The Role of Psychological Distress in the Relationship between Drinking Motives and Hazardous Drinking in Older Adults

Addictive behaviors in older adults: The role of psychopathological symptoms, health, purpose in life, and loneliness

BACKGROUND AND OBJETIVES

This study explored addictive behaviors, including both substance use and behavioral addictions. Specifically, we examined the predictive role of psychopathological symptoms, health, loneliness, and purpose in life in addictive behaviors, as well as analyzing gender differences in the variables studied.

METHOD

The sample comprises 100 individuals over 60 (Mage=69.1; SD=6.7; 52% men). Multiple linear regression analyses were conducted to examine predictors of addictive behaviors, and t-tests to analyze gender differences.

RESULTS

Psychopathological symptoms were identified as a risk factor for problematic alcohol and substance use (β between -.392 and .877). Additionally, psychopathological symptoms (β between .314 and .432) and mental health were both significant predictors of compulsive buying (β=-.579). Women exhibited higher scores in psychopathological symptoms (p≤.015), while men showed higher levels of physical and mental health (p≤.022).

CONCLUSION

Understanding the risk factors associated with addictive behaviors in older adults is crucial to increasing public awareness of these problems and to improving early detection and effective management of addictions in this demographic group.

Age-Related Motives for Substance Use and Outcomes Among Veteran Patients Receiving Detoxification Services: A Longitudinal Study

OBJECTIVES

Study objectives were to examine (1) baseline differences in substance use motives (social, coping, enhancement, and physical discomfort) among older, middle-aged, and younger adults, and (2) whether age group moderated associations between substance use motives at baseline and substance use outcomes at six-month follow-up.

DESIGN

Participants were assessed at baseline and followed for six months (91.1%).

SETTING

U.S. military veterans receiving alcohol and/or opioid detoxification services.

PARTICIPANTS

298 participants in a study of telephone monitoring to improve detoxification outcomes.

MEASUREMENTS

Baseline substance use motives were measured using the Motives for Alcohol and Drug Use questionnaire. At baseline and 6-month follow-up, substance use, substance use risk, and substance use protection were measured using the Brief Addiction Monitor.

RESULTS

One-way analyses of variance with post-hoc tests found that older adults endorsed significantly lower social and coping motives for substance use than younger and middle-aged adults, and significantly lower enhancement motives than younger adults. Moderation models were analyzed using linear regression, with demographics controlled. Significant interactions of motives with age group revealed that higher endorsement of enhancement motives for substance use was associated with less protection against substance use among older adults but not among younger or middle-aged adults.

CONCLUSIONS

Enhancement motives among older adults may represent a specific age-related risk for substance use. Older adults who use substances to enhance their mood and well-being may need additional resources and skills for improving mental health so that unhealthy substance use is reduced or avoided.

Drinking and mental health in middle adulthood: exploring the impact of wellbeing, mental health literacy, and drinking motives on risk of alcohol dependence

OBJECTIVES

Risky drinking is a concern among UK-based middle-aged adults. We aimed to explore the relationship between risky drinking, drinking motives, wellbeing, and mental health literacy (MHL).

METHOD

Cross-sectional analysis of online survey data completed by 193 UK-based adults aged 40-65 who drank alcohol, incorporating the Alcohol Use Disorders Identification Test (AUDIT); Drinking Motives Questionnaire-Revised (DMQ-R); Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS); Mental Health Literacy Scale (MHLS) and demographic questions.

RESULTS

Coping, enhancement and conformity motives and gender significantly predicted higher AUDIT scores (measuring risky drinking). Enhancement motives were found to mediate the relationship between the self-help component of MHL and AUDIT scores, while coping motives mediated the association between wellbeing and AUDIT scores.

CONCLUSION

Findings support research emphasising the influence of drinking motives on risky drinking and highlights how low wellbeing may interact with coping motives to explain risky drinking among middle-aged adults, particularly men. Interventions supporting individuals to understand the relationship between drinking motives and risky drinking, develop adaptive coping strategies, and address the causes of low wellbeing, may be beneficial. However, as the sample was 84% ethnically White, 64% women, 85% educated to at least undergraduate level, and reported a relatively high mean socioeconomic status (6.98 out of 10), the results may not generalise beyond these groups. Future research should use stratified sampling to increase generalisability, as well as exploring whether alcohol-specific, component-specific, or disorder-specific MHL is associated with risky drinking and wellbeing.

Individualized treatment effects of a digital alcohol intervention and their associations with participant characteristics and engagement

AIMS

Conditional average treatment effects are often reported in intervention studies, in which assumptions are made regarding how effects are similar across a heterogeneous sample. Nonetheless, differing factors, such as genetics, age, and sex, can impact an intervention's effect on outcomes. The study aimed to estimate the individualized effects of a digital alcohol intervention among individuals looking online to reduce their drinking.

