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Alcohol use and drinking motives across five countries: a post-COVID-19 pandemic update
The American Journal of Drug and Alcohol Abuse
Abstract
Background: It is necessary to understand drinking motives to inform tailored interventions counteracting high-risk alcohol use and alcohol use disorder. Research suggests that, during the COVID-19 pandemic, drinking to cope with the current situation (i.e. coping motive) increased. This was alarming since the coping motive is a predictor of alcohol use and alcohol-related problems.Objective: In the current study, we aimed to elucidate whether this COVID-19-induced increase in coping-motivated alcohol use outlasted the COVID-19 pandemic in the USA, Great Britain, Mexico, Spain, and Germany. We provide a 2023 post-COVID-19 update on alcohol use and drinking motives.Methods: In spring 2023, 1032 participants recruited via Prolific (48% female) across the five countries completed a cross-sectional online survey, including the Alcohol Use Disorder Identification Test (AUDIT) for alcohol use patterns and the Drinking Motives Questionnaire-Revised (DMQ-R) for drinking motives.Results: Across all five countries, 20-30% of the participants exceeded the AUDIT cutoff score for high-risk alcohol use. The ranking of all four motives for alcohol use was cross-nationally consistent: Social > Enhancement > Conformity > Coping.Conclusion: Compared to most research before the pandemic, with a Social > Enhancement > Coping > Conformity motive ranking, and research during COVID-19, with an Enhancement > Coping > Social > Conformity motive ranking, our data suggests that post-COVID drinking to socialize and to enhance one's own mood, are again the most important motives to drink alcohol. Furthermore, it seems like the increase in the coping motive found in research during the pandemic, did luckily not persist but conversely, post- compared to pre-COVID, the conformity motive seems more important than coping motive.
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The COVID-19 pandemic has resulted in negative mental health outcomes throughout the world, and its impact on social interactions and relationships is likely to be evident in problematic social anxiety. This systematic review qualitatively synthesized data from studies that have reported on the effects of the pandemic on social anxiety. A systematic search of Web of Science Core Collection, Embase, PsychINFO, Scopus, EBSCOhost, Cochrane Central Register of Controlled Trials, and Proquest Central—Dissertations and Theses was conducted, with thirty-three studies meeting the inclusion criteria. The results suggest that social anxiety has been heightened in the general population due to the pandemic, with women and low-income earners being especially vulnerable. Other contributing factors include impaired coping strategies, lower socio-emotional well-being, limited support networks, and contraction of the SARS-CoV-2 virus. Individuals with a Social Anxiety Disorder diagnosis may be at risk of a deterioration of mental health in general. Limitations of the literature reviewed include the predominance of cross-sectional study designs, which limit causal inferences are limited. Additionally, associations may be inflated as many studies have not accounted for mediating variables. Taken together, the research suggests that social anxiety, either pre-pandemic or arising due to the pandemic environment, has contributed to a variety of negative mental health outcomes related to social anxiety.
COVID-19 has accelerated the substitution of videoconferencing for business travel. However, little research exists about the decision-making behavior of business travelers considering virtual alternatives. We fill this gap by reconceptualizing the decision-making process and investigating the fundamental choice between face-to-face (FtF) and virtual communication (VC) using an adaptive choice-based conjoint analysis. We argue that the process of decision making of business travelers is distinct to that of leisure travelers, as the fundamental decision between FtF and VC occurs prior to subsequent travel decisions. We show that the purpose of the meeting, the character of the message, and the location of the meeting are the decision attributes of greatest importance. Using a novel methodology we present a holistic decision model that increases the theoretical understanding of business traveler decision-making and provides practitioners with comprehensive insights relevant to travel policy development, and executives in the business travel market with guidance with management decisions.
The COVID-19 pandemic related government interventions produced rapid decreases in worldwide economic and social activity, with multifaceted economic and social consequences. In particular, the disruption of key industries and significant lifestyle changes in the aftermath of the pandemic outbreak led to the exponential adoption of web and video conferencing Software as a Service (SaaS) programs and to the solutions-led video conferencing market growth. However, the magnitude and persistence of the COVID-19 pandemic impact on the video conferencing solutions segment remain uninvestigated. Building on previous evidence linking population web-search behavior, private consumption, and retail sales, this study sources and employs Google Trends data as an analytical and forecasting tool for the solutions segment of the videoconferencing market. It implements a univariate forecast evaluation approach that assesses the predictive performance of several statistical and machine-learning models for the relative search volume (RSV) in the two SaaS program leaders, Zoom and Teams. ETS is found to provide the best forecast of consumer GT search interest for both RSV series. A baseline level for the consumer interest over the first pandemic wave is subsequently produced with ETS and further serves to estimate the excess search interest over the February 2020–August 2020 period. Results indicate that the pandemic has created an excess or abnormal consumer interest in the global web and videoconferencing SaaS market that would not have occurred in the absence of the pandemic. Other findings indicate that the impact is persistent as the excess interest stabilized at higher levels than in the pre-pandemic period for both SaaS market leaders, although a higher saturation of the Zoom market is detected.
The COVID-19 crisis is arguably the most important development of the 21st century so far and takes its place alongside the great eruptions of the past century. As with any crisis, the current pandemic has stimulated visions and proposals for post-COVID-19 societies. Our focus is on narratives—both predictive and prescriptive—that envisage post-COVID-19 political societies. Combining narrative analysis with thematic analysis, we argue that societal changes conditioned by the pandemic have accelerated a turn toward five inter-related developments: A renaissance in rationality and evidence-based science; a return to social equality and equity, including wage equity and guaranteed incomes; a reimagining of the interventionist state in response to crises in the economy, society, the welfare state, and social order; a reorientation to the local and communitarian, with reference in particular to solidaristic mutual aid, community animation, local sourcing, and craft production; and the reinvention of democracy through deep participation and deliberative dialogical decision making. The empirical focus of our work is an analysis of predominantly legacy media content from the Canadian Periodicals Index related to life after the pandemic and post-COVID-19 society.
