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Solitary drinking is associated with specific alcohol problems in emerging adults
Abstract
Hazardous drinking in emerging adulthood is associated with multiple domains of alcohol problems, which range in type and severity. Alcohol problems at the severe end of the spectrum (e.g., impaired control) may be early warning signs of alcohol use disorders (AUDs) among emerging adults. However, given the emphasis in the literature on predictors of overall problem risk, we still know very little about predictors of these specific (and severe) domains of alcohol problems in emerging adults. Many emerging adults drink at social events (e.g., parties), but an estimated 15% engage in solitary drinking. Solitary drinking - a developmentally atypical behavior in emerging adulthood - may be especially risky. Data suggests that frequent solitary drinking may reflect a loss of control over drinking, leading to hazardous use and subsequent problems. Accordingly, we expected that frequent solitary drinking among emerging adults would predict severe alcohol problems that map onto diagnostic criteria for AUDs and these effects would be mediated by hazardous alcohol use. Undergraduates (N=118) completed self-report measures as a part of a larger study on motivation and alcohol use. As predicted, path analysis showed that solitary drinking positively predicted hazardous alcohol use, and this in turn predicted severe alcohol problems associated with diagnostic criteria for AUDs, particularly risky behaviors and blackout drinking. Solitary drinking also positively predicted less severe problems of diminished self-perception and poor self-care through hazardous use. Though comparatively smaller, some indirect effects were observed from social drinking (at parties, but not at bars) to alcohol problems, via hazardous alcohol use. Overall, our results suggest that solitary drinking is particularly harmful in emerging adulthood.
... Furthermore, a growing literature suggests that solitary drinking is a strong and consistent risk factor for a variety of alcohol-related problems (e.g., Creswell, 2020, 2021). Young adults who drink alone (compared to those who drink socially) report heavier drinking, are more likely to develop AUD symptoms, and are more likely to report negative physical and mental health outcomes (Gonzalez et al., 2009;Keough et al., 2018;Mason et al., 2020;Skrzynski and Creswell, 2020). ...
... 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. ...
... There were moderate relations among the random intercepts of solitary drinking and those of coping motives (r = 0.33) and alcohol problems (r = 0.21), and a strong relation between the random intercept of coping motives and alcohol problems (r = 0.55). Thus, although past studies have shown evidence of mediation, both with solitary drinking (e.g., Corbin et al., 2020;Waddell et al., 2021b) and coping motives (e. g., Keough et al., 2018) as the distal predictor, the current findings suggest that each is associated with person-level variance in alcohol problems above and beyond the other. Solitary drinkers have higher levels of impulsivity and lack active coping skills (e.g., Creswell et al., 2015), and thus solitary drinking may be a marker of risk for alcohol problems above and beyond coping motives for drinking. ...
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.
... Additional factors influencing drinking context or drinking opportunities could have implications for the incidence of unhealthy alcohol consumption during the COVID-19 pandemic. 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). ...
... Questions on drinking context were adapted from those reported in Keough et al. (24). These questions were originally adapted from Cooper's (56) drinking contexts measure. ...
... Specifically, in another study of alcohol use during the early stages of the pandemic, living alone (an external context factor) predicted increased solitary drinking, whereas internal context factors did not (77). Because past research has demonstrated that increased frequency of solitary drinking predicts increases in alcohol-related problems (24,78) it is imperative to understand which specific environmental factors during COVID-19 may elevate individuals' risk to develop this pattern of drinking. ...
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.
... However, it is unclear whether these contexts are linked to alcohol-related social harms for 30 year olds. 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). ...
... 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 . ...
... Drawing on the strengths of a population-based sample, we found patterns in the role of drinking contexts on social harms from drinking, some of which appeared to be gender specific. Our finding of gender-specific links between solitary drinking and drinkers' reports of social harm is consistent with those of Keough et al. (2018) among younger undergraduates (aged 18-25 years). Our study adds to this evidence by demonstrating that the solitary drinking context varies by gender, that these contexts are linked to a broader range of social harms from drinking than previously seen, and in an age group not previously considered. ...
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.
... Recent studies have shown that emerging adults that are depressed, likely due to their symptoms of low behavioural activation and interpersonal difficulties, engage in solitary drinking (Bilevicius, Single, Rapinda et al., 2018b;Keough et al., 2018), which is atypical for this age group (Neff, 1997). Solitary drinking has been associated with a host of negative outcomes, such as suicidal ideation and increased symptoms of depression, compared to social drinking (Gonzalez and Skewes, 2013). ...
... Solitary drinking has been associated with a host of negative outcomes, such as suicidal ideation and increased symptoms of depression, compared to social drinking (Gonzalez and Skewes, 2013). 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). ...
... First, neither studies used a sample of emerging adults that experience depression. This is problematic as it is important to investigate depression-related drinking behaviours, like solitary drinking, among those that are the most likely to engage in such behaviours (Keough et al., 2018). Relatedly, the authors assessed the relevance of neuroticism and its association to solitary drinking. ...
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.
... Additional factors influencing drinking context or drinking opportunities could have implications for the incidence of risky alcohol consumption patterns during the COVID-19 pandemic. 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). ...
... We did, however, observe a significant direct effect of environmental reward on Specifically, in a Canadian study of alcohol use during the early stages of the pandemic, living alone (an external context factor) predicted increased solitary drinking, whereas internal context factors did not (Wardell et al., 2020). Because past research has demonstrated that increased frequency of solitary drinking predicts increases in alcohol-related problems (Cresswell et al., 2014;Keough et al., 2018) it is imperative to understand which specific environmental factors during COVID-19 may elevate individuals' risk to develop this pattern of drinking. ...
... To the extent that interventions oriented towards mitigating the effects of constrained environmental reward secondary to social distancing, this might have beneficial effects on preventing escalations in alcohol consumption and the increased frequency of risky drinking patterns. Similarly, we found that environmental contexts predicted the frequency of alcohol consumption in solitary contexts, which is considered to be a risky pattern of alcohol use due to its relation to future problematic use (e.g., Keough et al., 2018). ...
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.
... Knowing if specific contexts are associated with greater alcohol use will increase our understanding of risk factors associated with substance use, and this information may improve the development of interventions targeted to prevent or reduce substance use involvement during the transition to college. Based on previous work, we hypothesized that drinking with friends and at parties would be more prevalent than drinking with the romantic partner (Rodriguez et al., 2016) or alone (Keough et al., 2018). Additionally, we expected that drinking at parties or at prepartying would be associated with greater alcohol use (Lipperman-Kreda et al., 2018. ...
... Probably due to the distinctive social component of substance use during emerging adulthood (Keough et al., 2018), alcohol use was more prevalent in contexts characterized by the presence of peers, particularly the closest friend, small same-sex or coed groups. Moreover, and in line with previous work (Rodriguez et al., 2016), drinking with the romantic partner was, compared to the other contexts, one of the less frequently endorsed. ...
... In line with previous work (Lipperman-Kreda et al., 2015), alcohol use was more prevalent in parties and in off-premises places (e.g., pregaming, and friends' homes). Occurrence of solitary drinking, an atypical behavior among emerging adults (Phillips et al., 2018) that increases the risk of alcohol disorders (Creswell et al., 2014;Keough et al., 2018;Tucker et al., 2014), was similar to that found in previous work with college students in U.S. (Keough et al., 2018). Frequent solitary use of alcohol (Buckner and Terlecki, 2016), in line with the classical theory of stress reduction (Sinha, 2001), is robustly associated with indicators of social anxiety. ...
Background
Alcohol use, and the association between alcohol-related variables and drinking outcomes, seem to be context dependent. We employed Latent Class Analysis, a person-centered approach, to identify distinct subpopulations based on contexts of alcohol use. We also examined if the resulting classes differ in a set of alcohol-related variables that hold promise as potential targets of interventions.
Method
Argentinean college students N = 1083; 64 % women; M age = 19.73 ± 3.95) completed an online survey that assessed alcohol outcomes and related variables [motives for substance use, protective behavioral strategies (PBS) and normative perceptions of alcohol use].
Results
Latent Class Analysis identified a 4-classes model for drinking contexts. These classes showed differential patterns of alcohol use (both in terms of frequency and quantity) and also differed in alcohol-related variables. Alcohol use was more prevalent in contexts characterized by the presence of peers, particularly the closest friend, small same-sex or coed groups. Close to 50 % of the sample reported drinking with family members. Students with a high probability of engaging in pregaming and nightclub drinking tend to use more PBS to control how much alcohol is consumed than those who do not drink in these contexts. All the classes significantly differed in their social reasons for drinking and in the number of alcohol-related negative consequences.
Conclusions
Our findings revealed subpopulations of college students that are heterogeneous regarding contexts of alcohol use, patterns of use and in a number of relevant variables. These distinctive subpopulations require different targeted interventions.
... While most young people do not drink alone, research indicates there is substantial risk associated with solitary drinking for the adolescents (14-27%; [3,5,6]) and young adults (~24-40%; [4,5]) who engage in this drinking behavior [1]. Adolescent and young adult solitary drinking is both cross-sectionally and prospectively associated with greater alcohol consumption and more alcohol problems (e.g., [4,[7][8][9][10][11][12][13]). For example, Tucker and colleagues [13] found that 8 th grade solitary (vs. ...