METHODS

We used data from a randomized controlled trial (RCT), including 2129 adults from the Swedish general population. The RCT concerned a text message-based alcohol intervention that sought to engender change through increasing knowledge on how to change and instilling confidence in changing behaviour. Outcomes were total weekly alcohol consumption and monthly heavy episodic drinking. Individualized treatment effects were modelled using baseline characteristics (age, gender, alcohol consumption, and psychosocial variables) and engagement with the intervention content.

RESULTS

We found evidence that the effects of the digital alcohol intervention were heterogeneous concerning participants' age, baseline alcohol consumption, confidence, and importance. For heavy episodic drinking, there was evidence that effects were heterogeneous concerning age, sex, and baseline alcohol consumption. Overall, women, older individuals, and heavier drinkers benefitted more from the intervention in terms of effect size. In addition, participants who engaged more with the goal-setting and screening content reported better outcomes.

CONCLUSIONS

The results highlight how different individuals respond differently to a digital alcohol intervention. This allows insight into who benefits the most and least from the intervention and highlights the potential merit of designing interventions adapted to different individuals' needs.

Development and Validation of the Maternal Drinking Motives Scale (M-DMS)

BACKGROUND

Alcohol use is a gendered behavior and motherhood is a life stage which may influence drinking motives. However, there are no drinking motive scales uniquely tailored to maternal populations. This work developed a new maternal drinking motives scale (M-DMS) and determined associations between the M-DMS and alcohol-related behavior.

METHODS

An online observational survey (n = 534) and online test-retest survey (n = 164) were conducted with adult, UK mothers. From the observational study, data on drinking motives was extracted to determine M-DMS items and factor loading. This was split into two data sets for exploratory and confirmatory factor analyses. Alcohol Use Disorders Identification Test (AUDIT) and Timeline Follow back data, taken from both surveys, were combined to determine the M-DMS's predictive validity.

RESULTS

Following a parallel analysis and exploratory factor analysis, a two-factor model (positive reinforcement motives, negative reinforcement motives) was deemed the best fit. Probability functional analysis identified items with problematic responses. These were removed before confirmatory factor analysis (on the second dataset) demonstrated a good fit for the two-factor model. All factor loadings were significant and positive (βs > 0.56). Reliability of the two subscales was excellent: negative reinforcement (ωT = 0.95), positive reinforcement (ωT = 0.89). Test-retest reliability was good for both negative (ICC = 0.84, 95%CI = 0.80-0.88) and positive (ICC = 0.77, 95% CI = 0.71-0.82) subscales. Both subscales predicted AUDIT and quantity of alcohol consumption (ps < 0.001).

CONCLUSION

The first tailored Maternal Drinking Motives Scale (M-DMS) provides a more valid research tool for assessing psychological mechanisms of alcohol use in mothers.

Psychache status and associated contributing factors among the Hakka elderly in Fujian, China

BACKGROUND

Little is known about the state of psychological distress of the elderly in China, and research on specific subgroups such as Hakka older adults is almost lacking. This study investigates psychache and associated factors among Hakka elderly in Fujian, China.

METHODS

The data analysed in this study were derived from China's Health-Related Quality of Life Survey for Older Adults 2018. The Chinese version of the Psychache Scale (PAS) was used to assess the frequency and intensity of psychache in Hakka older adults. Generalized linear regression analysis was conducted to identify the main socio-demographic factors associated with psychache overall and its frequency and intensity.

RESULTS

A total of 1,262 older adults participated, with mean scores of 18.27 ± 6.88 for total PAS, 12.50 ± 4.79 for PAS-Frequency and 5.77 ± 2.34 for PAS-Intensity. On average, females scored higher than males on PAS-Frequency (β = 0.84, 95% CI = 0.34, 1.35) and PAS-Intensity (β = 0.48, 95% CI = 0.22, 0.73). Older adults currently living in towns (β = -2.18, 95% CI = -2.81, -1.54), with their spouse only (β = -3.71, 95% CI = -4.77, -2.65), or with children (β = -3.24, 95% CI = -4.26, -2.22) were more likely to score lower on PAS-Frequency. Conversely, older adults who were regular sleepers (β = -1.19, 95% CI =-1.49, -0.88) or lived with their spouse only (β = -1.25, 95% CI = -1.78, -0.72) were more likely to score lower on PAS-Intensity.

CONCLUSION

Among Hakka elderly, we found a higher frequency and greater intensity of psychache in females, those with poor health status, irregular sleepers, rural residents, solo dwellers, those with below CNY 10,000 in personal savings, and the medically uninsured. The study's findings indicate that policymakers should give more attention to the susceptible population and implement practical interventions to reduce their psychological burden.