Objective: The present study meta-analyzed studies examining changes in alcohol consumption during the coronavirus disease (COVID-19) pandemic and systematically reviewed contextual and individual difference factors related to these changes. Method: Following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) protocol, studies were gathered via PsycINFO, PubMed/MEDLINE, and preprint databases (published April 29, 2021) that examined individual-level changes in consumption during the initial COVID-19 mitigation measures (before October 2020). Next, sample proportion increases and decreases in consumption, in addition to mean change in consumption variables from pre- to during-COVID, were meta-analyzed, and contextual and individual difference variables related to consumption changes during the pandemic were summarized. Results: One hundred and twenty-eight studies provided data from 58 countries (M n = 3,876; Mdn n = 1,092; aggregate sample n = 492,235). The average mean change in alcohol consumption was nonsignificant (Cohen’s d = −0.01, p = .68); however, meta-analysis revealed that 23% of participants reported increases in consumption and 23% reported decreases. These changes were moderated by per capita gross domestic product and country. Narrative synthesis revealed multiple predictors of increased drinking, including contextual changes (e.g., children at home, income loss, working remotely), individual difference variables (being female, a young-to-middle aged adult, or Black), and mental health/alcohol-related risk factors (e.g., depression). Conclusions: The identified factors associated with increased alcohol consumption should be considered in planning behavioral health services during future crisis events that abruptly alter everyday environments in ways that increase stress and decrease access to naturally occurring rewards.
Background:
The aim of this paper was to examine the early impact of COVID-19 on substance use to assess implications for planning substance use treatment and support systems.
Method:
A systematic review of literature published up to March 2021 was conducted to summarize changes in prevalence, incidence, and severity of substance use associated with COVID-19 and the accompanying public health measures, including lockdown, stay-at-home orders, and social distancing.
Results:
We identified 53 papers describing changes to substance use at the population level. The majority of papers described changes related to alcohol use and most relied on self-reported measures of consumption during the COVID-19 pandemic, compared with pre-pandemic use. There was less evidence to support changes in non-alcohol substance use. In general, risky pre-pandemic alcohol use, caregiving responsibilities, stress, depression, anxiety, and current treatment for a mental disorder were found to be associated with increased substance use.
Conclusion:
This review provides preliminary data on changes in substance use, indicating that certain segments of the population increased their alcohol use early on in the COVID-19 pandemic and may be at greater risk of harm and in need of additional services. There is a need for additional population-level information on substance use to inform evidence-based rapid responses from a treatment system perspective.
Background
We aimed to evaluate how coronavirus (COVID-19) restrictions had altered individual's drinking behaviours, including consumption, hangover experiences, and motivations to drink, and changing levels of depression and anxiety.
Method
We conducted an online cross-sectional self-report survey. Whole group analysis compared pre- versus post-COVID restrictions. A correlation coefficient matrix evaluated the associations between all outcome scores. Self-report data was compared with Alcohol Use Disorders Identification Test (AUDIT) scores from the 2014 Adult Psychiatric Morbidity Survey. Multiple linear modelling (MLM) was calculated to identify factors associated with increasing AUDIT scores and post-restriction AUDIT scores.
Results
In total, 346 individuals completed the survey, of which 336 reported drinking and were therefore analysed. After COVID-19 restrictions 23.2% of respondents reported an increased AUDIT score, and 60.1% a decreased score. AUDIT score change was positively correlated with change in depression ( P < 0.01, r = 0.15), anxiety ( P < 0.01, r = 0.15) and drinking to cope scores ( P < 0.0001, r = 0.35). MLM revealed that higher AUDIT scores were associated with age, mental illness, lack of a garden, self-employed or furloughed individuals, a confirmed COVID-19 diagnosis and smoking status.
Conclusions
COVID-19 restrictions decreased alcohol consumption for the majority of individuals in this study. However, a small proportion increased their consumption; this related to drinking to cope and increased depression and anxiety.
To determine whether the past half-year of COVID-19-related lockdowns, stay-at-home orders, and social isolation were associated with changes in high-risk alcohol use, a total of 5,931 individuals completed the Alcohol Use Disorders Identification Test (AUDIT) at one of six time points from April through September 2020. Over the 6-month period, hazardous alcohol use and likely dependence increased month-by-month for those under lockdowns compared to those not under restrictions. This increase in harmful alcohol use and related behaviors is likely to have prolonged adverse psychosocial, interpersonal, occupational, and health impacts as the world attempts to recover from the pandemic crisis.
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.
Background
The COVID‐19 pandemic has resulted in massive disruptions to society, to the economy, and to daily life. Some people may turn to alcohol to cope with stress during the pandemic, which may put them at risk for heavy drinking and alcohol‐related harms. Research is needed to identify factors that are relevant for coping‐motivated drinking during these extraordinary circumstances to inform interventions. This study provides an empirical examination of coping motive pathways to alcohol problems during the early stages of the COVID‐19 pandemic.
Methods
Participants (N = 320; 54.7% male; mean age of 32 years) were Canadian adult drinkers who completed an online survey assessing work‐ and home‐related factors, psychological factors, and alcohol‐related outcomes over the past 30 days, covering a time period beginning within 1 month of the initiation of the COVID‐19 emergency response.
Results
The results of a theory‐informed path model showed that having at least 1 child under the age of 18, greater depression, and lower social connectedness each predicted unique variance in past 30‐day coping motives, which in turn predicted increased past 30‐day alcohol use (controlling for pre‐COVID‐19 alcohol use reported retrospectively). Income loss was associated with increased alcohol use, and living alone was associated with increased solitary drinking (controlling for pre‐COVID‐19 levels), but these associations were not mediated by coping motives. Increased alcohol use, increased solitary drinking, and greater coping motives for drinking were all independently associated with past 30‐day alcohol problems, and indirect paths to alcohol problems from having children at home, depression, social connectedness, income loss, and living alone were all supported.
