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The nomological network of drinker identity: A scoping review
Abstract
Background: Despite the growing interest in the construct of drinker identity and empirical evidence for its role in drinking behavior, there is a paucity of papers that evaluate and integrate the results of studies on drinker identity, leaving a gap in our knowledge of the importance of the drinker identity construct. The current paper addresses this gap by reviewing and integrating the results of the studies of drinker identity.
Methods: The scoping review identified, retrieved, and evaluated the existing literature regarding drinker identity. English language studies from EBSCOHost, PubMed, ScienceDirect, and Scopus databases were reviewed. Studies were included in the review if they were data-based studies or theoretical publications with drinker identity as the primary topic published in peer-reviewed journals. Studies were reviewed and coded based on their reported methodology and findings and codes were used to integrate and present findings.
Results: This review advances this line of research in four ways. First, the operationalization of drinker identity is evaluated by examining the theoretical frameworks defining the construct. Second, the conceptualization and measurement of drinker identity is assessed, with suggestions for future measurement research. Third, an integrated framework of predictors, outcomes, moderators, and mediators is presented. Finally, the research gaps, future recommendations, and clinical implications are discussed.
Conclusions: There is a need for continued research, specifically research which aims to standardize and improve measurement of drinker identity, considers longitudinal and developmental processes, and broadens the research samples and settings.
... Since then, both implicit and explicit drinker identity research proliferated, concluding that drinker identity is a consistent predictor of alcohol consumption and problems, above, and independently of, other alcohol-related implicit associations (Janssen et al., 2018;Lindgren, Foster, et al., 2013; as well as current drinking behaviors and habits (Lindgren, Neighbors, Teachman, et al., 2015). Several lines of research have been advanced in the study of drinker identity (see Ingram & Finn, 2023 for review). Lindgren and colleagues are continuing to investigate this topic from dual-and interacting cognitive process perspectives (Lindgren, Hendershot, et al., 2016). ...
... Conversely, the replication of findings using different drinker identity measures is an indication of their robustness. Although these measures may be open to psychometric criticism, especially with respect to potentially inadequate validity, they have been used successfully in several lines of research (see Ingram & Finn, 2023 for review). However, for work to progress in this area, several aspects of the measures need to be taken into consideration. ...
Background: Drinker identity research has proliferated over the last decade, resulting in 10 self-report questionnaire measures of this construct. However, it is unknown to what extent these measures accurately reflect the theorized multi-dimensional conceptualization of drinker identity. Objectives: The current study set out to investigate and compare these different measures using content, correlational, and factor analyses. A content analysis is conducted to investigate dimensions captured
within the 10 measures of drinker identity. Correlational and exploratory factor analyses on the items is conducted within a young adult sample (n = 1006). Descriptions of the measures, items, and factors within the measures are discussed. Results: Across the 10 measures, seven distinct factors were identified by the content analysis, and multi-dimensionality was confirmed by both the correlational and factor analyses. Factor analysis on all items yielded four interpretable factors representing generalized identity, relative identity importance, identity value/affect, and social identification. Conclusions: The results are discussed in terms of the multi-dimensional nature of drinker identity, the psychometric equivalence of the included measures, and further issues in defining and measuring drinker identity
... The function and significance of related social identities in understanding engagement with and severity of addictive behaviours has recently become a focus of work (see Ingram & Finn, 2023;see Frings & Albery, 2015, 2021see Montes & Pearson, 2021). This evidence suggest that social identities are related to behavioural engagement and frequency as a function of the saliency of a desired identity and investment in that identity, as well as being strongly implicated in levels of self-efficacy, recovery confidence and behavioural change (e.g., see Shono et al., 2023;Buckingham, Frings & Albery, 2013;Albery et al, 2021;Frings, Wood & Albery, 2021;Frings, Kim & Albery, in press;Frings, Wood, Lionetti & Albery, 2019;Best, Beckwith, Haslam, Haslam, Jetten, Mawson, & Lubman, 2016 ;Dingle, Cruwys, & Frings, 2015). ...
... The focus on shifting drinking identity stems from evidence that it is a unique risk factor for college students' hazardous drinking (Ingram & Finn, 2023;Lindgren, Neighbors, Teachman, et al., 2016;Lindgren, Ramirez, Olin, & Neighbors, 2016) and is not directly targeted in existing interventions (Lindgren et al., 2019). ...
Background
Drinking identity (the extent to which one links the self with drinking alcohol) is a unique risk factor for college students' hazardous drinking that is not directly targeted by existing interventions. We conducted a study that aimed to decrease drinking identity among college students with hazardous drinking. We adapted a writing task about the future self and tested whether three writing sessions could decrease drinking identity and change drinking. We also investigated whether two additional factors (writing perspective and inclusion of participants' social networks) would enhance task impact. The present study evaluated whether posited proximal cognitive and motivational outcomes (drinking identity, self‐efficacy, readiness to change, and drinking intentions) changed immediately after each writing session.
Method
The study is a randomized clinical trial in which hypotheses and analyses were pre‐registered. Participants were 328 college students who met hazardous drinking criteria. The study had a 2 (narrative writing topic: low‐risk drinker vs. reduced smartphone use) × 2 (writing perspective: first‐person vs. non‐first‐person) × 2 (social network instruction: instructed to include vs. not) factorial design. Proximal outcomes were drinking identity, self‐efficacy, readiness to change, and drinking intentions. The clinical outcome was alcohol consumption. Participants completed three laboratory sessions at weekly intervals that included the writing task and pre‐ and post‐task assessments.
Results
Results were largely null, except that readiness to reduce drinking was higher in the low‐risk drinker condition and increased over the lab sessions. Time effects indicated that reductions in drinking identity, drinking intentions, and alcohol consumption, and increases in self‐efficacy were observed but did not change above and beyond control conditions.
Conclusions
Findings indicate the need to strengthen the writing task and select a more appropriate control task to target proposed proximal outcomes. Future studies might try personalizing the task, evaluating its efficacy with individuals motivated to change their drinking, and using a control task that does not involve imagining a future self.
Indirect measures have been used to assess the strength of automatically activated, alcohol-related associations and their relation to hazardous drinking. However, little is known about the longitudinal contributions of between-person and within-person components of implicit alcohol associations (IAAs) to college students' hazardous drinking over time. This study examined how within- and between-person variability in three measures of IAA (drinking identity, alcohol approach, and alcohol excite) are related to hazardous drinking while controlling for their explicit, self-report counterparts. First- and second-year U.S. college students (N = 506; 57% female) completed web-based assessments once every 3 months up to eight assessments, which included IAA measures (Implicit Association Tests), explicit counterparts of the IAAs, and self-reported hazardous drinking (alcohol consumption, problems, and risk of alcohol use disorder). Bayesian generalized multilevel models were used to examine between- and within-person associations among IAA, their explicit counterparts, and hazardous drinking. Results showed that between persons, mean levels of all three IAAs were positively associated with hazardous drinking over time. Once their explicit, self-report counterparts were included, however, only drinking identity IAA remained significant. Within persons, increases in drinking identity IAA were associated with increases in subsequent hazardous drinking risk, even after controlling for its explicit counterpart. These results suggest the importance of disentangling and simultaneously investigating between- and within-person processes in IAAs. Although the between-person component of IAAs may play a larger role in the prediction of hazardous drinking, examining the within-person component of IAA, at least for drinking identity, also appears to be important. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
A prevalent critique of Alcoholics Anonymous (AA) is that members must adopt an inflexible illness narrative, taking on an “alcoholic” identity and performing a set of practices to address this condition. Conversely, a small body of research suggests that, rather than comprising the uniform adoption of a rigid narrative, integration into AA is achieved by negotiating individual beliefs, values, and preferences with the AA model. To investigate such processes of negotiation, the current study aimed to explore the politics of belonging in AA. The study involved semi-structured interviews with 15 AA members recruited from meetings across Sydney, Australia, and data were analyzed thematically. Findings illustrated how participants navigated the politics of inclusion/exclusion within AA. While some aspects of AA were found to be negotiable by participants, a non-negotiable aspect of AA ideology that emerged was the axiom that “alcoholics” have no control over alcohol and therefore should maintain abstinence. Findings raise questions about how the politics of belonging in AA may shift over time following broader patterns of societal change.
