Do Drinking Motives Mediate the Relationship between Neighborhood Characteristics and Alcohol Use among Adolescents?

Drinking to Cope is Uniquely Associated with Less Specific and Bleaker Future Goal Generation in Young Hazardous Drinkers

Groups with mental health and/or substance use problems generate less detailed descriptions of their future goals. As substance use to cope with negative affect is common to both groups, this characteristic might be uniquely associated with less specific goal descriptions. To test this prediction, 229 past year hazardous drinking undergraduates aged 18-25 years wrote about three positive future life goals in an open-ended survey, before reporting their internalizing (anxiety and depression) symptoms, alcohol dependence severity and motivations for drinking: coping, conformity, enhancement and social. Future goal descriptions were experimenter-rated for detail specificity, and participant-self-rated for positivity, vividness, achievability, and importance. Effort in goal writing was indexed by time spent writing and total word count. Multiple regression analyses revealed that drinking to cope was uniquely associated with the production of less detailed goals, and lower self-rated positivity and vividness of goals (achievability and importance were also marginally lower), over and above internalizing symptoms, alcohol dependence severity, drinking for conformity, enhancement and social motives, age, and gender. However, drinking to cope was not uniquely associated with reduced effort in writing goals: time spent and word count. In sum, drinking to cope with negative affect is a unique characteristic predicting the generation of less detailed and bleaker (less positive and vivid) future goals, and this is not due to lower effort in reporting. Future goal generation may play a role in the aetiology of comorbidity of mental health and substance use problems, and therapeutic targeting of goal generation might benefit both conditions.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10862-023-10032-0.

Family affluence as a protective or risk factor for adolescent drunkenness in different countries and the role drinking motives play

AIMS

Previous research has shown mixed results (positive, negative or no effects) regarding socio-economic disparities in adolescent drunkenness. This study investigates whether family affluence is differently associated with frequency of adolescent drunkenness in traditional countries, at a later diffusion of innovation adopter stage according to the Theory of Diffusions of Innovations by Rogers (2003), compared with more progressive countries at a more advanced stage. Furthermore, we investigated as to whether differences in this association can be explained by differences in adolescent drinking motives.

METHODS

This study used data from the 2009/2010 survey of the Health Behaviour in School-aged Children (HBSC) study, including 25,566 alcohol-using adolescents aged 11-19 years old from 11 European countries. The Global Innovativeness Index was used to classify countries in progressive or more traditional countries. Multi-level regression analyses and structural equation modelling were conducted.

FINDINGS

In traditional countries, family affluence showed a positive association with adolescent frequency of drunkenness. A higher endorsement of social (drinking to celebrate an event) and enhancement motives (drinking to increase moods) by adolescents with a higher family affluence mediated this positive association between family affluence and frequency of drunkenness. In progressive countries, family affluence was negatively associated with frequency of drunkenness. In these countries, a higher endorsement of coping drinking motives by adolescents with a lower family affluence mediated this association.

CONCLUSION

A country's diffusion of innovation stage (i.e., traditional vs. progressive) seems to shape the direction of the association between family affluence and adolescent drunkenness including the psychological pathways that explain these socio-economic inequalities. This is most likely due to a quicker and smoother adoption of the new 'low drunkenness norms' ('it is not cool to drink to get drunk') in progressive countries and among adolescents with a higher family affluence.

Risk Pathways Contributing to the Alcohol Harm Paradox: Socioeconomic Deprivation Confers Susceptibility to Alcohol Dependence via Greater Exposure to Aversive Experience, Internalizing Symptoms and Drinking to Cope

Socioeconomic deprivation is associated with greater alcohol problems despite lower alcohol consumption, but the mechanisms underpinning this alcohol harm paradox remain obscure. Fragmented published evidence collectively supports a multistage causal risk pathway wherein socioeconomic deprivation increases the probability of exposure to aversive experience, which promotes internalizing symptoms (depression and anxiety), which promotes drinking alcohol to cope with negative affect, which in turn accelerates the transition from alcohol use to dependence. To evaluate this proposed risk pathway, 219 hazardous drinkers from an undergraduate population completed questionnaires assessing these constructs in a single, cross sectional, online survey. Partial correlation coefficients revealed that each variable showed the strongest unique association with the next variable in the proposed multistage model, when adjusting for the other variables. Bootstrapped serial mediation analysis revealed that the indirect pathway linking all the variables in the proposed serial order was significant, while all other permutations were non-significant. Network centrality analysis corroborated the serial order of this indirect path. Finally, risk ratios estimated by categorizing the variables suggested that socioeconomic deprivation increased the risk of aversive experience by 32%, which increased the risk of internalizing symptoms by 180%, which increased the risk of drinking to cope by 64%, which increased susceptibility to alcohol dependence by 59%. These preliminary findings need to be corroborated by future research, nevertheless, they call for prevention strategies founded on social justice and the minimization of aversive experience in socially deprived individuals to mitigate mental health problems, maladaptive coping and addiction.