Conclusions
Findings provide insight into coping‐motivated drinking early in the COVID‐19 pandemic and highlight the need for longitudinal research to establish longer term outcomes of drinking to cope during the pandemic.
Background:
The COVID-19 pandemic has had a significant impact on public mental health. Therefore, monitoring and oversight of the population mental health during crises such as a panedmic is an immediate priority. The aim of this study is to analyze the existing research works and findings in relation to the prevalence of stress, anxiety and depression in the general population during the COVID-19 pandemic.
Method:
In this systematic review and meta-analysis, articles that have focused on stress and anxiety prevalence among the general population during the COVID-19 pandemic were searched in the Science Direct, Embase, Scopus, PubMed, Web of Science (ISI) and Google Scholar databases, without a lower time limit and until May 2020. In order to perform a meta-analysis of the collected studies, the random effects model was used, and the heterogeneity of studies was investigated using the I2 index. Moreover. data analysis was conducted using the Comprehensive Meta-Analysis (CMA) software.
Results:
The prevalence of stress in 5 studies with a total sample size of 9074 is obtained as 29.6% (95% confidence limit: 24.3-35.4), the prevalence of anxiety in 17 studies with a sample size of 63,439 as 31.9% (95% confidence interval: 27.5-36.7), and the prevalence of depression in 14 studies with a sample size of 44,531 people as 33.7% (95% confidence interval: 27.5-40.6).
Conclusion:
COVID-19 not only causes physical health concerns but also results in a number of psychological disorders. The spread of the new coronavirus can impact the mental health of people in different communities. Thus, it is essential to preserve the mental health of individuals and to develop psychological interventions that can improve the mental health of vulnerable groups during the COVID-19 pandemic.
Background:
Synthesis of psychometric properties of substance use measures to identify patterns of use and substance use disorders remains limited. To address this gap, we sought to systematically evaluate the psychometric properties of measures to detect substance use and misuse.
Methods:
We conducted a systematic review and meta-analysis of literature on measures of substance classes associated with HIV risk (heroin, methamphetamine, cocaine, ecstasy, alcohol) that were published in English before June 2016 that reported at least one of the following psychometric outcomes of interest: internal consistency (alpha), test-retest/inter-rater reliability (kappa), sensitivity, specificity, positive predictive value, and negative predictive value. We used meta-analytic techniques to generate pooled summary estimates for these outcomes using random effects and hierarchical logistic regression models.
Results:
Findings across 387 paper revealed that overall, 65% of pooled estimates for alpha were in the range of fair-to-excellent; 44% of estimates for kappa were in the range of fair-to-excellent. In addition, 69, 97, 37 and 96% of pooled estimates for sensitivity, specificity, positive predictive value, and negative predictive value, respectively, were in the range of moderate-to-excellent.
Conclusion:
We conclude that many substance use measures had pooled summary estimates that were at the fair/moderate-to-excellent range across different psychometric outcomes. Most scales were conducted in English, within the United States, highlighting the need to test and validate these measures in more diverse settings. Additionally, the majority of studies had high risk of bias, indicating a need for more studies with higher methodological quality.
Background
The Alcohol Use Disorders Identification Test (AUDIT) is the gold standard in assessing harmful alcohol intake, which is responsible for substantial morbidity and mortality.
Objective
The goal of this study is to evaluate the psychometric properties and factor structure of an Ecuadorian adaptation of a Spanish translation of the AUDIT in a large sample of college students in Ecuador.
Methods
A total of 7905 students, including 46.26% males, and 53.75% females, from 11 universities in Ecuador, were surveyed. The questionnaire was tested for two- and three-factor structures, reliability, and correlations with other health related measures.
Results
The Kaiser-Meyer-Olkin test for sampling adequacy was satisfactory (.0885), and Bartlett´s test for sphericity was significant (p < .001). Although both models showed a good fit to the data, the two-factor model was preferred based on the high correlations between the factors 2 and 3 within the three-factor model (.86 for the total sample, .77 for females, and .91 for males). The reliability for the two-factor model was good, as indicated by Cronbach´s α = .806 (factor I) and .716 (factor II) for the total sample, .808 (factor I) and .667 (factor II) for females, and .787 (factor I) and .728 (factor II) for males. Additionally, the AUDIT scores positively correlated with several health-related measures: stress, psychological inflexibility, loneliness and depression/anxiety symptomatology.
Conclusion
The Ecuadorian adaptation of the Spanish version of the AUDIT has good reliability, and internal consistency and correlates with other health related measures, proving to be a reliable tool that can be used by researchers and clinicians to screen hazardous alcohol intake in college students.
Mental well-being and excessive alcohol consumption each represent a significant public health concern, and evidence suggests an association between them. Furthermore, drinking motivations associated with harmful drinking have been studied, but not systematically in the UK population. A representative sample of 6174 UK adults aged 18–75 were surveyed online. Low risk drinkers were found to have higher mental well-being than hazardous, harmful, and, probable, dependence drinkers. Using a hierarchical multiple regression analysis, it was found that just over 5% of the variance in well-being scores was accounted for by the level of harmful drinking and drinking motivation; the most significant contribution was drinking to cope. Among people drinking to cope, those drinking in more harmful ways were statistically significantly more likely to have low well-being compared to less harmful drinkers. In the UK adult population there is a clear association between poor mental well-being and harmful drinking. Furthermore, coping was a significant motivation to drink for many with low mental well-being. While mental well-being was found to be directly linked with levels of harmful drinking, the motivation for drinking was a stronger predictor of mental well-being.
Background:
The robustness of F-test to non-normality has been studied from the 1930s through to the present day. However, this extensive body of research has yielded contradictory results, there being evidence both for and against its robustness. This study provides a systematic examination of F-test robustness to violations of normality in terms of Type I error, considering a wide variety of distributions commonly found in the health and social sciences.