... Solitary drinking is a risky drinking pattern associated with heavier alcohol consumption and more alcohol-related problems, both concurrently and prospectively (e.g., [1,3,4,8,9,11,13]). Self-medication, in which individuals drink alone to alleviate negative affect, is the most compelling theory for solitary drinking [1,3,21], and recent studies demonstrate that drinking to cope motives mediate the link between solitary drinking and alcohol problems [22,24]. ...
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.
... 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). ...
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.
... Otro aspecto por considerar es que el consumo de sustancias parece variar según los contextos de consumo (Beck et al., 2009;Braitman et al., 2017;Spinella et al., 2019), que generalmente refieren a lugares -el entorno físico-o elementos sociales -elementos que caracterizan a las personas presentes-que definen la ocasión de consumo de sustancias como alcohol o marihuana (Lipperman-Kreda et al., 2018). En general, el consumo de sustancias (Keough et al., 2018) -y de marihuana en particular (Beck et al., 2009;Buckner et al., 2012;Phillips et al., 2018)se caracteriza por ser un consumo social, realizado junto a -o en presencia de-otras personas. Ciertamente, el consumo de sustancias en solitario es un comportamiento atípico durante la adultez emergente (Phillips et al., 2018) y su mayor frecuencia parece asociarse a mayor cantidad de consecuencias negativas, incluyendo mayor cantidad de síntomas de dependencia (Spinella et al., 2019). ...
... Por su parte, el resultado de consumo en solitario -predominante de los cf-es consistente con trabajos que sugieren que aquellos que consumen sustancias en solitario están en más riesgo de escalar a un consumo problemático o de experimentar efectos negativos de dicho consumo, que aquellos que consumen únicamente en contextos caracterizados por la presencia de amigos o familiares (Skrzynski & Creswell, 2020). El consumo en solitario es un comportamiento atípico durante la adultez emergente (Phillips et al., 2018) y, además, incrementa el riesgo de presentar problemas asociados a estos consumos (Creswell et al., 2014;Keough et al., 2018). De hecho, estudios previos indican que la mayor frecuencia de consumo en solitario de marihuana (Buckner & Terlecki, 2016) se asocia de manera robusta con indicadores de ansiedad social. ...
Aunque el consumo de marihuana es altamente prevalente entre universitarios de Argentina, poco se sabe respecto a los factores que permiten distinguir a los consumidores frecuentes de marihuana de quienes consumen esporádicamente. Por esta razón, en el presente trabajo se indagó sobre las posibles variaciones en los contextos de consumo, motivos de consumo, normas percibidas y estrategias conductuales de protección entre universitarios con consumo frecuente o esporádico de marihuana, y se analizó la utilidad de este conjunto de variables para distinguir entre estos los tipos de consumidores mencionados. Para ello, se contó con una muestra de 1083 estudiantes universitarios argentinos que completó una encuesta en línea sobre el consumo de sustancias. En particular, este trabajo se realizó con la submuestra que reportó consumir marihuana en los últimos 30 días (n = 158; 51.3 % mujeres). Dicha encuesta interrogaba sobre el consumo de marihuana y las consecuencias negativas asociadas, así como por motivos de consumo, normas sociales percibidas y estrategias conductuales de protección. Como resultado, los consumidores frecuentes presentaron mayor cantidad de consecuencias negativas (M = 4.92) que los consumidores esporádicos (M = 1.82; p ≤ .05), y se halló un perfil distintivo en un conjunto de variables. A nivel multivariado, los motivos de animación (or = 1.230; p ≤ .05), las estrategias conductuales de protección (or = .941; p ≤ .05), el consumo en solitario (or = 2.024; p ≤ .05) y el consumo en fiestas universitarias (or = 2.669; p ≤ .05) discriminaron significativamente entre ambas clases de consumidores. En general, los hallazgos revelaron subpoblaciones heterogéneas de consumidores de marihuana que difieren no solo en el consumo y sus consecuencias, sino también en los contextos de consumo y en un conjunto de variables relevantes. Estas subpoblaciones distintivas requieren de intervenciones diferentes y específicas.
... An important tool for fostering these social connections, especially for students, seems to be the use of alcohol (Brown & Murphy, 2020). Particularly, students engage in social drinking practices, usually in bars or campus facilities, because it assists in the challenging aspect of fitting in with the group (Grüne et al., 2017;Keough et al., 2018). Given the social nature of students' alcohol use, public health measures to reduce the spread of the disease may have directly (e.g. ...
... Second, to cope with this challenging situation, social drinking may have turned into solitary drinking (Cooper, 1994;Merrill et al., 2014). This, in turn, has been linked to lasting alcohol problems in previous studies (Corbin et al., 2020;Keough et al., 2018). As such, the viral containment measures may have also increased the probability of more problematic drinking. ...
Background
COVID-19 and measures to contain it may have impacted college students’ behavior, including their drinking behavior. Students’ drinking may have decreased—for example, due to the closure of bars—but problematic drinking may have increased—for example, due to (solitary) drinking at home. Another behavior that has increased due to COVID-19 and the accompanying social isolation is students’ social networking site (SNS) use. This is worrisome because students’ SNS use has been shown to increase their alcohol use. Nevertheless, little research has investigated these behaviors and the possible link between them during a lockdown. Therefore, this study aimed to examine (1) whether students engaged in drinking during a lockdown, (2) whether they displayed their drinking behavior on SNSs, and (3) whether exposure to and posting of alcohol-related content was linked to their daily alcohol use.
Methods
337 college students (Mage = 20.63 years, SDage = 1.55 years; 50.3% male) participated in a two-week daily diary study. Descriptive statistical analyses and generalized linear mixed modeling (GLMM) were deployed.
Results
Descriptive analysis results showed that during the week, students’ drinking occurred with friends in dormitories, while in the weekend, this behavior shifted to drinking with friends and parents at home. Moreover, students mostly saw visual and posted textual posts of this drinking on SNSs. Furthermore, GLMM revealed associations between exposure to alcohol postings, sharing of alcohol postings, and students’ probability of drinking on the same day.
Conclusion
This study provides important insights into students’ alcohol use and its underlying mechanisms during health crises.
... For instance, drinking with friends has been linked to greater alcohol consumption and consequences than drinking with family members (Clapp & Shillington, 2001;Connor et al., 2014). Drinking alone has consistently been linked to alcohol-related consequences (Gonzalez & Skewes, 2013;Keough et al., 2018). Additionally, people tend to consume more alcohol in public (e.g., bars, parties) than in private or intimate locations (for example, at home or friend's home; Kairouz et al., 2002;Kuntsche et al., 2005). ...
... When we extracted one additional class, the fifth class was too small to examine (n = 13) but individuals in this class were highly likely to drink alone. Given that drinking alone is a risk factor for problematic alcohol use (Gonzalez & Skewes, 2013;Keough et al., 2018), it will be important for future research with larger samples to examine drinking alone among SM-AFAB and determine whether this group grows in later adulthood. ...
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.
... The literature on risk factors for SU problems during the pandemic is limited by its infrequent consideration of SU contexts and reliance on cross-sectional methods. Pre-pandemic studies have demonstrated that SU contexts (e.g., who an individual uses substances with) influence SU behaviors among the general population (Connor et al., 2014;Keough et al., 2018) and SGM (Dyar et al., 2021;Fairlie et al., 2018). While social distancing has led to dramatic changes in SU contexts for many, few studies have examined the effects of these changes (for an exception see Dumas et al., 2020), and we are not aware of any to have done so among SGM. ...
... 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). Studies of cannabis use contexts are less common; however, solitary cannabis use has been linked with more problematic use (Creswell et al., 2015). ...
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.
... 경향을 보이며, 혼술은 해로운 알코올 사용과 그 후의 문제행 동 발생에 영향을 미치는 요인이라는 결과가 보고되어왔다 [3][4][5]. 그러나 [6,10,11]. 여성의 음주 행위는 음주에 대한 인식과 기대, 음주 상황 등의 심리적 요인과 관련이 있어 [12,13], 알코올 섭취가 원하는 결과를 이룰 수 있을 것이라는 음주 기대 가 높을수록 문제음주와 관련이 있음이 보고되었다 [13,14]. ...
... 여성의 음주 행위는 음주에 대한 인식과 기대, 음주 상황 등의 심리적 요인과 관련이 있어 [12,13], 알코올 섭취가 원하는 결과를 이룰 수 있을 것이라는 음주 기대 가 높을수록 문제음주와 관련이 있음이 보고되었다 [13,14]. 특 히 일부 연구에서 '혼술'의 증가가 여성의 폭음과 연관된 것으 로 보고되어 [2,15] [3,5,7,16,17], 알코올 소비 증가, 음주 후 기억 상실 및 음주 문제와 연결될 수 있다는 사실 도 보고되었다 [3,4]. 하지만 ...
... Solitary drinking has been positively associated with problematic and dysfunctional alcohol use in adolescents and emerging adults, including: achieving drinking milestones earlier (e.g. age at first intoxication or onset of regular drinking; Christiansen et al., 2002;Creswell et al., 2014), greater alcohol consumption (Bourgault & Demers, 1997;Buckner & Terlecki, 2016;Christiansen et al., 2002;Creswell et al., 2015;Gonzalez et al., 2009;Gonzalez & Skewes, 2013;Neff, 1997;Tucker et al., 2006), heavy or hazardous drinking (Bilevicius et al., 2018;Gaunekar et al., 2005;Gonzalez & Skewes, 2013;Keough et al., 2018;Stickley et al., 2015), alcohol-related consequences and alcohol use disorder symptoms (Assanangkornchai et al., 2000;Cranford et al., 2011;Stickley et al., 2015), and severity of alcohol dependence (Gonzalez & Skewes, 2013). Further, longitudinal studies suggest that in adolescents solitary drinking is a unique risk factor leading to the development of problems with alcohol (Creswell et al., 2014;Tucker et al., 2006). ...
