Article

Context counts: Solitary drinking explains the association between depressive symptoms and alcohol-related problems in undergraduates

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Abstract

According to theory, depressed individuals self-medicate their negative affect with alcohol. Due to isolation and interpersonal difficulties, undergraduates with elevated depressive symptoms may do much of their drinking alone and/or in intimate contexts (e.g., with family or romantic partners) rather than at normative social events (e.g., parties). Evidence suggests drinking in these contexts leads to heavy use and alcohol-related problems. Accordingly, context may be an explanatory mechanism linking depressive symptoms to problematic drinking. This pathway remains understudied in the literature. Our study aimed to examine solitary and intimate drinking as distinct mediators of the depression-problematic drinking association. We hypothesized that depressive symptoms would be positively associated with solitary and intimate drinking which in turn would be associated with elevated alcohol use and related problems. Undergraduates (N=295; 72% women) completed online self-reports. Consistent with hypotheses, path analyses supported depressive symptoms as a positive predictor of solitary drinking, which in turn was a positive predictor of alcohol-related problems, but not of alcohol use. Counter to hypotheses, depressive symptoms were unrelated to intimate drinking. Interestingly, depressive symptoms were negatively associated with drinking at parties, which in turn led to reduced risk for elevated alcohol use and related problems. Our results shed new light on the depression pathway to problematic drinking in undergraduates by considering the role of drinking context. Our findings suggest undergraduates with elevated depressive symptoms are at risk for potentially problematic drinking because they are drinking alone. Solitary drinking represents a malleable target for clinical interventions aimed at reducing risky depression-related alcohol use. Copyright © 2014 Elsevier Ltd. All rights reserved.

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... Alcohol consumption and alcohol problems-Several cross-sectional studies found that adolescent and young adult solitary drinkers reported greater alcohol use than their social-only drinking peers [5,[8][9][10]15,18,51], and solitary drinking frequency was positively associated with alcohol use and problems in these individuals [52][53][54]. Further, solitary (versus social-only) young adult drinkers reported more alcohol-related problems [9], greater alcohol dependence severity [15], and less likelihood to change problem drinking [18], and adolescent solitary (versus social-only) drinkers reported more AUD symptoms [8]. Notably, in analyses controlling for alcohol use quantity/frequency, the association between solitary drinking (measured as both a continuous variable and a categorical yes/no variable) and alcohol problems held for both adolescents and young adults [5,8,53,54], suggesting that this association was not due to greater alcohol involvement but was specific to solitary drinking (although see [15] for null findings). ...
... Further, solitary (versus social-only) young adult drinkers reported more alcohol-related problems [9], greater alcohol dependence severity [15], and less likelihood to change problem drinking [18], and adolescent solitary (versus social-only) drinkers reported more AUD symptoms [8]. Notably, in analyses controlling for alcohol use quantity/frequency, the association between solitary drinking (measured as both a continuous variable and a categorical yes/no variable) and alcohol problems held for both adolescents and young adults [5,8,53,54], suggesting that this association was not due to greater alcohol involvement but was specific to solitary drinking (although see [15] for null findings). Corroborating this, the metaanalytical results revealed significant small effect sizes for the relationships between solitary drinking and both increased 'alcohol consumption' and more 'drinking problems' (see Table 3). ...
... Adolescent solitary drinkers reported more NA than adolescent socialonly drinkers [8], and young adult heavy solitary drinkers reported more depressive symptoms than their social-only drinking counterparts [9,15,18]. Additionally, solitary drinking frequency was positively associated with depressive symptoms among both adolescents and young adults [14,53], and quantity of alcohol consumed in solitary settings was related to suicidal ideation and attempts [27] and NA among young adults [58]. These associations may be bi-directional, given that NA has been shown to predict later solitary drinking in longitudinal research [54], and laboratory findings show that drinking in a solitary context increases NA [59][60][61]. ...
Article
Background and aims Emerging evidence suggests that solitary drinking may be an important early risk marker for alcohol use disorder. The current paper is the first meta‐analysis and systematic review on adolescent and young adult solitary drinking to examine associations between solitary drinking and increased alcohol consumption, alcohol problems, and drinking to cope motives. Methods PsychINFO, PubMed, and Google Scholar were searched using the PRISMA methodology and a pre‐registered PROSPERO protocol (#CRD42020143449). Data from self‐report questionnaires regarding negative correlates of solitary drinking (e.g., alcohol problems) and solitary drinking motives (e.g., drinking to cope) were pooled across studies using random effects models. Studies included adolescents (ages 12‐18) and young adults (mean age between 18‐30 or samples with the majority of participants age 30 or younger). Results Meta‐analytic results from 21 unique samples including 28,372 participants showed significant effects for the associations between solitary drinking and the following factors: increased alcohol consumption, r=0.23, 95%CI [0.13,0.33]; drinking problems, r=0.23, 95%CI [0.13,0.32]; negative affect, r=0.21, 95%CI [0.16,0.26]; social discomfort, r=0.17, 95%CI [0.06,0.27]; negative reinforcement, r=0.28, 95%CI [0.24,0.31]; and positive reinforcement, r=0.10, 95%CI [0.03, 0.17]. These associations were not moderated by age group (i.e., adolescent versus young adult), study quality, or differing solitary drinking definitions. Accounting for publication bias increased the effect sizes from r=0.23 to 0.34 for alcohol consumption and from r=0.23 to 0.30 for drinking problems, and lowered it from r=0.10 to 0.06, and r=0.17 to 0.11, for positive reinforcement and social discomfort, respectively. Conclusions Solitary drinking among adolescents and young adults appears to be associated with psychosocial/alcohol problems and drinking to cope motives.
... Given that isolation and solitary drinking, financial stress, and academics have been shown to impact drinking behavior (Brown & Richman, 2012;de Goeij et al., 2015;Keough et al., 2015;Singleton, 2007;Wormington et al., 2011); we hypothesized stressors related to isolation, the COVID-19 virus, academics, living situation, and finances would increase drinking in college students. We also examined sex differences in pandemic-related stress and drinking behavior due to evidence suggesting females are more likely to drink to cope with stress compared to males (Peltier et al., 2019). ...
... Additionally, drinking alone predicted much higher AUDIT-C scores, well above the problematic drinking cutoff, in males but not females. Given the relationship between depressive symptoms and solitary drinking (Keough et al., 2015), it is possible that these individuals were experiencing heightened depressive symptoms and were using alcohol as a coping mechanism. Moreover, the hesitancy of some men to seek out social support for mental health problems (McKenzie et al., 2018;Staiger et al., 2020) may have made them more susceptible to the isolation stress and more likely to use alcohol as a coping mechanism for being alone. ...
Article
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The COVID-19 pandemic brought about unprecedented stressors for college students. Early reports found the immediate onset of these stressors led to increased problematic drinking and psychological distress in university students. However, it has remained unclear what lasting effects the pandemic will have on drinking and coping mechanisms. The current study examined the impact of prolonged COVID-19 stressors on the drinking behavior of college students a year into the pandemic. College students (N = 377) completed an online survey in the spring of 2021 that assessed their drinking during the pandemic, coping styles, and level of stress on 8 COVID-19 specific stressors developed by the research team. Our results showed a large percentage of college students continued to report problematic and increased drinking a year into the pandemic. Stress concerning online education was the strongest predictor of increased drinking, problematic drinking, and using substances to cope. These results suggest that students may be sensitive to abrupt changes in learning modality, and many may turn to negative coping mechanisms. This is an important consideration for educators when making changes to their instructional plans and suggests helping students regain an internal locus of control concerning their academics could be beneficial.
... Correlates of solitary alcohol use may generalize to solitary cannabis use. These may include demographic correlates such as male sex (Creswell et al. 2014), older age (Hopfer, Tan, and Wylie 2014), and earlier age at initiation of regular use and/or intoxication (Creswell et al. 2014;Keough et al. 2015). Additionally, several affective and social factors associated with solitary drinking may generalize to solitary cannabis use, including depression (Bilevicius et al. 2018;Keough et al. 2015), social anxiety (Keough et al. 2016), loneliness (Stickley et al. 2015), or interpersonal sensitivity (Mohr et al. 2001). ...
... These may include demographic correlates such as male sex (Creswell et al. 2014), older age (Hopfer, Tan, and Wylie 2014), and earlier age at initiation of regular use and/or intoxication (Creswell et al. 2014;Keough et al. 2015). Additionally, several affective and social factors associated with solitary drinking may generalize to solitary cannabis use, including depression (Bilevicius et al. 2018;Keough et al. 2015), social anxiety (Keough et al. 2016), loneliness (Stickley et al. 2015), or interpersonal sensitivity (Mohr et al. 2001). Affective and social correlates may be of particular importance given higher levels of depression, anxiety, and loneliness reported by college students in the context of the COVID-19 pandemic (Horigian, Schmidt, and Feaster 2021). ...
Article
Solitary cannabis use has been associated with greater cannabis problems than social use and may be increasingly prevalent due to pandemic-related isolation. However, little is known about patterns, correlates, and consequences of solitary cannabis use. This study sought to characterize solitary cannabis use since pandemic onset, examine psychosocial risk factors, and examine interactions between solitary and social cannabis use frequency on cannabis consequences. College students (N = 168) who were lifetime cannabis users at a private, northeastern university in the US completed an online cross-sectional survey in fall of 2020. Past-year solitary cannabis use was common among life-time cannabis users (42% past year, 29% monthly or more), especially among past-year regular cannabis users (85% monthly or more). Solitary use frequency was associated with interpersonal sensitivity and pandemic-related stress. Further, solitary use attenuated associations of social use frequency with cannabis consequences, such that social use frequency was associated with greater consequences only among exclusively social users. In contrast, regardless of social use frequency, solitary users reported greater cannabis consequences than exclusively social users. Findings suggest solitary cannabis use is concurrently associated with greater cannabis consequences, and affective risk factors (interpersonal sensitivity, pandemic stress) should be considered for prevention and intervention strategies.
... Non-drinkers in this study may have included both never-and former-drinkers and thus associations with non-drinkers should be treated with caution; however, the link between extremes of social support and extremes of drinking found in this study, and in previous research, indicates that loneliness and social isolation affect people differently in terms of alcohol consumption. It might be that people who feel lonely and/or are socially isolated and consume alcohol, do so to manage these negative feelings, and both drinking to cope with negative feelings (161)(162)(163) and drinking alone, particularly amongst young people (254)(255)(256)(257), have been linked to more harmful alcohol consumption. Equally, those who do not drink to cope with negative emotions may manage their loneliness/isolation in different ways, and may also have fewer (social) opportunities to consume alcohol. ...
... So, some of the people I know will go and have ten pints in the pub every day, but they're in the boozer, so they think ten pints is fine. (Participant B, male, inpatient) The view that drinking alone is in itself problematic is pervasive (129) and indeed there is a significant literature base stating that solitary drinking is associated with more problems with alcohol (255,256,338). This was acknowledged by some participants, though not enthusiastically: Despite the traditional view that drinking alone is problematic, recent evidence suggests that a significant proportion of drinking occasions (17% of drinking occasions within a large UK quota sample) take place alone and the majority of these occasions are low risk (339). ...
Thesis
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Background Both social support and alcohol consumption are known to influence health outcomes, but the relationship between social support and alcohol consumption is complex and poorly understood. A better understanding of which aspects of social support influence risky drinking could lead to improved public health messaging and interventions that incorporate social, as well as health aspects of alcohol consumption. Methods A mixed methods design was used to explore the relationship between social support and alcohol consumption at different life course stages. Cross-sectional data from the National Child Development Study and the UK Household Longitudinal Study were used in i) multinomial logistic regression models exploring associations between aspects of social support and alcohol consumption and ii) structural equation models testing the direct and indirect (via psychological distress) effects of quality of support on alcohol consumption. A thematic analysis of qualitative one-to-one interviews undertaken with 12 adults accessing alcohol treatment services was conducted. Results Key areas of social support associated with risky drinking were identified: conflict and negative support; isolation and loneliness; supportive and unsupportive friendships. Depending upon the quality of support, relationships with partners could be protective of, or associated with, risky drinking. There were no clear differences according to life course stage; however, psychological distress mediated the relationship between quality of support and drinking frequency amongst early adults and drinking volume amongst mid-adults. Conclusions Negative aspects of support, such as conflict, isolation and loneliness, were associated with risky drinking; however, so were positive aspects, such as emotional support from friends. Mixed methods enabled the representation of heavy drinker experiences missed from population-level surveys. Measures of drinking risk should consider life course stage. Interventions to address risky drinking should consider drinking motivations linked to social support to identify and address coping motives, and support the maintenance of positive relationships.
