Specifying the relations between affect and heavy alcohol use among young adults

Age-related patterns in high-risk alcohol and cannabis use and their associations with positive and negative affect in young adulthood

OBJECTIVE

We examined age-varying associations between young adult simultaneous alcohol and marijuana/cannabis use (SAM) and heavy episodic drinking (HED) and positive and negative affect to inform harm reduction efforts.

METHODS

Young adults reporting past-year alcohol use (n = 556; ages 19-25) were recruited in a state where alcohol and nonmedical cannabis use was legal for those 21 +. Participants provided 24 repeated monthly assessments. Among those reporting past-month cannabis use on at least one survey, logistic time-varying effect models estimated (1) the age-varying prevalence of and associations between past-month SAM and HED and (2) age-varying unique associations of affect with SAM and HED.

RESULTS

There was a positive age-varying association between HED and SAM over time that was highest at age 19 (OR = 7.56), decreased until age 20.7 (OR = 3.39), increased until age 23.0 (OR = 4.85), and decreased until the association became non-significant by age 25. Negative affect was positively associated with SAM from ages 20.7 to 23.0, peaking at age 21.8 (OR = 1.36). Positive affect was positively associated with HED from ages 19.4 to 20.4 (peak OR = 1.25) and ages 22.5 to 24.5 (peak OR = 1.38). In contrast, positive affect was not uniquely associated with SAM nor negative affect with HED across ages 19-25.

CONCLUSIONS

While HED and SAM were positively associated throughout young adulthood and interventions could target them in tandem, their associations with affect suggest differential etiologic processes. Preventive intervention and harm reduction efforts should attend to psychological context in which these behaviors occur.

College Students' prescription drug misuse over time and links with their mental health and well-being

Prescription drug misuse (PDM) is a mounting public health concern in the U.S., particularly among college students. The field's reliance on cross-sectional designs and limited controls for other substance use has failed to capture the specific role of misuse for longer-term health. Therefore, the present study tested associations between trajectories of PDM problems and college students' mental health and subjective happiness over time. Participants were 300 students who completed a baseline assessment (T1) and follow-ups every 6 months for two years (T2-T5). Participants self-reported problems associated with PDM and mental health. Results from univariate latent growth models indicated that problems with PDM were initially on an increasing trajectory. Based on parallel process models, problems with PDM were concurrently associated with higher levels of depressive symptoms, disinhibition, callousness/aggression, and lower levels of subjective happiness at T1. Further, we found support for parallel trajectories between PDM problems and both depressive symptoms and general disinhibition. Participants whose PDM problems were on an increasing (worsening) trajectory at baseline showed an increase in depressive symptoms and general disinhibition over the next two years. Participants whose PDM problems accelerated over time (got worse at a faster and faster rate over time) also showed a significant increase in their depressive symptoms over time. Most findings, however, were no longer statistically significant in sensitivity analyses that controlled for alcohol and other drug problems. Findings highlight college as an important time for interventions to prevent substance use and its associated negative consequence on later young adult mental health.

Temporal priority of lifetime alcohol use disorders and comorbid psychiatric disorders in adults: Results from a population-based nationwide survey in Korea

BACKGROUND

Despite the high prevalence of alcohol use disorders (AUDs) in Korea, few studies have been conducted on the temporal priority with comorbid mental disorders. We investigated the temporal priority of lifetime AUDs and comorbid mood and anxiety disorders among the general population of Korea.

METHODS

Data of 18,807 respondents aged 18 years or older, collected from three national epidemiological surveys comprising face-to-face interviews using the Korean version of the Composite International Diagnostic Interview for DSM-IV mental disorders. For each mood or anxiety disorder, the extent to which one mental disorder precedes another was investigated by calculating the proportion of primary AUDs by that of primary mood or anxiety disorder.

RESULTS

Regarding alcohol dependence, dysthymic disorder is 5.6 times more likely to occur before alcohol dependence. Moreover, generalized anxiety disorder, social phobia, and specific phobia are 3.6 times, 4.5 times, and 6.3 times more likely to occur before, respectively. Regarding alcohol abuse, specific phobia is 6.3 times more likely to occur before, whereas major depressive disorder is two times more likely to occur after. Moreover, the lag times between primary alcohol abuse and subsequent mood or anxiety disorders were longer than those between primary alcohol dependence and the latter.

LIMITATIONS

The age of onset might be subject to recall bias. The presence of non-respondents could have influenced the results.

CONCLUSION

We need to recognize that one of the mental disorders could lead to another and consider it in the management of people with AUDs or mood and anxiety disorders.

Discrete emotions and global affect: Applying empirically driven approaches to experience sampling data to model state and trait affective structure and affect-alcohol use associations in a heavy drinking young-adult sample

Affective functioning is central to most contemporary models of alcohol use. However, the affective structure at the within- and between-person levels is rarely investigated nor is the differential predictive value of specific affect dimensions assessed across state and trait formats. We examined a) the structure of state and trait affect using experience sampling methodology (ESM) and b) predictive associations between the empirically derived affect facets and alcohol use. Participants were 92 heavy drinking college students aged 18-25 who completed 8 momentary assessments of their affect and drinking a day for 28-days. We found evidence for a single positive affect factor at both the within- (i.e., state) and between-person (i.e., trait) levels. We found a hierarchical factor structure for negative affect, represented by a general, superordinate dimension as well as facet-level sadness, anxiety, and anger dimensions. Associations between affect and alcohol use differed across trait and state levels and across specific types of negative affect. Lagged state positive affect and sadness as well as trait positive affect and sadness were inversely associated with drinking. Lagged state anxiety and trait general negative affect were positively associated with drinking. Thus, our study demonstrates how associations between drinking and affect can be studied in relation to general (e.g., general negative affect) and more specific aspects of affective experiences (e.g., sadness versus anxiety) concurrently within the same study and across trait and state levels of assessment.

