The Indirect Effect of Distress Tolerance on Young Adult Alcohol Use Behaviors via Coping Motives

Brief online negative affect focused functional imagery training (FIT) improves four-week drinking outcomes in hazardous student drinkers: A pilot randomised controlled trial replication in South Africa

Background

Previous study has shown that functional imagery training (FIT) to utilise positive mental imagery in response to negative affect could improve alcohol-related outcomes. The current study aimed to replicate whether this negative affect focused FIT would improve alcohol-related outcomes in hazardous student drinkers in South Africa at four-week follow-up.

Methods

50 hazardous student drinkers who reported drinking to cope with negative affect were randomised into two groups. The active group (n = 25) was trained online over two weeks to respond to personalised negative drinking triggers by retrieving a personalised adaptive strategy they might use to mitigate negative affect, whereas the control group (n = 25) received standard risk information about binge drinking. Outcome measures including alcohol consumption, drinking motives, anxiety and depression, self-efficacy and use of protective behavioural strategies were obtained at baseline and four-week follow-up.

Results

FIT effects were revealed by three significant group-by-timepoint interactions in a per-protocol analysis: there was a significant decrease in depressive symptoms, drinking to cope and drinking for social reasons from baseline to follow-up in the active group, but not the control group. No effects were observed on alcohol consumption, self-efficacy, protective behaviour strategies and anxiety.

Conclusions

Preliminary evidence supports that online negative affect focused FIT can improve depression as well as coping and social drinking motives in South African hazardous student drinkers who drank to cope, at four-week follow-up, suggesting that the principles of this FIT approach might be adapted and incorporated into a clinical intervention to test for efficacy in mitigating substance use problems.

Distress tolerance, coping motives, and alcohol craving and consumption: Two experiments testing momentary responses to a mood induction

BACKGROUND

The current studies examined the relationship between state and trait distress tolerance (DT), drinking-related variables (alcohol craving and consumption), and the moderating role of drinking to cope with negative affect (i.e., coping motives).

METHODS

Study 1 was a laboratory-based experiment. Participants (n=71) completed measures of trait DT, craving, coping motives, and affect valence prior to a negative mood induction task. Post-mood induction, participants completed measures of affect valence, alcohol craving, and state DT. Next, participants completed an alcohol taste task, measuring alcohol consumption. Study 2 was completed online. Participants (n=592) completed the same pre- and post-mood induction measures as study 1, but were randomized to a mood condition (neutral, negative, or positive). Study 2 did not include alcohol consumption.

RESULTS

Negative mood induction lowered reported affect in both studies. In study 1, higher coping motives predicted increased craving in response to negative mood induction but state and trait DT did not predict craving change alone. Contrary to our hypothesis, individuals with higher coping motives showed a positive relationship between trait DT and craving. Analyses predicting alcohol consumption were not significant. In study 2, lower trait DT predicted post-mood induction craving prior to inclusion of interactions in the model. Higher coping motives were the strongest and most consistent predictor of craving. Other predictors (state DT, mood condition) and interaction terms were not significant.

CONCLUSIONS

Findings broadly align with previous research suggesting that coping motives are predictive of craving and indicate that trait DT may also impact craving.

Drinking motives as a predictor of readiness to change alcohol use

Drinking motives have been identified as important predictors of alcohol consumption. Similarly, the degree of readiness to change (RTC) can predict behavioral changes when drinking alcohol. However, the link between drinking motives and RTC has not been explored in previous research. The aim of this study is to investigate whether the four drinking motives (coping, enhancement, social, conformity) can predict the three stages of RTC (precontemplation, contemplation and action) in relation to alcohol consumption. Two hundred and fifty-two undergraduates’ students completed an online self-assessment survey on Qualtrics that assessed motives for alcohol use, drinking behavior, and RTC. Hierarchical regressions showed that among the four specific drinking motives, coping motives significantly predicted all three stages of RTC; conformity motives positively predicted the action stage of change; social motives negatively predicted the precontemplation and action stages of change; enhancement motives were not significant in predicting RTC stages. These results indicate that the three RTC levels can be predicted by coping, social, and conformity motives, but not by enhancement motives. Additionally, given the importance of coping motives, it might be useful to address and include healthier coping mechanisms as part of clinical interventions and prevention methods to circumvent unsafe drinking behaviors independent of a single RTC stage.

The relationship between distress tolerance and symptoms of depression: Validation of the Distress Tolerance Scale (DTS) and short-form (DTS-SF)

OBJECTIVE

Distress tolerance (DT) has been found to be implicated in the development and maintenance of depressive symptomatology and various other significant psychological conditions. As such, it is critical to have measures of DT that are effective and easy to administer. This study aimed to examine the factor structure, psychometric properties, and clinical utility of the Distress Tolerance Scale (DTS) and the short-form version, the Distress Tolerance Scale Short-form (DTS-SF), in a large population of individuals with varying levels of self-reported depressive symptoms.

METHOD

A total of 959 participants completed an online battery of questionnaires which included an assessment of depressive symptoms as well as the DTS and related measures. Results: Confirmatory factor analyses validated the four-factor structure of the DTS and the one-factor structure of the DTS-SF. Good construct validity and good internal consistency were observed across both the DTS and DTS-SF.

CONCLUSION

Overall, this paper provides new evidence for the validity, reliability and discriminative ability of the DTS and the brief version of the questionnaire, the DTS-SF.

The Association between Distress Tolerance and Alcohol Outcomes via Internal Drinking Motives

Previous work suggests that college students who perceive themselves as less able to tolerate negative affect are more motivated to use alcohol to alleviate psychological distress. Recent findings also indicate that distress tolerance influences alcohol outcomes via a positive reinforcement pathway. However, results concerning the association between distress tolerance and alcohol outcomes remain inconsistent. Aim: The present study examined the association between distinctive features of distress tolerance and alcohol outcomes via internal drinking motives (i.e., coping and enhancement) in Argentinean college students. Method: From April to November 2019, a sample of 387 college students with last-month alcohol use (Mean age = 21.09 ± 4.98) completed an online survey assessing alcohol outcomes (past-month frequency of binge drinking and negative alcohol-related consequences), internal drinking motives, and four components of distress tolerance (i.e., tolerance, appraisal, absorption, and regulation). Results: The associations between specific facets of distress tolerance and drinking outcomes were atemporally mediated by coping and enhancement motives. Coping motives significantly mediated the effect of absorption and appraisal on alcohol-related problems (i.e., lower absorption and lower appraisal were associated with more problems via higher coping motives). Enhancement motives significantly mediated the effect of absorption (lower absorption was associated with greater enhancement motives) on binge drinking frequency and alcohol-related problems. Conclusions: Distress tolerance was associated with alcohol outcomes via coping and enhancement motives in this sample of Argentinean undergraduates. The ability to withstand negative affect could be a focal point of interventions to prevent the development of maladaptive patterns of drinking.