... Our findings suggest that in an adult treatment seeking sample, unlike in college students and adolescents, solitary drinking is normative. This is consistent with the notion that solitary drinking represents a loss of control over drinking (Christiansen et al., 2002;Creswell et al., 2014;Keough et al., 2018;Tucker et al., 2006). Social and solitary drinking variables were moderately negatively correlated, suggesting that those who drank alone more drank socially less. ...
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.
... 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. ...
... For example, Creswell et al. (2014) found that solitary drinking was prospectively associated with AUD symptoms at age 25 above and beyond focal predictors of negative consequences, such as drinking quantity/frequency, demographics, and past AUD symptoms. Additionally, Bilevicius et al. (2018) found that solitary drinking (compared with social drinking) had the largest effect size when predicting hazardous alcohol use, and Keough et al. (2018) found that solitary but not social drinking was indirectly associated with young adult negative consequences through hazardous drinking. Taken together, these studies suggest that solitary drinking may represent a critical risk factor for a shift toward more problematic use of alcohol and/or development of AUD. ...
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).
... 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). It is important to note that, although solitary drinking is linked to coping motives, many may also drink while in social situations to alleviate anxiety (Keough et al., 2016). ...
... Indeed, when total problems were disaggregated into individual subscales, solitary drinking uniquely predicted self-care, academic/occupational, and physical dependence. 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 . ...
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.
... It is important to understand how drinking norms may differentially influence social and solitary alcohol consumption given their differential influence on alcohol-related consequences. 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). ...
... 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. ...
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).
... One such moderator may be social anxiety which is closely aligned with the neurotic construct of anxiety and underrepresented in current measures of neuroticism. Given drinking generally occurs within a social context in emerging adulthood (Gullo et al., 2017;Keough, Battista, O'Connor, Sherry, & Stewart, 2016;Keough, O'Connor, Sherry, & Stewart, 2015;Keough, O'Connor, & Stewart, 2018), a propensity to be socially anxious could affect the relationship between neuroticism and drinking. Research has found social anxiety to both increase risk of alcohol use disorders in clinical and community samples of young people (Black et al., 2015;Buckner et al., 2008;Buckner & Turner, 2009) and reduce drinking (including problem drinking) in emerging adults (Ham, 2009 Note. ...
... This may be because this group who is high in BIS and social anxiety feels particularly at risk of negative consequences resulting from their drinking (e.g., social embarrassment), given their perceived inability to interact with others. This favours abstinence in social situations, or alternatively, may lead to abstinence via social avoidance (given drinking during this age generally occurs within a social context; Gullo et al., 2017;Keough et al., 2016;Keough et al., 2015;Keough et al., 2018). Conversely, emerging adults who have less fear of negative consequences (i.e., low BIS) and low confidence in their ability to interact with others (i.e., social anxiety) may consume alcohol as a social lubricant (regardless of perceived risk of negative consequences resulting from their drinking), given they are not as sensitive to negative consequences. ...
Personality traits provide one way of understanding differential susceptibility to drinking. However, the relationship between trait neuroticism and drinking is unclear. This exploratory study aimed to clarify this relationship by examining whether: (1) existing measures of neuroticism (based on prominent personality models) assess similar or different constructs; (2) social anxiety moderated the relationship between the resulting neuroticism factors and problematic drinking. Emerging adults (N = 757; Mage = 20.71; 72% female) completed an online survey assessing problematic drinking, six facets of neuroticism, and social anxiety. Factor analyses of the neuroticism scales yielded a four-factor solution comprising emotional instability (EI), behavioural inhibition system (BIS), fight-flight-freeze system, and hopelessness. Regression analyses revealed a positive main effect of EI and a significant interaction between BIS and social anxiety on problematic drinking (B = −0.009, p =.008). The BIS was associated with reduced problematic drinking when participants were high in social anxiety (B = −0.177, p =.032) and unrelated to problematic drinking when participants were low in social anxiety (B = 0.091, p =.220). Emerging adults with elevated EI are a vulnerable group which may benefit from personality-targeted interventions. High BIS is associated with reduced problem drinking in socially anxious emerging adults.
... Meta-analyses of studies involving adolescents and emerging adults have identified significant positive associations between solitary drinking and both alcohol use and alcohol problems. 7,26,27 The current study, which was conducted in Uruguay with participants whose mean age was 30 years, suggests that efforts should be made to curtail solitary drinking, particularly among early-onset drinkers. ...
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.
... However, consistent with hypothesis, only alcoholic beverage intake, and not nonalcoholic beverage intake, was correlated with negative affect scores and only among the high AS participants. Given that solitary alcohol consumption and alcohol use motivated by a desire to manage negative affect are both risk factors for problematic alcohol use (e.g., Bresin & Mekawi, 2021;Keough et al., 2018), these lab-based findings were consistent with high AS individuals showing a risky pattern of situation specific alcohol consumption. Findings suggest the importance of reducing solitary drinking and coping-motivated alcohol use among high AS students. ...
Le présent article résume notre programme de recherche sur la sensibilité à l’anxiété (SA) – un facteur dispositionnel cognitif et affectif impliquant des craintes de sensations liées à l’anxiété en raison de croyances selon lesquelles ces sensations entraînent des conséquences catastrophiques. La SA et ses dimensions d’ordre inférieur sont considérées comme des facteurs transdiagnostiques de risque ou de maintien des troubles émotionnels et des troubles addictifs. La compréhension des mécanismes par lesquels la SA exerce ses effets peut révéler des cibles d’intervention clés pour les programmes de prévention et de traitement axés sur la SA. Dans le présent article, je passe en revue les recherches fondamentales que nous avons menées pour comprendre les mécanismes qui relient la SA à ces troubles et à leurs symptômes. Je décris également les interventions transdiagnostiques ciblées sur la SA et j’illustre la manière dont la recherche fondamentale a permis d’orienter le contenu de ces interventions. Enfin, je passe en revue les projets en cours dans mon laboratoire et je souligne les orientations futures importantes dans ce domaine. Bien que des progrès considérables aient été réalisés au cours des trois dernières décennies et que la recherche ait considérablement fait avancer notre compréhension de la SA en tant que facteur transdiagnostique, de nombreuses questions restent en suspens. Les réponses devraient nous aider à affiner les interventions afin d’en faire bénéficier au maximum les personnes qui ont une grande peur d’avoir peur.
... Drinking context, often defined by whether an individual is drinking in the presence of other drinkers (i.e., social drinking) or drinking alone (i.e., solitary drinking), has been conceptualized as a risk factor for AUD for several decades (Akerlind & Hörnquist, 1992;Jellinek, 1946). Across studies and developmental stages, those who drink in a solitary setting report greater negative alcohol consequences/AUD, controlling for drinking quantity, whereas social drinkers report heavier drinking which, in turn, places them at risk for greater negative alcohol consequences (e.g., Creswell et al., 2014;Keough et al., 2018;Skrzynski & Creswell, 2020, 2021Waddell, Corbin, & Marohnic, 2021). In line with Baker et al.'s (2004) affective processing model of substance use, it is possible that the lack of external stimulation in solitary settings allows for increased introspection regarding negative affect, driving engagement with negatively reinforcing behavior. ...
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.
... This is consistent with published data on Canadian undergraduate drinking practices (American College Health Association, 2019). Students who endorsed drinking in the past 3 months reported 7.76 (SD = 8.29) alcohol-related problems in the past month, consistent with other Canadian undergraduate drinking research (Keough et al., 2018). ...
Objective: Undergraduates frequently engage in risky drinking (i.e., drinking alcohol in ways that may result in problems). The reasoned action approach identifies injunctive norms (i.e., perceptions that others approve of risky drinking) as central in predicting engagement in risky drinking. However, research linking injunctive norms and risky drinking is equivocal, possibly because of extensive variability in the operationalization of injunctive norms across studies. This study describes the development and validation of the Perceived Approval of Risky Drinking Inventory (PARDI), designed according to best practice guidelines in questionnaire development. Method: Undergraduate students (N = 1,313) participated in one of the three phases of data collection, including focus group interviews for item generation (n = 31), self-report questionnaires for scale refinement (n = 407), and self-report questionnaires for scale validation (n = 875). Results: Exploratory and confirmatory factor analyses supported a 20-item four-factor solution (Heavy Drinking, Drinking-Related Problems, Coping-Related Drinking, and Sexual-Risk Taking) across the three assessed referent groups (friends, parents, and typical students), all of which present satisfactory estimates of scale score and composite reliability. The results also provided preliminary support for the convergent validity of scores obtained on the PARDI, as demonstrated through correlations with other measures of perceived norms, alcohol use, alcohol-related problems, and coping-motivated drinking. Finally, the results supported the generalizability of the PARDI factor structure by demonstrating its measurement invariance across gender and drinking status (i.e., alcohol use and problems). Conclusions: The PARDI represents a reliable, valid, yet nuanced measure of injunctive norms that can be used to support further theory development and intervention.