Objective: Research indicates that a substance user identity (i.e., drinking, smoking, and marijuana identity) is positively correlated with substance use-related outcomes (e.g., frequency, quantity, consequences, and disorder symptoms). The current study aimed to meta-analytically derive single, weighted effect size estimates of the identity–outcome association as well as to examine moderators (e.g., substance use type, explicit/implicit assessment, demographic characteristics, and research design) of this association. Method: Random effects meta-analysis was conducted on 70 unique samples that assessed substance user identity and at least one substance use-related outcome (frequency, quantity, consequences, and/or disorder symptoms), and provided the necessary information for effect size calculations. Results: Substance user identity was found to be a statistically significant moderate-to-large correlate of all substance use-related outcomes examined in the current study (rw = .365, p < .001, rw² = .133). The strongest associations were observed between identity and disorder symptoms (alcohol) and frequency of substance use (tobacco or marijuana). In terms of moderators of the identity–outcome association, the link between explicit drinking identity and alcohol use-related outcomes appeared to be stronger in magnitude than the relationship between implicit drinking identity and alcohol use-related outcomes; however, this difference appears to be largely due to the finding that implicit measures have lower reliability. The strongest identity–outcome association was observed among younger individuals. Conclusions: Substance user identity is clearly an important correlate of substance use-related outcomes and this association is stronger among younger individuals. Additional theoretical, empirical, and intervention research is needed to utilize knowledge gleaned from the current study on the identity–outcome association.
Introduction
Binge drinking (BD) is a public health concern, especially in young people. Multiple individual factors referring to different level of analyses - positional, inter-individual and intra-individual – are associated to BD. As they have mainly been explored separately, little is known about the psychological variables most associated with BD. This study, based on an integrative model considering a large number of variables, aims to estimate these associations and possible dominance of some variables in BD.
Methods
A sample of university students (N = 2851) participated in an internet survey-based study. They provided information on alcohol related variables (AUDIT, BD score), positional factors (sex, age), inter-individual factors (subjective norm, social identity, external motivations), and intra-individual factors (internal motivations, meta-cognitions, impulsivity and personality traits). The data were processed via a backward regression analysis including all variables and completed with a dominance analysis on variables that are significantly associated with BD intensity.
Results
The strongest variables associated with BD intensity were enhancement motives and drinking identity (average ΔR² = 21.81%), followed by alcohol subjective norm and social motives (average ΔR² = 13.99%). Other associated variables (average ΔR² = 2,84%) were negative metacognition on uncontrollability, sex, coping motives, lack of premeditation, positive metacognition on cognitive self-regulation, positive urgency, lack of perseverance, age, conformity motives and loneliness.
Conclusion
Results offer new avenues at the empirical level, by spotting particularly inter-individual psychological variables that should be more thoroughly explored, but also at the clinical level, to elaborate new prevention strategies focusing on these specific factors.
In a prior publication, I used structural equation modeling of multimethod data to examine the construct validity of Implicit Association Tests. The results showed no evidence that IATs measure implicit constructs (e.g., implicit self-esteem, implicit racial bias). This critique of IATs elicited several responses by implicit social-cognition researchers, who tried to defend the validity and usefulness of IATs. I carefully examine these arguments and show that they lack validity. IAT proponents consistently ignore or misrepresent facts that challenge the validity of IATs as measures of individual differences in implicit cognitions. One response suggests that IATs can be useful even if they merely measure the same constructs as self-report measures, but I find no support for the claim that IATs have practically significant incremental predictive validity. In conclusions, IATs are widely used without psychometric evidence of construct or predictive validity.
Because beer is one of the most common alcoholic beverages consumed in the world, this research adopted an expanded theory of planned behavior (TPB) perspective to understand why beer consumers purchase beer. This study investigated the effects of injunctive norms, descriptive norms, attitude, and perceived behavioral control on alcohol identity and purchase intention. The possible mediating role of alcohol identity was also investigated. This study was conducted in Taiwan, and a total of 452 beer consumers participated in the survey. Structural equation modeling was used to examine the relationship among the study variables. The results revealed that alcohol identity positively influences purchase intention, and attitude positively affects alcohol identity and purchase intention. In addition, injunctive norms have a positive influence on alcohol identity, and descriptive norms positively affect purchase intention. In particular, perceived behavioral control has a negative influence on alcohol identity but has a positive influence on purchase intention. This study also found that alcohol identity mediates the attitude–purchase intention relationship. By examining the consumption behavior of beer consumers from the TPB perspective, this study contributed to an understanding of beer consumption behavior.
Substance use identity has been consistently associated with problematic substance use. Limited attention has considered mechanisms of this association. This research examined whether greater identification as a drinker or marijuana user would be associated with the use of fewer alcohol/marijuana protective behavior strategies (PBS; e.g., avoiding drinking games/avoiding using marijuana in public places). Further, PBS have been associated with lower levels of negative alcohol/marijuana-related outcomes (i.e., frequency, quantity, consequences). In the current multi-sample study, PBS were examined as a mediator of the relationship between drinking/marijuana identity and alcohol/marijuana-related outcomes across three studies. Study 1 was an intervention study with heavy drinking college students (N=605), Study 2 was a multisite study of marijuana outcomes among college students (N=2.077), and Study 3 was a study of substance use in a community sample (n=369alcohol; n=146marijuana). Cross-sectional and/or longitudinal data were collected across studies. Substance use identity, PBS, and use-related outcomes were measured across the three studies. Indirect effects were evaluated by Monte Carlo confidence intervals. Manner of Drinking PBS were found to be the only statistically significant mediator of the relationship between drinking identity and alcohol-related outcomes (i.e., quantity and consequences) cross-sectionally. These significant cross-sectional mediation effects for alcohol were replicated in one of three longitudinal models. Marijuana PBS were also found to mediate the relationship between marijuana identity and all marijuana-related outcomes examined in the current study. Study findings may help to inform the development of identity-based and PBS-based interventions that aim to reduce negative alcohol/marijuana-related outcomes.
Objectives
University students commonly engage in heavy episodic drinking (HED), which contributes to injury risk, deleterious educational outcomes, and economic costs. Identification of the determinants of this risky behaviour may provide formative evidence on which to base effective interventions to curb HED in this population. Drawing from theories of social cognition and dual‐process models, this study tested key hypotheses relating to reasoned and implicit pathways to action for HED in a sample of Australian university students who drink alcohol.
Design
A two‐wave correlational design was adopted.
Methods
Students ( N = 204) completed self‐reported constructs from social cognition theories with respect to HED at an initial time point (T1): attitude, subjective norm, perceived behavioural control, intentions, habit, past behaviour, and implicit alcohol identity. Four weeks later (T2), students self‐reported their HED behaviour and habit.
Results
An initial path model indicated attitude and subjective norm predicted intentions, and intentions and implicit alcohol identity predicted HED. Inclusion of past behaviour and habit revealed direct effects of these on HED. Effects of T1 habit on HED were indirect through T2 habit, and there were indirect effects of past behaviour on HED through habit at both time points and the social cognition constructs. Direct effects of intentions and implicit alcohol identity, and indirect effects of attitude and subjective norm, on HED, were attenuated by the inclusion of past behaviour and habit.
Conclusion
Results indicate that university students’ HED tends to be governed by non‐conscious, automatic processes than conscious, intentional processes.
Statement of contribution
What is already known on this subject? Social cognitive factors are associated with risky alcohol consumption behaviours.
Dual‐process models are being used to explain health behaviours, such as heavy episodic drinking (HED).