Method:
We conducted a Monte Carlo simulation study involving a design with three groups and several known and unknown distributions. The manipulated variables were: Equal and unequal group sample sizes; group sample size and total sample size; coefficient of sample size variation; shape of the distribution and equal or unequal shapes of the group distributions; and pairing of group size with the degree of contamination in the distribution.
Results:
The results showed that in terms of Type I error the F-test was robust in 100% of the cases studied, independently of the manipulated conditions.
Presents an integrative theoretical framework to explain and to predict psychological changes achieved by different modes of treatment. This theory states that psychological procedures, whatever their form, alter the level and strength of self-efficacy. It is hypothesized that expectations of personal efficacy determine whether coping behavior will be initiated, how much effort will be expended, and how long it will be sustained in the face of obstacles and aversive experiences. Persistence in activities that are subjectively threatening but in fact relatively safe produces, through experiences of mastery, further enhancement of self-efficacy and corresponding reductions in defensive behavior. In the proposed model, expectations of personal efficacy are derived from 4 principal sources of information: performance accomplishments, vicarious experience, verbal persuasion, and physiological states. Factors influencing the cognitive processing of efficacy information arise from enactive, vicarious, exhortative, and emotive sources. The differential power of diverse therapeutic procedures is analyzed in terms of the postulated cognitive mechanism of operation. Findings are reported from microanalyses of enactive, vicarious, and emotive modes of treatment that support the hypothesized relationship between perceived self-efficacy and behavioral changes. (21/2 p ref)
Objectives. Extending individual planning of health behaviour change to the level of the dyad, dyadic planning refers to a target person and a planning partner jointly planning the target person’s health behaviour change. To date, predictors of dyadic planning have not been systematically investigated. Integrating cognitive predictors of individual planning with four established predictor domains of social support provision, we propose a framework of predictors of dyadic planning. Including target persons’ and partners’ perspectives, we examine these predictor domains in the context of prostate cancer patients’ rehabilitative pelvic floor exercise (PFE) following radical prostatectomy. Design. Longitudinal data from 175 patients and their partners were analysed in a study with four post-surgery assessments across 6 months. Methods. PFE-related dyadic planning was assessed from both partners together with indicators from four predictor domains: context, target person, partner, and relationship factors. Individual planning and social support served as covariates. Results. Findings from two-level models nesting repeated assessments in individuals showed that context (patients’ incontinence), target person (i.e., positive affect and self- efficacy), and relationship factors (i.e., relationship satisfaction) were uniquely associated with dyadic planning, whereas partner factors (i.e., positive and negative affects) were not. Factors predicting patients’ and partners’ accounts of dyadic planning differed. Conclusions. Resembling prior findings on antecedents of support provision in this context, partner factors did not prevail as unique predictors of dyadic planning, whereas indicators from all other predictor domains did. To establish predictive direction, future work should use lagged predictions with shorter intermeasurement intervals.
The Drinking Motives Questionnaire-Revised (DMQ-R; Cooper, 1994) is the most widely used questionnaire to assess drinking motives. This research aimed to adapt and study the validity and reliability of the Spanish DMQ-R and its short form in a sample of adolescents. We assessed 504 drinkers at Time 1 (T1, Mage = 14.15, SD = 0.60, 52.38% female), of whom 238 participated in a 1-year follow-up (T2, Mage = 15.05, SD = 0.54, 58.82% female). They completed the DMQ-R at T1, the alcohol use measure at T1 and T2, and the alcohol-related problems questionnaire at T2. We performed Confirmatory Factor Analyses (CFAs) to test the structure validity of the questionnaire, Cronbach’s alphas to test the internal consistencies of the scales, and path analyses to test the concurrent and predictive validity of motives on alcohol outcomes. CFA indicated that the short form of the 4-factor model best fitted the data. Cronbach’s alphas were .70 or higher. Direct effects of the path analysis showed that social motives cross-sectionally predicted alcohol use, while coping motives prospectively predicted alcohol-related problems. Indirect effects showed that social motives prospectively predicted alcohol use and problems. To conclude, the DMQ-R short form appears to be reliable and valid to assess drinking motives among Spanish adolescents.
Specific personality dimensions may increase susceptibility to alcohol misuse by encouraging motives for drinking that are associated with risky alcohol use. In the current study, we examined associations between personality risk factors (hopelessness (HOP), anxiety sensitivity (AS), sensation seeking (SS), and impulsivity (IMP)) and drinking motives (coping, conformity, enhancement, and social motives) in a sample of high-risk youth receiving child protection services. These personality factors were assessed using the Substance Use Risk Profile Scale (SURPS) and drinking motives were assessed using the Drinking Motives Questionnaire-Revised (DMQ-R). The structural validity of the DMQ-R was first explored in this novel sample of high-risk adolescents using principal components analysis. Correlational analyses showed that HOP and IMP were associated with drinking to cope with negative emotions, and AS was associated with drinking to conform. Unexpectedly, enhancement motives were not related to any of the personality dimensions. This suggests that youth receiving child welfare services who are high in the described personality risk factors drink primarily for negative reinforcement.
a b s t r a c t Specific personality dimensions may increase susceptibility to alcohol misuse by encouraging motives for drinking that are associated with risky alcohol use. In the current study, we examined associations between personality risk factors (hopelessness (HOP), anxiety sensitivity (AS), sensation seeking (SS), and impulsivity (IMP)) and drinking motives (coping, conformity, enhancement, and social motives) in a sample of high-risk youth receiving child protection services. These personality factors were assessed using the Substance Use Risk Profile Scale (SURPS) and drinking motives were assessed using the Drink-ing Motives Questionnaire-Revised (DMQ-R). The structural validity of the DMQ-R was first explored in this novel sample of high-risk adolescents using principal components analysis. Correlational analyses showed that HOP and IMP were associated with drinking to cope with negative emotions, and AS was associated with drinking to conform. Unexpectedly, enhancement motives were not related to any of the personality dimensions. This suggests that youth receiving child welfare services who are high in the described personality risk factors drink primarily for negative reinforcement.