Differential Momentary Reports of Stress and Affect Associated With Alcohol Consumption in Middle-Aged Versus Younger Adults

Background: Stress is a motivator to consume alcohol, a well-documented relapse risk, and is known to differentially affect biological and psychological processes as people age.Objectives: Because alcohol consumption is known to acutely decrease stress and increase affect, this study examined differences in ratings of stress and affect in middle-aged versus younger adults who regularly consume alcohol.Methods: A sample of younger (n = 17) and middle-aged (n = 18) drinkers was studied during a 3-day period of typical alcohol consumption. Resting levels of respiratory sinus arrhythmia (RSA) were measured during a baseline study visit since RSA is a well-documented biomarker of stress and is known to decrease with age. Ecological momentary assessment (EMA) survey ratings (n = 1,598) were modeled using hierarchical regression to assess differences in stress and affect throughout the day between the two age groups.Results: As anticipated, middle-aged participants had lower RSA than those who were younger. Although the middle-aged adults showed overall lower stress, generally they also experienced higher affect than the younger adults. Middle-aged adults experienced a significant reduction in stress following drinking while no such effect was observed in the younger adults.Conclusions: To our knowledge, this is the first investigation using EMA methodology to examine stress and affect between younger and middle-aged adults who habitually consume alcohol. These cross-sectional data suggest potential momentary stress relief to engaging with moderate alcohol consumption in a middle-aged population. Future work must address this important motivational process in curtailing maintenance of alcohol consumption and preventing escalation of consumption.

To Drink or Not to Drink: Is That the Question? Examining Correspondence and Predictive Validity of Morning Drinking Intentions for Young Adults' Drinking Behaviors and Consequences

The Theory of Planned Behavior suggests that intentions are significant and proximal determinants of behavior. The purpose of this study was to test the predictive validity of drinking intentions for subsequent same-day drinking behaviors and negative consequences. Regularly drinking young adults (N = 222, 21-29 years, 84% undergraduates) completed an ecological momentary assessment (EMA) protocol and wore an alcohol monitor for five consecutive 24-h periods spanning 6 days (Wednesday-Monday). Each morning, participants reported their drinking intentions for the day and their previous day's alcohol consumption and the number of negative drinking consequences. Multilevel models showed that, at the within-person level, on days when people reported intending to drink, to get drunk, or to drink more than usual, they had higher odds of drinking, consumed more drinks, and had higher peak transdermal alcohol concentrations later that day. However, drinking occurred on 28% of days without drinking intentions, suggesting intentions were an imperfect signal for future drinking behavior. Morning drinking intentions also predicted experiencing more negative consequences, even after controlling for alcohol consumption. On average, young adults' morning-reported drinking-related intentions predicted increased odds of same-day drinking behavior and alcohol-related consequences. However, drinking frequently occurred on days participants did not intend to drink, suggesting that focusing only on drinking intention days will result in many missed prevention opportunities. Together, these results suggest the need for additional research to increase the predictive value of drinking intention assessments and for prevention interventions aimed at helping individuals follow through on their intentions not to drink.

Development and evaluation of an online intervention for reducing hostile interpretation bias: A randomized controlled trial

Hostility is a trait-level construct characterized by a generally suspicious and cynical view of other people that results in a tendency to interpret ambiguous social situations in hostile or threatening ways. Cognitive behavioral treatments for hostility have high dropout rates, which may be due to hostile beliefs interfering with treatment engagement. As such, there is a need for an alternative approach to prevent dropout and enhance engagement. The current study therefore developed and tested a 1-session, 40-minute online intervention targeting hostility. It was hypothesized that the hostility intervention would be rated as acceptable as indexed by self-report and completion rates. It was also hypothesized that the hostility intervention would be associated with greater reductions in hostility as compared to a control intervention. Finally, it was hypothesized there would be indirect effects of intervention condition on anger and aggression via changes in hostility. Undergraduates (N = 101) who reported elevated hostility and hazardous alcohol use were randomized to complete either the hostility intervention or a control condition targeting physical health habits. Results showed that individuals randomized to the hostility intervention found the intervention to be highly acceptable and all participants completed the intervention in its entirety. The hostility intervention was associated with significantly faster reductions in hostile interpretations than the control condition with medium to large effects. There were significant indirect effects of intervention condition on month one follow-up anger and aggression via changes in hostile cognitions. This proof-of-concept study provides initial evidence that a brief, single-session intervention may be a promising approach for reducing hostility and its correlates.

Quantifying heterogeneity in mood-alcohol relationships with idiographic causal models

BACKGROUND

Ecological momentary assessment (EMA) studies have provided conflicting evidence for the mood regulation tenet that people drink in response to positive and negative moods. The current study examined mood-to-alcohol relationships idiographically to quantify the prevalence and intensity of relationships between positive and negative moods and drinking across individuals.

METHOD

We used two EMA samples: 96 heavy drinking college students (sample 1) and 19 young adults completing an ecological momentary intervention (EMI) for drinking to cope (sample 2). Mood and alcohol use were measured multiple times per day for 4-6 weeks. Mood-alcohol relationships were examined using three different analytic approaches: standard multilevel modeling, group causal modeling, and idiographic causal modeling.

RESULTS

Both multilevel modeling and group causal modeling showed that participants in both samples drank in response to positive moods only. However, idiographic causal analyses revealed that only 63% and 21% of subjects (in samples 1 and 2, respectively) drank following any positive mood. Many subjects (24% and 58%) did not drink in response to either positive or negative mood in their daily lives, and very few (5% and 16%) drank in response to negative moods throughout the EMA protocol, despite sample 2 being selected specifically because they endorse drinking to cope with negative mood.

CONCLUSION

Traditional group-level analyses and corresponding population-wide theories assume relative homogeneity within populations in mood-alcohol relationships, but this nomothetic approach failed to characterize accurately the relationship between mood and alcohol use in approximately half of the subjects in two samples that were demographically and clinically homogeneous. Given inconsistent findings in the mood-alcohol relationships to date, we conclude that idiographic causal analyses can provide a foundation for more accurate theories of mood and alcohol use. In addition, idiographic causal models may also help improve psychosocial treatments through direct use in clinical settings.

Modeling reciprocal relations between emotion dysregulation and alcohol use using dynamic structural equation modeling: A micro-longitudinal study

BACKGROUND

Research examining emotion dysregulation and alcohol use has increased exponentially over the past decade. However, these studies have been limited by their use of cross-sectional designs and narrow definitions of emotion dysregulation. To address these significant gaps in the extant literature, this study utilized state-of-the-art methodology (i.e., experience sampling) and statistics (i.e., dynamic structural equation modeling) to examine potential reciprocal associations between negative and positive emotion dysregulation and alcohol use at the momentary level.

METHODS

Participants were 145 community women (mean age = 40.56, 40.3% white) experiencing intimate partner violence (IPV) and using substances. Surveys assessing negative and positive emotion dysregulation and alcohol use (i.e., number of standard drinks) were administered three times a day for 30 days using phone-based interactive voice recording.