... That is, based on the distribution of the bootstrapped histograms, the coefficient was negative and indicated that increases in NA were associated with solitary alcohol consumption over social alcohol consumption. This supports prior research in which NA and related constructs (e.g., depression) have shown positive associations with solitary drinking (e.g., [7,11,12,46]). Similarly, PA change was not retained in a final model suggesting that it has less importance in influencing solitary drinking behavior. ...
... These findings support the current literature on solitary drinking to a degree. The increased preference of individuals high in neuroticism to choose to drink alcohol alone aligns with prior research on related constructs and their associations with solitary drinking (e.g., positive associations between NA experiences/traits and solitary drinking; e.g., [46]). However, the post hoc findings also showed that increases in NA did not lead to increased choices of solitary alcohol consumption over social alcohol consumption for those high in neuroticism-in fact, there was not a discernable difference in choices across smaller and larger changes in NA in these individuals. ...
Article
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Solitary drinking is a risk marker for alcohol use disorder; thus, it is important to identify why individuals drink alone and for whom this association is particularly relevant. Evidence suggests the desire to ameliorate negative affect (NA) motivates solitary drinking, with some individuals particularly likely to drink alone to cope, but all past studies are cross-sectional. The present study therefore aimed to determine whether 1) experimentally induced NA increased preferences to drink alcohol alone, and 2) whether the relationship between NA and choosing to drink alcohol alone was moderated by neuroticism, drinking to cope motives, and social anxiety. Current drinkers (ages 21-29) with a solitary drinking history (N=126) were randomly assigned to either NA, positive affect [PA], or no affect change (control) conditions via differing cognitive task feedback. After the mood manipulation, participants chose between drinking alcoholic or nonalcoholic beverages in one of two contexts: alone or socially. Evidence regarding effectiveness of the mood manipulation was mixed, and few chose non-alcoholic beverages in either context. Condition did not influence outcome choice. Across conditions, increases in NA and the importance placed on receiving one’s context choice were associated with solitary (versus social) alcohol preference. Neuroticism and its interaction with NA change also influenced choice; individuals high in neuroticism chose more solitary (versus social) drinking contexts while the opposite was true for those low in neuroticism, and among the latter, the preference difference was more pronounced with relatively smaller NA increases. Findings are discussed based on the existing solitary drinking literature.
... Evidence also suggests that lone drinking, regardless of setting, is associated with alcohol-related social harms (Keough et al., 2018;Bilevicius et al., 2018;Creswell et al., 2014). However, this evidence is focused among much younger adults and did not explore the alcohol-related harms to family members and close friends (Keough et al., 2018;Keough et al., 2015;Creswell et al., 2014). In the same way, there is scarce evidence assessing links between drinking in a social context and harms affecting family members and friends . ...
... Our findings among women are partly consistent with longitudinal findings suggesting a mediating role of solitary drinking in the association between depressive symptoms and harmful drinking (Bilevicius et al., 2018). The mechanism underlying this association remains unclear; however, it has long been suggested that solitary drinking is a coping strategy for people with depressive symptoms (Keough et al., 2015;Creswell et al., 2014). ...
Article
Aims: Understanding contexts in which social harms from drinking occur can help develop context-based harm reduction efforts. However, there is little knowledge of specific drinking contexts where such harms occur and whether these are gender or age specific. We aimed to investigate associations of a range of drinking contexts and social harms from drinking among young adults at age 30. Methods: We used data from 2187 30-year-old adults. Latent constructs of gender-specific drinking contexts were created using factor analysis. We performed multivariate logistic regression between drinking contexts and a range of social harms from drinking, separately by gender. Results: After accounting for social roles and binge drinking, gender-specific solitary drinking contexts ('home drinking' for men and 'daytime drinking' for women) were positively associated with marital problems and problems with other family members and friends. Conversely, 'social drinking' was not. Work-related drinking among men was associated with marital/intimate relationship problems and friendship problems. After accounting for mental health symptoms, women's home drinking was associated with marital problems. Conclusion: We found that experiences of social harms from drinking at 30 years differ depending on the drinker's gender and context. Our findings suggest that risky contexts and associated harms are still significant among 30-year-old adults, indicating that a range of gender-specific drinking contexts should be represented in harm reduction campaigns. The current findings also highlight the need to consider gender to inform context-based harm reduction measures and to widen the age target for these beyond emerging adults.
... Several studies have found that solitary drinking is related to both high-risk alcohol use and alcohol-related problems (e.g., Bilevicius et al., 2018;Bourgault & Demers, 1997;Christiansen et al., 2002;Creswell, Chung, Clark, & Martin, 2014;Gonzalez et al., 2009;Holyfield, Ducharme, & Martin, 1995;Keough, Battista, O'Connor, Sherry, & Stewart, 2016;Keough, O'Connor, Sherry, & Stewart, 2015;Keough, O'Connor, & Stewart, 2018;Skrzynski et al., 2018). More recent studies have used comprehensive designs to more clearly isolate solitary drinking as a risk factor. ...
... In an effort to better understand associations between solitary drinking and risk for later alcohol-related problems, several studies have examined relations between solitary drinking and other known risk factors including depression, anxiety, and/or loneliness. For example, Keough et al. (2015) and Buckner and Terlecki (2016) found that solitary drinking mediated the effect of depressive and anxiety symptoms, respectively, on alcohol-related problems, and Bilevicius et al. (2018) found that solitary drinking mediated the effect of negative affect on alcohol-related problems. Additionally, Åkerlind and Hörnquist (1992) suggest that individuals may drink in solitary settings because they lack social support to drink in a group, and Gonzalez et al. (2009) found that suicidal ideation was associated with more frequent solitary drinking. ...
Article
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Recent studies suggest that solitary (but not social) drinking may confer risk for negative alcohol consequences via beliefs about alcohol's ability to reduce tension, and explicit motivations to drink to cope with negative mood states. However, because prior studies are largely cross-sectional, it is unclear if tension reduction expectancies and drinking to cope are antecedents or consequences of solitary drinking. The current study aimed to address this gap in the literature using prospective data (3 waves across 12 months) from a sample of moderate to heavy drinking young adults. Data were drawn from a larger investigation of contextual influences on subjective alcohol response. Participants (N = 448) reported on alcohol use in multiple drinking contexts and tension reduction expectancies at baseline (T1), drinking motives at a 6-month follow-up (T2), and past-month negative alcohol consequences at a 12-month follow-up (T3). We examined potential indirect effects of drinking contexts on negative consequences operating through alcohol expectancies and drinking motives. Solitary drinking was indirectly associated with later negative consequences through stronger coping motives, although tension reduction expectancies did not serve as a significant mediator. Social drinking was not directly or indirectly related to later alcohol consequences. Results suggest that solitary drinking contexts confer risk for negative consequences through coping motives, and that these effects are invariant across sex, race, and ethnicity. These findings have important clinical implications as they suggest that targeting solitary drinkers for skills-based coping interventions may reduce risk for a developmental trajectory toward negative alcohol consequences. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
... Indeed, solitary drinking episodes are related to higher levels of alcohol problems than are social drinking episodes (Gonzalez et al., 2009), which may be in part due to the fact that solitary drinking seems driven by coping motives, which are often associated with higher levels of alcohol problems than other motives for drinking (e.g., enhancement, conformity, celebration;Gonzalez et al., 2009;Mohr et al., 2013). In support of this explanation, those reporting solitary drinking are more likely to report depression, suicidal ideation, and anxiety (Gonzalez et al., 2009), and solitary drinking mediates the relation between both depression and alcohol problems among young adults (Keough et al., 2015). Solitary drinking may also be associated with a loss of control over drinking (Keough et al., 2018) and increased risk for alcohol use disorder (Creswell et al., 2014). ...
... Further, our findings corroborated evidence suggesting higher correlations between solitary drinking and these 3 specific alcohol problem domains compared to other domains (Keough et al., 2018). Solitary drinking has been previously connected with coping motives and internalizing spectrum psychiatric states, such as anxiety and depression (Gonzalez et al., 2009;Keough et al., 2015Keough et al., , 2016, which are also uniquely connected with alcohol problems . Future research might investigate this phenomenon in the context of elevated stress or depressive symptoms and coping-related drinking motives (Dennhardt et al., 2016;Luciano et al., 2019). ...
Article
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Background Young adults typically drink in social settings and report high levels of episodic heavy drinking despite a range of adverse consequences. Behavioral economics posits that this may reflect a reinforcer pathology in which alcohol is overvalued relative to other reinforcers. Theoretically, the value of alcohol is related to both the direct pharmacological effects of alcohol (euphoria, sedation) and the associated social reinforcement, but to date no studies have differentiated the value of social vs. solitary drinking. The current study examines two modified hypothetical alcohol purchase tasks (APTs), one explicitly social and one explicitly solitary, in order to quantify the reward value of social vs. solitary drinking and to determine whether there are unique clinical correlates of solitary alcohol demand. Methods Participants were young adults (N = 274, Mage = 25.15, SD = 4.10) recruited from Mturk and from a university subject pool. Participants completed a solitary and social APT, in addition to measures of alcohol consumption and problems. Results Participants reported significantly greater demand in the social APT compared to the solitary APT across all demand indices. Elevated solitary and social demand were associated with elevated levels of alcohol use and problems. Using a residualized change approach, solitary demand amplitude (maximum consumption and expenditure) and persistence (price sensitivity) contributed additional variance above and beyond their social APT composite counterparts in predicting typical drinks per week and the self‐care, academic/occupational, and physical dependence subscales of the YAACQ. Conclusions The presence of peers increases alcohol demand compared to a solitary scenario, and greater relative solitary drinking demand may be a risk factor for greater alcohol consumption and problems.
... Solitary drinking more strongly predicts hazardous drinking and related consequences than social drinking (Keough, O'Connor, & Stewart, 2018). Further, solitary drinking explains the pathway between negative affect and harmful drinking (Bilevicius, Single, Rapinda, Bristow, & Keough, 2018) and between depressive symptoms and alcohol-related problems (Keough, O'Connor, Sherry, & Stewart, 2015). Thus, solitary drinking seems to be particularly harmful. ...
... In addition, the current study differentiated between social and solitary alcohol consumption and between average drinking quantity and drinking frequency. In view of research suggesting that social and solitary consumption leads to different outcomes (Bilevicius et al., 2018;Keough et al., 2015Keough et al., , 2018, making this distinction between social and solitary consumption is important. The current study suggests that drinking norms differentially influence these different forms of alcohol consumption, adding to our understanding of the nuances of normative effects on alcohol consumption. ...