This study adapted and extended M. L. Cooper's (1994) Drinking Motives Measure to examine marijuana motives among 299 college students. An exploratory factor analysis supported the hypothesized 5-factor marijuana motives model, resulting in enhancement, conformity, expansion, coping, and social motives. Analyses supported the internal consistency and concurrent validity of the 5 marijuana motives. Marijuana motives were significant predictors of marijuana use and added to the prediction of use-related problems above and beyond the contribution of lifetime use. Motives and gender interacted in predicting use and use-related problems. Parallel regression analyses revealed that marijuana and alcohol motives predicted comparable amounts of variance in use and use-related problems. However, different patterns of relations emerged across drugs, supporting the discriminant validity of the marijuana and alcohol motives. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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)
We integrated research on emotion and on small groups to address a fundamental and enduring question facing alcohol researchers: What are the specific mechanisms that underlie the reinforcing effects of drinking? In one of the largest alcohol-administration studies yet conducted, we employed a novel group-formation paradigm to evaluate the socioemotional effects of alcohol. Seven hundred twenty social drinkers (360 male, 360 female) were assembled into groups of 3 unacquainted persons each and given a moderate dose of an alcoholic, placebo, or control beverage, which they consumed over 36 min. These groups' social interactions were video recorded, and the duration and sequence of interaction partners' facial and speech behaviors were systematically coded (e.g., using the facial action coding system). Alcohol consumption enhanced individual- and group-level behaviors associated with positive affect, reduced individual-level behaviors associated with negative affect, and elevated self-reported bonding. Our results indicate that alcohol facilitates bonding during group formation. Assessing nonverbal responses in social contexts offers new directions for evaluating the effects of alcohol.
This chapter describes the development of the Alcohol Use Disorders Identification Test (AUDIT) among various Mexican populations,
the evaluations that followed the World Health Organization international research project from where this screening instrument
was derived, its use in nonclinical settings, modifications introduced in its wording, the development of a short version,
and validity and reliability tests. It also describes rates of hazardous, harmful, and dependent drinkers and biobehavioral
consequences of abuse among various Mexican populations. Data drawn from different samples showed adequate levels of specificity
and sensitivity. Findings from general population samples confirmed previous observations in general practice: That the AUDIT
could capture not only regular consumption at hazardous levels, but also episodic heavy drinking. Data from an International
Labor Office/World Health Organization project on model programs for alcohol prevention in the workplace showed that it was
possible to derive a short version, easily used for intervention programs, that differentiated categories of drinkers at various
risk levels. Rates of problem drinkers in clinical samples varied between 28 and 43% for males and 3.6 and 4.8% among females.
Hazardous drinking varied between 0.7 and 15.5% among males and females in general populations and reached 44% in a sample
of male workers; in clinical settings, harmful drinking ranged from 7 to 16% among males and dependence from 3 to 10%.
The screening and brief intervention modality of treatment for at-risk college drinking is becoming increasingly popular. A key to effective implementation is use of validated screening tools. Although the Alcohol Use Disorders Identification Test (AUDIT) has been validated in adult samples and is often used with college students, research has not yet established optimal cutoff scores to screen for at-risk drinking. Four hundred and one current drinkers completed computerized assessments of demographics, family history of alcohol use disorders, alcohol use history, alcohol-related problems, and general health. Of the 401 drinkers, 207 met criteria for at-risk drinking. Receiver operating characteristic (ROC) curve analysis revealed that the area under the ROC (AUROC) of the AUDIT was .86 (95% CI [.83, .90]). The first 3 consumption items of the AUDIT (AUDIT-C; AUROC = .89, 95% CI [.86, .92]) performed significantly better than the AUDIT in the detection of at-risk drinking in the whole sample, and specifically for females. Gender differences emerged in the optimal cutoff scores for the AUDIT-C. A total score of 7 should be used for males, and a score of 5 should be used for females. These empirical guidelines may enhance identification of at-risk drinkers in college settings. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
This paper had three aims: (1) to validate a Spanish adaptation of the Modified Drinking Motives Questionnaire-Revised (M DMQ-R), (2) to explore the relationship of each drinking motive with different patterns of alcohol use, and (3) to compare the drinking motives of moderate drinkers, heavy drinkers, and alcohol abusing/dependent individuals.
Two studies were carried out. In Study 1, a sample of 488 participants completed the M DMQ-R and a self-report scale of alcohol consumption in order to study the factor structure and different indices of reliability and validity of the Spanish M DMQ-R. In Study 2, we compared the drinking motives of moderate and heavy drinkers from Study 1 and an additional sample of 59 clinical drinkers.
The M DMQ-R demonstrated sound reliability and validity indices. Coping-with-anxiety, social, and enhancement motives predicted higher alcohol use on weekends, but only coping-with-anxiety and social motives were related to consumption on weekdays. Furthermore, moderate drinkers had the lowest scores for all motives, whereas alcohol-dependent participants obtained the highest scores for negative reinforcement drinking motives.
The Spanish M DMQ-R is a reliable and valid measure of drinking motives and has potential for assisting with treatment planning for problem drinkers.
The present study was designed to investigate motivational patterns for drinking alcohol and their relation about alcohol consumption and problems related to alcohol consumption. Data were collected by semistructured interviews and questionnaires, containing questions about reasons for drinking, alcohol consumption, and problems related to alcohol consumption during the years 2001, 2004, and 2005. Three independent population samples from two different counties of central Sweden were included. A total of 11,167 adolescents participated. Data on reasons for drinking were analyzed by factor analysis to extract components explaining drinking motives. Relationships between motivational patterns and alcohol use were examined with correlation analysis. Three drinking motives emerged (social-enhancement, coping, and dominance motives) and related to alcohol consumption and problems related to alcohol consumption. Limitations of the study are noted and discussed.