What does this study add? Past HED behaviour and HED habits have direct and indirect effects on students’ HED behaviour.
Past behaviour and habit attenuate the effects of intentions and implicit alcohol identity on HED.
Background
Explicit (self‐report) and implicit (indirect) measures of identification with drinking alcohol—drinking identity—are associated with drinking outcomes cross‐sectionally and longitudinally. A key next step is to identify moderators. The current study evaluated a promising moderator: mindsets of alcoholism. Believing people can change (growth mindset) is associated with adaptive outcomes in domains such as mental health, but research is scant regarding mindsets related to problematic drinking. We evaluated whether individuals’ alcoholism mindsets moderated the drinking identity to drinking relation as part of a larger, longitudinal web‐based study of heavy drinkers.
Methods
A total of 422 US college graduates (59% women) who were heavy drinkers completed measures assessing drinking identity, mindsets, and drinking outcomes (consumption, problems, and risk of alcohol use disorder). Drinking outcomes were assessed at 2 subsequent assessments occurring 4 and 8 months after the initial assessment.
Results
Drinking identity was positively associated with drinking outcomes, and drinking outcomes reduced following college graduation. Alcoholism mindsets were significantly and negatively correlated with all drinking outcomes. Mindsets were only conditionally associated with drinking behaviors over time in models that evaluated mindsets, drinking identity measures, and their interaction. Mindsets moderated the relationship between drinking identity and changes in drinking behaviors, but the relation was specific to explicit drinking identity and consumption. Among participants with stronger drinking identity, those who had stronger (vs. weaker) growth mindsets reported reduction in consumption over time.
Conclusions
Growth mindsets of alcoholism appear adaptive for college graduate heavy drinkers with a stronger drinking identity. Mindsets are amenable to interventions; targeting them may be useful in heavy‐drinking college graduates.
Nearly half of college students engage in risky alcohol use, and college women may be more likely than men to drink in excess. However, little research has examined predictors of alcohol use unique to college women. College women often experience sexism; however, whether sexism contributes to greater alcohol use is not well established. The present study assessed alcohol-related outcomes among college women, examining the interaction between sexism and alcohol identity, associations in memory between self and alcohol-related constructs. Part 1 found that greater anticipation of sexism predicted higher self-reported alcohol use among women strongly identifying with alcohol. Part 2 manipulated the presence of sexist feedback and assessed automatic alcohol action tendencies. Results indicated that women receiving sexist feedback and strongly identifying with alcohol exhibited greater automatic tendencies toward alcohol compared to women receiving non-sexist feedback. Results suggest that sexism may contribute to greater alcohol use among college women who strongly identify with alcohol.
Self-persuasion (i.e., generating your own arguments) is often more persuasive than direct persuasion (i.e., being provided with arguments), even when the technique is applied in media messages by framing the message as a question. It is unclear, however, if these messages are more persuasive when viewed for a long period to allow more elaboration about the message, or for a short period to reduce elaboration. In the current experiment, this is addressed by examining whether anti-alcohol posters framed as a statement (direct persuasion) or an open-ended question (self-persuasion) are more effective to reduce alcohol consumption under conditions of short- or long message exposure, compared to a control condition (no poster). Additionally, the potentially moderating roles of self-perceived alcohol identity and self-esteem on both types of persuasion are examined. Participants (N = 149) were exposed to a self-persuasion or direct persuasion anti-alcohol poster, either briefly before or continuously during a bogus beer taste task. The amount of alcohol consumed was the covert dependent variable. Contrary to expectations, both posters failed to affect alcohol consumption, regardless of exposure length. No moderation effects for self-perceived alcohol identity and self-esteem of the participants were found. Possible explanations are discussed.
Objective:
Pre-drinking, the practice of consuming alcohol prior to attending a subsequent event, increases the risk of alcohol-related harm, and is common in undergraduate student populations. The current study tested an integrated behaviour change model to identify the motivational, social-cognitive, and implicit predictors of pre-drinking.
Design:
University students (N = 289) completed an online questionnaire comprising measures of motivational and social-cognitive constructs related to reducing pre-drinking alcohol consumption and past behaviour, and an implicit association test for drinking identity. Participants reported their pre-drinking alcohol consumption at follow-up, 4 weeks from baseline.
Main outcome measures:
Self-reported pre-drinking alcohol consumption.
Results:
A variance-based structural equation model revealed that few model hypotheses were supported. Although the effects of past behaviour, perceived behavioural control, and implicit drinking identity, on follow-up pre-drinking alcohol consumption were statistically significant, the effect of intention was not.
Conclusions:
Current findings indicate pre-drinking alcohol consumption is associated with past behaviour, perceived behavioural control and implicit drinking identity, and no intentions to reduce pre-drinking alcohol consumption. The finding raise questions over the validity of applying the integrated model in this context. Interventions should consider these factors and attempt to facilitate the formation of intentions that lead to subsequent behaviour.
The high levels of problematic drinking in college students make clear the need for improvement in the prediction of problematic drinking. We conducted a laboratory-based experiment that investigated whether implicit measures of alcohol-related associations, self-control, and their interaction predicted drinking. Although a few studies have evaluated self-control as a moderator of the relationship between implicit measures of alcohol-related associations and drinking, this study extended that work by using a previously-validated manipulation that included a more (vs. less) cognitively demanding task and incentive to restrain drinking and by evaluating multiple validated measures of alcohol-related associations. Experimental condition was expected to moderate the relationship between implicit measures of alcohol-related associations and drinking, with a more positive relationship between alcohol-related associations and drinking among participants who completed the more (vs. less) cognitive demanding task. Secondary aims were to evaluate how individual differences in control factors (implicit theories about willpower and working memory capacity) might further moderate those relationships. One hundred and five U.S. undergraduate heavy episodic drinkers completed baseline measures of: drinking patterns, three Implicit Association Tests (evaluating drinking identity, alcohol excite, alcohol approach associations) and their explicit measure counterparts, implicit theories about willpower, and working memory capacity. Participants were randomized to complete a task that was more (vs. less) cognitively demanding and were given an incentive to restrain their drinking. They then completed an alcohol taste test. Results were not consistent with expectations. Despite using a previously validated manipulation, there was no evidence that one condition was more demanding than the other, and none of the predicted interactions reached statistical significance. The findings raise questions about the relation between self-control, implicit measures of alcohol-related associations, and drinking, as well as the conditions under which implicit measures of alcohol-related associations predict alcohol consumption in the laboratory.
The concept of recovery has become an organizing paradigm in the addiction field globally. Although a convenient label to describe the broad phenomena of change when individuals resolve significant alcohol or other drug (AOD) problems, little is known regarding the prevalence and correlates of adopting such an identity. Greater knowledge would inform clinical, public health, and policy communication efforts. We conducted a cross-sectional nationally representative survey (N = 39,809) of individuals resolving a significant AOD problem (n = 1,995). Weighted analyses estimated prevalence and tested correlates of label adoption. Qualitative analyses summarized reasons for prior recovery identity adoption/nonadoption. The proportion of individuals currently identifying as being in recovery was 45.1%, never in recovery 39.5%, and no longer in recovery 15.4%. Predictors of identifying as being in recovery included formal treatment and mutual-help participation, and history of being diagnosed with AOD or other psychiatric disorders. Qualitative analyses regarding reasons for no/prior recovery identity found themes related to low AOD problem severity, viewing the problem as resolved, or having little difficulty of stopping. Despite increasing use of the recovery label and concept, many resolving AOD problems do not identify in this manner. These appear to be individuals who have not engaged with the formal or informal treatment systems. To attract, engage, and accommodate this large number of individuals who add considerably to the AOD-related global burden of disease, AOD public health communication efforts may need to consider additional concepts and terminology beyond recovery (e.g., “problem resolution”) to meet a broader range of preferences, perspectives and experiences.