Article
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Despite the wealth of research on the effects of drinking norms on college students' alcohol consumption, researchers have not yet examined changes in drinking norms and their association with drinking level after students leave the college environment. The current study filled this gap by following students into postcollege life, measuring drinking norms and daily drinking behavior. College students (N = 1,848) were recruited to take part in a daily diary study measuring social and solitary alcohol consumption, and 1,142 moderate to heavy drinkers from the college cohort were invited to complete a second wave of daily diaries 5 years later, with 906 providing at least 15 days of diary data in each wave. Results of multilevel modeling analyses suggest that family injunctive drinking norms become more strongly related to alcohol consumption after individuals leave college. In contrast, institutional injunctive norms may have a greater limiting effect among college students (i.e., the association was greater among college students) and the relations between friend injunctive and descriptive norms to drinking behavior did not change between waves in the current study. This suggests that friend drinking continues to be related to own drinking behavior among adults after leaving the college environment, and highlights the changing importance of institutional norms and family approval. These results may have implications for intervening in young adults' heavy drinking. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
... However, given that alcohol use by young people also occurs in private settings (Callinan, Livingston, Room, & Dietze, 2016;Dietze et al., 2014;Mustonen, Makela, & Lintonen, 2016;Wundersitz & Raftery, 2017), it has been suggested that drinking at home may also be a risky context for problematic drinking (Bahler et al., 2014;Huckle, Gruenewald, & Ponicki, 2016;Studer et al., 2015). Solitary drinking has also traditionally been linked with alcohol-related problems (Creswell, Chung, Clark, & Martin, 2014;Keough, O'Connor, Sherry, & Stewart, 2015) and, studies indicate that this context is associated with drinking among young people with depression (Baddeley, Pennebaker, & Beevers, 2013;Keough et al., 2015). In fact, depression has been consistently linked with harmful alcohol consumption (Boden & Fergusson, 2011;Caldwell et al., 2002;Sullivan, Fiellin, & O'Connor, 2005). ...
... However, given that alcohol use by young people also occurs in private settings (Callinan, Livingston, Room, & Dietze, 2016;Dietze et al., 2014;Mustonen, Makela, & Lintonen, 2016;Wundersitz & Raftery, 2017), it has been suggested that drinking at home may also be a risky context for problematic drinking (Bahler et al., 2014;Huckle, Gruenewald, & Ponicki, 2016;Studer et al., 2015). Solitary drinking has also traditionally been linked with alcohol-related problems (Creswell, Chung, Clark, & Martin, 2014;Keough, O'Connor, Sherry, & Stewart, 2015) and, studies indicate that this context is associated with drinking among young people with depression (Baddeley, Pennebaker, & Beevers, 2013;Keough et al., 2015). In fact, depression has been consistently linked with harmful alcohol consumption (Boden & Fergusson, 2011;Caldwell et al., 2002;Sullivan, Fiellin, & O'Connor, 2005). ...
Article
Aims: Understanding the social contexts in which problematic drinking occurs can inform prevention strategies. In this article, we investigate gender-specific social contexts associated with problematic drinking and depression among adults aged 30 years. Because depression has been consistently linked with harmful alcohol consumption, we will also examine its association with drinking contexts. Methods: We used data from 2490 young adults who completed the 30-year follow-up phase of the Mater-University of Queensland Study of Pregnancy and its Outcomes, a prospective study commenced in 1981. Exploratory and confirmatory factor analyses were used to identify latent constructs of drinking contexts stratified by gender, with subsequent regression analysis to assess the role of these contexts in problematic drinking (measured using the Alcohol Use Disorders Identification Test). Results: Six distinct drinking contexts were identified, which differed by gender, three for men and three for women. For both men and women, “social drinking”, was associated with problematic drinking. “Home drinking” was also common to men and women but associations with problematic drinking differed, being risky only among men. “Daytime drinking” (women) was associated with risk but “work-related drinking” (men) was not. Both “home drinking” (men) and “daytime drinking” (women) were linked to depression symptoms. Conclusion: Specific contexts appeared to be associated with problematic drinking for both sexes. Among both men and women, “social drinking” was associated with problematic drinking. Both “home drinking” (men) and “daytime drinking” (women) contexts, were associated with problematic drinking and depressive symptoms. Targeted alcohol-focused interventions need to address co-occurring mental health issues.
... Nevertheless, several studies have sought to incorporate drinking context into motivational models of substance use. Research suggests that higher levels of negative affectivity are indirectly related to alcohol problems through solitary drinking (Bilevicius et al., 2018;Buckner & Terlecki, 2016;Keough et al., 2015), and drinking to cope is indirectly associated with alcohol problems through solitary drinking (e.g., Creswell et al., 2015;Gonzalez et al., 2009). Thus, within a motivational and affective processing framework, findings suggest that negative affectivity predisposes individuals to drink to cope, which is indirectly related to alcohol problems through solitary drinking. ...
Article
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Objective: Decades of research has found support for the motivational model of alcohol use at the between-person level, yet research on event-level drinking motives is in its nascent stage. Similarly, drinking context has been largely ignored in studies of day-level motives. Therefore, the present study sought to test whether drinking context mediates the relation between affect and motivation on drinking outcomes at both day and person levels. Method: Emerging adults who drank in solitary and social settings (N = 107; 61.2% female) completed 21 days ecological momentary assessments. Affect was assessed during morning/afternoon reports; drinking motives were assessed during afternoon reports; and past-night drinking context, drinking quantity, and negative consequences were assessed during next morning reports. Two-level multilevel structural equation models tested whether within-person and between-person levels of predrinking affect were indirectly associated with negative consequences through predrinking motives, drinking context (social vs. solitary), and drinking quantity. Results: At the day and person levels, positive affect was associated with higher social and enhancement motives. At the day level, positive affect indirectly predicted consequences through social motives, social (vs. solitary) drinking, and drinking quantity, whereas positive affect indirectly predicted consequences through enhancement motives and drinking quantity above and beyond context. At the day and person levels, negative affect was associated with coping motives, but coping was not associated with context, drinking quantity, nor consequences. Conclusions: Findings suggest that positive affect was linked to drinking outcomes through motives (enhancement and social) and contexts (social), whereas negative affect was not. Findings suggest that positively valenced drinking motives may be an important just-in-time intervention target.
... Studies on solitary drug use are predominantly focused on alcohol and cannabis. Solitary alcohol use tends to be associated with problematic use (Keough, O'Connor, Sherry, & Stewart, 2015) and negative outcomes such as depression (Christiansen, Vik, & Jarchow, 2002;Cooper, Russell, Skinner, & Windle, 1992). Similarly, solitary cannabis use tends to be associated with problematic cannabis use such as emotion-focused coping (Creswell, Chung, Clark, & Martin, 2015;Spinella, Stewart, & Barrett, 2019;Tucker, Ellickson, Collins, & Klein, 2006). ...
... Furthermore, the relationship between alcohol consumption and depression is more related to larger quantities of alcohol intake per occasion and unrelated to frequency of consumption [40]. However, depression has been related to alcohol-related problems mainly through solitary drinking [41]. Another study also reported that the relationship between depression and alcohol use was more significant for females who met the criteria for major depression and those with heavy episodic alcohol consumption [39]. ...
... In addition to problematic alcohol consumption, solitary drinking is associated with several other negative psychosocial factors in adolescents and young adults, including problems in emotional, social, academic, and legal domains (e.g., [12][13][14][15]). For instance, solitary drinkers report more negative affect and social discomfort (e.g., greater social anxiety; lower perceptions of social skills) [4,[16][17][18], earn poorer grades [13], engage in more violent and deviant acts [15], and experience more problems with authorities than their social-only drinking peers [19]. Because solitary drinking is a risky drinking style, it is critical to know why individuals engage in this behavior to develop effective intervention and prevention programs aimed at helping those most vulnerable to drinking alone. ...
Article
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Objective Adolescent and young adult solitary drinking is prospectively associated with alcohol problems, and it is thus important to understand why individuals engage in this risky drinking behavior. There is substantial evidence that individuals drink alone to cope with negative affect, but all prior studies have assessed motives for alcohol use without specifying the context of such use. Here, we directly compared solitary-specific drinking to cope motives with general drinking to cope motives in their ability to predict solitary drinking behavior and alcohol problems. We hypothesized that solitary-specific drinking motives would provide additional predictive utility in each case. Methods Current underage drinkers (N = 307; 90% female; ages 18–20) recruited from a TurkPrime panel March-May 2016 completed online surveys querying solitary alcohol use, general and solitary-specific coping motives, and alcohol problems. Results Both solitary-specific and general coping motives were positively associated with a greater percentage of total drinking time spent alone in separate models, after controlling for solitary-specific and general enhancement motives, respectively. However, the model with solitary-specific motives accounted for greater variance than the general motives model based on adjusted R² values (0.8 versus 0.3, respectively). Additionally, both general and solitary-specific coping motives were positively associated with alcohol problems, again controlling for enhancement motives, but the model including general motives accounted for greater variance (0.49) than the solitary-specific motives model (0.40). Conclusion These findings provide evidence that solitary-specific coping motives explain unique variance in solitary drinking behavior but not alcohol problems. The methodological and clinical implications of these findings are discussed.
... Solo drinking, as opposed to social drinking, was generally perceived in the literature to be against the social norms of drinking culture. University students with more depressive traits and higher anxiety were more likely to engage in solitary drinking or solitary predrinking, and were more likely to develop problematic drinking habits (Ju et al., 2019;Keough et al., 2015Keough et al., , 2016. Young adults also exhibited a high correlation between depression and anxiety, and frequent solitary drinking (Bilevicius et al., 2018;Samoluk et al., 1999). ...
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It is counterintuitive to suggest that even in solitude one is not completely separated from the world, as the social and physical surroundings might continue to interact with internal experiences. This systematic review explored the roles of norms and the physical environment in shaping individuals’ perceptions of being alone. We conducted searches in Medline, Web of Science, PsycINFO, and Google Scholar, for both published and unpublished articles between 1981 and 2021 using specific keywords. Using a set of predetermined inclusion criteria, 157 papers met the criteria. We summarised statistics on study designs and sample characteristics, coded and organised themes into three sections. First, we identified norms that form around specific activities that appear to shape perceptions and experiences in solitude and strategies that the individual adopts to cope with it. Second, when it comes to physical environment, solitude is more positive in spaces with less social intrusion and when there are less safety concerns. Across the first two themes, there is also interaction between norms and physical environment, with specific norms that apply for women, and especially women from non-Western cultures, being alone in public spaces. Finally, norms and experiences vary depending on what stage of life one is at, with solitude and solo experiences being portrayed as more maladaptive and unfavourable earlier on in life while these experiences become more tolerable and enjoyable in older ages. Overall, findings from this review suggested that research on solitary experiences need to be contextualized within societal and physical contexts where they occur.
... Importantly, contemporary conceptualizations of the negative reinforcement model propose that individuals who engage in excessive drinking behavior tend to endorse coping with negative affect as a motivation for alcohol use (Webb et al., 2020), and report greater depressive symptoms (Keough et al., 2015), which by extension, may also relate to an NMB. Indeed, greater alcohol consumption is associated with using alcohol as a coping mechanism (Patrick and Schulenberg, 2011;Decaluwe et al., 2019), which may facilitate alcohol-related neurological changes that, in turn, increase recall of negative information (Stephens and Duka, 2008). ...
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Background In this three-part study, we investigate whether the associations between binge and problematic drinking patterns with a negative emotional memory bias (NMB) are indirectly related through coping motivations and depressive symptoms. We also address potential sex differences in these relations. Methods Participants (N = 293) completed the Timeline Followback to assess binge drinking, the Alcohol Use Disorder Identification Test (AUDIT) to assess problematic alcohol use, the Drinking Motives Questionnaire-Revised to assess coping motivations, and the Depression, Anxiety, and Stress Scales-21 to assess depression. Participants were asked to identify whether 30 emotional sentences were self-referent or not in an incidental encoding task; 24 h later they were asked to recall as many sentences as possible and a negative memory bias score was calculated. Results Across all three studies, we found significant bivariate relations between AUDIT scores, coping, depression, and an NMB, particularly for sentences participants deemed self-referent. In two undergraduate samples, there were significant indirect effects through coping motivations and depressive symptoms between binge drinking and an NMB in females as well as between AUDIT scores and an NMB in females only. In the community sample, there was only an indirect effect through coping motives, but this was observed in both females and males. Conclusion These findings support a relation between binge drinking as well as problematic alcohol use and a self-referent NMB in the context of coping motivations for alcohol use and depressive symptoms. Moreover, the pattern of findings suggests this model primarily holds for females, yet may also apply to males at higher levels of problematic alcohol use.