... Alcohol, for example, increases subjective feelings and objective indicators of social connection (Sayette et al., 2012), and people reporting a greater number of heavy drinking friends, in addition to having friends present during a specific drinking episode, also report greater heavy drinking (Murphy et al., 2006;Thrul and Kuntsche, 2015) and motivation to drink (Acuff et al., 2020a;Acuff et al., 2020b). On the other hand, solitary drinking is generally associated with increased alcohol-related problems, in addition to greater suicidal ideation, depression, and social anxiety (Bilevicius et al., 2018;Keough et al., 2018), illustrating the complex interaction between social context (or lack thereof), substance use, and accompanying risky behaviors. ...
While social context has long been considered central to substance use disorder prevention and treatment and many drug-taking events occur in social settings, experimental research on social context has historically been limited. Recent years have seen an emergence of concerted preclinical and human laboratory research documenting the direct impact of social context on substance use, delineating behavioral and neurobiological mechanisms underlying social influence's role. We review this emerging preclinical and human laboratory literature from a theoretical lens that considers distinct stages of the addiction process including drug initiation/acquisition, escalation, and recovery. A key conclusion of existing research is that the impact of the social environment is critically moderated by the drug-taking behavior and drug use history of a social peer. Specifically, while drug-free social contexts can reduce the likelihood of drug use initiation and as a competitive non-drug alternative preventing escalation, drug-using peers can equally facilitate initiation and escalation through peer modeling as a contingent reward of use. Likewise, social context may facilitate recovery or serve as a barrier that increases the chances of a return to regular use. We conclude by discussing evidence-based interventions that explicitly target social mechanisms or that have identified social context as a mechanism of change within treatment. Ultimately, new areas for research including the expansion of drug classes studied and novel human laboratory designs are needed to further translate emerging findings into clinical practice.
... Drinking context, often defined by whether an individual is drinking in the presence of other drinkers (i.e., social drinking) or drinking alone (i.e., solitary drinking), has been conceptualized as a risk factor for AUD for several decades (Akerlind & Hörnquist, 1992;Jellinek, 1946). Across studies and developmental stages, those who drink in a solitary setting report greater negative alcohol consequences/AUD, controlling for drinking quantity, whereas social drinkers report heavier drinking which, in turn, places them at risk for greater negative alcohol consequences (e.g., Creswell et al., 2014;Keough et al., 2018;Skrzynski & Creswell, 2020, 2021Waddell, Corbin, & MacKinnon, 2021). In line with Baker et al.'s (2004) affective processing model of substance use, it is possible that the lack of external stimulation in solitary settings allows for increased introspection regarding negative affect, driving engagement with negatively reinforcing behavior. ...
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.
... In fact, we hypothesize that people mostly affected from lockdown measures in terms of alcohol consumption have been those with previous hazardous drinking patterns, which suddenly found themselves without social connections, deprived of all the support instruments that were usually available for alcohol related issues, and with a high availability of online alcoholic products for sale. Furthermore, while for those who were used to "social drinking" the lockdown could have represented a deterrent for alcohol consumption, those who had the dangerous tendency to drink alone found themselves with unprecedented occasions to drink [39,40], without a social context that would usually hold them back from drinking. A further element in support of our hypothesis is the fact that many people -once more those from the lower socioeconomic status -found themselves temporarily laid off, if not unemployed, lacking therefore of another strong deterrent from drinking. ...
Introduction:
The COVID-19 pandemic came along with several health and social unprecedented emergencies, among which handling people with substance use disorder issues.
Methods:
In this work, data from a cross-sectional online survey conducted among more than 40,000 adults in 21 European countries during the spring of 2020 are analyzed. The survey recorded participants drinking habits during the year preceding the survey and the changes in alcohol consumption during lockdown. The analyses focused on alcohol consumers' type, investigating on the behavioral change in people who already had a problematic alcohol consumption attitude.
Results and conclusion:
The results show how subjects with risky or hazardous use of alcohol increased both drinking quantity and frequency in most European countries, underlining the urge to establish regulations on online and home delivered alcoholic beverages availability and reinforcing and restructuring health care services.
... On one hand, these data suggest the reduction of social binge drinking (Graupensperger et al., 2021;McPhee et al., 2021). However, solitary drinking is the most risky drinking pattern for emerging adults, due to its frequent association with alcohol dependence (Keough et al., 2018). Therefore, observing the protective and risk factors for binge drinking during the COVID-19 lockdown may be specifically important to understand whether and how home confinement impacted on alcohol misuse, favoring the implementation of more targeted intervention and rehabilitation programs. ...
This study investigated binge behaviors during COVID-19 lockdown in Italy, exploring individual and contextual risk factors. Participants were 1925 emerging adults (M age = 24.18, SD age = 2.75; 71.9% women), recruited during the national lockdown in Italy. An online survey investigated binge behaviors both prior and during quarantine. Binge drinking significantly diminished during quarantine, while binge eating episodes did not vary in frequency. However, participants with pre-existent binge eating disorder (BED) reported a worsening in BED symptoms. Lower education, lower SES, job suspension due to lockdown, and higher pandemic-related stress were associated to an increase in binge behaviors during home confinement, whereas living with family was a protective factor. Participants reporting co-occurrent binge behaviors also had significantly higher pandemic-related stress and lower perceived support during home confinement, in comparison with no-binge participants. The study provides new insights about protective and risk factors for binge behaviors in emerging adults during COVID-19 lockdown.
... The former finding is not necessarily expected, but it may reflect that in Norway, most of all drinking occasions occur on the weekends. The latter observation corroborates previous findings of solitary drinking being associated with hazardous drinking behaviour and alcoholrelated problems (Keough, O'Connor, & Stewart, 2018). Notably, the heaviest drinkers in terms of hazardous drinking had a larger fraction of their drinking occasions at licensed premises, consistent with their younger age profile. ...
Background
There is little knowledge about characteristics of the heaviest drinkers. This study aimed at exploring 1) socio-demographic characteristics and 2) drinking patterns and drinking contexts of heavy drinkers and other drinkers in Norway, applying various criteria for heavy drinking.
Methods
Data from cross-sectional population surveys among adults in Norway (aged 16 +) in 2015 through 2018 (current drinkers, n=6 940) were analysed. Two measures were applied to categorize heavy drinkers: 1) AUDIT score (10+), and 2) annual consumption volume (445+ units) (both above 90th percentile). Social contexts of drinking included location (private homes, licensed premises); social company (partner/family, work mates, friends, no one); and weekend versus weekdays.
Results
Heavy drinkers accounted for 10% of the sample and up to half of the total consumption. Heavy drinkers differed significantly from other drinkers with regard to age, education level and criterion; by AUDIT score, the prevalence of heavy drinkers decreased with increasing age and education level, whereas the opposite was the case for by volume. Compared to other drinkers, heavy drinkers drank relatively more often on weekdays and relatively more often alone, and more frequently at licenced premises.
Conclusions
In Norway, the distribution of alcohol consumption is heavily skewed, and the heaviest drinkers differ from the rest of the population in several aspects. This group of drinkers represent an important target for public policy, and there is a need for further knowledge of this group enabling more targeted interventions in addition to policies aimed at reducing the per-capita consumption.
... The context of drinking is important, as previous findings suggest that drinking at home and alone is associated with more harmful drinking behaviors and drinking to cope (Keough et al., 2018;Skrzynski and Creswell, 2020;Wardell et al., 2020). The current study showed a strong association between always drinking at home alone and increased consumption, whereas drinking online with others or in public with others was not associated. ...
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.
... Destaca-se, ainda, o hábito de beber de forma solitária. Embora seja incomum em adultos jovens, ao se fazer presente pode indicar uma perda de controle, levando ao uso abusivo e problemas posteriores (Keough, O'Connor & Stewart, 2018). ...
A pesquisa buscou integrar o conhecimento relativo à percepção dos estudantes universitários em relação aos riscos no uso e abuso de substâncias psicoativas. Objetivou-se verificar se a percepção em relação ao risco poderia ser um fator que contribui para o uso, bem como a proximidade com os colegas e o pertencimento a grupos que façam uso dessas substâncias. Foram seguidos os passos de uma revisão integrativa. 27 estudos foram incluídos por estarem de acordo com os critérios estabelecidos. Os achados sugerem que há uma associação significativa entre a maneira como o estudante universitário percebe os riscos e o seu padrão de consumo de drogas, bem como a relação que ele estabelece com os pares e demais colegas. Outro aspecto relevante foi a evidência sobre o uso de substâncias que só podem ser adquiridas com prescrição médica e que são utilizadas de forma indiscriminada para o aumento do desempenho acadêmico.
... Importantly, emerging evidence suggests that solitary drinking may be an early risk marker for alcohol use disorder (AUD) [12]. For example, solitary drinking in younger individuals is associated with greater quantity and frequency of alcohol consumption (e.g., [10], more negative consequences from alcohol-use (e.g., [13]), greater alcohol dependence severity (e.g., [11]), and greater persistence of problem drinking across time [7]. Of note, longitudinal studies examining solitary drinking have found prospective links from this drinking behavior to later alcohol problems (e.g., [6,12,14]). ...
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.
... The significant mediation involving PBS and negative reinforcement motives was unexpected. Substance use during emerging adulthood occurs predominantly in social contexts (Keough et al., 2018) and, additionally, most PBSs describe strategies likely to be used in social contexts. In line with that, several studies consistently supported PBS as a mechanism through which positively (i.e. ...
Aims
The present study examined which types of alcohol protective behavioral strategies ([PBSs], Manner of Drinking [MOD] strategies, Serious Harm Reduction [SHR] or Limiting/Stopping Drinking strategies [LSD]) mediate the effects of a comprehensive number of distal antecedents on alcohol drinking quantity and alcohol-related negative consequences.