Multiple studies indicate that implicit alcohol-related associations (i.e., indices of relatively fast, spontaneous processes) predict drinking. An important next step is to investigate moderators of the implicit association-drinking relationship. Mood state has been proposed as a moderator of this relationship: implicit associations have been theorized to be stronger predictors of drinking under positive mood states. From the same theoretical perspective, explicit measures (indices of relatively slow, reflective processes) have been proposed to be stronger predictors of drinking under negative mood states. The current study evaluated these hypotheses by investigating whether mood state (manipulated via exposure to a brief video clip) moderated the relations between three types of implicit alcohol-related associations (alcohol excite, alcohol approach, and drinking identity), their explicit counterparts, and drinking in a taste test that included beer and soft drinks. A sample of 152 undergraduate social drinkers (81 men; 71 women) completed baseline measures of implicit alcohol-related associations, their explicit counterparts, and typical drinking behaviors. Participants then viewed a mood-state-inducing video clip (positive, neutral, or negative), and completed the taste test. Results were mixed but generally indicated that prediction of drinking by baseline implicit alcohol excite (but not alcohol approach or drinking identity) associations was moderated by mood. Specifically, implicit alcohol excite associations were more negatively associated with drinking after viewing the sad video and more positively associated with drinking after watching the happy/neutral video. Moderation was also observed for the explicit counterpart of alcohol excite. Findings are discussed in terms of models of negative reinforcement drinking.
Introduction: Drinking identity strength (how strongly one views oneself as a drinker) is a promising risk factor for hazardous drinking. A critical next step is to investigate whether the centrality of drinking identity (i.e., the relative importance of drinking vs. other identity domains, like well-being, relationships, education) also plays a role. Thus, we developed explicit and implicit measures of drinking identity centrality and evaluated them as predictors of hazardous drinking after controlling for explicit drinking identity strength.
Methods: Two studies were conducted (Ns = 360 and 450, respectively). Participants, who self-identified as full-time students, completed measures of explicit identity strength, explicit and implicit centrality, and the Alcohol Use Disorders Identification Test (AUDIT). Study 1a evaluated two variants of the implicit measure (short- vs. long-format of the Multi-category Implicit Association Test); Study 1b only included the long form and also assessed alcohol consumption.
Results: In Study 1a, implicit and explicit centrality measures were positively and significantly associated with AUDIT scores after controlling for explicit drinking identity strength. There were no significant differences in the implicit measure variants, but the long format had slightly higher internal consistency. In Study 1b, results replicated for explicit, but not implicit, centrality.
Conclusions: These studies provide preliminary evidence that drinking identity centrality may be an important factor for predicting hazardous drinking. Future research should improve its measurement and evaluate implicit and explicit centrality in experimental and longitudinal studies.
Purpose: Our aim was to (a) describe alcohol use in a community-based sample of young sexual and gender minority (SGM) women, (b) determine the influence of sexual minority stress, early drinking onset, and a drinker self-schema on alcohol use, and (c) determine subgroup difference in these effects. Method: Fifty-three women (mean age = 20.5) from a larger cross-sectional study of identities and behavior in LGBT people aged 16 to 24 were recruited using flyers posted in and near a community-based health center that provides services for SGM persons. Participants completed a computer-assisted self-interview that included questions about alcohol use (last 90 days), age of drinking onset, drinker self-schema (extent to which drinking is a central source of self-definition), and sexual minority stress. Results: Lesbians were less likely to define themselves in terms of alcohol and reported lower levels of alcohol use (.22 drinks/day) compared with other SGM women (bisexual/transgender/curious/prefer no labels 58–.63 drinks/day). Sexual minority stress was associated with high drinker self-schema scores for women who started drinking prior to the age of 15 (p = .016), but not for those who started drinking later (p = .93). High drinker self-schema scores were associated with high levels of alcohol use (p = 004). Findings held for bisexual and transgender women, but were muted for lesbians. Conclusions: Interventions to prevent early drinking onset and sexual minority stress may prevent alcohol from becoming an important source of self-definition that contributes to high levels of alcohol use for bisexual and transgender women, but longitudinal studies with larger probability samples of SGM women are needed.
Purpose
The purpose of this paper is to better understand the relationship between substance abuse counselors’ personal recovery status, self-schemas, and willingness to use empirically supported treatments for substance use disorders.
Methods
A phenomenological qualitative study enrolled 12 practicing substance abuse counselors.
Results
Within this sample, recovering counselors tended to see those who suffer from addiction as qualitatively different from those who do not and hence themselves as similar to their patients, while nonrecovering counselors tended to see patients as experiencing a specific variety of the same basic human struggles everyone experiences, and hence also felt able to relate to their patients’ struggles.
Discussion
Since empirically supported treatments may fit more or less neatly within one or the other of these viewpoints, this finding suggests that counselors’ recovery status and corresponding self-schemas may be related to counselor willingness to learn and practice specific treatments.
Objective:
There is considerable excitement about implicit alcohol associations (IAAs) as predictors of college-student hazardous drinking; however, few studies have investigated IAAs prospectively, included multiple assessments, or controlled for previous drinking. Doing so is essential for showing the utility of these associations as predictors, and ultimately, targets for screening or intervention. Therefore, 3 IAAs (i.e., drinking identity, alcohol approach, and alcohol excitement) were evaluated as prospective predictors of drinking in 1st- and 2nd-year undergraduates in the United States.
Method:
A sample of 506 undergraduates completed 8 online assessments of IAAs, explicit measures of the IAA constructs, and hazardous drinking (i.e., consumption, problems, and risk of alcohol-use disorders) every 3 months over a 21-month period. Retention rates, ordered by follow-up time points, were 90%, 76%, 76%, 77%, 72%, 67%, and 66%, respectively. Half of the participants were nondrinkers at baseline; 21% were above clinical cutoffs for hazardous drinking.
Results:
Drinking-identity and alcohol-excitement associations predicted future alcohol consumption and problems after controlling for previous drinking and explicit measures; drinking identity also predicted future risk of alcohol-use disorder. Relative to the other IAAs, drinking identity predicted alcohol consumption for the longest duration (i.e., 21 months). Alcohol-approach associations rarely predicted variance in drinking.