RESULTS

Significant contemporaneous effects indicated that negative and positive emotion dysregulation both co-occurred with alcohol use. However, levels of negative and positive emotion dysregulation did not predict later alcohol use, nor did alcohol use predict later levels of negative or positive emotion dysregulation. There was significant variability among participants in cross-lagged effects.

CONCLUSIONS

Findings showed that negative and positive emotion dysregulation co-occurred with alcohol use and that there was significant interindividual variability in the cross-lagged associations between negative and positive emotion dysregulation and alcohol use. Research using idiographic approaches may identify women experiencing IPV for whom negative and positive emotion dysregulation drive alcohol use and alcohol use drives negative and positive emotion dysregulation.

No evidence for trait- and state-level urgency moderating the daily association between negative affect and subsequent alcohol use in two college samples

It remains unclear whether the negative reinforcement pathway to problematic drinking exists, and if so, for whom. One idea that has received some support recently is that people who tend to act impulsively in response to negative emotions (i.e. people high in negative urgency) may specifically respond to negative affect with increased alcohol consumption. We tested this idea in a preregistered secondary data analysis of two ecological momentary assessment studies using college samples. Participants (N = 226) reported on their current affective state multiple times per day and also the following morning reported alcohol use of the previous night. We assessed urgency both at baseline and during the momentary affect assessments. Results from our Bayesian model comparison procedure, which penalises increasing model complexity, indicate that no combination of the variables of interest (negative affect, urgency, and the respective interactions) outperformed a baseline model that included two known demographic predictors of alcohol use. A non-preregistered exploratory analysis provided some evidence for the effect of daily positive affect, positive urgency, as well as their interaction on subsequent alcohol use. Taken together, our results suggest that college students' drinking may be better described by a positive rather than negative reinforcement cycle.

Associations between discrimination and substance use among college students in the United States from 2015 to 2019

Discrimination has been associated with adverse health behaviors and outcomes, including substance use. Higher rates of substance use are reported among some marginalized groups, such as lesbian, gay, and bisexual populations, and have been partially attributed to discrimination. This study uses 2015-2019 National College Health Assessment data to determine whether college students reporting discrimination due to sexual orientation, race/ethnicity, gender, or age report greater substance use than their peers who do not report such experiences. Additionally, we assess exploratory questions regarding whether substance choices differ among students who reported facing discrimination. Over time, about 8.0% of students reported experiencing discrimination in the past year. After applying inverse probability treatment weights (IPTWs), exposure to discrimination was associated with an excess of 44 cases of marijuana use per 1000 students, an excess of 39 cases of alcohol use per 1000 students, and an excess of 11 cases of prescription painkiller use per 1000 students. Multivariable logistic regression models with IPTW demonstrated that students who experienced discrimination were more than twice as likely to use inhalants and methamphetamine. These students were also significantly more likely to use other drugs, including opiates, non-prescribed painkillers, marijuana, alcohol, hallucinogens, cocaine, and cigarettes; however, the differences with peers were smaller in magnitude. Students who experienced discrimination did not differ from peers who reported non-prescribed antidepressants use and were significantly less likely to use e-cigarettes and smokeless tobacco. Associations between discrimination and substance use vary by race, gender, sexual orientation, and age. These findings indicate that discrimination has significant associations with many kinds of substance use; however, the magnitude varies by substance type. More institutional efforts to address sources of discrimination affecting college students are needed.

Digital Parenting of Emerging Adults in the 21st Century

In emerging adulthood, when many young people are away from their families for the first time, mobile phones become an important conduit for maintaining relationships with parents. Yet, objective assessment of the content and frequency of text messaging between emerging adults and their parents is lacking in much of the research to date. We collected two weeks of text messages exchanged between U.S. college students (N = 238) and their parents, which yielded nearly 30,000 parent-emerging adult text messages. We coded these text message exchanges for traditional features of parent-emerging adult communication indexing positive connection, monitoring and disclosures. Emerging adults texted more with mothers than with fathers and many messages constitute parental check-ins and emerging adult sharing regarding youth behavior and well-being. Findings highlight that both the frequency and content of parent-emerging adult text messages can be linked with positive (perceived text message support) and negative (perceived digital pressure) aspects of the parent-emerging adult relationship. The content of parent-emerging adult text messages offers a valuable, objective window into the nature of the parent-emerging adult relationships in the digital age of the 21st century.

Associations between simultaneous alcohol and cannabis use and next-day negative affect among young adults: The role of sex and trait anxiety

BACKGROUND AND AIMS

The simultaneous use of alcohol and cannabis ("simultaneous alcohol and marijuana [SAM] use") is common among young adults and associated with negative substance-related consequences. SAM use may be tied to fluctuating mood states such as negative affect and individual characteristics including trait level of anxiety and sex. However, little is understood about their collective role. In this study, we sought to understand the daily link between SAM use and negative affect and whether this link might differ by both trait anxiety and sex.

METHOD

Participants were 154 young adults (57.8% female, 72.7% White, M age = 20.2) who completed baseline surveys on trait anxiety symptoms and up to 14 consecutive daily surveys on their substance use and affective states.

RESULTS

Multilevel models tested for associations of type of substance use day (i.e., alcohol-only days, cannabis-only days, and no use days relative to SAM use days) with next-day negative affect. Three-way and lower order interactions were tested for substance use day type, anxiety, and sex. Two three-way interactions between cannabis-only days, anxiety, and sex and between alcohol-only days, anxiety, and sex emerged such that SAM use was associated with greater next-day negative affect relative to single substance use days particularly among female participants with elevated anxiety.

CONCLUSIONS

Anxiety and sex are salient factors in the link between SAM use relative to single-substance use and daily negative affect. Study findings reinforce the need to account for all of these factors in order to develop maximally efficacious substance use interventions.

The role of rash-impulsivity, emotional dysregulation and reward drive in comorbid disordered eating and substance use disorders

Purpose

Substance use disorder (SUD) frequently co-occurs with other psychological conditions, such as eating disorders (EDs). Psychological factors such as emotional dysregulation, rash impulsivity (RI) and reward sensitivity (RS) play a role in the etiology of each disorder, yet little is known about the combined effects of these on comorbid SUDs and EDs or disordered eating behaviours (DEBs). This study aims to examine the role of these psychological factors in comorbid DEBs and SUDs among individuals in treatment for SUDs. The role of gender is tested as a moderator.