Methods
A sample of 762 last-month college freshman drinkers from Argentina (Mean age = 19.60 ± 3.80) completed a survey that assessed alcohol outcomes (drinking quantity during a typical week and alcohol-related negative consequences), frequency of use of PBS and a set of distal antecedents (i.e. age at drinking onset, drinking motives, college alcohol beliefs and impulsivity-like traits).
Results
MOD significantly mediated the effects of college alcohol beliefs (higher beliefs were associated with lower MOD use) and coping motives (higher coping motives were associated with lower MOD use) on alcohol outcomes. SHR significantly mediated the effects of sex (women reported more frequent SHR use) and enhancement motives (higher motivation was associated with lower SHR use) on alcohol-related negative consequences.
Conclusion
Our findings partially support a mediational role of PBS in the association between risk factors and alcohol outcomes, and offer valuable information for the design of interventions to reduce alcohol use in South-American college students. More studies examining PBS as mediators of distal antecedents are needed to fully understand the peculiarities of these associations in different cultures.
... First, there was a gender and racial imbalance in our sample of predominantly White females. Although this is common limitation in the literature on problem drinking in emerging adults (Bilevicius et al., 2018;Keough et al., 2017;Terlecki and Buckner, 2015;Terlecki et al., 2014), it is important to consider the related implications. It has been suggested that race and ethnicity are associated with trait impulsivity and the T1 SA by trait impulsivity interaction term predicting the intercept and slope of alcohol problems. ...
Aims
Alcohol use follows a developmental trajectory—steadily increasing and peaking in the early stages of emerging adulthood (e.g. first year of university) and declining thereafter. While most individuals ‘mature out’ of problem drinking as they move through emerging adulthood, some continue to drink heavily and experience serious problems. Tension reduction theory identifies social anxiety (SA) as a potential risk factor for problem drinking during emerging adulthood. However, mixed data suggest that the associations between SA and drinking behaviours are not straightforward. Cross-sectional studies demonstrate that socially anxious emerging adults are at risk for problem drinking, but only if they are also high in trait impulsivity. This study aimed to expand on previous work by examining trait impulsivity as moderator of the prospective associations between SA and maturing out of problem drinking in emerging adulthood.
Methods
Undergraduates (N = 302) completed online self-reports at regular intervals (6-months) over an 18-month period, resulting in four waves of data.
Results
Unconditional latent growth curve models indicated that alcohol problems (but not use) declined linearly over time. Next, conditional growth curve models revealed that SA was associated with impeded maturing out of alcohol problems, but this effect was only present in socially anxious participants with high levels of trait impulsivity.
Conclusion
Our study advances growing literature on the crucial moderating role that impulsivity plays in the SA pathway to problem drinking. Clinical interventions for problem drinking among socially anxious students should both assess for and target concurrent impulsivity.
... Drinking alone is a predictor of alcohol problems in the general population [27]. 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. ...
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.
... For men, this was "home drinking" and for women, "daytime drinking". Solitary drinking is a traditional risk for heavy alcohol consumption and alcohol-related problems (Creswell et al., 2014;Keough et al., 2018). ...
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.
Objective: Playing drinking games (DGs) is a common, socially-interactive risky drinking activity. During the pandemic, many students either returned home to live with their parents or remained on campus. Because DGs often require social interaction, playing DGs in-person can increase students' risk for COVID-19 exposure. Thus, we examined whether living situation and perceptions of one's college/university as a party school increased risk for playing DGs in-person during a pandemic. Method: Students who reported recent alcohol use from 12 colleges/universities (n = 874; Mage = 19.38/SDage = 1.40; 75.6% White) completed self-report measures of alcohol use, DGs participation, demographics, and residential status in Fall 2020 to Spring 2021. Univariate and multivariate analyses were conducted. Results: Overall, 62.8% of students played DGs in-person during the pandemic. Those who lived with roommates were at increased risk compared to those who lived with parents. Conclusions: Given health risks of playing DGs in-person, targeted efforts may be warranted among at-risk students.
Background: Loneliness is a predisposing and maintaining factor of alcohol use behavior. Several studies have
linked loneliness to daily drinking and elevated alcohol use disorder (AUD) risk; however, operationalizations of
both loneliness and drinking have varied greatly.
Methods: The current study adopted a multidimensional framework of loneliness (i.e., emotional and social
subtypes) to examine daily prospective relations between loneliness and drinking among non-treatment seeking
individuals with AUD. Participants (N= 60) reported on current loneliness and drinking twice daily for 14-days.
Scores on emotional and social loneliness were disaggregated into within- and between-person predictors, and a
multilevel hurdle model proxy was fitted with drinking likelihood (logistic) and quantity (zero truncated
negative binomial) specified as separate outcomes.
Results: Emotional loneliness (within-person) was associated with increased drinking likelihood (OR=1.05, 95 %
BCI [1.01, 1.10]) and quantity (IRR=1.05, 95 % BCI [1.02, 1.09]), while social loneliness (within-person) was
associated with decreases in both drinking likelihood (OR=.94, 95 % BCI [.89,.99]) and quantity (IRR=.96, 95 %
BCI [.93,.99]). Between-person loneliness scores were unrelated to both outcomes.
Conclusions: These discrepant findings by loneliness subtype may be ascribed to differences in subjective man
ifestations, in that emotional loneliness is a more severe form of loneliness that overlaps significantly with other
negative affective states and promotes a coping response, while social loneliness may be readily alleviated by
adaptive behavioral strategies for some, and social withdrawal for others. These findings offer insight into the
nuances of loneliness-drinking relations and their clinical implications.
Socially assistive robots can support people in making behavior changes by socially engaging in or moderating certain behaviors, such as physical exercise and snacking. However, there has not been much work on designing social robots that aim to support both social engagement and behavior moderation, i.e., offering social interactions for engaging in behaviors without over-engagement. This work explores how social robots can moderate alcohol consumption while socially engaging them in a solitary drinking context. As alcohol consumption can have benefits when done in moderation, this companion robot aims to guide the user toward moderate drinking by using social engagement (i.e., creating an enjoyable atmosphere) and drinking moderation (i.e., regulating the drinking pace). Our preliminary user study (n=20) reveals that the robot is perceived as a friendly companion, and its human-likeness is partly attributed to the robot's intervention. Most participants followed the robot's guidance and perceived it as an intelligent friend due to its social interactions and behavior tracking features. We discuss the benefit of physical interactions for social engagement, utilizing interaction rituals for enjoyable but moderate commensality, and ethical considerations in solitary drinking contexts.
Purpose of Review
Sexual and gender minorities (SGM) appear to be at elevated risk for cannabis use (CU) and cannabis use disorder (CUD) compared to cisgender heterosexuals. However, risk factors remain understudied among SGM. This review aims to summarize evidence for disparities in CU and CUD affecting SGM and factors contributing to these disparities.
Recent Findings
There is strong evidence that sexual minorities are at elevated risk for CU and CUD is elevated for sexual minority women. Evidence supports a concurrent association between minority stress and CUD symptoms. There is robust support for coping motives as a mechanism linking minority stress to subsequent CU and CUD. Studies also point to CU norms and contexts as potential risk factors.
Summary
SGM are at high risk for CU and CUD, and minority stress, CU norms, and contextual factors are implicated. Additional research is needed on CU among gender minorities, prospective effects of risk factors, and interventions for SGM.
Purpose
Previous research have shown that individuals with high trait impulsivity are at high risk of engaging in problem alcohol use and that drinking motives differentially predicted alcohol use and problems. This study aimed to investigate whether these previously shown associations still existed during the global outbreak of the pandemic, COVID-19, which resulted in a long period of lockdown and raised concerns about the effects of alcohol.
Design/methodology/approach
The data was collected from 185 adults between ages of 18 and 35 during the lockdown period (November 20–May 21) through an online survey. Participants completed an impulsivity questionnaire, drinking motives and alcohol use measures.
Findings
The results revealed that enhancement and coping motives mediated the effects of positive and negative urgency, respectively, and lack of premeditation facet of impulsivity was directly linked to alcohol use. These findings are partially in line with the previous studies before the lockdown.
Research limitations/implications
Overall, individuals with particularly high urgency and premeditation maybe at high risk for problem alcohol use and may require tailored support for regulating emotions, particularly during stressful life events such as a global pandemic.
Practical implications
Findings may inform prevention and intervention strategies. Individuals with high trait urgency may benefit from more adaptive coping strategies such as learning specific emotion regulation strategies to minimise engaging in risk behaviours in stressful situations.
Originality/value
Findings suggest that traits positive and negative urgency are risk factors for alcohol use through enhancement and coping motives respectively, and these associations are particularly strong during stressful life events.
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.
Background
Because of the role alcohol outcome expectancies play in subsequent drinking, it is important to understand factors that can shape alcohol expectancies to guide intervention efforts. This study examined among college students whether intended social contexts for drinking were associated with positive and negative alcohol expectancies at the daily-level.
Methods
Participants included in analyses were 323 students, ages 18 to 24 years, enrolled at a 4-year university in the Pacific Northwest. At four 2-week measurement bursts across one year, participants were asked each afternoon to report whether they planned to drink alcohol later that day. If so, they were further asked how much they intended to drink, whether they plan to drink alone or with others, whether they plan to drink at home or bar/party, and their positive and negative expectancies of alcohol use that evening.