... Future research should examine whether occasions where young adults are more willing to engage in simultaneous use when feeling stressed/down/sad are associated with more negative consequences. If such associations are found for simultaneous use, this would correspond to alcohol research that has found people report experiencing more drinking consequences (controlling for consumption) when they report feeling more depressed or increased negative affect (Keough et al., 2015;Simons et al., 2005). If so, these situations of simultaneous use may be high risk and should be considered targets for in-the-moment intervention. ...
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Background Alcohol and cannabis use are common among young adults and most young adults who use both substances have used them simultaneously (i.e., using both substances so their effects overlap). Because simultaneous use is associated with a greater number and severity of consequences than single substance use, research is needed to examine the decision‐making process of engaging in this high‐risk behavior. We conducted a qualitative examination of intentions (i.e., plans) and willingness (i.e., one's openness to engage in the behavior if an opportunity presents itself) to engage in simultaneous use from the perspective of young adults who frequently report this substance use behavior. Methods We recruited 36 young adults who reported simultaneous use and heavy drinking (4+/5+ drinks for women/men; 64% women, ages 18 to 25) to participate in semi‐structured interviews. All interviews were double coded for thematic analysis and both novel and a priori themes were found. Results Young adults distinguished between intending to engage in simultaneous use and being willing to engage in simultaneous use. They reported that intentions and willingness varied from occasion to occasion. They also reported that context and alcohol consumption influenced their willingness to engage in simultaneous use. Peer pressure or offers increased their willingness to use cannabis while drinking and having current or next‐day responsibilities decreased their willingness to engage in simultaneous use. Additionally, planned simultaneous use occasions were characterized as being special events where young adults consumed more substances, but were more likely to monitor their use than unplanned occasions. Conclusions Intentions and willingness may be important proximal predictors of simultaneous use of alcohol and cannabis. Building off this qualitative work, quantitative research should identify which factors influence the decision‐making process to engage in simultaneous use and determine when intentions and willingness are most predictive of risky simultaneous use behavior.
... Furthermore, the relationship between alcohol consumption and depression is more related to larger quantities of alcohol intake per occasion and unrelated to frequency of consumption [40]. However, depression has been related to alcohol-related problems mainly through solitary drinking [41]. Another study also reported that the relationship between depression and alcohol use was more significant for females who met the criteria for major depression and those with heavy episodic alcohol consumption [39]. ...
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Aim: To determine the prevalence and correlations of depression and problematic drinking among undergraduates in a Nigerian University. Study Design: The study design was a descriptive cross-sectional survey Methodology: The study was conducted among 412 full-time undergraduates of LAUTECH, 18 years and above and apparently well without previous history of mental illness. Alcohol Use Disorder Identification Test (AUDIT) and Patient Health Questionnaire-9 (PHQ-9) are instruments used for the study. Data analysis was done with the statistical package for social sciences version 21. Results: Approximately half (49.5%) of the respondents were depressed and 20.4% of them had major depression. The prevalence of problematic alcohol use in the study population was 10.4% mostly among males. There was no significant association between depression, alcohol use and problematic alcohol use (χ 2 = 1.125, df = 1, P-value = 0.289) in the study sample. Original Research Article Alatishe et al.; INDJ, 17(4): 25-36, 2022; Article no.INDJ.90500 26 Conclusion: The increasing prevalence of depression and problematic drinking among university students is worrisome as this will not only adversely impact their academic performance but future productivity and the risk of other psychosocial and health problems.
... As drinking motives are in part influenced by contextual factors Klinger, 1988, 2011), theory suggests that drinking in a solitary setting is more closely associated with negative affectivity and drinking to cope, thereby increasing risk for alcohol-related problems, directly (Creswell, 2021). In support, cross-sectional studies show that negative affect is indirectly linked to alcohol problems via solitary drinking (e.g., Bilevicius et al., 2018;Keough et al., 2015Keough et al., , 2018. However, temporal relations among solitary drinking, coping motives, and alcohol problems are less clear given that most prior studies have been cross-sectional or examined only one direction of effect. ...
Article
Introduction Solitary drinking (i.e., drinking alone) and coping drinking motives are risk factors for alcohol problems. Theoretical models suggest that solitary drinking and coping motives are highly related. However, the direction of effects between solitary drinking and coping motives is unclear. It also remains unclear if relations are present solely at the between-person level, or if there are also dynamic, within-person relations. Therefore, the current study tested dynamic, reciprocal relations among solitary drinking, coping motives, and alcohol problems using Random Intercept Cross Lagged Panel Modeling (RI-CLPM). Methods Data came from a large alcohol administration study with longitudinal follow-ups over 2 years (N=448). Participants completed a baseline session and then were followed up 6, 12, 18, and 24 months later. Participants reported their solitary drinking frequency, coping motives, drinking behavior, and alcohol problems at all assessments. Results Person-level solitary drinking was related to person-level coping motives and alcohol problems, and person-level coping motives were related to person-level alcohol problems. There were also contemporaneous within-person effects, such that a within-person increase in solitary drinking was associated with a concurrent within-person increase in coping motives, and a within-person increase in coping motives was associated with a concurrent within-person increase in alcohol problems. There were no within-person prospective relations among any variables. Conclusions Findings suggest strong between-person associations among solitary drinking, coping motives, and alcohol problems. Within-person associations were concurrent but not prospective. Targeting solitary and coping-motivated drinkers, as well within-person increases in both may be effective at reducing risk for alcohol problems.
... Nevertheless, several studies have sought to incorporate drinking context into motivational models of substance use. Research suggests that higher levels of negative affectivity are indirectly related to alcohol problems through solitary drinking (Bilevicius et al., 2018;Buckner & Terlecki, 2016;Keough et al., 2015), and drinking to cope is indirectly associated with alcohol problems through solitary drinking (e.g., Creswell et al., 2015;Gonzalez et al., 2009). Thus, within a motivational and affective processing framework, findings suggest that negative affectivity predisposes individuals to drink to cope, which is indirectly related to alcohol problems through solitary drinking. ...
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Objective: Decades of research has found support for the motivational model of alcohol use, such that positive/negative affect are indirectly associated with drinking behavior through drinking motives. However, research on event-level drinking motives is in its nascent stage, and studies have yet to consider how drinking context plays a role in the motivational pathway to both event- and person-level drinking behavior. Therefore, the present study seeks to test whether drinking context mediates the effect of affect and motivation on drinking outcomes at both the event- and person-level. Method: Data for this Stage 1 Registered Report will come from a recently completed ecological momentary assessment (EMA) study in emerging adults. The study collected data on 131 emerging adults, of whom 107 reported event-level social and solitary drinking during the EMA period. Multilevel structural equation modeling will be used to test whether predrinking affect is associated with predrinking motives, and whether drinking context (social vs. solitary drinking) mediates the effect of drinking motives on drinking outcomes. Models will parse within-/between-person variance, allowing the present study to test whether drinking context serves as a mechanism of risk in the motivational model at the event-level, or solely at the between-person level. Findings will inform personalized interventions and motivational models of drinking behavior.
... Even prior to the pandemic, AYA who reported solitary drinking were more likely to have depressive symptoms, suicidal ideation, and lower distress tolerance, which can lead to developing an alcohol use disorder (Creswell 2021;Keough et al. 2015;Williams, Vik, and Wong 2015). As the majority of colleges have resumed in-person classes, and students return to regular socialization practices, substance use may rise to pre-pandemic levels. ...
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Purpose This study seeks to characterize substance use, mental health, and academic persistence in college students during the COVID-19 pandemic, emphasizing variations by race, sexual orientation, and gender identity Methods National samples (n=146,810) of undergraduate students from the Healthy Minds Study were compared in two time periods: Fall 2017-Winter 2020 (pre-COVID) and March-December 2020. Descriptive statistics were conducted including t-tests/chi square tests comparing differences between time periods. Logistic regressions were estimated for main outcomes: substance use (licit, illicit, none), anxiety and/or depression symptoms, and academic persistence (student confidence that they will finish their degree). Marginal effects of race, sexual orientation, and gender identity were reported for all logistic regressions. Results In March-December 2020, students had 1.70 higher odds of screening positive for anxiety and/or depression compared to pre-COVID semesters. Latinx, Black, and “other” race/ethnicity had significantly higher probabilities of screening positive, as did transgender and gender non-conforming (TGNC) and lesbian, gay, bisexual, and queer (LGBQ) students.;Students had 0.43 times lower odds of reporting substance use in March-December 2020. Asian, Black, and Latinx students had significantly lower probabilities of reporting substance use, as did TGNC and LGBQ students.; During the pandemic, most students (86.7%) report at least 1 day of academic impairment (emotional/mental difficulties that hurt academic performance) in the last month due to mental health (up from 79.9% pre-pandemic). Conclusions Using the most comprehensive mental health data in college student populations, this is the first study to describe the impact of the pandemic on undergraduate students’ substance use, mental health, and academic persistence/impairment.
... Since the current study found underlying depression/anxiety in co-users, two additional person-level characteristics could be drinking to cope and solitary drinking, since both are related to depression/anxiety (e.g. Keough et al. 2015;Bravo and Pearson 2017), and AUD symptoms/ negative consequences (e.g. Morris et al. 2005;Corbin et al. 2020;Waddell et al. 2021b). ...
Article
Background Alcohol and cannabis co-use is associated with negative alcohol consequences and alcohol use disorder. However, mediating and distal effects remain largely unstudied. Co-use is associated with alcohol use disorder/negative consequences even when accounting for drinking levels and personality, suggesting that other person-level characteristics may explain relations between co-use and negative outcomes. Method The current study tested whether internalizing symptoms, strong correlates of co-use and alcohol use disorder, explained the effect of co-use on alcohol use disorder. Data from adults (N = 353,000) in the 2008–2019 National Study on Drug Use and Health (NSDUH) were used. Analyses tested whether (1) substance use profiles reduced/dissipated the effect of co-use on alcohol use disorder, (2) internalizing symptoms (anxiety, depression) reduced/dissipated the effect of co-use on alcohol use disorder, and (3) internalizing symptoms were indirectly associated with alcohol use disorder via co-use. Results When accounting for frequency/quantity of use, co-use was still associated with higher odds of alcohol use disorder. Anxiety and depression were related to higher odds of an alcohol use disorder, however, the effect of co-use on higher odds of alcohol use disorder remained. Anxiety and depression scores were indirectly associated with higher odds of alcohol use disorder via co-use. Conclusions Depressive and anxiety symptoms only accounted for a portion of the variance of co-use on alcohol use disorder, and there were indirect effects of internalizing symptoms through co-use. Future longitudinal research is needed to elucidate other person-level characteristics that drive associations between co-use and alcohol use disorder to target via interventions.
... With few exceptions (Dworkin et al., 2018;Fairlie et al., 2018), research has neglected social contexts in which SM-AFAB drink (e.g., drinking locations and companions). As drinking context is a strong predictor of alcohol problems in heterosexual samples (e.g., Connor et al., 2014;Keough et al., 2015), research on contexts in which SM-AFAB drink is necessary to advance our understanding of problematic alcohol use in this population. The current study aimed to: (a) identify classes of SM-AFAB based on drinking context; (b) examine associations between drinking contexts, minority stressors, and problematic alcohol use; and (c) examine changes in drinking contexts over time. ...
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Sexual minority individuals assigned female at birth (SM-AFAB) are at increased risk for problematic alcohol use compared to heterosexual women. Despite evidence that drinking locations and companions play an important role in problematic alcohol use among heterosexuals, few studies have examined these social contexts of alcohol use among SM-AFAB. To address this gap, the current study examined two aspects of social contexts in which SM-AFAB drink (locations and companions). We utilized two waves of data (six-months between waves) from an analytic sample of 392 SM-AFAB ages 17-33 from a larger longitudinal study. The goals were: (1) to identify classes of SM-AFAB based on the contexts in which they drank; (2) to examine the associations between drinking contexts, minority stressors, and problematic alcohol use; and (3) to examine changes in drinking contexts over time. Using latent class analysis, we identified four classes based on drinking locations and companions (private settings, social settings, social and private settings, multiple settings). These classes did not differ in minority stress. Drinking in multiple settings was associated with more problematic alcohol use within the same timepoint and these differences were maintained six months later. However, drinking in multiple settings did not predict subsequent changes in problematic alcohol use when problematic alcohol use at the prior wave was controlled for. Based on these findings, SM-AFAB who drink in multiple settings may be an important subpopulation for interventions to target. Interventions could focus on teaching SM-AFAB strategies to limit alcohol consumption and/or minimize alcohol-related consequences.