Design/methodology/approach

A cross-sectional self-report survey was completed by 131 participants attending Australian residential substance use treatment centres. A binomial logistic regression analysis was performed to examine the effects of emotional dysregulation, RI and RS on comorbid DEB and SUD. Further, moderation analyses were used to examine the moderating effect for gender on the relationship between these three personality variables and comorbidity.

Findings

The most commonly reported primary substance of use was alcohol (43.5%), followed by amphetamines (38.6%). Findings showed that emotional dysregulation and RI were significantly related to an increase in comorbidity likelihood; however, RS was not. Gender moderated the relationship between comorbidity and RI only.

Originality/value

The significant positive relationship found between RI and comorbidity for females only was a novel finding for the current study. Further research is needed to develop an understanding of the etiology of comorbidity.

A Mobile Intervention to Promote Low-Risk Drinking Habits in Young Adults: Protocol for a Randomized Controlled Trial

BACKGROUND

Young adults' drinking habits commonly exceed recommendations for low-risk drinking, which may have a negative effect on their mental, social, and physical health. As smartphones are highly accessible to young adults, mobile apps could be used to support young adults to develop low-risk drinking habits and improve their general health.

OBJECTIVE

The objective of this study is to evaluate the effectiveness of Boozebuster, a self-guided mobile app based on healthy lifestyle-related components that aim to develop and maintain low-risk drinking habits among young adults.

METHODS

This two-arm, parallel-group randomized controlled trial will investigate whether a 6-week self-guided mobile intervention (Boozebuster) targeting drinking behavior is more effective than a minimal intervention consisting of an educational website on alcohol use and its consequences for young adults. We will recruit 506 young adults (aged 18-30 years) from the Netherlands via an open recruitment strategy by using an open access website. All outcomes will be self-assessed through questionnaires. The primary outcome is the quantity and frequency of alcohol consumption in standard drinks (10 g ethanol per standard drink) per month (timeline follow-back [TLFB]). Secondary outcomes include binge-drinking sessions per month, alcohol-related problem severity (Rutgers Alcohol Problem Index), cannabis use frequency and quantity in grams (TLFB), depressive symptoms (Center for Epidemiological Studies Depression Scale), perceived stress (Perceived Stress Scale), engagement (Twente Engagement with eHealth Technologies Scale), readiness to change (Readiness to Change Questionnaire), mental well-being (Warwick-Edinburgh Mental Wellbeing Scale), trauma and COVID-19-related trauma (Short-Form Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition), impulsivity (Urgency, Premeditation, Perseverance, Sensation Seeking, Positive Urgency Impulsive Behavior Scale), study or work performance (Individual Work Performance Questionnaire), and treatment adherence. Baseline (T0), 6-week postbaseline (T1), and 3-month postbaseline (T2) assessments will be conducted and analyzed on the basis of the intention-to-treat principle using multilevel mixed modeling analyses.

RESULTS

Recruitment began in September 2020. We received 933 registrations via our study information website; 506 participants have completed the T0 assessment, 336 participants have completed the T1 assessment, and 308 participants have completed the T2 assessment as of May 2021. The study is still in progress, and results will be reported in 2021 and 2022.

CONCLUSIONS

Self-guided mobile interventions based on a lifestyle approach might be an attractive approach for young adults due to their preference on self-reliance, healthy living, and increased perceived anonymity. Such interventions are yet understudied, and it is known that interventions addressing solely problem drinking are less appealing to young adults. We hypothesize that the Boozebuster mobile app will effectively reduce drinking levels compared to an alcohol educational website (control condition). If effective, our intervention could be an inexpensive and scalable public health intervention to improve drinking habits in young adults.

TRIAL REGISTRATION

Netherlands Trial Register NL8828; https://www.trialregister.nl/trial/8828.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/29750.

Intraindividual association of PTSD symptoms with binge drinking among trauma-exposed students

People, particularly undergraduate students, who report elevated symptoms of posttraumatic stress disorder (PTSD) are at elevated risk of binge drinking. The present study used ecological momentary assessment to (a) evaluate whether PTSD severity, specifically, or psychological distress, generally, are associated with binge drinking and (b) examine the self-medication and susceptibility models of the comorbidity of PTSD with binge drinking while accounting for shared liability (i.e., the between-person association of PTSD symptom severity with binge drinking). Within a larger study of undergraduate student mental health, for 14 days, students who reported a potentially traumatic experience (N = 276) reported nightly on use of alcohol and psychoactive substances and thrice daily on current affect, internalizing symptoms, and PTSD symptoms. Daily binge drinking, per the NIAAA definition, was analyzed using multivariate mixed effects, multilevel logistic regression. Results support the self-medication model; participants were more likely to binge drink on days marked by elevated PTSD symptoms, OR = 2.82, p < .01. Binge drinking was also more likely on weekends, OR = 4.21, p < .0001, and days marked by elevated daily positive affect, OR = 1.60, p < .001. Binge drinking was not associated with concurrent depressive or general anxiety symptoms (p > .30). PTSD symptoms were not associated with use of cannabis or other substances (p > .06). Regarding the susceptibility model, following a binge drinking episode, participants reported elevated depressive symptoms, B = 0.34, p = .04, but no change in affect, PTSD symptoms, or general anxiety symptoms (p > .16). Results suggest that, beyond understanding who is at risk for binge drinking, fluctuations in PTSD severity clarify when students engage in binge drinking. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Daily associations between affect and alcohol use among adults: The importance of affective arousal

OBJECTIVE

Little is known about whether level of affective arousal (i.e., high vs. low) is associated with alcohol use and whether this relationship differs by valence (i.e., positive vs. negative affect) among adults.

METHODS

Participants were n = 93 self-reported current drinkers (ages 25-65) who reported positive (PA) and negative affect (NA) seven times a day and alcohol use once a day for seven consecutive days. For each individual, mean levels of high arousal PA (e.g., excited), low arousal PA (e.g., satisfied), high arousal NA (e.g., frustrated), and low arousal NA (e.g., sad) were computed for each day.

RESULTS

Alcohol use was reported on 30% of person-days, with an average of 2.3 drinks consumed on drinking days. Heavy episodic drinking (4+/5+ drinks for women/men) occurred on 4% of days. After covarying for age, gender, and weekday, days with higher-than-usual levels of high arousal PA were associated with a 52% increase in the odds of consuming any alcohol and a 105% increase in the odds of engaging in heavy episodic drinking. Individuals reporting more low arousal PA on average had a 77% increase in the odds of heavy episodic drinking. No significant associations between high or low arousal NA and alcohol use were found.