The Alcohol Use Disorders Identification Test (AUDIT) is an instrument used to screen for alcohol-related problems. It has been increasingly used in many different countries in both the original English-language version and its many translated versions. Because of the need for screening instruments of faster administration, shortened versions of the AUDIT have also been developed. This study was aimed at expanding the work by Berner and colleagues (2007) in an attempt to answer some remaining questions as well as to identify and evaluate studies on the validation of modified versions of the AUDIT, which have not been previously analyzed. In order to do so, we identified indexed articles published between 2002 and 2009 related to the psychometric qualities of the AUDIT by matching the keywords: alcohol, Alcohol Use Disorders Identification Test, and AUDIT. We found 47 articles that evaluated the AUDIT in different countries and in diverse health and community contexts, involving adolescent, adult, and elderly samples. The studies confirmed the validity and efficiency of the AUDIT in the identification of harmful use, abuse, and dependence of alcohol, both in the original version and in modified ones. The possibility of using brief and efficient versions is of great value, since certain health contexts demand faster assessment. The results also showed that the reduced versions have satisfactory psychometric qualities, sometimes with sensitivity values higher than those of the AUDIT itself. The studies analyzed confirm the efficiency of the AUDIT both in its original, reduced, and language-adapted versions in different contexts and cultures.
The incentive-sensitization theory (IST) of addiction was first published in 1993, proposing that ( a ) brain mesolimbic dopamine systems mediate incentive motivation (“wanting”) for addictive drugs and other rewards, but not their hedonic impact (liking) when consumed; and ( b ) some individuals are vulnerable to drug-induced long-lasting sensitization of mesolimbic systems, which selectively amplifies their “wanting” for drugs without increasing their liking of the same drugs. Here we describe the origins of IST and evaluate its status 30 years on. We compare IST to other theories of addiction, including opponent-process theories, habit theories of addiction, and prefrontal cortical dysfunction theories of impaired impulse control. We also address critiques of IST that have been raised over the years, such as whether craving is important in addiction and whether addiction can ever be characterized as compulsive. Finally, we discuss several contemporary phenomena, including the potential role of incentive sensitization in behavioral addictions, the emergence of addiction-like dopamine dysregulation syndrome in medicated Parkinson's patients, the role of attentional capture and approach tendencies, and the role of uncertainty in incentive motivation.
Background
Although evidence suggests substance and alcohol use may change during the Covid-19 pandemic there has been no full review of the evidence around this.
Methods
A systematic review of all available evidence was carried out to document and interpret the frequency and severity of alcohol and other substance use during the Covid-19 pandemic and their relationship to demographic and mental health variables that may suggest further clinical implications. Peer reviewed articles in MEDLINE, Embase, PsycINFO, CINAHL complete and Sociological Abstracts were searched from December 2019 until November 2020.
Results
The search and screening identified 45 articles from 513 deduplicated records. The evidence suggests a mixed picture for alcohol use. Overall, there was a trend towards increased alcohol consumption. The proportion of people consuming alcohol during the pandemic ranged from 21.7% to 72.9% in general population samples. Unlike alcohol use, there was a clear trend towards increased use of other substances use during the COVID-19 pandemic. The proportion of people consuming other substances during the pandemic ranged from 3.6% to 17.5% in the general population. Mental health factors were the most common correlates or triggers for increased use of both alcohol and other substances.
Conclusion
There is an increased need for treatment for alcohol and other substance use related problems during the pandemic. Increased targeting and evidence-based interventions will also be important in the period which follows this pandemic, to improve the quality of life for individuals and families, but also to prevent additional costs to society and health systems.
There are some concerns regarding alcohol use behaviors during the COVID-19 pandemic. The mixed findings of the first alcohol use studies during this pandemic may reflect the lack of differentiation between on-premise and home consumption. Most of the countries adopted severe restrictions on drinking place functioning. Alcohol retail store sales temporal data was used to examine alcohol sales changes in the U.S. throughout the COVID-19 pandemic as a proxy indicator of at-home drinking. Data was sourced from the Monthly Retail Trade Survey, which provides U.S. representative estimates of sales at retail and food services stores since 1951. In the present study, we analyzed data from seasonally adjusted beer, wine, and liquor store sales from January 1992 to September 2020. Poisson cubic spline models were used to assess nonlinearity in such sales during the period. These models were adjusted to the consumer price index for alcoholic beverages. There was a significant increase in retail alcohol sales during the beginning of the pandemic, reaching a plateau in the third quarter of this year. During the COVID-19 period (March 2020 to September 2020), there were 41.9 billion dollars in BWLS sales, representing an increase of 20% compared to the same period in 2019. On the other hand, food and drinking place retail sales decreased by 27% during the same period in the same survey. These results may indicate an increase in home drinking during the period, which could potentially lead to higher alcohol consumption and alcohol-related adverse health outcomes. More aggressive efforts should be made to warn the population about the risks associated with increased home alcohol consumption during the pandemic. Additionally, tracking individual alcohol consumption and releasing real-time data at different levels are needed to better assess the effects of increased alcohol consumption during the pandemic.
An online survey among French-speaking Belgians (N=7711) investigated self-reported changes in alcohol consumption during the first COVID-19-related lockdown (March 17th – May 4th 2020). Population-weighted estimates indicated that 31.37% of the population increased consumption during lockdown, 30.32% decreased consumption and 38.31% reported unchanged consumption. The magnitude of change was higher for “decreasers” than “increasers”, resulting in a slight reduction in overall consumption. A multiple regression analysis revealed that age, occupational status, number of cohabitants, perceived alcohol accessibility, drinking motivations and previous consumption predicted consumption changes. The lockdown was thus associated with consumption modifications among French-speaking Belgians, without prevailing direction of change.
Background: The coronavirus disease-2019 (COVID-19) pandemic has disrupted life around the globe and has the potential to seriously impact alcohol consumption for individuals experiencing social isolation and pandemic-related stress. Evidence from prior epidemics suggests increased alcohol consumption during quarantine and times of high stress are associated with a greater chance of developing an alcohol use disorder (AUD). This study examines alcohol sales data to ascertain how individuals are interacting with alcohol during the pandemic.