Conclusion:
IAAs vary in their utility as prospective predictors of college-student hazardous drinking. Drinking identity and, to a lesser extent, alcohol excitement, emerged as robust prospective predictors of hazardous drinking. Intervention and screening efforts could likely benefit from targeting those associations. (PsycINFO Database Record
Drinking identity-how much individuals view themselves as drinkers-is a promising cognitive factor that predicts problem drinking. Implicit and explicit measures of drinking identity have been developed (the former assesses more reflexive/automatic cognitive processes; the latter more reflective/controlled cognitive processes): each predicts unique variance in alcohol consumption and problems. However, implicit and explicit identity's utility and uniqueness as predictors relative to cognitive factors important for problem drinking screening and intervention has not been evaluated. Thus, the current study evaluated implicit and explicit drinking identity as predictors of consumption and problems over time. Baseline measures of drinking identity, social norms, alcohol expectancies, and drinking motives were evaluated as predictors of consumption and problems (evaluated every 3 months over 2 academic years) in a sample of 506 students (57% female) in their first or second year of college. Results found that baseline identity measures predicted unique variance in consumption and problems over time. Further, when compared to each set of cognitive factors, the identity measures predicted unique variance in consumption and problems over time. Findings were more robust for explicit versus implicit identity and in models that did not control for baseline drinking. Drinking identity appears to be a unique predictor of problem drinking relative to social norms, alcohol expectancies, and drinking motives. Intervention and theory could benefit from including and considering drinking identity. (PsycINFO Database Record
Behavioral economic demand curve indices of alcohol consumption reflect decisions to consume alcohol at varying costs. Although these indices predict alcohol-related problems beyond established predictors, little is known about the determinants of elevated demand. Two cognitive constructs that may underlie alcohol demand are alcohol-approach inclinations and drinking identity. The aim of this study was to evaluate implicit and explicit measures of these constructs as predictors of alcohol demand curve indices. College student drinkers (N = 223, 59% female) completed implicit and explicit measures of drinking identity and alcohol-approach inclinations at 3 time points separated by 3-month intervals, and completed the Alcohol Purchase Task to assess demand at Time 3. Given no change in our alcohol-approach inclinations and drinking identity measures over time, random intercept-only models were used to predict 2 demand indices: Amplitude, which represents maximum hypothetical alcohol consumption and expenditures, and Persistence, which represents sensitivity to increasing prices. When modeled separately, implicit and explicit measures of drinking identity and alcohol-approach inclinations positively predicted demand indices. When implicit and explicit measures were included in the same model, both measures of drinking identity predicted Amplitude, but only explicit drinking identity predicted Persistence. In contrast, explicit measures of alcohol-approach inclinations, but not implicit measures, predicted both demand indices. Therefore, there was more support for explicit, versus implicit, measures as unique predictors of alcohol demand. Overall, drinking identity and alcohol-approach inclinations both exhibit positive associations with alcohol demand and represent potentially modifiable cognitive constructs that may underlie elevated demand in college student drinkers. (PsycINFO Database Record
College drinking continues to remain a public health problem that has been exacerbated by alcohol-related posts on social networking sites (SNSs). Although existing research has linked alcohol consumption, alcohol posts, and adverse consequences to one another, comprehensive explanations for these associations have been largely unexplored. Thus, we reasoned that students’ personal motivations (i.e., espousing an alcohol identity, needing entertainment, and adhering to social norms) influence their behaviors (i.e., alcohol consumption and alcohol-related posting on SNSs), which can lead to alcohol problems. Using structural equation modeling, we analyzed data from 364 undergraduate students and found general support for our model. In particular, espousing an alcohol identity predicted alcohol consumption and alcohol-related SNS posting, needing entertainment predicted alcohol consumption but not alcohol-related SNS posting, and adhering to social norms predicted alcohol-related SNS posting but not alcohol consumption. In turn, alcohol consumption and alcohol-related SNS posting predicted alcohol problems. It is surprising that alcohol-related SNS posting was a stronger predictor of alcohol problems than alcohol consumption. We discuss the findings within their applied applications for college student health.
Many college students reduce hazardous drinking (HD) following graduation without treatment. Identifying cognitive mechanisms facilitating this “natural” reduction in HD during this transition is crucial. We evaluated drinking identity as a potential mechanism and tested whether within-persons changes in one’s social network’s drinking were linked to within-persons changes in drinking identity and subsequent within-persons changes in HD. A sample of 422 undergraduates reporting HD was followed from 6 months before graduation until 2 years after graduation. Their drinking, drinking identity, and social networks were assessed online. Within-persons changes in drinking identity did not mediate the relationship between within-persons changes in social-network drinking and personal HD, although significant positive between-persons associations among all constructs were found. Instead, there was some evidence that within-persons changes in drinking identity followed changes in HD, which suggests that drinking identity may function as a marker versus mechanism of “natural” HD reduction during transition out of college.
Background:
Previous research suggests that self-knowledge, particularly perceptions of oneself as a "drinker," may influence the development and progression of alcohol use and related problems, such as binge drinking. While existing studies have provided empirical evidence for the importance of assessing drinking self-perception within the five-factor model of personality framework, further examination with novel analytic methods, such as network analyses, could improve understanding of the drinker self-concept. Methods: Five factor traits of openness to experience, conscientiousness, extraversion, agreeableness, and emotional stability were assessed among a large sample of young adults (n = 423) across "general" and "drinking" contexts. Features of the personality networks were investigated, including topology, network centrality, stability of the network across "general" and "drinking" assessments, as well as differences in the network across the two assessments. Results: Individual personality items were more related to other items within the same trait than to other traits. There was no most central item in the networks, but item strength was uncorrelated to mean-level of the item. The network structure was stable across both assessments, although the overall strength of item relationships significantly increased in the drinking personality network. Conclusions: Examining drinking personality using a network analytic framework provided novel insights into drinker self-concept and the role drinking contexts might play in self-perception of personality in those contexts.
Supplemental data for this article is available online at https://doi.org/10.1080/10826084.2022.2034874 .
College male alcohol use continues to be a topic of interest due to its prevalence and the nature of consequences reported by this group. Research concerned with prevention and intervention efforts has focused on alcohol protective behavioral strategies (PBS) and the subtypes (i.e., manner of drinking, stopping/limiting drinking, and serious harm reduction), as a promising approach to reduce harm associated with drinking. Past research indicates college males are less likely than their female peers to use PBS. Currently, little research has explored whether explicit drinking identity may be associated with college males’ relative lack of PBS use. The current study examined the indirect association of explicit drinking identity with alcohol outcomes through the relation with PBS subtypes. This study utilized a national sample of 599 college males (M = 22.52, SD = 2.02) who completed measures of drinking identity, PBS use, and alcohol outcomes (i.e., negative consequences and hazardous use). Results indicated a positive association between drinking identity and alcohol outcomes (i.e., hazardous alcohol use and alcohol-related negative consequences). The relationship between drinking identity and hazardous alcohol use was partially explained by less use of serious harm reduction-PBS strategies. Research and clinical practice implications are discussed.
In recent years, the role of media in individuals' alcohol consumption has been touched upon by several researchers. Nevertheless, the underlying processes explaining the relationship between media use and alcohol consumption, as well as the differences in strength of the associations between social and traditional media use and alcohol consumption remain understudied. The present exploratory cross-sectional study (N = 381) among emerging adults (M = 21.83, SD = 2.04, 75.3% females, 67.7% college students) examined drinking identity and non-drinking identity as underlying mechanisms of the relationship between alcohol-related media use and alcohol consumption, while comparing the role of social and traditional media in these processes. We found no associations between traditional media use and drinking identity, non-drinking identity or alcohol consumption. In contrast, social media use was both directly and indirectly related to alcohol consumption via drinking identity and non-drinking identity. This demonstrates that social media can play a socializing role in emerging adults' alcohol consumption.
Cross-sectional research has demonstrated that endorsing, or acknowledging, and frequently thinking about having a drinking identity are uniquely and positively associated with alcohol consumption and risk for hazardous drinking. In the current investigation, we evaluated whether these facets of drinking identity indicated a latent drinking identity variable. We also investigated whether greater identification with drinking predicted subsequent increases in alcohol consumption and risk for hazardous drinking, and whether higher levels of these drinking behavior variables predicted subsequent increases in identification with drinking. Data were collected from participants (N = 422) near their graduation from college and then again eight months later. Drinking identity endorsement and drinking identity thought frequency were positive indicators of a latent drinking identity variable. Identification with drinking was concurrently, positively associated with both alcohol consumption and risk for hazardous drinking at both time points. Greater identification with drinking at the first assessment predicted subsequent increases in alcohol consumption and risk for hazardous drinking. Surprisingly, the drinking behavior variables did not prospectively predict changes in identification with drinking. These findings support an expanded conceptualization of drinking identity, provide further evidence that greater identification with drinking prospectively predicts more drinking behaviors, and suggest that drinking identity should be considered in interventions to reduce hazardous drinking.
Purpose
Drinking behaviors and depression are common and highly correlated behaviors in undergraduates. Child adversity and drinker self-schemas have been recognized as significant risk factors of drinking behaviors and depression. However, how the various child adversity forms differentially influence the formation of drinker self-schema and behaviors is underexplored. We aimed to determine whether drinker self-schema serves as a mechanism underlying the influence of child adversity forms on drinking frequency, drinking problems, and depressive symptoms.
Methods
A cross-sectional, correlational study design with an anonymous, internet-based survey was conducted. Participants were 330 first- and second-year undergraduates enrolled in a four-year college/university as full-time students in Taiwan. Path analysis was performed to examine the direct and indirect effects (through drinker self-schema) of child adversity forms on drinking frequency, drinking problems, and depressive symptoms. Gender and friend’s alcohol use were the covariates.