Results
A total of 2953 person-day observations from planned drinking days were used. Results from linear mixed models, adjusted for covariates including intended number of drinks, showed that students reported greater positive alcohol expectancies on days when they intended to drink with others vs. alone and intended to drink at a bar or party vs. at home. For negative expectancies, only intended drinking with others showed a statistically significant association.
Conclusion
This study suggests that contextual factors may shape college students’ expectancies about effects of alcohol at the daily-level. Intended drinking contexts may be important to address in event-level interventions to reduce high-risk drinking in young adults.
Background
Behavioral economic theory predicts decisions to drink are cost benefit analyses, and heavy episodic drinking occurs when benefits outweigh costs. Social interaction is a known benefit associated with alcohol use. Although heavy drinking is typically considered more likely during more social drinking events, people who drink heavily in isolation tend to report greater severity of use. This study explicitly disaggregates between-person and within-person effects of sociality on heavy episodic drinking and examines behavioral economic moderators.
Methods
We used day-level survey data over an 18-week period in a community adult sample recruited through crowdsourcing (mTurk; N = 223). Behavioral economic indices were examined to determine if macro person-level variables (alcohol demand, delay discounting, proportionate alcohol-related reinforcement [R-ratio]) interact with event-level social context to predict heavy drinking episodes.
Results
Mixed effect models indicated significant between-person and within-person social context associations. Specifically, people with a higher proportion of total drinking occasions in social contexts had decreased odds of heavy drinking, whereas being in a social context for a specific drinking occasion was associated with increased odds of heavy drinking. Person-level R-Ratio, demand elasticity, and breakpoint variables interacted with social context to predict heavy episodic drinking, such that the event-level social context association was stronger when R-Ratios, alcohol price insensitivity, and demand breakpoints were high.
Conclusions
These results demonstrate an ecological fallacy, in which the size and direction of effects were divergent at different levels of analysis, and highlight the potential for merging behavioral economic variables with proximal contextual effects to predict heavy drinking.
Although many college students view drinking as a means of gaining a community and being social, research has not established whether alcohol consumption influences students’ enjoyment and perceptions of how others view them or how this may differ based on the social or solitary nature of that consumption. The current study used online daily diary methods to examine the association between alcohol consumption and enjoyment and self-perceptions at the within- and between-person levels of analysis. Results indicated that undergraduate students ( N = 877, 52% female) enjoyed their evenings more when they consumed more than their typical number of drinks with others but enjoyed evenings less when they consumed more than their typical number of drinks alone. In addition, consuming greater than their average number of drinks with others (but not alone) was related to feeling more social and attractive but less competent. These findings further highlight the distinct nature of social and solitary drinking and demonstrate positive outcomes of social alcohol consumption that may contribute to college alcohol consumption.
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.
Introduction
Behavioral economic theory views addiction as a reinforcer pathology characterized by excessive demand for drugs relative to alternatives. Complementary to this theory, Lamb and Ginsburg (Pharmacology Biochemistry and Behavior, 164, 2018, 62) describe addiction as a behavioral allocation disorder and predict that decisions to drink under increasingly stringent constraints are a central indicator of addiction. This study used a modified demand‐curve paradigm to examine alcohol demand in the context of a next‐day contingency (high opportunity cost demand) as a specific indicator of a severe pattern of alcohol problems.
Methods
Participants were 370 undergraduates (61.1% female, 86.5% white, Mage = 18.8) reporting multiple past‐month heavy drinking episodes (5/4 drinks per occasion for men/women) who completed 2 versions of an alcohol purchase task (APT), along with measures of past‐month alcohol use and problems. In 1 APT (low opportunity cost), students imagined they had no next‐day responsibilities, and in the other APT (high opportunity cost), they imagined having a 10:00 am test the next day. Item‐response theory analyses were used to determine mild and severe alcohol problems from the Young Adult Alcohol Consequences Questionnaire (Journal of Studies on Alcohol, 67, 2006, 169), and the most and least severe binge drinking days throughout the week.
Results
Low opportunity cost demand (β = 0.15, p = 0.02) significantly predicted beyond high opportunity cost demand for the least severe problems, and high opportunity cost demand (β = 0.17, p = 0.009) significantly predicted beyond low opportunity cost demand for the most severe problems. Similarly, low opportunity cost demand (β = 0.26, p < 0.001) was more highly associated with weekend drinking, whereas high opportunity cost demand (β = 0.21, p = 0.001) was more highly associated with weekday drinking.
Conclusions
The current results suggest high opportunity cost alcohol demand is a distinct marker of severe alcohol problems among college student heavy drinkers.
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.
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.
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.
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)
Baron and Kenny's procedure for determining if an independent variable affects a dependent variable through some mediator is so well known that it is used by authors and requested by reviewers almost reflexively. Many research projects have been terminated early in a research program or later in the review process because the data did not conform to Baron and Kenny's criteria, impeding theoretical development. While the technical literature has disputed some of Baron and Kenny's tests, this literature has not diffused to practicing researchers. We present a nontechnical summary of the flaws in the Baron and Kenny logic, some of which have not been previously noted. We provide a decision tree and a step-by-step procedure for testing mediation, classifying its type, and interpreting the implications of findings for theory building and future research. (c) 2010 by JOURNAL OF CONSUMER RESEARCH, Inc..
Individuals consume alcohol for a variety of reasons (motives), and these reasons may be differentially associated with the types of drinking outcomes that result. The present study examined whether specific affect-relevant motivations for alcohol use (i.e., coping, enhancement) are associated with distinct types of consequences, and whether such associations occur directly, or only as a function of increased alcohol use. It was hypothesized that enhancement motives would be associated with distinct problem types only through alcohol use, whereas coping motives would be linked directly to hypothesized problem types. Regularly drinking undergraduates (N = 192, 93 female) completed self-report measures of drinking motives and alcohol involvement. Using structural equation modeling, we tested direct associations between coping motives and indirect associations between enhancement motives and eight unique alcohol problem domains: risky behaviors, blackout drinking, physiological dependence, academic/occupational problems, poor self-care, diminished self-perception, social/interpersonal problems, and impaired control. We observed direct effects of coping motives on three unique problem domains (academic/occupational problems, risky behaviors, and poor self-care). Both coping and enhancement motives were indirectly associated (through use) with several problem types. Unhypothesized associations between conformity motives and unique consequence types also were observed. Findings suggest specificity in the consequences experienced by individuals who drink to cope with negative affect versus to enhance positive affect, and may have intervention implications. Findings depict the coping motivated student as one who is struggling across multiple domains, regardless of levels of drinking. Such students may need to be prioritized for interventions.
In college students, solitary heavy drinking (i.e., while alone) is associated with depression and with higher rates of drinking problems than heavy drinking in social contexts. This study explored the relationship among heavy episodic drinking context, suicidal ideation, and drinking motives among underage college drinkers (n=91) with a history of passive suicidal ideation. Participants completed measures of depression, suicidal ideation, alcohol consumption and problems, and drinking motives. Multiple regression analyses revealed that suicidal ideation, but not depression, was significantly related to solitary heavy drinking. Neither was related to social heavy drinking. Enhancement motives for drinking, but not other drinking motives (i.e., social, conformity, drinking to cope), were significantly associated with social heavy drinking. In contrast, only drinking to cope was associated with solitary heavy drinking. These findings suggest that greater suicidal ideation is associated with greater frequency of becoming intoxicated while alone, and that this drinking is motivated by attempts to cope. Solitary heavy drinking is a potentially dangerous coping strategy for an individual experiencing suicidal ideation.
Individuals use and misuse alcohol (and other drugs) because of the pharmacologically mediated effects these substances have on the operation of 4 psychobiological systems, mediating response to motivationally relevant unconditioned and conditioned stimuli. These 4 systems have unique neuroanatomical structure, biochemical modes of operation, association with affect, behavior and cognition, and responsiveness to drugs of abuse. Individual variation in the operation of these systems determines individual susceptibility to initiation and maintenance of drug use and abuse. Sources of such variation differ, in a vitally important fashion, in various specific populations of individuals at heightened risk for drug abuse. Nonalcoholic sons of male alcoholics, with multigenerational family histories of male alcoholism, appear to be at heightened risk for the development of alcohol abuse because alcohol eliminates their heightened response to threat, and because they are hypersensitive to ethanol's psychomotor stimulant effects. Anxiety-sensitive individuals also appear attracted to alcohol for its anxiolytic properties. Many other important sources of idiosyncratic variability exist. Detailed analysis of such sources may lead to the development of more effective prevention and treatment programs.
This article reviews evidence of adolescent and young adult drinking motives and their relation to possible consequences over the last 15 years. To this end, a computer-assisted search of relevant articles was conducted. Results revealed that most young people reported drinking for social motives, some indicated enhancement motives, and only a few reported coping motives. Social motives appear to be associated with moderate alcohol use, enhancement with heavy drinking, and coping motives with alcohol-related problems. However, an enormous heterogeneity was found in terms of how motives were measured: 10 to 40 items were grouped into between 2 and 10 dimensions and sometimes the same items occurred under different dimensions. Future studies should therefore use well-defined, theoretically based, homogenous instruments to disentangle cultural from measurement differences across surveys.