Associations of Psychological Distress and Alcohol Use Patterns Among Older Adults of Sexual Minority Status and Heterosexual Peers

BACKGROUND

There is limited research investigating sexual-orientation-related differences in older adults and their relationship with alcohol use.

OBJECTIVE

The purpose of this study was to determine if sexual minority status moderates the relationship between psychological distress and alcohol drinking patterns.

METHODS

This study was a secondary analysis of data from the 2017-2018 National Survey on Drug Use and Health. Health outcomes among lesbian, gay, and bisexual (LGB) older adults (N = 462) aged 50 years or older were compared with heterosexual (N = 16,856) peers using univariate analyses and logistic regressions. Interaction terms evaluated the influence of sexual orientation on psychological distress and alcohol consumption.

RESULTS

Sexual orientation was a predictor of alcohol use in the past year, past month, and at any time (p < .001) but was not a predictor of alcohol dependence or misuse, binge drinking, or heavy drinking. Heterosexual older adults were less likely to consume alcohol than those who identified as LGB. Respondents not reporting psychological distress were less likely to engage in problematic drinking. However, there was no evidence that sexual minority status moderates the relationship between psychological distress and alcohol use.

CONCLUSION

Limited evidence supports higher rates of alcohol use and alcohol-related problems among sexual minority persons than heterosexuals. Prediction models for alcohol use were not improved by using sexual orientation and psychological distress as interaction terms. Future research should examine the underlying causes of impaired health in the older LGB population. Those findings should be used to research methods of preventing and minimizing alcohol misuse.

Marital Quality and Alcohol Use among Couples in Mid- and Later-Life

Spouses influence one another’s drinking behavior, but little research has explored how relationship quality may impact older couples’ alcohol use. Using data from the 2014–2018 waves of the Health and Retirement Study (HRS) and actor-partner interdependence models, we examined how marital quality is related to total alcohol consumption and risk of heavy drinking for married couples over age 50. Neither husbands’ nor wives’ perceptions of negative marital quality were related to changes in heavy drinking or number of drinks consumed over the observation period. However, wives’ positive marital quality was associated with increased risk of heavy alcohol use for both wives and husbands, and with an increase in the number of drinks wives consume over time. Couples over age 50 do not appear to use alcohol as a way of coping with negative marital relationships, but rather may increase their drinking in the context of positive relationships.

Gender-specific characteristics of alcohol use in community-dwelling older adults in Belgium

OBJECTIVES

Gender has been identified as an important social determinant for health. This study investigates gender-specific characteristics for alcohol use (AU) among community-dwelling older adults.

METHODS

This is a retrospective cross-sectional study in 1.406 community-dwelling older adults. We used standardized questionnaires to collect self-reported data on alcohol use behavior, mental health, drinking motives and resilience by using, respectively, the Alcohol Use Identification Test (AUDIT), the Brief Symptom Inventory (BSI), the Drinking Motives Questionnaire (DMQ), and the Connor-Davidson Resilience Scale (CD-RISC). Multiple linear regression was used to identify the joint contribution of those factors on AU. Hierarchical regression was used to investigate the influence of the interaction between gender and those factors on AU.

RESULTS

Linear regression analyses showed different associations with AU in men and women. Hierarchical regression analyses showed that gender presented a two-way interaction effect with enhancement and anxiety variables related to AU.

CONCLUSIONS

Different characteristics were found as predictors for AU among older men and women.

CLINICAL IMPLICATIONS

Clinicians and health-care providers should be aware of these differences in order to provide tailored screening and intervention programs to reduce AU in older adults.

Addressing the needs of older adults receiving alcohol treatment during the COVID-19 pandemic: a qualitative study

OBJECTIVES

The COVID-19 global pandemic resulted in major changes to the provision of alcohol treatment in the UK, these changes coincided with increases in the use of alcohol. This study sought to understand the impact of the pandemic on older adults in alcohol treatment, and to explore how changes in the provision of alcohol treatment were experienced.

METHOD

Semi-structured interviews were completed with older adults (aged 55+) in alcohol treatment, as well as alcohol practitioners providing support to older adults. Data were analysed using thematic analysis. Alcohol use was assessed using the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C).

RESULTS

Thirty older adults in alcohol treatment and fifteen alcohol practitioners were recruited. The COVID-19 pandemic was found to result in both increases and decreases in alcohol use; changes in alcohol use depended on a number of factors, such as living arrangements, family support, physical and mental health. Many alcohol treatment services moved to a model of remote support during the pandemic. However, face-to-face service provision was considered to be essential by both older adults in alcohol treatment and alcohol practitioners. Engagement with online support was low, with older adults facing barriers in using online technology.

CONCLUSION

The study highlights the importance of face-to-face treatment and intervention for older adults in alcohol treatment. Addiction services may see increased demand for treatment as a result of the pandemic; it is important that services consider the needs of older adults, many of whom may be marginalised by a remote model of service provision.