... Physical context is also important in understanding substance use behaviors. Both survey and within-subject studies show that underage drinking frequently occurs at friends' houses (Lipperman-Kreda et al., 2018), in public settings Keough et al., 2015), or in multiple locations (Connor et al., 2014). Endorsing being in these settings is associated with greater consumption, intoxication, and consequences (Braitman et al., 2017;Patrick et al., 2016). ...
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Objective: Given the adverse outcomes associated with simultaneous alcohol and marijuana (SAM) use, understanding factors that give rise to occasions of simultaneous use is critical. This study examines the relationships between situational motives and contexts and three situational outcomes: simultaneous alcohol and marijuana use (SAM) use versus cannabis-only use, number of cannabis uses, and subjective effects. Method: Past-month SAM users (n = 341; 52% female; 75% White; 10% Latinx/Hispanic; age 18-24) from three U.S. college campuses completed 8 weeks of surveys up to five times a day. Three-level generalized linear mixed-effects models tested the effects of situational motives and social and physical contexts on occasion type (SAM vs. cannabis-only), cannabis use, and subjective effects. Results: Situational social and enhancement motives were related to greater odds of SAM relative to cannabis-only use; expansion motives were reported more often on cannabis-only occasions. Using with others and at friends' places, being with others consuming cannabis, and being with others who are intoxicated were more likely when combining alcohol with cannabis. Increased number of cannabis uses and subjective effects in a social context were evident only on cannabis-only occasions. Using alone and using at home were greater on cannabis-only occasions and were associated with lower cannabis use and subjective effects. Conclusions: The combination of alcohol and cannabis use occurs during social situations and when motivated by positive reinforcement but number of cannabis uses is not increased when consuming cannabis with alcohol in social situations. Characterizing the complex interplay of situational factors that contribute to risky use will inform interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... For example, drinking with friends has been associated with more alcohol consumption and consequences than drinking with family members (Connor et al., 2014). There is mixed evidence for the effects of drinking with romantic partners, with some finding it to be associated with less alcohol consumption (Rodriguez et al., 2016) and others finding no association (Keough et al., 2015). Solitary drinking has been consistently linked to more drinking consequences (Keough et al., 2018), and this has been attributed to higher coping motives for solitary drinking (Creswell et al., 2014). ...
Article
Background Problematic substance use (SU) has increased substantially during the COVID-19 pandemic. While studies have identified risk factors for problematic SU during the pandemic (e.g., anxiety, depression, using substances to cope), these studies have been predominately cross-sectional, rarely examined changes in SU contexts during the pandemic as potential risk factors, and neglected sexual and gender minorities (SGM) – a health disparity population disproportionately impacted by substance use disorders and the pandemic. Method We utilized two waves of data collected one month apart from a sample of 212 SGM assigned female at birth who used alcohol and/or cannabis (18-25 years old) collected between August 2020-February 2021. We examined associations between potential risk factors (i.e., retrospectively reported changes in anxiety/depression and in using substances in different contexts since before the pandemic): and 1) retrospectively reported changes in alcohol and cannabis consumption; 2) coping motives for use and SU consequences; and 3) subsequent changes in coping motives and consequences. Results An increase in solitary SU was a robust risk factor for concurrent and prospective increases in SU, coping motives, and consequences. Increases in SU with romantic partners were associated with concurrent increases in alcohol/cannabis consumption and consequences. Increases in anxiety and depression were associated with concurrent increases in SU and higher coping motives and consequences. Conclusions Results indicate that solitary SU and increases in SU with romantic partners are robust risk factors for increases in SU and consequences in the context of the pandemic. Further, findings provide support for the self-medication theory of substance use.
... Context might also influence drinking behavior. Drinking alone is linked to higher levels of consumption required to reach intoxication , drinking to cope (Irizar et al., 2020), and alcohol-related problems (Keough et al., 2015). During lockdown, heavy drinking may be partially explained by a greater sense of isolation (Luchetti et al., 2020) and potential stress around financial concerns (Wilson et al., 2020). ...
Article
Background Coronavirus (COVID-19) resulted in lockdown measures in the UK, which has impacted alcohol use. Alcohol is often used as a coping mechanism and there are public health concerns regarding excessive consumption due to the pandemic. We aimed to longitudinally assess drinking behaviors, and associated factors, during the first UK government-mandated lockdown. Methods An online survey was distributed through social media (8th April 2020, onwards). Fortnightly follow up surveys were emailed to participants. The primary outcome measure was ‘weekly unit consumption’ and data was collected on a range of potentially related factors: demographics, factors relating to COVID-19 (e.g., health, work status), drinking motives, context of drinking, drinking intentions, mood, depression and anxiety. Findings A total of 539 self-selected participants completed the baseline survey, with 186 completing at least 3 follow up surveys for multilevel modelling analysis. Personal coping motives, anxiety, drinking at home alone, and drinking at home with others were positively associated with alcohol consumption during lockdown. The following baseline measures also predicted increased consumption: male gender, lower education, and higher AUDIT scores (based on behavior prior to lockdown). Findings were consistent when utilizing an inverse probability weight to account for predictors of attrition (female, younger age, higher baseline AUDIT scores). Conclusions Those already drinking at hazardous levels were more likely to increase their consumption, as were those who were drinking to cope. As we recover from the pandemic, there is a need for widespread alcohol support, and certain groups may need targeted support.
... Thus, though these contexts may be initially associated with unplanned any drinking (and thus less problematic), intentions and willingness to continue drinking may shift, thereby creating additional risks that warrant harmreduction intervention. Thus, it may be beneficial for EMIs to consider incorporating these proximal motives/contexts as well, as much work has shown the potential long-term consequences of drinking to cope (Cooper et al., 2016) and drinking alone (Corbin et al., 2020;Gonzalez et al., 2009;Keough et al., 2015), in particular. ...
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Objective: Problematic alcohol use among college students remains a public health concern; thus, there is a need to understand distinct drinking events, such as unplanned and planned drinking. The present study examined motives and social and physical contexts as correlates of unplanned and planned drinking to help inform prevention and intervention. Method: College student alcohol and cannabis users (N = 341; 53% women) completed 56 days of data collection (two 28-day bursts) with five repeated daily surveys. Three-level generalized linear mixed-effects models were used to examine associations among motives, physical and social contexts, and unplanned versus planned drinking. We also examined whether unplanned or planned drinking resulted in greater consumption and negative consequences. Results: Social and enhancement motives were related to planned drinking, whereas offered motives (i.e., offers of alcohol) and coping motives were linked to unplanned drinking. Drinking at home, with roommates, or alone was associated with unplanned drinking. Drinking at a bar/restaurant, a party, at a friend's place, with friends, with strangers/acquaintances, with a significant other, or with intoxicated people was linked to planned drinking. Unplanned drinking was related to fewer drinks consumed and fewer negative consequences endorsed. Conclusions: Findings showed that planned drinking-irrespective of consumption-was related to more negative consequences than unplanned drinking. In addition to targeting intentions to drink, the present study provided specific motives and social and physical contexts that are associated with planned drinking that could be incorporated into ecological momentary interventions focused on harm reduction. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... Among college students, drinking at bars and parties is associated with greater consumption and intoxication than drinking alone or in one's own home (Braitman et al., 2017;Patrick et al., 2016a;Wechsler et al., 2000). Drinking in public settings (Keough et al., 2015;Kypri et al., 2007) or in multiple locations (Connor et al., 2014) is also associated with greater risk. ...
Article
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Background Much of the prior research addressing risky drinking among young adults has focused on heavy episodic drinking (4+/5+ drinks in a single sitting for females/males). However, 1 in 3 young adults engaged in past‐year high‐intensity drinking (HID, 8+/10+ drinks in a single sitting for females/males). Consuming such large amounts of alcohol is associated with serious acute consequences (e.g., severe injury, overdose) and the development of alcohol use disorder. This qualitative study aimed to gain an in‐depth understanding of contextual influences on HID from drinkers’ perspectives. Methods We conducted individual interviews of 28 young adults (57% female, aged 20 to 25 years old) who engage in HID to assess the role of context in the prediction of HID (relative to non‐HID events). Two authors coded each interview following a structured codebook and thematic analysis was used to analyze the qualitative data. Results Based on identified themes, factors that may increase HID likelihood include being in larger groups or in social contexts where others are drinking heavily, having close relationships with others who are present, on special occasions, when feeling safe, being comfortable in a given situation, and experiencing intense affective states (especially positive ones). Noted deterrents for HID included friends’ extreme intoxication, perceptions that heavy drinking is less acceptable in certain contexts (i.e., at work, family events) or among others present, cost/financial constraints, next‐day responsibilities, and needing to drive. Conclusions Young adults identified a number of social and psychological factors that they perceived influenced their likelihood of engaging in HID. However, they also generated a number of factors that constrained this style of drinking. Understanding the contexts in which HID is most likely to occur will inform interventions that aim to reduce this high‐risk behavior.
... This finding is in line with other research which suggests that time spent playing video games may not be related to negative outcomes like depression (i.e., Brunborg et al., 2014). The unique association between depression and gaming problems is similar to the broader addiction literature on coping motivated alcohol and substance use (Keough et al., 2015). Using alcohol to cope with negative feelings is associated with a wide array of negative problems, regardless of levels of drinking (Merrill & Read, 2010). ...
Article
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En Amérique du Nord, le jeu pathologique et la dépression sont fréquemment des troubles concomitants. La littérature actuelle apporte un appui mitigé à trois modèles différents de la préséance temporelle : le modèle de la vulnérabilité, le modèle blessure-complication et le modèle de réciprocité. Dans la présente étude, nous avons examiné les associations directionnelles entre le jeu pathologique et la dépression au moyen d’une étude à court terme en plusieurs vagues. Les 289 participants recrutés en Amérique du Nord ont réalisé une étude en trois vagues de quatre semaines par l’entremise de Mechanical Turk d’Amazon. Nous avons utilisé deux modèles de panels à décalage croisé (MPDC) pour vérifier les associations temporelles entre la dépression et, à la fois, le temps consacré au jeu et les problèmes reliés au jeu. Le premier MPDC a révélé la présence d’effets réciproques entre la dépression et les problèmes reliés au jeu. Toutefois, au fil du temps, les effets concordaient davantage avec une antériorité de la dépression par rapport aux problèmes de jeu (modèle de la vulnérabilité). Le deuxième MPDC n’a dévoilé aucune association croisée au fil du temps entre la dépression et le temps consacré au jeu. Pour les deux modèles, les résultats ne variaient pas selon le genre. Les résultats de l’étude clarifient la relation unique de la dépression avec les problèmes liés au jeu, indépendamment du genre. Les résultats de l’étude clarifient la relation unique de la dépression avec les problèmes liés au jeu, indépendamment du genre.
... A departure from a social context where alcohol is commonly available or consumed may actually be protective for college students, who tend to drink in social situations. Young adult drinking typically occurs in social settings such as parties (Beck et al., ,2008(Beck et al., , , 2013Lipperman-Kreda et al., 2015), in public settings (Keough et al., 2015;Kypri et al., 2007), and rarely alone (Simons et al., 2005), and drinking typically takes place in groups of friends (Baer, 2002;Beck et al., 2008). College students are more likely to drink in high quantities when with peers (Thrul et al., 2017) and often affiliate with heavily-drinking peer networks that include close friends who serve as "drinking buddies" (Lau- Barraco and Linden, 2014;Reifman et al., 2006). ...