CONCLUSIONS

Greater PA, but not NA, was associated with heavy alcohol use at both the within- and between-person levels, perhaps attributable to social and enhancement drinking motives. Results differed by arousal, highlighting the importance of considering a wide range of affective states when examining alcohol use behavior.

An Ecological Momentary Assessment of Affect, Mental Health Symptoms, and Decisions to Drink Among First-Year College Women: A Pilot Study

College women experience more consequences (e.g., blacking out, unprotected/unwanted sex) on days when they engage in their heaviest drinking. To inform prevention efforts, research is needed to understand decision-making processes that influence women's drinking behaviors at the event level. The present study used ecological momentary assessment (EMA) methods to examine: (1) associations between positive affect (PA) and negative affect (NA) and decision-making processes on days leading up to, during, and following heavy drinking events; and (2) mental health symptoms as moderators of these associations. Female undergraduate drinkers (N = 57) completed a 14-day EMA protocol on their smartphones, which included three daily assessments of PA, NA, and willingness and intentions to drink. Trait anxiety and depressive symptoms were measured before the EMA protocol and assessed as moderators. Time-varying effect models were used to examine covariation among PA, NA, and willingness and intentions to drink on the days leading up to participants' heaviest drinking events, the day of the event itself, and the days following the event. Results revealed PA was positively associated with willingness to drink the 2 days before, the day of, and the day after the heaviest drinking event. Similar effects were observed for PA and intentions to drink. Trait anxiety moderated the association between PA and intentions to drink. Findings underscore that positive affect may influence drinking-related decision-making processes surrounding heavy drinking events, particularly in those college women low in anxiety. Results identify potential entry points for real-time intervention efforts targeting college women during times of elevated PA.

Linguistic Predictors of Problematic Drinking in Alcohol-related Facebook Posts

Emerging adults often increase problematic drinking during college. Although they generally do not seek help for problematic drinking, college students discuss their drinking on social media. This study followed college students' Facebook profiles from the inception of their attendance at a university and identified alcohol-related posts. Within 28 days of their first alcohol-related Facebook post, participants were interviewed to assess problematic drinking (binge drinking episodes and number of drinks). Linguistic analysis of alcohol-related Facebook posts found that use of negative emotion language and swear words were related to problematic drinking, in support of proposed hypotheses. Results are situated within alcohol use disorder and health research examining the link between problematic drinking and anxiety, deviant behavior, and negative emotions.

Does it work and does it last? Effects of social and drinking behavior on same- and next-day mood

Both social and drinking behavior have the potential to modify mood. However, if social drinking enhances positive mood and reduces negative mood, as compared to non-drinking social behavior, then interventions to reinforce non-drinking via sober social activity are undermined. Using multilevel modeling analyses, we compared end-of-day mood on drinking days versus non-drinking days, and on days spent with other people as compared to days spent primarily alone. We evaluated the interaction between drinking/non-drinking and social/solitary behavior and assessed whether the effects of social and drinking behavior extended to mood the next day. Participants were 352 college students (53% female; 55% fraternity/sorority membership; mean age 19.7 years) who completed three automated telephone surveys each day during four 14-day intervals over 1 year. Drinking and being social were associated with higher end-of-day positive mood and significantly lower end-of-day negative mood. However, no positive enhancement or negative attenuation effects of alcohol were observed in interaction analyses. Alcohol provided no improvement in mood over-and-above being social at the end of the day or on the following day. However, drinking the previous day significantly reduced next-day positive mood, whereas being social significantly reduced next-day negative mood. These findings provide support for the reinforcing potential of interventions that increase rewarding social activity in the place of alcohol use.

Affective Risk for Problem Drinking: Reciprocal Influences Among Negative Urgency, Affective Lability, and Rumination

BACKGROUND

Affective disturbances have long been implicated in the onset and maintenance of problematic alcohol use. Affective risk theory for problem drinking has moved beyond early documentation that negative affect broadly confers risk to models specifying specific affectbased risk processes.

OBJECTIVE

This paper provides a theory-driven review of recent literature on the role of affect-based factors in the etiology of problematic alcohol use. First, we review recent advances in the understanding of affect-based risk for problem drinking. Second, we highlight the importance of three specific affect-based risk factors: urgency, affective lability, and rumination. Third, we offer hypotheses regarding the reciprocal relationships between specific risk factors and drinking problems. Finally, we suggest possible avenues for future research.

CONCLUSION

Recent advances in the understanding of reciprocal prediction between affect-based risk factors and problem drinking have set the stage for important new avenues of investigation into the risk process. Affect-based risk processes appear to influence each otherover time, and they influence and are influenced by problem drinking. Further understanding of these processes will pave the way for a new generation of intervention strategies.

Peer Victimization, Internalizing Problems, and Substance Use in Urban African American Adolescents in Chicago: The Relevance of the Self-Medication Hypothesis

The aim of the study was to explore the link between peer victimization and substance use and tested the mediating role of internalizing problems in urban African American adolescents in Chicago. Six hundred and thirty-eight adolescents in Chicago's Southside participated in the study. Results from the hierarchical linear regression analysis showed that youth who reported peer victimization were at risk of internalizing problems. Those who were bullied by their peers were more likely to display internalizing problems, which was also significantly associated with substance use. Consistent with the self-medication hypothesis, findings from the study suggest that bullied youth are likely to display internalizing problems and turn to substance use. Implications for mental health practice in school settings are also discussed.

A straightforward approach for coping with unreliability of person means when parsing within-person and between-person effects in longitudinal studies

Longitudinal studies enable researchers to distinguish within-person (i.e., time-varying) from between-person (i.e., time invariant) effects by using the person mean to model between-person effects and person-mean centering to model within-person effects using multilevel models (MLM). However, with some exceptions, the person mean tends to be based on a relatively small number of observations available for each participant in longitudinal studies. Unreliability inherent in person means generated with few observations results in downwardly biased between-person and cross-level interaction effect estimates. This manuscript considers a simple, easy-to-implement, post-hoc bias adjustment to correct for attenuation of between-person effects caused by unreliability of the person mean. This correction can be applied directly to estimates obtained from MLM. We illustrate this method using data from a panel study predicting adolescent alcohol involvement from perceived parental monitoring, where parental monitoring was disaggregated into within-person (i.e., person-mean-centered) and between-person (i.e., person-mean) components. We then describe results of a small simulation study that evaluated the performance of the post-hoc adjustment under data conditions that mirrored those of the empirical example. Results suggested that, under a condition in which parameter bias is known to be problematic (i.e., moderate ICC_X, small n, presence of a compositional effect), it is preferable to use the bias-adjusted MLM estimates over the unadjusted MLM estimates for between-person and cross-level interaction effects.