Disinhibition is a strong correlate of alcohol use, yet limited alcohol research has examined the facets of this personality construct. Recent work suggests that sensation seeking and impulsivity show differential relations with alcohol outcomes, indicating unique mechanisms of risks associated with each of these dimensions of disinhibition. The goal of the study was to examine sensation seeking and impulsivity as unique predictors of alcohol use and problems, and to test a broad range of drinking motives as potential mediators of these relations. Self-reported data from college students (N=310) were utilized for the study. Results suggested that sensation seeking and impulsivity were associated with alcohol use and problems through different mediational pathways. There was some evidence for gender moderating these pathways. The findings indicate that alcohol prevention and intervention programs should be tailored to specifically target individuals elevated on impulsivity versus sensation seeking.
Mediation models are widely used, and there are many tests of the mediated effect. One of the most common questions that researchers have when planning mediation studies is, "How many subjects do I need to achieve adequate power when testing for mediation?" This article presents the necessary sample sizes for six of the most common and the most recommended tests of mediation for various combinations of parameters, to provide a guide for researchers when designing studies or applying for grants.
Background:
There is great interest in the role of the behavioral inhibition system (BIS) and the behavioral approach system (BAS) in the etiology of alcohol use because of the strong links of these systems to neuroscience and cognitive models of addiction. The revised Reinforcement Sensitivity Theory suggests that the strength of the BIS and BAS jointly influences behavior, so-called the joint systems hypothesis. Yet, relatively little work has examined this hypothesis, particularly with respect to alcohol information processing. Grounded in dual-process theories of alcohol information processing, this study aimed to clarify the roles of implicit (i.e., automatic processes) and explicit (i.e., controlled processes) cognitions in BIS-related drinking. When anxious and presented with an alcohol (vs. neutral) cue, we expected those with an elevated BIS to have increased implicit and explicit alcohol cognitions related to tension reduction, but only at elevated BAS. Shifts in cognitions following cue exposure were expected to positively correlate with alcohol misuse.
Methods:
Students (N = 110) completed baseline measures followed by the Trier Social Stress Test. This was followed by a cue exposure (random assignment to alcohol or water cue), during which participants completed postmood assessments of implicit/explicit alcohol cognitions.
Results:
Overall, participants' implicit alcohol cognition was negative. The effect of BIS on implicit and explicit cognitions was moderated by BAS; however, results were not as hypothesized. In the alcohol condition only (when controlling for baseline implicit cognition), BIS predicted relatively weak implicit negative alcohol cognition, but only at low BAS. Interestingly, in the alcohol condition only, BIS predicted increased explicit reward (but not relief) expectancies, but only at high BAS. Changes in explicit reward expectancies positively correlated with alcohol misuse.
Conclusions:
Our results suggest that explicit cognitions may be relevant to drinking among anxious individuals who are also reward responsive. Cognitive behavioral interventions should target reward expectancies to reduce anxiety-related drinking.
The social contexts in which individuals drink and the expected outcomes of that drinking (i.e., individual beliefs about the effects of drinking beverage alcohol) have recently been found to represent conceptually distinct models of alcohol consumption patterns. This paper examines the relationships between contexts, beliefs, and a variety of problem drinking patterns, and reestimates these relationships in a large national probability sample of 2,100 adults (U.S. National Alcohol Survey [National 7], Alcohol Research Group 1984:Berkeley, Calif.). Regression analyses indicate that the interrelationship of drinking contexts and drinking beliefs, and their impact on drinking behavior, is more complex than previously described. Consistent with earlier research, when simple frequency of drinking is the focus, social contexts for drinking emerge as the more important independent influences. When several indicators of maladaptive drinking are considered, however, beliefs regarding the effects of drinking, particularly beliefs regarding drinking as a means to modify affect, are found to be more influential. Logic is developed for a comprehensive model of the sources of problem drinking that incorporates both classes of explanatory variables.
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.
Heavy drinking is common among college students and typically occurs in social contexts. Heavy drinking when alone, however, is less common. The present study hypothesized that students who drink heavily when alone (HD-Alone) would differ from college students who only drink heavily in social contexts (Social HD). Forty-nine HD-Alone students (at least one heavy-drinking episode when alone), 213 Social HDs, and 63 non-heavy drinkers (Non-HDs) were compared on alcohol-related consequences, drinking milestones, alcohol-outcome expectancies, and symptoms of depression. HD-Alone students reported more negative drinking consequences, earlier onset of regular drinking, more alcohol expectancies, less self-efficacy and motivation to reduce drinking, and higher depression scores than Social HDs and Non-HDs. Findings imply individual differences among heavy-drinking college students according to their drinking context.
Aims: Despite the various settings and diverse populations in which the utility of the AUDIT-C has been examined, college students have remained conspicuously absent from the vast majority of these studies. We evaluated the psychometric properties of the AUDIT-C with a sample of college student bar patrons.
Methods: Intercept interviews were used to recruit currently enrolled college students (n = 347) exiting bars. A brief face-to-face interview assessed demographic data, alcohol-related behaviors (AUDIT-C), and breath alcohol concentration (BrAC). AUDIT-C responses were subjected to a principal component analysis. BrAC was used as a measure of concurrent validity against two distinct gender-based AUDIT-C cut-off scores.
Results: All AUDIT-C items loaded on a single factor, accounting for 68% of total variance. Pearson’s product–moment correlation coefficients between BrAC and both hazardous drinking AUDIT-C cut-offs (r = 0.32; r = 0.38) were statistically significant (p
Conclusions: Results reported herein highlight the sound psychometric qualities of the AUDIT-C and its ability to produce valid and reliable scores among college students.
Objective:
Although college students experience a diverse range of alcohol consequences, most studies focus on global, rather than distinct, consequence types. One predictor of unique consequences-drinking motives-has been studied only cross-sectionally. We aimed to examine the prediction of unique alcohol consequence domains (social/interpersonal, academic/occupational, risky behavior, impaired control, poor self-care, diminished self-perception, blackout drinking, and physiological dependence) by coping and enhancement motives over the course of one year. We hypothesized that coping motives would directly predict and that enhancement motives would indirectly (through alcohol use) predict unique consequences.
Method:
Web surveys were administered to a sample of college students (n = 552, 62% female) at the beginning of the fall semester for 2 consecutive academic years. Structural equation modeling was used to test direct and indirect paths from motives to consequences.
Results:
The data supported hypothesized direct, prospective paths from coping motives to several alcohol consequences (impaired control, diminished self-perception, poor self-care, risky behaviors, academic/occupational, and physiological dependence). These associations were not mediated by alcohol consumption. Enhancement motives were indirectly associated with all eight consequence domains by way of increased alcohol use at follow-up. Models were invariant across gender, year in school, and symptoms of posttraumatic stress.
Conclusions:
Findings suggest that whether motives act as a final common pathway to problem drinking may depend on which motives and which drinking outcomes are examined. As coping motives demonstrate a direct link to unique alcohol problem types over time, individuals endorsing these motives may need to be prioritized for intervention.
Since the 1930s, many of our top methodologists have argued that significance tests are not conducive to science. Bakan (1966) believed that “everyone knows this” and that we slavishly lean on the crutch of significance testing because, if we didn’t, much of psychology would simply fall apart. If he was right, then significance testing is tantamount to psychology’s “dirty little secret.” This paper will revisit and summarize the arguments of those who have been trying to tell us—for more than 70 years—that p values are not empirical. If these arguments are sound, then the continuing popularity of significance tests in our peer-reviewed journals is at best embarrassing and at worst intellectually dishonest.
Understanding communication processes is the goal of most communication researchers. Rarely are we satisfied merely ascertaining whether messages have an effect on some outcome of focus in a specific context. Instead, we seek to understand how such effects come to be. What kinds of causal sequences does exposure to a message initiate? What are the causal pathways through which a message exerts its effect? And what role does communication play in the transmission of the effects of other variables over time and space? Numerous communication models attempt to describe the mechanism through which messages or other communication-related variables transmit their effects or intervene between two other variables in a causal model. The communication literature is replete with tests of such models. Over the years, methods used to test such process models have grown in sophistication. An example includes the rise of structural equation modeling (SEM), which allows investigators to examine how well a process model that links some focal variable X to some outcome Y through one or more intervening pathways fits the observed data. Yet frequently, the analytical choices communication researchers make when testing intervening variables models are out of step with advances made in the statistical methods literature. My goal here is to update the field on some of these new advances. While at it, I challenge some conventional wisdom and nudge the field toward a more modern way of thinking about the analysis of intervening variable effects.
The current study identified gender-specific correlates of hazardous drinker status as defined by the AUDIT.
A total of 462 college student volunteers completed the study in 2006. The sample was predominantly Caucasian (75%) and female (55%).
Participants completed a survey assessing demographics, alcohol use patterns, and health indices. Scores of 8 or more on the AUDIT defined the at-risk subsample. Logistic regression models determined which variables predicted AUDIT risk status for men and women.
The at-risk participants reported higher alcohol use and related problems, elevated sleep problems and lower health ratings. High typical blood alcohol concentration (BAC), lifetime drug use, and psychosocial problems predicted risk status for males. Binge frequency and psychosocial problems predicted risk status for females.
Different behavioral profiles emerged for men and women identified as hazardous drinkers on the AUDIT. The efficacy of brief alcohol interventions could be enhanced by addressing these behavioral correlates.