Results
Psychological abuse, psychological neglect, physical neglect, and household substance use were associated with drinker self-schema, which was associated with drinking frequency, drinking problems, and depressive symptoms. Physical abuse was associated with drinking frequency. Household substance use and parent(s) treated violently were associated with drinking problems. Psychological neglect and household mental illness were associated with depressive symptoms. Moreover, psychological abuse and psychological neglect had indirect effects on drinking frequency and drinking problems through drinker self-schema.
Conclusions
Different forms of childhood adversity are differently associated with drinker self-schema, drinking behaviors, and depression. Drinker self-schema serves as an underlying mechanism linking psychological maltreatments to drinking behaviors.
Purpose
Although the association between social norms and alcohol dependence has been noted, how social norms cause alcohol dependence remains unclear. This study thus investigated how social norms affect the perceived benefits of drinking and alcohol identity, which in turn affect alcohol dependence.
Design/methodology/approach
Convenience sampling was used, and 452 valid questionnaires were collected from alcohol (specifically, beer) consumers over the age of 18; answers were analyzed through structural equation modeling.
Findings
Social norms positively affected the perceived benefits of drinking and alcohol identity; alcohol identity positively affected alcohol dependence; moreover, alcohol identity fully mediated the effects of social norms and the perceived benefits of drinking on alcohol dependence.
Originality/value
How social norms affect alcohol dependence has rarely been studied; thus, the present study has value for integrating the findings in the lines of research on social norms and alcohol dependence. Based on the study results, the authors recommend that policies aimed at discouraging alcohol dependence should focus on mitigating the social pressure to drink and the perceived benefits of drinking as well as labeling others as drinkers.
The risk for alcohol misuse among emerging adults can increase by the development of a maladaptive identity structure. Recent research has shown that drinking identity serves as a risk factor for hazardous drinking. Despite this, existing measures have largely relied on unidimensional conceptualizations of drinking identity. Addressing this gap,the current study sought todevelop and validate the Drinking Identity Management Scale (DIMS), a multidimensional measure of drinking identity development. The sample included 475 college students (78.1% women; Mage = 20.08 years; SD = 4.19 years). The results supported a multi-dimensional conceptualization of drinking identity consisting of exploration, commitment,compatibility, and endorsement.Additionally, drinking identity dimensions were associated with severity of alcohol use and related consequences. The current study provided preliminary evidence for the validity of the DIMS and highlights the need for future studies to capture the developmental processes underlying a drinking identity development.
Implicit measures of alcohol-related associations or implicit alcohol associations are associated with drinking outcomes over time and can be understood as vulnerability markers for problem drinking. Longitudinal research remains rare, leaving open questions about how implicit alcohol associations themselves change over time and what factors moderate that change. We examined these questions with data from a larger study of first and second year U.S. college students. We investigated how these implicit alcohol associations change over time and potential moderators of those changes (gender, lifetime drinking history, family history of problem drinking, and class standing). A sample of 506 students (57% women) completed baseline demographic measures and implicit measures (variants of the Implicit Association Test [IAT]) assessing associations with drinking and the self [drinking identity], alcohol and excite [alcohol-excite], and alcohol and approach [alcohol-approach]). IATs were completed at 3-month intervals for a total of 8 assessments. Results indicated small, but significant, change in alcohol-excite and alcohol-approach IAT scores over time, and mixed findings for hypothesized moderators. Drinking history moderated change in drinking identity IAT scores, with increases over time among individuals with no history of drinking or no history of intoxication and decreases among individuals with a history of intoxication. Gender moderated change in alcohol-excite IAT scores with greater change among women (vs. men). No significant moderators of change in alcohol approach IAT scores were found. Results point to the importance of evaluating implicit associations’ trajectories and identifying additional factors that predict those trajectories and concomitant vulnerability to problem drinking.
Purpose:
The objective of this study was to empirically test a theoretical model to determine the cognitive mechanisms that are associated with adolescent alcohol use and alcohol problems. We posited that alcohol outcome expectancies would affect alcohol-refusal self-efficacy through the drinker self-schema. We also posited that alcohol outcome expectancies and the drinker self-schema would affect alcohol use and problems through alcohol-refusal self-efficacy.
Methods:
A survey was administered to 225 adolescents in a public junior high school in Taiwan at two-time points, six months apart. Path analysis was used to determine the mechanisms underlying the alcohol-related cognitive constructs on the alcohol use and alcohol problems separately, controlling for appropriate alcohol-related personal and environmental factors. Indirect effects were estimated using the bootstrapping method.
Results:
Higher positive alcohol outcome expectancies and lower negative alcohol outcome expectancies predicted higher drinker self-schema scores. Higher positive alcohol outcome expectancies and drinker self-schema scores predicted lower alcohol-refusal self-efficacy. Lower alcohol-refusal self-efficacy was associated with a history of drinking and alcohol problems in the past six months. Effects of alcohol outcome expectancies on alcohol use and alcohol problems were partially mediated through the drinker self-schema and alcohol-refusal self-efficacy.
Conclusions:
Findings support the proposed theoretical cognitive mechanisms underlying alcohol use and alcohol problems in a sample of Taiwanese adolescents. Given that alcohol-related cognitive constructs are modifiable, the findings also provide a foundation to suggest that interventions to reduce positive alcohol outcome expectations and prevent the formation of a drinker self-schema may facilitate alcohol-refusal self-efficacy and mitigate drinking behaviors in this adolescent population.
Heavy drinking and alcohol use disorder are major public health problems. Practitioners not specialising in alcohol treatment are often unaware of the guidelines for preventing, identifying, and treating heavy drinking and alcohol use disorder. However, a consensus exists that clinically useful and valuable tools are available to address these issues. Here, we review existing information and developments from the past 5 years in these areas. We also include information on heavy drinking and alcohol use disorder among individuals with co-occurring psychiatric disorders, including drug use disorders. Areas covered include prevention; screening, brief intervention, and referral for treatment; evidence-based behavioural interventions; medication-assisted treatment; technology-based interventions (eHealth and mHealth); and population-level interventions. We also discuss the key topics for future research.
Problematic alcohol consumption is elevated among those who identify (i.e., associate themselves) with drinking. We extended prior research on drinking identity by considering two dimensions of investment in identity – i.e., mental resources allocated to that identity that may motivate the pursuit of identity-related goals. We considered drinking identity importance (i.e., how important one considers it to be) and drinking identity thought frequency (i.e., how frequently one thinks about it). We investigated these dimensions from two perspectives: an absolute perspective (i.e., investment in drinking identity irrespective of other identities) and a relative perspective (i.e., investment in drinking identity compared to identities associated with other life domains [education, well-being, and personal relationships]). We aimed to evaluate whether these investment dimensions were positively associated with alcohol consumption and risk of alcohol use disorder either in interaction with or in addition to endorsement of drinking identity. College students (N = 521) who were screened for exhibiting hazardous drinking completed self-report measures of alcohol consumption, risk of alcohol use disorder, and drinking identity endorsement and investment. Controlling for gender and drinking identity endorsement, absolute and relative drinking identity thought frequency were uniquely and positively associated with alcohol consumption and risk of alcohol use disorder. Neither absolute nor relative importance of identification with drinking uniquely predicted outcomes. Drinking identity investment, as signaled by absolute and relative frequency of thought related to identification with drinking, may be an additional risk factor and/or clinical target for alcohol consumption and risk of alcohol use disorder.