The impact of exposure to wagering advertisements and inducements on intended and actual betting expenditure: An ecological momentary assessment study

BACKGROUND AND AIMS

Research suggests that a large proportion of regular sports and race bettors experience harm related to their gambling. In Australia, people who bet regularly are targeted by a proliferation of different forms of inducements and advertising - many of which are believed to encourage excessive betting and erroneous perceptions of risk. However, scant research has examined the impact of marketing messaging to this group, which is also limited to cross-sectional or qualitative designs. We aimed to determine whether exposure to wagering advertisements and inducements influenced intended betting expenditure, actual betting expenditure, and spending more than intended.

METHODS

We report on an ecological momentary assessment study, measuring regular exposure to 20 different forms of marketing, as well as wagering spend from 318 race bettors and 279 sports bettors. Up to 15 assessments per participant were conducted over 3 weeks (mean = 11.46, median = 14), yielding 6,843 observations for analysis.

RESULTS

Exposure to advertising and inducements was reliably linked to a greater likelihood of betting, higher intended and actual betting expenditure, and spending more than intended. "Push" messaging and inducements that convey the impression of reduced risk (stake-back inducements and multibet offers) were particularly influential, as well as brands promoted during events and advertisements on betting websites/apps.

DISCUSSION AND CONCLUSIONS

Given that a large proportion of regular sports and race bettors experience problems, restrictions on these forms of marketing are advisable. These findings suggest that this is particularly important for marketing that is "pushed" to gamblers or that suggests reduced risk.

Identifying Behaviors Predicting Early Morning Emotions by Observing Permanent Supportive Housing Residents: An Ecological Momentary Assessment

BACKGROUND

Behavior and emotions are closely intertwined. The relationship between behavior and emotions might be particularly important in populations of underserved people, such as people with physical or mental health issues. We used ecological momentary assessment (EMA) to examine the relationship between emotional state and other characteristics among people with a history of chronic homelessness who were participating in a health coaching program.

OBJECTIVE

The goal of this study was to identify relationships between daily emotional states (valence and arousal) shortly after waking and behavioral variables such as physical activity, diet, social interaction, medication compliance, and tobacco usage the prior day, controlling for demographic characteristics.

METHODS

Participants in m.chat, a technology-assisted health coaching program, were recruited from housing agencies in Fort Worth, Texas, United States. All participants had a history of chronic homelessness and reported at least one mental health condition. We asked a subset of participants to complete daily EMAs of emotions and other behaviors. From the circumplex model of affect, the EMA included 9 questions related to the current emotional state of the participant (happy, frustrated, sad, worried, restless, excited, calm, bored, and sluggish). The responses were used to calculate two composite scores for valence and arousal.

RESULTS

Nonwhites reported higher scores for both valence and arousal, but not at a statistically significant level after correcting for multiple testing. Among momentary predictors, greater time spent in one-on-one interactions, greater time spent in physical activities, a greater number of servings of fruits and vegetables, greater time spent interacting in a one-on-one setting as well as adherence to prescribed medication the previous day were generally associated with higher scores for both valence and arousal, and statistical significance was achieved in most cases. Number of cigarettes smoked the previous day was generally associated with lower scores on both valence and arousal, although statistical significance was achieved for valence only when correcting for multiple testing.

CONCLUSIONS

This study provides an important glimpse into factors that predict morning emotions among people with mental health issues and a history of chronic homelessness. Behaviors considered to be positive (eg, physical activity and consumption of fruits and vegetables) generally enhanced positive affect and restrained negative affect the following morning. The opposite was true for behaviors such as smoking, which are considered to be negative.

Stress vulnerability and alcohol use and consequences: From human laboratory studies to clinical outcomes

It is well known that vulnerability to stress is a risk factor for alcohol use disorder (AUD). Chronic alcohol use can result in neuroadaptations in cortico-striatal pathways and hypothalamic pituitary adrenal (HPA) axis function that are manifested in altered behavioral and cognitive control functions contributing to alcohol craving, compulsive motivation, consumption, and consequences. This symposium brings together studies utilizing novel approaches to help improve our understanding of stress - past, acute, and chronic - on alcohol seeking and consumption and related outcomes using a combination of human laboratory models, neuroimaging, and clinical measures. Examining factors that determine vulnerability as well as resilience to stress are of particular interest in the study of AUD because, in addition to increasing our understanding of the risk factors for AUD, such knowledge can be used to develop more effective treatments. Dr. Stangl presented a novel human experimental model that demonstrates, for the first time, stress-induced increases in alcohol self-administration in binge drinkers using a guided imagery paradigm combined with intravenous alcohol self-administration (IV-ASA). Dr. Blaine presented data demonstrating that glucocorticoid response to stress drives compulsive alcohol motivation and intake in binge/heavy drinkers. Dr. Plawecki presented data examining sex differences in the effect of two distinct stress paradigms - mood induction and abstinence - on IV-ASA in moderate drinkers. Dr. Schwandt presented clinical data providing a new perspective on the relationship between childhood trauma and AUD by suggesting possible underlying mechanisms that confer resilience, rather than vulnerability, to severe early life stress exposure.

Bidirectional Relationships between Alcohol-Specific Parental Socialization Behaviors and Adolescent Alcohol Misuse

BACKGROUND

Although numerous studies have examined parental influence on adolescent alcohol misuse, few have examined how adolescents impact parental behavior or the reciprocal nature of parent-adolescent behavior relative to alcohol misuse.

OBJECTIVES

This study assessed bidirectional relationships between adolescent alcohol misuse and three alcohol-specific parenting behaviors (substance-specific monitoring, permissive communication messages about alcohol, and cautionary communication messages about alcohol).

METHODS

Data were from 1,645 parent-adolescent dyads drawn from a longitudinal study spanning grades 6-10. A multivariate latent curve model with structured residuals was used to test study hypotheses.

RESULTS

One marginally significant result emerged (increased alcohol misuse leads to greater substance-specific monitoring) after accounting for underlying developmental processes.

CONCLUSIONS

Though practical implications are limited based on the results of the study, further directions for research regarding study design and measurement are provided to more fully examine dynamic processes between parents and adolescents relative to alcohol use.