Materials and method: Monthly off premises alcohol sales data for select US alcoholic beverage control states were used to construct monthly sales patterns from 2015 to 2020. An independent samples t-test was used to determine if COVID-19 era alcohol sales were higher than those that occurred from 2015 to 2019.
Results: Alcohol sales from March to August 2020 were significantly higher than sales from the same span of months from 2015 to 2019 (t=–2.47, p<.05). The associated monthly percentage increase in sales ranged from 14 to 44% with the overall trend indicating a move toward pre-pandemic sales totals.
Conclusion: As COVID-19 continues to disrupt typical ways of being across the globe, the implications of increased sales of alcohol should not be overlooked. Taken together, the evidence on increased use during isolation and later AUD diagnosis coupled with the ABC state sales figures here, point to a potential increase in the development of AUD and an increase in alcohol-related harms.
The global ‘lockdowns’ and social distancing measures triggered by the COVID-19 pandemic have brought about unprecedented social changes, including the sudden, temporary closure of licensed venues and significant modifications to leisure and drinking practices. In this piece, we argue that these changes invite researchers to consider the short and longer-term consequences in terms of continuities and changes to the practices and symbolism of alcohol consumption both within and beyond domestic spaces. We do this by drawing on illustrations from our emergent qualitative research involving internet-mediated semi-structured interviews and focus groups with 20 participants from the UK (aged 26–65) concerning experiences of drinking in and beyond ‘lockdown’. In sharing these early findings, we hope to highlight themes relevant to understanding drinking behaviour during the COVID-19 pandemic and to stimulate dialogue for immediate research priorities in this area. Key topic areas in our data appear to concern; variability in heavy/moderate/light/non-drinking practices while drinking at home, lockdown as an opportunity to reassess relationships with alcohol, and the symbolic role of alcohol in internet-mediated communications and interactions. Longstanding policymaker and practitioner concerns with managing public drinking and public order may have been unsettled by a growth in home-based drinking, although, as we argue, such changes were in motion before the global pandemic. We propose that a greater understanding of the challenges and opportunities the pandemic presents for (re)negotiating relationships with alcohol may offer wider lessons around how individuals and communities might be supported via innovative policy measures to change their relationships with alcohol both during and beyond lockdown.
This cohort study characterizes emergent trends in overdose-related cardiac arrests in the US during the coronavirus disease 2019 (COVID-19) pandemic using a large, national emergency medical services database.
Introduction:
The Alcohol Use Disorders Identification Test (AUDIT) is an internationally well-established screening tool for the assessment of hazardous and harmful alcohol consumption. To be valid for group comparisons, the AUDIT should measure the same latent construct with the same structure across groups. This is determined by measurement invariance. So far, measurement invariance of the AUDIT has rarely been investigated. We analyzed measurement invariance across gender and samples from different settings (i.e., inpatients from general hospital, patients from general medical practices, general population).
Methods:
A sample of n = 28,345 participants from general hospitals, general medical practices and the general population was provided from six studies. First, we used Confirmatory Factor Analysis (CFA) to establish the factorial structure of the AUDIT by comparing a single-factor model to a two-factor model for each group. Next, Multiple Group CFA was used to investigate measurement invariance.
Results:
The two-factor structure was shown to be preferable for all groups. Furthermore, strict measurement invariance was established across all groups for the AUDIT.
Conclusion:
A two-factor structure for the AUDIT is preferred. Nevertheless, the one-factor structure also showed a good fit to the data. The findings support the AUDIT as a psychometrically valid and reliable screening instrument.
Introduction and aims:
This study tested the measurement invariance of the Drinking Motives Questionnaire-Revised Short Form (DMQ-R-SF) in undergraduates across 10 countries. We expected the four-factor structure to hold across countries, and for social motives to emerge as the most commonly endorsed motive, followed by enhancement, coping and conformity motives. We also compared individualistic and collectivistic countries to examine potential differences in the endorsement of drinking motives when countries were divided according to this broad cultural value.
Design and methods:
A sample of 8478 undergraduate drinkers from collectivistic (Portugal, Mexico, Brazil, Spain; n = 1567) and individualistic (Switzerland, Hungary, Canada, the Netherlands, the UK and Ireland, and the USA; n = 6911) countries completed the DMQ-R-SF. Countries were classified as individualistic or collectivistic based on world-wide norms.
Results:
Using multigroup confirmatory factor analysis, the 4-factor model of the DMQ-R-SF showed configural and metric invariance across all 10 countries. As predicted, the rank order of undergraduates' drinking motive endorsement was identical across countries (social > enhancement > coping > conformity), although a mixed model analysis of variance revealed a significant interaction where undergraduates from individualistic countries more strongly endorsed social and enhancement motives relative to undergraduates from collectivistic countries.
Discussion and conclusions:
There was broad cross-cultural consistency in the factor structure and mean patterns of drinking motives. Undergraduate students appear to drink mainly for positive reinforcement (i.e. for social and enhancement reasons), although this tendency is particularly pronounced among those from more individualistic countries. [Mackinnon SP, Couture M-E, Cooper ML, Kuntsche E, O'Connor RM, Stewart SH, and the DRINC Team. Cross-cultural comparisons of drinking motives in 10 countries: Data from the DRINC project.
The present study aimed to evaluate the invariance of the factor structure of the Drinking Motives Questionnaire Revised (DMQ-R) between Portuguese and US university students. Following tests of factor model invariance we further evaluated cross-cultural differences in (1) mean levels of the four motives, and (2) the association of the four motives with weekly drinking, peak drinking, and binge drinking among college students from the United States and Portugal. Participants were 983 undergraduate students (67% female) from the US (N=515) and Portugal (N=468). Participants completed a confidential online (US) or paper and pencil (Portugal) survey. Results of a CFA demonstrated that the four-factor model of the DMQ-R was invariant with respect to factor loadings, factor variances, and factor covariances across the two countries. Mean differences in ratings of drinking motives were found, with US students ranking all motives higher than Portuguese students. However, rank order of motives (social>enhancement>coping>conformity) were equivalent across countries. Support for convergent validity was demonstrated by significant associations between drinking motives and alcohol consumption for men and women of both samples. Results support the factorial invariance and convergent validity of the DMQ-R across US and Portuguese college students, making it a trustworthy means of assessing college students' drinking motives, and a useful instrument for clinical and research purposes, both within and across cultures.