Background and Objectives
Emerging adulthood is a time of identity formation, and is also the most common time period for individuals to consume alcohol. Alcohol self‐concept (or drinking identity) has been associated cross‐sectionally with rates of alcohol use and use‐related problems. Additionally, there is preliminary evidence that alcohol self‐concept is related to negative affect and to alcohol use motives. However, less research has evaluated the longitudinal nature of these variables, particularly in a community sample. The current study evaluated relationships between self‐concept, alcohol‐related variables, and negative affect among emerging adults. Additionally, the study explored self‐concept as a mediator between motives and alcohol use and problems.
Methods
Community‐recruited participants (n = 226, 55.3% male) involved in a health behaviors study were assessed over the course of 12 months.
Results
Results substantiated both the cross‐sectional and longitudinal relationships between these variables. Self‐concept, rates of use, and problems decreased over the course of time. Decreases in motives for alcohol use (including coping and enhancement motives) were related to subsequent decreases in alcohol self‐concept, which in turn were associated with decreases in use and use‐related problems. Alcohol self‐concept mediated the longitudinal relationship between coping motives and use as well as use‐related problems.
Discussion and Conclusions
Results from this study underscore the importance of motivation for alcohol use and internalization of alcohol identity in predicting changes in behavior across emerging adulthood and suggest future avenues of research.
Scientific Significance
Alcohol self‐concept may be a risk factor and intervention target. (Am J Addict 2018;XX:1–8)
Measures of drinking identity are predictive of hazardous drinking. The extent to which hazardous drinking is differentially related to implicit compared to explicit drinking identity is not well understood. Neurocognitive models of addiction indicate that chronic alcohol use is associated with deficits in self-awareness which could limit the growth or recognition of drinking identity for individuals engaging in hazardous drinking. This might be particularly true for more reflective explicit measures of identity because their assessment and underlying cognitive processes rely more on self-awareness and conscious introspection. We predicted there would be different patterns of relationships between hazardous drinking and implicit/explicit drinking identity measures. A linear model was predicted to better fit the hazardous drinking and implicit identity relationship whereas a non-linear model was predicted to better fit the hazardous drinking and explicit identity relationship due to decreased ability to reflect on changes in identity at high levels of hazardous drinking. The present study is a re-analysis of a large secondary dataset (Project Implicit Mental Health; N = 11,320) which included measures of hazardous drinking (e.g., Alcohol Use Disorder Identification Test) and implicit/explicit identity. Results were consistent with predictions. The relationship between hazardous drinking and implicit drinking identity was best modeled by a linear function whereas the relationship between hazardous drinking and explicit drinking identity was best modeled by a non-linear cubit spline function. These findings are consistent not only with neurocognitive models but also with dual process formulations that implicit and explicit drinking identity are somewhat related but also quite distinct.
Aims:
The current study aimed to test for potential interactive effects of three implicit alcohol-related associations (drinking identity, alcohol approach and alcohol excitement) in predicting concurrent and prospective alcohol consumption and risk of alcohol use disorders (AUDs) in two samples of the US undergraduate drinkers and non-drinkers.
Short summary:
We investigated the independent and interactive effects of three implicit associations on alcohol consumption and risk of AUD in two US undergraduate student samples. We found that implicit associations had independent but not interactive effects on concurrent and subsequent alcohol consumption and risk of AUD in two independent samples.
Methods:
Implicit drinking identity, alcohol approach and alcohol excitement associations were assessed in two US undergraduate student samples (Sample 1: N = 300, 55% female; Sample 2: N = 506, 57% female). Alcohol consumption and risk of AUD were assessed at baseline (Samples 1 and 2) and 3 months later (Sample 2). We fit zero-inflated negative binomial models to test for independent and interactive effects of the three implicit associations on alcohol consumption and risk of AUD.
Results:
Although we found multiple, unique main effects for alcohol associations, we found minimal evidence of interactions between implicit alcohol-related associations. There was no reliable evidence of interactions in models in predicting alcohol consumption or risk of AUD, concurrently or prospectively, in either sample.
Conclusions:
Contrary to expectations, results from both studies indicated that implicit alcohol-related associations in the US undergraduate samples generally have independent, not interactive, relationships with alcohol consumption and risk of AUD.
Aims:
Implicit measures of alcohol associations (i.e. measures designed to assess associations that are fast/reflexive/impulsive) have received substantial research attention. Alcohol associations related to the self (drinking identity), the effects of alcohol (alcohol excite) and appetitive inclinations (alcohol approach) have been found to predict drinking cross-sectionally and over time. A critical next step in this line of research and the goal of this study is to evaluate whether increases in the strength of these associations predict increases in drinking and vice versa. These hypotheses were tested in a sample of first- and second-year US university students: a sample selected because this time period is associated with initiation and escalation of drinking, peak levels of alcohol consumption and severe alcohol-related negative consequences.
Short summary:
This study's purpose was to evaluate whether increases in the strength of alcohol associations with the self (drinking identity), excitement (alcohol excite) and approach (alcohol approach) as assessed by implicit measures predicted subsequent increases in drinking risk and vice versa using a longitudinal, university student sample. Results were consistent with hypotheses.
Methods:
A sample of 506 students' (57% women) alcohol associations and alcohol consumption were assessed every 3 months over a 2-year period. Participants' consumption was converted to risk categories based on NIAAA's criteria: non-drinkers, low-risk drinkers and high-risk drinkers. A series of cross-lagged panel models tested whether changes in alcohol associations predicted subsequent change in drinking risk (and vice versa).
Results:
Across all three measures of alcohol associations, increases in the strength of alcohol associations were associated with subsequent increases in drinking risk and vice versa.
Conclusion:
Results from this study indicate bi-directional relationships between increases in alcohol associations (drinking identity, alcohol excite and alcohol approach) and subsequent increases in drinking risk. Intervention and prevention efforts may benefit from targeting these associations.
Background:
Drinking and smoking commonly co-occur in undergraduate students. Although an identity as a drinker is a known predictor of alcohol use and alcohol problems, and early evidence suggests that it also predicts smoking, the role of these behaviors in the development of an identity as a drinker is unknown. In this study, we conceptualized a drinker identity as an enduring memory structure referred to as a self-schema, and conducted a preliminary investigation of the relationships between early drinking experiences, drinker self-schema, and alcohol and tobacco use in undergraduate students.
Methods:
Three-hundred thirty undergraduates who reported current alcohol and tobacco use were recruited for an on-line survey study. Frequency of alcohol and tobacco use in the past 30 days, drinker self-schema, and early experiences with alcohol were measured.
Results:
Structural equation modeling showed parental alcohol problems were associated with early onset of drinking. Early onset of drinking and high school friends' drinking were associated with more alcohol use and alcohol-related problems in high school. Alcohol problems during high school were associated with high drinker self-schema scores, which were associated with high frequency of alcohol and tobacco use during college. The indirect effects through the drinker self-schema were significant.
Conclusions:
Though cross-sectional, this preliminary examination supports theoretical predictions that early alcohol experiences may contribute to development of the drinker self-schema, which as expected, was positively associated with alcohol and tobacco use in college. Longitudinal studies that track the unfolding of drinking behavior and the contextual factors that are associated with it on the development of the self-drinker schema are essential to confirm the theoretical model. If supported, implications for intervention at different developmental stages to prevent early onset of drinking, limit adolescent alcohol use, and modify the development of a drinker self-schema may mitigate undergraduate drinking and smoking.
Background:
Adolescent alcohol use continues to be a critical public health problem with both short- and long-term negative health consequences. Defining oneself in terms of alcohol, a drinking-related identity, has been shown to predict high levels of alcohol use. Because adolescence is the developmental period during which identity development is most salient, preventing the development of the drinker identity and early identification of youth who have a developing drinker identity may be important for prevention and early intervention.
Methods:
We review the theory- and evidence-based literature about identity development and the effects of a drinker identity on alcohol use behaviors in adolescents, discuss potential determinants of the drinker identity, and discuss future implications for practice and research.
Results:
There is some evidence that the drinker identity forms in early adolescence and becomes more well-developed during adolescence. The drinker identity predicts alcohol use behaviors both concurrently and over time in adolescence and young adulthood. There is also some evidence that early exposure to alcohol may contribute to formation of the drinker identity.