Tension reduction and affect regulation: An examination of mood indices on drinking and non-drinking days among university student drinkers

Several theories posit problematic alcohol use develops through mechanisms of positive and negative reinforcement. However, the literature on these mechanisms remains inconsistent. This may be due to a number of issues including a failure to disaggregate negative mood or a failure to account for mood functioning (i.e., stability in mood). Alternatively, there may be differences in typical postdrinking/evening mood on drinking and nondrinking days, however, this has yet to be fully explored. We examined multiple indices of distinct mood states prior to and after typical drinking onset times on drinking and nondrinking days using ecological momentary assessment. College student drinkers (n = 102) carried personal data devices for 15 days. They reported on mood and alcohol use several times per day. Tonic positive mood was higher on drinking days than nondrinking days prior to typical drinking initiation. After typical drinking times, positive mood was higher on drinking days than nondrinking days. Similarly, negative moods (anxiety, stress, anger, and stress instability) indicated a pattern of lower levels relative to both predrinking mood on drinking days, and matched mood time-points on nondrinking days; though, not all of these differences were statistically different. Results suggest positive and negative reinforcing mechanisms may be at play-though the negative reinforcement effects may manifest through subjectively "better" mood on drinking versus nondrinking days. (PsycINFO Database Record

Advancing statistical analysis of ambulatory assessment data in the study of addictive behavior: A primer on three person-oriented techniques

Ambulatory assessment (AA) methodologies have the potential to increase understanding and treatment of addictive behavior in seemingly unprecedented ways, due in part, to their emphasis on intensive repeated assessments of an individual's addictive behavior in context. But, many analytic techniques traditionally applied to AA data - techniques that average across people and time - do not fully leverage this potential. In an effort to take advantage of the individualized, temporal nature of AA data on addictive behavior, the current paper considers three underutilized person-oriented analytic techniques: multilevel modeling, p-technique, and group iterative multiple model estimation. After reviewing prevailing analytic techniques, each person-oriented technique is presented, AA data specifications are mentioned, an example analysis using generated data is provided, and advantages and limitations are discussed; the paper closes with a brief comparison across techniques. Increasing use of person-oriented techniques will substantially enhance inferences that can be drawn from AA data on addictive behavior and has implications for the development of individualized interventions.

Is shame a proximal trigger for drinking? A daily process study with a community sample

Between-subjects studies show that people with higher levels of shame tend to experience more negative drinking-related consequences than people with lower levels of shame. However, within-subjects studies of the association between daily fluctuations in shame and subsequent drinking have yielded mixed findings. This study aimed to resolve these inconsistencies by examining the association between daily fluctuations in shame, between-subjects differences in shame, and subsequent evening alcohol consumption in a sample of 70 community-dwelling drinkers. In addition, we examined whether the previous night's drinking predicted shame the next day based on the theory that shame may operate in a cyclical fashion in some people to maintain problematic drinking patterns. Multilevel model analyses showed a cross-level interaction in which individuals' average levels of ashamed mood moderated the effect of daily fluctuations in shame on solitary drinking. In contrast, previous day's drinking was only weakly related to shame the next day. This study contributes to existing literature by refining models of negative mood-related drinking and further elucidating the patterns by which shame serves as a trigger for drinking, particularly among high shame individuals. The authors interpret results in terms of self-control theory and demonstrate the importance of disaggregating between- and within-subjects variance when examining longitudinal data. (PsycINFO Database Record

Negative Affect Intensity and Hostility in Individuals With Alcohol Use Disorder With or Without Posttraumatic Stress Disorder

OBJECTIVE

Negative affect intensity and hostility have both been implicated in alcohol use disorders (AUD) and posttraumatic stress disorder (PTSD) when they occur separately, but neither have been compared or explored among those with comorbid AUD and PTSD. This study is a secondary analysis designed to compare levels of negative affect intensity and hostility among those with AUD to those with comorbid AUD and PTSD.

METHODS

Participants (n = 113) were recruited from the placebo-controlled groups of two distinct 12-week clinical trials (NCT00342563 and NCT00744055). The Short Affect Intensity Scale and Buss-Durkee Hostility Inventory were administered at weeks 0, 4, 8, and 12 to all study participants to assess negative affect intensity and hostility levels, respectively.

RESULTS

Individuals with comorbid AUD and PTSD showed significantly higher levels of negative affect intensity and hostility than individuals with AUD only. These levels remained relatively stable over the course of the study in spite of all study participants showing clinically significant improvements in AUD severity and PTSD symptomatology (for those with dual diagnosis).

CONCLUSIONS

Our results indicate that individuals with comorbid AUD and PTSD have higher levels of negative affect and higher levels of hostility compared to individuals with AUD alone. In addition, these heightened levels of negative affect intensity and hostility appear to function somewhat independently of diagnosis severity and symptomatology improvement. To our knowledge, this is the first study to compare negative affect intensity and hostility levels between individuals with AUD alone and those with comorbid AUD and PTSD.

An examination of heavy drinking, depressed mood, drinking related constructs, and consequences among high-risk college students using a person-centered approach

INTRODUCTION

Research has identified college students who experience depressed mood and consume alcohol are at an increased risk for experiencing alcohol problems. The present study identified profiles of differential alcohol use, depression, key psychosocial indicators of drinking (e.g., normative perceptions) and examined the relationship between these profiles and alcohol-related consequences.

METHOD

Students with a history of risky drinking and elevated depressed mood (n=311; 62.4% female) completed a web-based survey assessing typical and peak drinking, depressive symptoms, descriptive norms, drinking to cope motives, protective behavioral strategies, and alcohol-related consequences.

RESULTS

Latent profile analysis was used to classify participants into distinct profiles focusing on alcohol use patterns and level of depressed mood and drinking related constructs. Profiles were then compared based on their association with reported rates of alcohol-related consequences. Four profiles emerged: 1) Mild Depression, Heavy Drinkers; 2) Mild Depression, Severe Drinkers; 3) Moderate Depression, Heavy Drinkers; and 4) Moderate Depression, Severe Drinkers. Findings revealed significant differences between the four profiles on both risky drinking and alcohol-related consequences.

CONCLUSION

These findings suggest the importance of assessing and addressing depressive symptoms among college students in order to reduce rates of risky drinking and alcohol-related consequences.

