for Scientific Research (CNRS 5231), France
| | - Wai-Tat Chiu
- Department of Health Policy, Harvard University, Boston, Massachusetts
| | - Lisa Dierker
- Wesleyan University, Department of Psychology, Middletown, Connecticut
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of NSW, Sydney, Australia
| | - Meyer Glantz
- Division of Epidemiology, Prevention and Services Research of the National Institutes of Health, National Institute On Drug Abuse, Bethesda, Maryland
| | - Kathleen R. Merikangas
- Intramural Research Program of the National Institutes of Health, National Institute of Mental Health, Bethesda, Maryland
| | - Nancy Sampson
- Department of Health Policy, Harvard University, Boston, Massachusetts
| | - Ronald Kessler
- Department of Health Policy, Harvard University, Boston, Massachusetts
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