Conclusions:
Identity-based approaches may be promising strategies to identify adolescents who are at risk for alcohol use and to intervene with early prevention or treatment within the school setting.
Drinking identity, or the tendency to view one's self as a drinker, is a unique predictor of alcohol use and related consequences among young adults; yet the mechanism by which it leads to alcohol problems is poorly understood. Based on self-presentation and self-verification perspectives, we examined drinking to cope as a mediator of the association between explicit drinking identity and alcohol-related problems among two samples of young adults. Study data come from two large, longitudinal studies. Participants from Sample 1 and Sample 2 included undergraduates (55% and 59% female, respectively) who reported drinking in the previous three months. Tests of the indirect effects indicated that 3-month drinking to cope significantly mediated the positive association between baseline drinking identity and 6-month alcohol-related problems in both samples. In contrast, 3-month drinking identity did not mediate the association between baseline drinking to cope and 6-month alcohol-related problems. Findings indicate that individuals with a stronger drinking identity are more likely to use alcohol to cope and, subsequently, experience more problems. Thus, drinking identity may be an important intervention target for college students as it appears to temporally proceed drinking to cope in the prediction of alcohol-related problems.
Background
Co-occurrence of drinking and smoking is prevalent in undergraduate students. A drinker self-schema―cognition about the self as the drinker―is a common identity in undergraduates and a well-known predictor of drinking behaviors. Given that smoking commonly occurs in the context of drinking, a drinker self-schema may be a cognitive mechanism to motivate co-occurring alcohol and tobacco use (i.e., cross-substance facilitation hypothesis). This study was to determine whether the drinker self-schema influences the processing of drinking- and smoking-related information and facilitates the co-occurrence of alcohol and tobacco use in undergraduate students who drink and smoke but do not self-identify as smokers.
Methods
This study was the second phase of a 2-phase study. Of the 330 who completed phase 1 (online survey), 99 completed the phase 2 study. Phase 2 was an in-person session that included a computerized information processing task to measure endorsements and response latencies for drinking- and smoking-related attributes, and a computerized Timeline Followback that was used to measure 90-day alcohol- and tobacco-use behaviors. The 5-item drinker self-schema scale, administered in phase 1, was used to measure the strength of the drinker self-schema.
Results
A higher drinker self-schema score was associated with more endorsements of positive attributes for drinking and smoking, fewer endorsements of negative attributes for smoking, faster processing of agreements with positive alcohol-use-related attributes, higher levels of drinking and smoking, and more days of co-occurring alcohol and tobacco use.
Conclusions
Findings provide preliminary evidence to support the cross-substance facilitation hypothesis that the drinker self-schema facilitates the processing of not only drinking-related but also smoking-related stimuli and behaviors. Undergraduates who have higher drinker self-schema scores may be vulnerable to co-occurring alcohol and tobacco use.
Across various cultures there are robust stereotypes regarding how alcohol intoxication alters individuals’ normative personalities. However, whether these stereotypes are rooted in genuine average effects or in salient, socially proliferated exemplars remains unclear. The current study tested if differences between sober and intoxicated personality expression can be observed reliably by trained raters during a drinking episode. Participants (N = 156), half of whom received alcohol, attended laboratory sessions in same-gender friend groups and engaged in activities designed to elicit a range of personality expression. Participants completed self-reports of their “typical” sober and drunk personalities 2 weeks prior to their sessions and via two short measures during the session. In addition, participants were recorded and rated by multiple (range = 5–17) trained raters using three personality measures. Self-perceptions of sober-to-drunk personality differences were more pervasive than observer-perceptions, but alcohol-induced changes in Extraversion, specifically, were robust across measures and reporters.
This longitudinal study explored how consumers justify their alcohol consumption by compartmentalising or integrating their various drinking identities (i.e. description of one’s drinking behaviours and extent to which these are part of person’s overall identity). Thirty-one participants were interviewed twice. The findings revealed that identities are continuously altered/created according to context and social interactions. Consumers’ movement between social fields generated different perceptions of what constitutes ‘healthy’ drinking, leading to displays of different identities. After interviewees compared their alcohol consumption perceptions with results from an online 14-day alcohol tracker, some consumers reported a ‘newly perceived’ drinking identity and displayed integration tendencies. Others denied their consumption results and continued to exhibit compartmentalised identities, justified by various social selves, roles and responsibilities. Social marketing and policy recommendations are discussed.
Background:
This paper provides an overview of the self-concept as it relates to substance use. Self-concept has a long history in psychological theory and research; however, substance self-concept (e.g., viewing one's self as a drinker or smoker) is an understudied area of research with the potential to expand existing conceptualizations of substance use, addiction, and prevention and treatment efforts, and should receive greater research attention.
Objectives:
First, we review and provide a theoretical framework of substance self-concept that draws from dual process models and distinguishes between implicit and explicit self-concept. Next, we summarize key findings related to substance use in the extant literature, focusing on alcohol and tobacco (smoking).
Results:
Across both substances, there is converging evidence that substance self-concept is associated with substance use outcomes, including quantity and frequency of use and problems associated with use, and that change in substance self-concept is associated with recovery from substance misuse. Recommendations for the substance self-concept research agenda include routine assessment of substance self-concept, expanded use of implicit measures, investigation of moderators of substance self-concept, and targeting substance self-concept directly in prevention and intervention efforts.
Conclusion:
Ultimately, we suggest that substance self-concept is a promising, but understudied, construct. Greater research attention to substance self-concept could clarify its potential as an important risk factor for hazardous use and addiction as well as its utility as a prevention and treatment target.
Self-schemas have received increased attention as favorable targets for therapeutic intervention because of their central role in self-perception and behavior. The purpose of this integrative review was to identify, evaluate,
and synthesize existing research pertaining to drinking-related self-schemas. Russell’s integrative review strategy guided the search. Sixteen published works were identified, meeting criteria for evaluation (n = 12 data-based publications and n = 4 models). The retrieved data-based publications rated fair-good using Polit and Beck’s criteria; the overall body of literature rated “B” using Grimes and Schulz criteria. Retrieved models rated 4 to 7 using Fitzpatrick and Whall’s criteria. The existing literature strongly supports the availability of a drinking-related self-schema among moderate-to-heavy drinking samples, and suggests a positive relationship between elaboration and drinking behavior. The relationship between valenced content of the schema and drinking behavior remains unexplored. Identifying variation in the structural properties of drinking-related self-schemas could lay the foundation for future interventions.
Drinking identity (viewing oneself as a drinker) is a potential risk factor for problematic drinking in US undergraduate samples. Whether that risk extends to a broader, more general US sample is unknown. Additionally, there are critical, unanswered questions with respect to moderators of the drinking identity-problematic drinking relationship; an important issue for designing prevention efforts. Study aims were to assess the unique associations and interactive effects of implicit and explicit measures of drinking identity on problematic drinking, and to evaluate age and sex as potential moderators of the drinking identity-problematic drinking relationship. A sample of 11,320 adults aged 18-98 completed measures of implicit and explicit drinking identity and problematic drinking (the Alcohol Use Disorder Identification Test; AUDIT). Implicit and explicit drinking identity had positive, significant associations with AUDIT scores, as expected. Moderation analyses indicated small, but significant, interactions. There was an implicit by explicit identity interaction consistent with a synergistic effect: lower implicit and explicit identity was linked to a greater probability of being a non-drinker. Age moderated explicit but not implicit identity: lower drinking identity appeared to be more protective for younger individuals. Sex moderated implicit but not explicit identity: a weaker positive association with implicit identity and AUDIT scores was observed among men, potentially reflecting stigma against women's drinking. Findings suggest that drinking identity's potential as a risk factor for problematic drinking extends to a more general US sample and that both implicit and explicit identity should be targeted in prevention efforts.