Data from 606 (75.8%) undergraduate respondents drawn from a random sample (N = 800) at Rutgers University demonstrate that, although fewer college students may be drinking when compared to some previous estimates, there is still a large number of heavy drinkers. In addition, traditional demographic variables continue to predict alcohol consumption levels. Students also report a similar variety of drinking related problems as in previous college drinking studies. Women constitute half as many heavy drinkers as men, but report an equal amount of alcohol-related problems in this sample. When controlling for race, it appears that white students continue to drink the most, and show heavy drinking rates comparable to a previous large college sample in the northeast. Students who live on campus drink more than their commuting counterparts, and the drinking age has little effect on consumption levels or total reported alcohol-related problems, although it alters the context of drinking somewhat. Findings are generally compared to previous as well as more recent college drinking data. Sex differences and similarities are discussed, as well as the findings concerning legal drinking status. Implications for prevention efforts are suggested.
Two motives for alcohol consumption have been emphasized in the etiological and the reasons-for-drinking literature: (a) people drink alcohol to cope with stress, and (b) people drink alcohol because of social influences. There is support for both of these hypotheses, but the results are usually modest and most authors agree that more complex theories of alcohol consumption are needed. This study examined the interactional effects of reasons for drinking alcohol and situational factors on alcohol consumption. Standardized telephone interviews were conducted with 781 randomly selected Michigan drinkers. Hierarchical multiple regression analyses indicated that gender, friends' alcohol consumption, coping, and social motives for drinking were significant predictors of study participants' alcohol consumption. As predicted, there was a significant interaction between drinking to cope with stress and perceived stress, and there was also a significant interaction between drinking for social reasons and friends' alcohol consumption. Similarities and differences in the results for women, men, Blacks, and Whites are described.
The Alcohol Use Disorders Identification Test (AUDIT) has been developed from a six-country WHO collaborative project as a screening instrument for hazardous and harmful alcohol consumption. It is a 10-item questionnaire which covers the domains of alcohol consumption, drinking behaviour, and alcohol-related problems. Questions were selected from a 150-item assessment schedule (which was administered to 1888 persons attending representative primary health care facilities) on the basis of their representativeness for these conceptual domains and their perceived usefulness for intervention. Responses to each question are scored from 0 to 4, giving a maximum possible score of 40. Among those diagnosed as having hazardous or harmful alcohol use, 92% had an AUDIT score of 8 or more, and 94% of those with non-hazardous consumption had a score of less than 8. AUDIT provides a simple method of early detection of hazardous and harmful alcohol use in primary health care settings and is the first instrument of its type to be derived on the basis of a cross-national study.
Synopsis
Age of onset reports obtained retrospectively for each symptom of DSM-III-R alcohol dependence (AD) are used to study patterns of lifetime symptom progression in a large general-population survey of people in the United States. It is shown that symptom progression among a substantial majority of respondents can be summarized as movement across three clusters. Cluster A is defined by symptoms of role impairment/hazardous use (A4), use despite social, psychological or physical problems (A6), and drinking larger amounts or over a longer period of time than intended (A1). Cluster B is defined by tolerance (A7) and impaired control (A2, A3). Cluster C is defined by withdrawal (A8, A9) and giving up activities in order to drink (A5). Clusters are shown to follow a time sequence, with at least one symptom in Cluster A usually occurring first, followed by symptoms in Clusters B and C. In all, 83·4% of the symptom cluster transitions estimated from retrospective age of onset reports are consistent with this progression. Progression to AD is differentially predicted by symptom profiles reported at the age of first symptom onset, with persons reporting Cluster C symptoms most likely to progress subsequently to AD. Furthermore, profiles of AD defined by the highest symptom cluster present at AD onset are differentially predicted by prior personal and parental histories of psychopathology and, among men, are predictive of diagnosis persistence.
This paper addresses the phenomenon of 'solitary drinking', considering whether Anglo, African American and Mexican American male regular drinkers differ in the propensity to drink in solitary contexts and whether such differences may help to explain observed ethnic variation in patterns of heavy drinking. Further, the paper considers whether apparent relationships between solitary drinking and drinking patterns are explained by individual personality characteristics such as social isolation and/or by endorsement of 'escape drinking' motives. Data were analysed from a random community sample of 481 adult male regular drinkers in San Antonio, Texas, USA. Contingency table and logistic regression analyses indicated that initially observed ethnic differences in high quantity and high maximum drinking were largely eliminated by controls for education, escape motives and solitary drinking. Ethnic variation in the role of solitary drinking was suggested as well, with solitary drinking more strongly related to high quantity consumption, in particular, among African Americans than among Mexican Americans. The nature of the observed interactions suggests that fundamental differences between Anglos and African Americans in the roles of solitary drinking and escape drinking motives may underlie seemingly similar frequent, lower quantity drinking patterns in these groups that appear more frequently than among Mexican American males.
This paper investigates whether solitary drinking is a risk factor for alcohol-related problems using data from a general population of drinkers in Montréal, Canada. Three indicators of solitary drinking were used: (1) having had a drink alone; (2) frequency of solitary drinking; and (3) having had five drinks or more in a solitary setting. Among the 2015 respondent drinkers of a telephone survey, 31% reported drinking alone, of whom 27% did so more than once a week, and 17% had had five drinks or more alone at least once. Problems with family or social relationships, physical health, work, budget, physical security and happiness or view of life, self-reported as being alcohol-related, were measured by seven binary items. Strong positive associations were found at the univariate level between overall alcohol-related problems and both solitary drinking and having had five or more drinks alone, whereas frequency of solitary drinking had no effect. Only the relationship with having five or more drinks alone remained statistically significant in logistic regressions controlling for potential confounders. No evidence was found that solitary drinking per se is a risk factor for alcohol-related problems unless large quantities of alcohol are involved.
To evaluate the 3 alcohol consumption questions from the Alcohol Use Disorders Identification Test (AUDIT-C) as a brief screening test for heavy drinking and/or active alcohol abuse or dependence.
Patients from 3 Veterans Affairs general medical clinics were mailed questionnaires. A random, weighted sample of Health History Questionnaire respondents, who had 5 or more drinks over the past year, were eligible for telephone interviews (N = 447). Heavy drinkers were oversampled 2:1. Patients were excluded if they could not be contacted by telephone, were too ill for interviews, or were female (n = 54). Areas under receiver operating characteristic curves (AUROCs) were used to compare mailed alcohol screening questionnaires (AUDIT-C and full AUDIT) with 3 comparison standards based on telephone interviews: (1) past year heavy drinking (>14 drinks/week or > or =5 drinks/ occasion); (2) active alcohol abuse or dependence according to the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition, criteria; and (3) either.
Of 393 eligible patients, 243 (62%) completed AUDIT-C and interviews. For detecting heavy drinking, AUDIT-C had a higher AUROC than the full AUDIT (0.891 vs 0.881; P = .03). Although the full AUDIT performed better than AUDIT-C for detecting active alcohol abuse or dependence (0.811 vs 0.786; P<.001), the 2 questionnaires performed similarly for detecting heavy drinking and/or active abuse or dependence (0.880 vs 0.881).
Three questions about alcohol consumption (AUDIT-C) appear to be a practical, valid primary care screening test for heavy drinking and/or active alcohol abuse or dependence.
A collegiate athlete population was surveyed for alcohol abuse as well as self-reported depression, anxiety, and other psychiatric symptoms. This study revealed that in a group of 262 athletes there were 21 percent who reported high alcohol use and problems associated with its use. Significant correlations were found between reported alcohol abuse and self-reported symptoms of depression and general psychiatric symptoms. Subjects with positive depression and psychiatric symptom ratings in the "severe" range had a significantly higher rate of alcohol abuse than subjects who had low depression and low or mild symptom ratings. Conversely, subjects reporting higher rates of alcohol misuse had more psychiatric symptoms. These findings suggest a possible causal link between psychopathology and serious alcohol abuse among college athletes. They also point to the need for routine depression and anxiety screening in college students who are typically beginning a significant exposure to alcohol.
A substantial proportion of U.S. college students drink alcoholic beverages and report significant deleterious effects. The present study describes the development and initial validation of a measure designed to capture a broad range of alcohol-related consequences experienced by male and female college students.
College students (N=340, 176 women) completed a self-report questionnaire battery consisting of information about demographic characteristics, drinking behaviors, and drinking consequences. Drinking consequences were assessed with a composite measure based on the Drinker Inventory of Consequences, the Young Adult Alcohol Problem Screening Test (YAAPST) and items developed by the researchers. To assess concurrent validity, a subset of the total sample (n=126) also completed the Rutgers Alcohol Problem Index (RAPI).
Confirmatory factor analyses supported an eight-factor solution (Social-Interpersonal Consequences, Impaired Control, Self-Perception, Self-Care, Risk Behaviors, Academic/Occupational Consequences, Physical Dependence, and Blackout Drinking), with all factors loading on a single, higher-order factor. YAACQ total scores correlated with alcohol quantity and frequency, and the RAPI. Gender comparisons suggest that the YAACQ assesses constructs of interest equally well for women and men.
These results offer preliminary support for this measure. Research and clinical applications include the potential to predict future problems by specific type of consequence and to offer detailed feedback about drinking consequences to students as part of a preventive intervention. As such, the YAACQ may serve as an aid in both the description of and intervention for heavy drinking in college.
Canadian campus survey
- E M Adlaf
- A Demers
- L Gliksman
Adlaf, E. M., Demers, A., & Gliksman, L. (2005). Canadian campus survey 2004. Toronto,
ON: Centre for Addiction and Mental Health.
Diagnostic and statistical manual of mental disorders
American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association (text rev.).
Beyond significance testing
- R B Kline
Kline, R. B. (2013). Beyond significance testing (2nd ed.). Washington, DC: American
Psychological Association.