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Background In spring 2020, U.S. universities closed campuses to limit the transmission of COVID‐19, resulting in an abrupt change in residence, reductions in social interaction, and in many cases, movement away from a heavy drinking culture. The present mixed‐methods study explores COVID‐19‐related changes in college student drinking. We characterize concomitant changes in social and location drinking contexts and describe reasons attributed to changes in drinking. Methods We conducted two studies of the impact of the COVID‐19 pandemic on drinking behavior, drinking context, and reasons for both increases and decreases in consumption among college students. Study 1 (qualitative) included 18 heavy‐drinking college students (Mage = 20.2; 56% female) who completed semi‐structured interviews. Study 2 (quantitative) included 312 current and former college students who reported use of alcohol and cannabis (Mage = 21.3; 62% female) and who completed an online survey. Results In both studies, COVID‐19‐related increases in drinking frequency were accompanied by decreases in quantity, heavy drinking, and drunkenness. Yet, in Study 2, although heavier drinkers reduced their drinking, among non‐heavy drinkers several indices of consumption increased or remained stable . Both studies also provided evidence of reductions in social drinking with friends and roommates and at parties and increased drinking with family. Participants confirmed that their drinking decreased due to reduced social opportunities and/or settings, limited access to alcohol, and reasons related to health and self‐discipline. Increases were attributed to greater opportunity (more time) and boredom and to a lesser extent, lower perceived risk of harm and to cope with distress. Conclusion This study documents COVID‐19‐related changes in drinking among college student drinkers that were attributable to changes in context, particularly a shift away from heavy drinking with peers to lighter drinking with family. Given the continued threat of COVID‐19, it is imperative for researchers, administrators, and parents to understand these trends as they may have lasting effects on college student drinking behaviors.
... Another study reiterated the relationship between drinking alone and depressive symptoms, finding a positive correlation between them. Drinking at parties was a predictor for alcohol-related problems while no association was found when the subject drank with family and/or partner (Keough et al., 2015). At high levels of alcohol use (AUDIT) the association between depressive symptoms (BDI-II) and suicide proneness was stronger. ...
Chapter
Depression and alcohol have a higher prevalence among students in comparison to the general population and are often comorbidly cause significant burdens. These conditions differ among this population in various contexts such as type of student (middle, high, and university students), alcohol-related variables (e.g., alcohol use and alcohol use disorders), and other factors. Alcohol and depression positively correlate with suicidal ideation in students, while also relating to anxiety and presenting differences between genders. Social support is a protective factor to prevent the progression of depressive symptoms into suicidal ideation. All four main drinking motives (enhancement, social, cope, and conformity), impulsivity traits, and ruminative thinking mediate the relationship between depressive symptoms and alcohol. Positive expectancies partially explain alcohol use due to short-term positive consequences, but are associated with long-term negative consequences.
... Research demonstrates that solitary drinking is positively associated with various forms of negative affect in adolescents and college students (Armeli et al., 2014;Bilevicius et al., 2018;Creswell et al., 2014), such as depression (Christiansen et al., 2002;Gonzalez & Skewes, 2013;Keough et al., 2015), social anxiety (Buckner & Terlecki, 2016;Keough et al., 2016), and suicidal ideation and attempts (Gonzalez, 2012;Gonzalez et al., 2009;Gonzalez & Skewes, 2013). Solitary drinking has also been linked to lower tolerance for stress (Williams et al., 2015); decreased ability to resist drinking, especially during negative affect (Christiansen et al., 2002;Creswell et al., 2015;Tucker et al., 2014); lower expectancies regarding one's ability to adaptively regulate negative moods (Gonzalez & Skewes, 2013); and positive beliefs or expectations that drinking will reduce negative emotions (Christiansen et al., 2002;Tucker et al., 2006Tucker et al., , 2014. ...
Article
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.
... For example, adolescent solitary drinkers, compared with social-only drinkers, have higher levels of trait negative emotionality (Creswell, Chung, Wright, et al., 2015) and depressive symptoms (Tomlinson & Brown, 2012). Similarly, solitary drinking in young adults is associated with depressive symptoms, suicidal ideation, and lower distress tolerance (e.g., Gonzalez, Collins, & Bradizza, 2009;Keough, O'Connor, Sherry, & Stewart, 2015;Williams, Vik, & Wong, 2015), and a recent longitudinal study demonstrated that negative affect prospectively predicted young adult solitary drinking 4 months later, even after analyses accounted for baseline solitary drinking (Bilevicius, Single, Rapinda, Bristow, & Keough, 2018). Further, solitary drinking in adolescents and young adults has been linked to measures of social discomfort, such as social anxiety (Skrzynski, Creswell, Bachrach, & Chung, 2018) and loneliness (Gonzalez & Skewes, 2013). ...
Article
The context in which drinking occurs is a critical but relatively understudied factor in alcohol use disorder (AUD) etiology. In this article, I offer a social-contextual framework for examining AUD risk by reviewing studies on the unique antecedents and deleterious consequences of social compared with solitary alcohol use in adolescents and young adults. Specifically, I provide evidence of distinct emotion regulatory functions across settings, in which social drinking is linked to enhancing positive emotions and social experiences, and solitary drinking is linked to coping with negative emotions. I end by considering the conceptual, methodological, and clinical implications of this social-contextual account of AUD risk.
... Thus, frequent alcohol use, to a degree, may be more socially normative and not necessarily indicative of psychological distress. However, given that young adults who engage in solitary drinking are at risk for increased depressive symptoms (Fleming et al., 2020;Keough et al., 2015) and loneliness (Gonzalez and Skewes, 2013), we encourage future work to examine how contexts of alcohol and marijuana use (e.g., solitary versus social use) as well as their co-use and simultaneous use may impact psychosocial indicators of well-being. ...
Article
Objective To assess whether frequency of marijuana and alcohol use are cross-sectionally associated with indicators of social and emotional well-being including loneliness, psychological distress, and flourishing across important life domains among young adults. Method The study sample included 562 participants ages 22–29 who were originally recruited from an urban Pacific Northwest region in the US as part of a longitudinal study of social role transitions and alcohol use. At one assessment, participants completed an online survey that included a 3-item measure of loneliness, a 4-item measure of depression and anxiety symptoms, and a 12-item measure of flourishing as well as measures of marijuana and alcohol use frequency. Linear and generalized linear models were used to estimate associations of marijuana and alcohol use frequency with indicators of well-being. Results Greater frequency of marijuana use was associated with higher levels of loneliness, higher levels of psychological distress, and lower levels of flourishing, with the greatest difference observed for daily marijuana users compared to non-users. However, these indicators of well-being did not significantly differ by levels of alcohol use frequency. Conclusion Study findings suggest that frequent users of marijuana, but not alcohol, may experience more loneliness, more psychological distress, and less flourishing. Intervention approaches for frequent marijuana users may be warranted to reduce impacts of loneliness and psychological distress and improve overall well-being.
... Solitary drinking (i.e., use of alcohol alone vs. in social contexts) is positively associated with greater incidence of alcohol-related problems (23,24). Notably, frequency of solitary drinking (compared to drinking in social contexts) is positively predicted by severity of depressive symptoms (25). To the extent that environmental constraints may limit social drinking opportunities and increase depression symptoms, solitary drinking is likely to increase under social distancing conditions. ...
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Background: Increases in the incidence of psychological distress and alcohol use during the COVID-19 pandemic have been predicted. Behavioral theories of depression and alcohol self-medication theories suggest that greater social/environmental constraints and increased psychological distress during COVID-19 could result in increases in depression and drinking to cope with negative affect. The current study had two goals: (1) to examine self-reported changes in alcohol use and related outcomes after the introduction of COVID-19 social distancing requirements, and; (2) to test hypothesized mediation models to explain individual differences in self-reported changes in depression and alcohol use during the early weeks of the COVID-19 pandemic. Methods: Participants (n = 833) were U.S. residents recruited for participation in a single online survey. The cross-sectional survey included questions assessing environmental reward, depression, COVID-19-related distress, drinking motives, and alcohol use outcomes. Outcomes were assessed via retrospective self-report for two timeframes in the single survey: the 30 days prior to state-mandated social distancing (“pre-social-distancing”), and the 30 days after the start of state-mandated social distancing (“post-social-distancing”). Results: Depression severity, coping motives, and some indices of alcohol consumption (e.g., frequency of binge drinking, and frequency of solitary drinking) were significantly greater post-social-distancing relative to pre-social-distancing. Conversely, environmental reward and other drinking motives (social, enhancement, and conformity) were significantly lower post-social distancing compared to pre-social-distancing. Behavioral economic indices (alcohol demand) were variable with regard to change. Mediation analyses suggested a significant indirect effect of reduced environmental reward with drinking quantity/frequency via increased depressive symptoms and coping motives, and a significant indirect effect of COVID-related distress with alcohol quantity/frequency via coping motives for drinking. Discussion: Results provide early cross-sectional evidence regarding the relation of environmental reward, depression, and COVID-19-related psychological distress with alcohol consumption and coping motives during the early weeks of the COVID-19 pandemic. Results are largely consistent with predictions from behavioral theories of depression and alcohol self-medication frameworks. Future research is needed to study prospective associations among these outcomes.
... Coping motives for drinking could also lead to increased use of alcohol when at home alone due to COVID-19-related closures of bars and restrictions on social gatherings. Solitary drinking is generally viewed as an atypical drinking style, potentially indicating impaired control over alcohol (e.g., Keough et al., 2016;Keough et al., 2015). Research has linked solitary (vs. ...
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Background The COVID‐19 pandemic has resulted in massive disruptions to society, to the economy, and to daily life. Some people may turn to alcohol to cope with stress during the pandemic, which may put them at risk for heavy drinking and alcohol‐related harms. Research is needed to identify factors that are relevant for coping‐motivated drinking during these extraordinary circumstances to inform interventions. This study provides an empirical examination of coping motive pathways to alcohol problems during the early stages of the COVID‐19 pandemic. Methods Participants (N = 320; 54.7% male; mean age of 32 years) were Canadian adult drinkers who completed an online survey assessing work‐ and home‐related factors, psychological factors, and alcohol‐related outcomes over the past 30 days, covering a time period beginning within 1 month of the initiation of the COVID‐19 emergency response. Results The results of a theory‐informed path model showed that having at least 1 child under the age of 18, greater depression, and lower social connectedness each predicted unique variance in past 30‐day coping motives, which in turn predicted increased past 30‐day alcohol use (controlling for pre‐COVID‐19 alcohol use reported retrospectively). Income loss was associated with increased alcohol use, and living alone was associated with increased solitary drinking (controlling for pre‐COVID‐19 levels), but these associations were not mediated by coping motives. Increased alcohol use, increased solitary drinking, and greater coping motives for drinking were all independently associated with past 30‐day alcohol problems, and indirect paths to alcohol problems from having children at home, depression, social connectedness, income loss, and living alone were all supported. Conclusions Findings provide insight into coping‐motivated drinking early in the COVID‐19 pandemic and highlight the need for longitudinal research to establish longer term outcomes of drinking to cope during the pandemic.
... Solitary drinking has been associated with a greater number of alcohol-related problems compared to social drinking (Gonzalez and Skewes, 2013;Creswell et al., 2014), and more recently, with specific alcohol-related problems that overlap with AUDs (American Psychiatric Association [APA], 2013), such as blackout drinking, risky behaviours and poor self-care (Keough et al., 2018). There is consistent research that has identified solitary drinking as a mediator in the depression-alcohol misuse pathway in emerging adulthood (Keough et al., 2015;Bilevicius, Single, Rapinda et al., 2018b). Thus, solitary drinking appears to be a risky behaviour that can help explain the depression-alcohol misuse relationship in emerging adults. ...