Residents perceptions of the alcohol environment: A participatory photovoice project in two districts with different socio-economic status in a large city

The purpose of this study was to present the alcohol environment as perceived by its residents in two districts of Madrid using the Photovoice participatory methodology. Secondly, we compared the results according to the socio-economic status of the districts. The study was conducted in the city of Madrid, Spain, in two districts with different socio-economic status. A total of 26 people participated, who took and discussed photographs about their alcohol environment. They grouped them into 33 final categories, such as the socialising role of alcohol or the alcohol advertising. Co-authors further grouped participants final categories into seven general areas. The participants in the Photovoice project have helped to deepen the understanding of the alcohol urban environment. These results may help to design more effective policies to prevent hazardous alcohol consumption.

An examination of the extent to which drinking motives and problem alcohol consumption vary as a function of deprivation, gender and age

INTRODUCTION

Existing research points to a link between socioeconomic factors, alcohol consumption and harms, while another body of work documents the importance of varying motivations to drink in shaping alcohol behaviours. Yet, little is currently known about the extent to which alcohol consumption may be differentially associated with drinking motives as a function of deprivation, gender and age.

METHODS

Cross-sectional analysis of data from a UK sample aged between 18 and 75 years (n = 1639; 51% male, Mage 47.74, SD 14.66). Structural equation modelling, using clustering to account for the multi-level nature of the data set, was carried out to assesses the relationships between deprivation (Index of Multiple Deprivation), occupation, age, gender and problem alcohol consumption (Alcohol Use Disorder Identification Test) and social, conformity, enhancement and coping drinking motives.

RESULTS

Coping, enhancement and conformity, but not social, motives were associated with problem alcohol consumption. Drinking motives were stronger predictors of problem consumption than gender and age, with motives tending to be endorsed more strongly by younger and male respondents. Responses from participants with working-class occupations tended to be characterised by elevated endorsements of coping motives.

DISCUSSION AND CONCLUSION

Drinking motives are stronger predictors of problem alcohol consumption than socio-demographic variables although these factors exert influences on people's motives to drink.

Addiction is driven by excessive goal-directed drug choice under negative affect: translational critique of habit and compulsion theory

Drug addiction may be a goal-directed choice driven by excessive drug value in negative affective states, a habit driven by strong stimulus-response associations, or a compulsion driven by insensitivity to costs imposed on drug seeking. Laboratory animal and human evidence for these three theories is evaluated. Excessive goal theory is supported by dependence severity being associated with greater drug choice/economic demand. Drug choice is demonstrably goal-directed (driven by the expected value of the drug) and can be augmented by stress/negative mood induction and withdrawal-effects amplified in those with psychiatric symptoms and drug use coping motives. Furthermore, psychiatric symptoms confer risk of dependence, and coping motives mediate this risk. Habit theory of addiction has weaker support. Habitual behaviour seen in drug-exposed animals often does not occur in complex decision scenarios, or where responding is rewarded, so habit is unlikely to explain most human addictive behaviour where these conditions apply. Furthermore, most human studies have not found greater propensity to habitual behaviour in drug users or as a function of dependence severity, and the minority that have can be explained by task disengagement producing impaired explicit contingency knowledge. Compulsion theory of addiction also has weak support. The persistence of punished drug seeking in animals is better explained by greater drug value (evinced by the association with economic demand) than by insensitivity to costs. Furthermore, human studies have provided weak evidence that propensity to discount cost imposed on drug seeking is associated with dependence severity. These data suggest that human addiction is primarily driven by excessive goal-directed drug choice under negative affect, and less by habit or compulsion. Addiction is pathological because negative states powerfully increase expected drug value acutely outweighing abstinence goals.