The purpose of the present study was to place drinking motives within the context of the Five-Factor Model of personality. Specifically, we sought to determine whether certain personality domains and facets of the Revised NEO Personality Inventory (NEO-PI-R) predict Enhancement, Coping, Social, and/or Conformity drinking motives from the Revised Drinking Motives Questionnaire (DMQ-R). A sample of 256 university student drinkers (M age =21.3 years) completed the NEO-PI-R and DMQ-R. In bivariate correlations, the two negative reinforcement motives (Coping and Conformity) were positively correlated with Neuroticism and negatively correlated with Extraversion. The two positive reinforcement motives (Enhancement and Social) were positively correlated with Extraversion and negatively correlated with Conscientiousness. Multiple regression analyses revealed that personality domain scores predicted two of the four drinking motives (i.e. the internal drinking motives of Coping and Enhancement), after controlling for the influences of alternative drinking motives. Enhancement Motives were predicted by high Extraversion and low Conscientiousness, and Coping Motives by high Neuroticism. Supplementary correlational analyses involving certain personality facet scores revealed that the depression and self-consciousness facets of the Neuroticism domain were positively correlated with residual Coping and Conformity Motives, respectively, and that the excitement-seeking and gregariousness facets of the Extraversion domain were positively correlated with residual Enhancement and Social Motives, respectively. These results provide further validation of Cox and Klinger’s 2×2 (valence [positive vs negative reinforcement]×source [internal vs external]) model of drinking motivations, and confirm previous speculations that drinking motives are distinguishable on the basis of personality domains and facets. Understanding the relations between personality and drinking motives may prove useful in identifying young drinkers whose drinking motivations may portend the development of heavy and/or problem drinking.
Background:
In the motivational model of alcohol use, there are two dimensions underlying the classification of drinking motives resulting in four drinking motive categories: enhancement, social, coping, and conformity motives.
Methods:
Using confirmatory factor analysis, the current study provides evidence on the best fitting factor structure in a large representative general population study among adults in the Netherlands (n = 2,440; two data waves separated by 3 months) using the DMQ-R (Drinking Motives Questionnaire Revised).
Results:
The four-factor structure had the best fit at both time points in comparison with any other solution. Test-retest reliabilities indicate individual motive change in level over time, but not in terms of the four-factor structure.
Conclusion:
The results replicate and extend previous findings among adolescents, in line with the motivational model of alcohol use, and suggest the utility of using the DMQ-R in future studies on adults' drinking motives.
The present study investigated relations of anxiety sensitivity and other theoretically relevant personality factors to Copper's [Psychological Assessment 6 (1994) 117.] four categories of substance use motivations as applied to teens' use of alcohol, cigarettes, and marijuana. A sample of 508 adolescents (238 females, 270 males; mean age=15.1 years) completed the Trait subscale of the State-Trait Anxiety Inventory for Children, the Childhood Anxiety Sensitivity Index (CASI), and the Intensity and Novelty subscales of the Arnett Inventory of Sensation Seeking. Users of each substance also completed the Drinking Motives Questionnaire-Revised (DMQ-R) and/or author-compiled measures for assessing motives for cigarette smoking and marijuana use, respectively. Multiple regression analyses revealed that, in the case of each drug, the block of personality variables predicted “risky” substance use motives (i.e., coping, enhancement, and/or conformity motives) over-and-above demographics. High intensity seeking and low anxiety sensitivity predicted enhancement motives for alcohol use, high anxiety sensitivity predicted conformity motives for alcohol and marijuana use, and high trait anxiety predicted coping motives for alcohol and cigarette use. Moreover, anxiety sensitivity moderated the relation between trait anxiety and coping motives for alcohol and cigarette use: the trait anxiety–coping motives relation was stronger for high, than for low, anxiety sensitive individuals. Implications of the findings for improving substance abuse prevention efforts for youth will be discussed.
This paper presents a biopsychological theory of drug addiction, the ‘Incentive-Sensitization Theory’. The theory addresses three fundamental questions. The first is: why do addicts crave drugs? That is, what is the psychological and neurobiological basis of drug craving? The second is: why does drug craving persist even after long periods of abstinence? The third is whether ‘wanting’ drugs (drug craving) is attributable to ‘liking’ drugs (to the subjective pleasurable effects of drugs)? The theory posits the following.
To check the validity of the Alcohol Use Disorders Identification Test (AUDIT) among Spanish adult citizens.
This is a descriptive observational study. The surveyed group comprised patients aged 18-80 years who went to their doctors' surgeries at two primary care centres located in Cordoba (Spain). We examined the psychometric properties of AUDIT and its capacity to correctly diagnose alcohol abuse or dependence, as defined by DSM-IV, ICD-10, and hazardous drinking.
Six hundred and fourteen patients were studied (mean age 43+/-1.43 years). At a cut-off value of 7 points, the sensitivity of AUDIT in detecting hazardous drinking was 91.7%, and its specificity 91.9%; the area below the curve was 0.95 (95% confidence interval [CI] 0.937-0.975). To detect possible dependence, the optimum cut-off value was 6 points. According to ICD-10, sensitivity was 81.6%, specificity 82.3%, and the area under the curve 0.885 (95% CI 0.848-0.923; p<0.001), whereas according to DSM-IV criteria, sensitivity was 88.3%, specificity 83.1%, and the area under the curve 0.918 (95% CI 0.885-0.951).
The high criterion-related validity of AUDIT was proven, regardless of the gold standard used.