Article
Aims: Comorbid alcohol use and depression have the highest prevalence among emerging adults and are associated with a number of consequences. Self-medication theory posits individuals with depression use alcohol to cope with their negative emotions. Preliminary work has investigated the social context of depression-related drinking and found that solitary drinking is a risky, atypical behaviour in emerging adulthood that is associated with alcohol misuse. However, it is unknown about what is unfolding in the moment that is driving depression-related drinking in solitary contexts. Accordingly, we used an experimental study to examine if shame mediated the association between depression and in-lab alcohol craving. Methods: Emerging adults (N = 80) completed a shame induction followed by an alcohol cue exposure in either a solitary or social condition. We used moderated mediation to test hypotheses. Results: Consistent with hypotheses, conditional indirect effects supported the mediation of depression and alcohol craving through shame among those in the solitary condition, but not in the social condition. There was no support for guilt as a mediator. Conclusion: Our study demonstrates that shame is a specific emotional experience that contributes to solitary drinking among depressed emerging adults. It is important to use these results to inform interventions that directly target solitary contexts and shame.
... Solitary drinking (i.e., use of alcohol alone versus in social contexts) is positively associated with greater incidence of alcohol-related problems (Christiansen et al., 2002;Keough et al., 2018). Notably, frequency of solitary drinking (compared to drinking in social contexts) is positively predicted by severity of depressive symptoms (Keough et al., 2015). To the extent that environmental constraints may limit social drinking opportunities and increase depression symptoms, solitary drinking is likely to increase under social distancing conditions. ...
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Increases in the incidence of psychological distress and alcohol use during the COVID-19 pandemic have been predicted. Environmental reward and self-medication theories suggest that increased distress and greater social/environmental constraints during COVID-19 could result in increases in depression and drinking to cope with negative affect. The current study had two goals: (1) to clarify the presence and direction of changes in alcohol use and related outcomes after the introduction of COVID-19 social distancing requirements, and; (2) to test hypothesized mediation models to explain individual differences in alcohol use during the early weeks of the COVID-19 pandemic. Participants (n = 1127) were U.S. residents recruited for participation in an online survey. The survey included questions assessing environmental reward, depression, COVID-19-related distress, drinking motives, and alcohol use outcomes (alcohol use; drinking motives; alcohol demand, and solitary drinking). Outcomes were assessed for two timeframes: the 30 days prior to state-mandated social distancing (‘pre-social-distancing’), and the 30 days after the start of state-mandated social distancing (‘post-social-distancing’). Depression severity, coping motives, and frequency of solitary drinking were significantly greater post-social-distancing relative to pre-social-distancing. Conversely, environmental reward and other drinking motives (social, enhancement, and conformity) were significantly lower post-social distancing compared to pre-social-distancing. Time spent drinking and frequency of binge drinking were greater post-social-distancing compared to pre-social-distancing, whereas typical alcohol quantity/frequency were not significantly different between timeframes. Indices of alcohol demand were variable with regard to change. Mediation analyses suggested a significant indirect effects of reduced environmental reward with drinking quantity/frequency via increased depressive symptoms and coping motives, and a significant indirect effect of COVID-related distress with alcohol quantity/frequency via coping motives for drinking. Results provide early evidence regarding the relation of psychological distress with alcohol consumption and coping motives during the early weeks of the COVID-19 pandemic. Moreover, results largely converged with predictions from self-medication and environmental reinforcement theories. Future research will be needed to study prospective associations among these outcomes.
... We extend these findings to a military population, showing that personnel who drank at home and/or alone were more likely to meet the criteria for both alcohol misuse and binge drinking. Individuals with mental health problems tend to drink alone, but consequently, drinking alone increases the risk of harmful drinking [28]. We may have expected the associations to attenuate after adjusting for mental health, yet they remained significant, possibly suggesting that drinking alone/at home is associated with alcohol misuse, regardless of mental health. ...
Article
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Background: Drinking motivations within the UK military have not been studied despite the high prevalence of alcohol misuse in this group. Aims: We aimed to characterize drinking motivations and their demographic, military and mental health associations in UK serving and ex-serving personnel. Methods: Serving and ex-serving personnel reporting mental health, stress or emotional problems occurring in the last 3 years were selected from an existing cohort study. A semi-structured telephone interview survey examined participants' mental health, help-seeking, alcohol use and drinking motivations. Results: Exploratory factor analysis of drinking motivations in military personnel (n = 1279; response rate = 84.6%) yielded 2 factors, labelled 'drinking to cope' and 'social pressure'. Higher drinking to cope motivations were associated with probable anxiety (rate ratio [RR] = 1.4; 95% confidence interval [CI] = 1.3-1.5), depression (RR = 1.3; 95% CI = 1.2-1.4) and post-traumatic stress disorder (RR = 1.4; 95% CI = 1.3-1.6). Higher social pressure motivations were associated with probable anxiety (odds ratio = 1.1; 95% CI = 1.0-1.1). Alcohol misuse and binge drinking were associated with reporting higher drinking to cope motivations, drinking at home and drinking alone. Conclusions: Amongst military personnel with a stress, emotional or mental health problem, those who drink to cope with mental disorder symptoms or because of social pressure, in addition to those who drink at home or drink alone, are more likely to also drink excessively.
... As is often the case with substance-related variables (e.g., Buckner & Terlecki, 2016;Keough, Battista, O'Connor, Sherry, & Stewart, 2016;Keough, O'Connor, Sherry, & Stewart, 2015), inspection of the data (Table 1) revealed that some variables were not normally distributed (skew > 3.0; kurtosis > 10; Kline, 2005). Thus, hypotheses were tested using bootstrapping, which is robust against violations of assumptions of normality (Erceg-Hurn & Mirosevich, 2008). ...
Article
Background and Objectives: Individuals with elevated social anxiety are thought to be at high risk for developing cannabis-related problems because they use cannabis to cope with anxiety-provoking social situations. Social anxiety is unique among the anxiety conditions in that it is characterized by both elevated negative affect (NA) and lower positive affect (PA). Yet it is unclear whether persons with elevated social anxiety use cannabis to decrease their NA or to increase their PA. Methods: This study examined the role of PA and NA (including cannabis use to increase PA and to decrease NA in social situations) on cannabis use frequency and related problems among current (past three-month) cannabis users (N = 278). Results: Social anxiety was significantly correlated with NA, PA, cannabis use to decrease NA, and use to increase PA. Serial mediation analyses tested the paths between social anxiety, affect, use to manage affect, typical cannabis use frequency, and cannabis use-related problems. Contrary to prediction, social anxiety was not indirectly related to use frequency or related problems via NA or PA generally. Rather, social anxiety was indirectly related to cannabis problems via the serial effect of use to cope with NA and typical use frequency and via the serial effect of use to increase PA and typical use frequency. Conclusions/Importance: Social anxiety may be associated with using cannabis to decrease NA and increase PA specifically in social situations, which increases cannabis use frequency and thus, problem risk.
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Objectives An early age of drinking onset is linked to a greater likelihood of alcohol-related problems. Alcohol use occurs in places featuring characteristic social groups, and different drinking contexts are associated with different levels of alcohol-related outcomes. Drinking context may affect drinking motives, expectations or alcohol-related outcomes in concert with individual-level variables. The study aimed to examine how the preferred drinking context and age of the first drink affects the occurrence and volume of alcohol use, drinking motives and alcohol-related expectations. Methods This cross-sectional study was conducted at Faculty of Veterinary Medicine, University of the Republic, Montevideo, Uruguay, from September 2020 to January 2021. Uruguayan citizens ≥18 years old were asked about their preferred drinking context, the age of first alcohol use and alcohol consumption frequency. In addition, the Drinking Motives Questionnaire and Alcohol Outcome Expectancies Questionnaire were used. Results A total of 752 Uruguayan citizens were included. The distribution of alcohol consumption across social contexts was not influenced by the age of first alcohol use. Those who began drinking early and endorsed solitary drinking reported higher frequency of drinking (P <0.05) and coping motives (P <0.05) than any other group. Those who drank at parties reported more conformity motives than most of the groups (P <0.01). An early age of drinking onset was associated with greater enhancement and social motives (P <0.05) and higher alcohol expectancies for stress reduction and social facilitation (P <0.005). Conclusion Solitary drinking as a high-risk drinking context is likely to interact with the age of first alcohol use, suggesting that drinking in specific contexts is associated with specific drinking motivations and expectancies. This study represents progress towards exploring factors that influence alcohol consumption among a broader range of socio-cultural populations.
Article
Over the next two decades, the number of caregivers is expected to climb dramatically alongside a rise in older adults, particularly sexual and gender minority (SGM) older adults, yet little research has assessed differences between SGM and non-SGM care partners. Data for these analyses come from the Columbus Healthy Aging Project (N = 79). This study was designed to assess several domains of health among adults aged ≥50 years in Columbus, Ohio, US. Multivariable regression models were used to examine the likelihood of being a care partner, the SGM identity of the primary care recipient, and caregiver strain. In our sample, 227 (28.6%) participants self-identified as care partners for at least one individual. Compared to heterosexuals, gay/lesbian (aOR = 8.38; 95% CI: 5.29, 13.29) participants were more likely to be care partners but did not experience elevated caregiver strain. Bisexual individuals (aIRR = 1.70, 95% CI: 1.11, 2.61) reported greater caregiver strain, while those identifying as a different sexual identity reported lower caregiver strain (aIRR = 0.46, 95% CI: 0.23, 0.96). In turn, caregiver strain was reduced significantly when the care recipient identified as a member of the SGM community (aIRR = 0.67: 95% CI: 0.55, 0.80). These results suggest that SGM care partners may be at risk of unique stressors which may contribute to extant health disparities.
Article
Background: The drinking of social network members has been consistently associated with personal drinking. However, less attention has been paid to emerging adult populations outside of four-year college students and to potential moderators of this relationship. In a sample of emerging adults who never attended four-year college, this research examined: 1) the compositional characteristics of the social networks, 2) the association between the drinking of network members and personal drinking, and 3) how the association between network and personal drinking was moderated by relationship type (e.g., friend, parents, significant other). Methods: Data was provided by a sample of 525 emerging adults who participated in Qualtrics Panels. Results: In this noncollege sample, the composition of the social network was diverse, with roughly one-third of network members being friends and a little less than half being family members. Parents tended to consume alcohol more frequently than friends and significant others, but participants consumed alcohol more frequently with friends and significant others. Furthermore, drinking among friends and significant others tended to have stronger associations with personal alcohol use than drinking among parents. However, relationship type did not moderate the association between drinking with network members and personal alcohol use. Conclusions: Because of this, interventions need to be delivered to drinking groups.
Article
Objective: Using cannabis in solitary contexts is associated with greater cannabis use problems than using cannabis in social contexts. However, it remains unclear why solitary use predicts greater problems. Consistent with a social learning perspective, the current study examined whether cannabis use motives mediated the association between context of cannabis use and negative consequences. We also examined whether cannabis type (concentrates vs. flower) moderated the relation between context of use and motives. Method: Recreational college cannabis users (n = 387) reported their frequency of using cannabis alone or with others, motives for cannabis use, negative cannabis consequences, and type of cannabis typically used. Results: Solitary cannabis use was associated with greater global negative consequences through coping motives (β = 0.26, SE = 0.10, 95% CI [0.10, 0.43]). Cannabis type did not moderate relations between context and motives, despite concentrate users reporting more frequent cannabis use, more frequent solitary use, and greater consequences than flower users. Conclusions: Frequent cannabis use in solitary contexts was associated with greater negative cannabis consequences, both directly and indirectly via coping motives. Efforts to reduce frequent use of cannabis in solitary contexts, particularly for the purpose of coping, may be beneficial in reducing negative consequences.
Article
Introduction Depression and problem drinking are comorbid in emerging adulthood, yet the processes that link them are not well understood. Research has argued that shame has a unique influence on the experience of problematic drinking, but this has rarely been assessed at the state level. Using ecological momentary assessments (EMAs), we assessed whether shame, and not guilt, mediated the association between baseline depression and alcohol use and problems. Methods One hundred and eighty-four emerging adults (Mage= 19.27) completed a 12-day EMA study. Multilevel models were used to test hypotheses. Results In a model with alcohol use as the outcome, there were no significant associations between shame or guilt and alcohol use at the within- or between-subjects level. In a model with alcohol problems as the outcome, guilt was positively associated with alcohol problems but only at the daily level. At the between-subjects level and after controlling for guilt, there was a significant association between depression, shame, and alcohol problems; average levels of shame mediated the association between depression and alcohol problems. In post-hoc reverse directionality models, average alcohol problems mediated the relationship between depression and shame and guilt at the between-person level. No mediation was present for alcohol use. Conclusion After controlling for guilt, shame is an emotion that helps explain risk for alcohol problems among depressed emerging adults, which has implications for targeted interventions. Reciprocal associations between shame, guilt, and alcohol problems emerged highlighting the need for more fulsome assessments of shame and guilt in future EMA research.
Article
Background and aims Solitary drinking in adolescents and young adults is associated with greater risk for alcohol problems, but it is unclear whether this association exists in older demographics. The current paper is the first meta‐analysis and systematic review to determine whether adult solitary drinking is associated with greater risk for alcohol problems. Methods PsychINFO, PubMed, and Google Scholar were searched following a pre‐registered PROSPERO protocol (CRD42019147075) and PRISMA methodology. Following the methodology used in our recent systematic review and meta‐analysis on adolescent/young adult solitary drinking, we systematically reviewed solitary drinking measures/definitions, prevalence rates, and associated demographic variables in adults. We then meta‐analyzed (using random effects models) associations between adult solitary drinking and alcohol use/problems, negative affect, and negative/positive reinforcement‐related variables (e.g., drinking to cope or for enhancement). Results Solitary drinking was defined as drinking while physically alone in nearly all studies, but measures varied. Prevalence rates were generally in the 30‐40% range with some exceptions. In general, males were more likely than females to report drinking alone, and married individuals were less likely than unmarried individuals to report drinking alone; racial/ethnic differences were mixed. Meta‐analytic results showed significant effects for the associations between solitary drinking and the following factors: alcohol consumption, r=0.25, 95%CI [0.18, 0.33], k=15, I²=97.41; drinking problems, r=0.15, 95%CI [0.10, 0.21], k=14, I²=92.70; and negative reinforcement, r=0.24, 95%CI [0.14, 0.32], k=11, I²=91.54; but not positive reinforcement, r=0.02, 95%CI [‐0.06, 0.09], k=8, I²=76.18; or negative affect, r=0.03, 95%CI [‐0.02, 0.08], k=8, I²=52.06. Study quality moderated the association between solitary drinking and negative affect (β=‐0.07, p<0.01) such that lower quality studies were significantly associated with larger effect sizes. Study quality was generally low; the majority of studies were cross‐sectional. Conclusions Solitary drinking appears to have a small positive association with alcohol problems.
Article
Findings regarding the moderating influence of drinking motives on the association between affect and alcohol consumption have been inconsistent. The current study extended previous work on this topic by examining episode-specific coping, enhancement, conformity, and social drinking motives as moderators of the association between daytime experiences of positive and negative affect and evening social and solitary alcohol consumption. Nine hundred and six participants completed daily diary surveys measuring their daily affect and evening drinking behavior each day for 30 days during college and again 5 years later, after they had left the college environment. Results of multilevel modeling analyses suggest that the associations between affect, drinking motives, and alcohol consumption are not straightforward. Specifically, whereas daytime positive affect and non-coping drinking motives predicted greater social consumption, daytime positive affect was related to lower solitary alcohol consumption among college students who were low in state social drinking motives. In addition, coping motives were related to greater social consumption during college and greater solitary alcohol consumption after college. Future research should continue to examine these episode-specific drinking motives in addition to trait-level drinking motives.
Article
Although solitary drinking is less common than social drinking, it may be uniquely associated with heavy drinking and alcohol-related problems. There is also evidence that drinking contexts impact both expected and experienced alcohol effects. In particular, solitary drinking may be associated with an increased likelihood of drinking for negative reinforcement (e.g. to relieve stress). The current study examined how drinking context influences tension reduction expectancies and drinking motives, and the extent to which expectancies and motives mediate the link between solitary drinking and alcohol-related problems. We hypothesized that solitary drinking would be associated with greater tension reduction expectancies and coping motives which, in turn, would be associated with more alcohol related problems. Data were from 157 young adult moderate to heavy drinkers (21-30 years of age, 57% male) who completed baseline assessments in an alcohol administration study. A path model in Mplus tested the hypothesized mediated effects. Findings largely supported study hypotheses with significant indirect effects of solitary drinking (but not social drinking) on alcohol problems through stronger tension reduction expectancies and coping motives, though an indirect path through coping motives (but not expectancies) was also identified. Multi-group models by gender and race/ethnicity found that models operated similarly for men and women and for Non-Hispanic Caucasian and Racial/Ethnic Minority participants. The results provide important information about potential mechanisms through which solitary drinking may contribute to alcohol problems. These mechanisms represent potential targets of intervention (e.g. tension reduction expectancies, drinking to cope) for solitary drinkers.
Article
Background: Despite the fact that solitary drinking is becoming more common in Korea, few studies have investigated the association between drinking alone and mental health. This study aimed to investigate the relationship between solitary drinking, depressive symptoms, and suicidal ideation in Korean college students. Method: Primary data on a nationally representative sample of college students were used. Data were collected by Yonsei University and the Korean Center for Disease Control in 2017 to investigate alcohol-related behaviors and health consequences in students. The association between solitary drinking, depressive symptoms, and suicidal ideation were measured using multivariate logistic regression analysis. Results: A total of 3,935 students were analyzed, in which 11.5% had depressive symptoms and 2.8% suicidal ideation. Compared to non-solitary drinkers, solitary drinkers were more likely to have depressive symptoms [Odds Ratio (OR) 2.28, 95% Confidence Interval (95% CI) 1.72-3.02] and suicidal ideation (OR 2.24, 95% CI 1.32-3.81). Moreover, larger differences were found in individuals with higher alcohol use disorders identification test (AUDIT) scores and with more frequent underage drinking experience. Limitations: As this study was cross-sectional in design, causal inferences cannot be made on the association between solitary drinking, depressive symptoms, and suicidal ideation. Conclusion: Solitary drinking is associated with higher likelihoods of depressive symptoms and suicidal ideation in college students. The results suggest the importance of monitoring solitary drinkers as they may be more vulnerable to the negative mental health effects of alcohol.
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The 4-factor model of personality vulnerability identifies 4 personality risk factors for alcohol misuse: hopelessness, anxiety sensitivity, impulsivity, and sensation seeking. These personality traits are associated with distinct mechanisms and motivations for alcohol misuse. Individuals high in hopelessness drink to regulate dysphoric affect, while those high in anxiety sensitivity drink to reduce anxiety and to conform to peer expectations. Individuals high in sensation seeking are highly sensitive to the rewarding properties of alcohol, and misuse alcohol to maximize enjoyment. Impulsivity is a broad risk factor contributing to all drinking motives. We hypothesized that personality vulnerabilities would indirectly predict alcohol quantity and problems through specific drinking motives theorized by the 4-factor model. The present study tested hypotheses using a 3-wave, 1-year longitudinal study of undergraduate drinkers (N 302). Data were analyzed using multilevel path analysis. Hopelessness and impulsivity were positively related to drinking motives in the expected fashion. Anxiety sensitivity was related to coping-anxiety and conformity motives only in the between-subjects model (partially supporting hypotheses), while sensation seeking was generally unrelated to all drinking motives and alcohol outcomes (failing to support hypotheses). Enhancement motives predicted alcohol quantity and problems at both levels, coping-depression motives predicted alcohol problems at the between-subjects level only, and coping-anxiety, conformity, and social motives failed to predict alcohol outcomes beyond other motives. Overall, this study partially supports the 4-factor model, with the strongest support emerging for impulsivity and hopelessness. This study suggests that personality traits such as impulsivity and hopelessness may be important targets in prevention and treatment with undergraduate drinkers.
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Adolescent solitary drinking may represent an informative divergence from normative behavior, with important implications for understanding risk for alcohol-use disorders later in life. Within a self-medication framework, we hypothesized that solitary alcohol use would be associated with drinking in response to negative affect and that such a pattern of drinking would predict alcohol problems in young adulthood. We tested these predictions in a longitudinal study in which we examined whether solitary drinking in adolescence (ages 12-18) predicted alcohol-use disorders in young adulthood (age 25) in 466 alcohol-using teens recruited from clinical programs and 243 alcohol-using teens recruited from the community. Findings showed that solitary drinking was associated with drinking in response to negative affect during adolescence and predicted alcohol problems in young adulthood. Results indicate that drinking alone is an important type of alcohol-use behavior that increases risk for the escalation of alcohol use and the development of alcohol problems.
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In college students, solitary (i.e., while alone) heavy episodic drinking is associated with depression, suicidal ideation, drinking to cope, and having greater alcohol-related problems than heavy drinking only in social contexts. This study explored the possible explanatory factors for solitary heavy drinking. Social (n = 58) and solitary heavy episodic drinking (n = 32) emerging adult college students were compared in regards to: alcohol-related problems and dependence severity, negative affect, social relationship issues, socially related coping skills, and negative mood regulation. Multiple analyses of covariance revealed that solitary heavy drinkers were significantly higher in alcohol-related problems, severity of dependence, suicidal ideation, hopelessness, depression, loneliness, and drinking to cope and were lower in negative mood regulation expectancies and social competence. Heavy drinking groups did not differ in social network size, perceived social support, or in their drinking social network size or satisfaction. Our findings suggest that solitary heavy drinkers are not socially isolated or lacking in social support; however, they do experience greater social discomfort and difficulties with negative mood regulation than social heavy drinkers. Interventions focused on depression, affect regulation, adaptive coping, and alcohol abuse would be helpful with this population to address their related problems.
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Background: Depression is a common health problem, ranking third after cardiac and respiratory diseases as a major cause of disability. There is evidence to suggest that university students are at higher risk of depression, despite being a socially advantaged population, but the reported rates have shown wide variability across settings. Purpose: To explore the prevalence of depression in university students. Method: PubMed, PsycINFO, BioMed Central and Medline were searched to identify studies published between 1990 and 2010 reporting on depression prevalence among university students. Searches used a combination of the terms depression, depressive symptoms, depressive disorders, prevalence, university students, college students, undergraduate students, adolescents and/or young adults. Studies were evaluated with a quality rating. Results: Twenty-four articles were identified that met the inclusion and exclusion criteria. Reported prevalence rates ranged from 10% to 85% with a weighted mean prevalence of 30.6%. Conclusions: The results suggest that university students experience rates of depression that are substantially higher than those found in the general population. Study quality has not improved since 1990.
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A 4-factor measure of drinking motives based on a conceptual model by M. Cox and E. Klinger (see PA, Vol 75:32975; see also 1990) is presented. Using data from a representative household sample of 1,243 Black and White adolescents, confirmatory factor analyses showed that the hypothesized model provided an excellent fit to the data and that the factor pattern was invariant across gender, race, and age. Each drinking motive was related to a distinct pattern of contextual antecedents and drinking-related outcomes, and these relationships did not generally vary across demographic subgroups. Results support both the conceptual validity of Cox and Klinger's model and the utility of this measure for clinical and research purposes across a diverse range of adolescent populations. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The emphasis made on the significance of personality in the development of substance use problems has varied substantially through the years. Although early research has focused on identifying a single personality trait that conferred risk for substance use and misuse, recent research has highlighted the complex nature and heterogeneity of substance use behaviours and profiles, identifying a number of traits and risk pathways to substance use problems. This chapter reviews the evidence which provides support for the important aetiological role of a number of personality traits in the development and maintenance of substance use problems. Four personality-based causal pathways to substance misuse are proposed that help to explain some of the underlying mechanisms linking substance misuse with other mental disorders. Finally, implications for prevention and clinical practise are discussed.