The Prospective Association Between Internalizing Symptoms and Adolescent Alcohol Involvement and the Moderating Role of Age and Externalizing Symptoms

BACKGROUND

As predicted by self-medication theories that drinking is motivated by a desire to ameliorate emotional distress, some studies find internalizing symptoms (e.g., anxiety, depression) increase risk of adolescent drinking; however, such a risk effect has not been supported consistently. Our prior work examined externalizing symptoms as a potential moderator of the association between internalizing symptoms and adolescent alcohol use to explain some of the inconsistencies in the literature. We found that internalizing symptoms were protective against early adolescent alcohol use particularly for youth elevated on externalizing symptoms (a 2-way interaction). Our sample has now been followed for several additional assessments that extend into young adulthood, and the current study tests whether the protective effect of internalizing symptoms may change as youth age into young adulthood, and whether this age-moderating effect varied across different clusters of internalizing symptoms (social anxiety, generalized anxiety, and depression). Internalizing symptoms were hypothesized to shift from a protective factor to a risk factor with age, particularly for youth elevated on externalizing symptoms.

METHODS

A community sample of 387 adolescents was followed for 9 annual assessments (mean age = 12.1 years at the first assessment and 55% female). Multilevel cross-lagged 2-part zero-inflated Poisson models were used to test hypotheses.

RESULTS

The most robust moderating effects were for levels of alcohol use, such that the protective effect of all internalizing symptom clusters was most evident in the context of moderate to high levels of externalizing problems. A risk effect of internalizing symptoms was evident at low levels of externalizing symptoms. With age, the risk and protective effects of internalizing symptoms were evident at less extreme levels of externalizing behavior. With respect to alcohol-related problems, findings did not support age moderation for generalized anxiety or depression, but it was supported for social anxiety.

CONCLUSIONS

Findings highlight the importance of considering the role of emotional distress from a developmental perspective and in the context of externalizing behavior problems.

Stressor-related drinking and future alcohol problems among university students

Research using daily designs has shown that daily stressors (i.e., conflict, school/work demands) are associated with alcohol use, and that the strength of within-person links between stressors and alcohol use differs from person to person. However, to our knowledge no research has tested whether individual differences in stressor-related drinking-characterized by within-person associations between daily stressors and drinking-predict risk for future alcohol problems, a relationship suggested by theoretical models. The current study used an Internet-based daily diary design among 744 university students to (a) examine the day-level relationship between stressors and alcohol use during the first 3 years of college, and (b) test whether individual differences in the stressor-drinking relationship, captured by person-specific slopes generated from multilevel models, predicted alcohol problems as measured by the Alcohol Use Disorders Identification Test (AUDIT) in the fourth year of college. Results showed that students were more likely to drink on days with many versus fewer stressors, and on drinking days, students consumed more drinks with each additional stressor they experienced. Next, using individual multilevel modeling slopes as predictors, we found that students whose odds of drinking alcohol increased more sharply on high- versus low-stressor days (steeper slopes) had more severe AUDIT alcohol problems in the fourth year than students whose drinking odds increased less sharply (flatter slopes). Findings highlight the role of daily stressors in college student drinking and suggest stressor-related drinking as a risk factor for future alcohol problems. (PsycINFO Database Record

Testing bidirectional associations among emotion regulation strategies and substance use: a daily diary study

BACKGROUND AND AIMS

Alcohol and marijuana are widely used among college students. Emotion regulation strategies have been linked to alcohol and marijuana use, but little attention has been devoted to modeling the directionality of these associations. The aims of the current study were to test whether (a) daytime use of emotion regulation strategies influences the likelihood of evening substance use and (b) evening substance use influences the likelihood of next-day use of emotion regulation strategies.

DESIGN

Longitudinal daily diary data were collected for 30 days via on-line surveys.

SETTING

Northeastern United States.

PARTICIPANTS

A total of 1640 college students (mean age = 19.2 years, 54% female, 80% European American) were recruited each semester between Spring 2008 and Spring 2012.

MEASUREMENTS

Daily diaries assessed emotion regulation strategies (distraction, reappraisal, problem-solving, avoidance) and substance use (any drinking, heavy drinking, marijuana use, co-use of any drinking/heavy drinking and marijuana). Covariates included gender, age, race/ethnicity, fraternity/sorority involvement and baseline depression.

FINDINGS

Daytime distraction [odds ratio (OR) = 0.95], reappraisal (OR = 0.95) and problem-solving (OR = 0.94) predicted lower odds of evening marijuana use (P-values < 0.02). Evening heavy drinking (OR = 0.90) and marijuana use (OR = 0.89) predicted lower odds of next-day problem-solving, with heavy drinking also predicting higher odds (OR = 1.08) of next-day avoidance and marijuana use also predicting higher odds (OR = 1.08) of next-day reappraisal (P-values < 0.03).

CONCLUSIONS

There appear to be reciprocal relations among emotion regulation strategies and substance use: greater daytime use of distraction, reappraisal, and problem solving predicts lower evening substance use, while higher evening substance use predicts higher next-day avoidance and reappraisal but lower next-day problem-solving.

Parental divorce and initiation of alcohol use in early adolescence

Parental divorce/separation is among the most commonly endorsed adverse childhood events. It has been shown to increase subsequent risk of alcohol dependence and problems across adolescence and early adulthood, but its influence on early stages of alcohol involvement has only recently been explored. In the present study, we examined whether time to first full drink was accelerated among youth who experienced parental divorce/separation. To determine specificity of risk, models controlled for perceived stress as well as family history of alcoholism, current parental drinking, and internalizing and externalizing problems. Developmental specificity in terms of timing of both parental divorce and first drink was also examined. Participants were 931 middle-school students (488 girls, 443 boys) who were enrolled in a prospective study on drinking initiation and progression (52% female; 23% non-White, 11% Hispanic). Students indicated whether and at what age they had consumed a full drink of alcohol. Parental divorce/separation was coded from a parent-reported life-events inventory and was grouped based on age experienced (ages 0-5, ages 6-9, age 10+). Cox proportional hazard models showed increased risk for onset of drinking as a function of divorce/separation, even controlling for stress, parental alcohol involvement, and psychopathology. There was no evidence for developmental specificity of the divorce/separation effect based on when it occurred nor in timing of first drink. However, the effect of parental divorce/separation on initiation was magnified at higher levels of parental drinking. Given the rates of parental divorce/separation and its association with increased risk of early drinking, investigation of the mechanisms underlying this link is clearly warranted. (PsycINFO Database Record

Urgency traits moderate daily relations between affect and drinking to intoxication among young adults

BACKGROUND

Young adults with higher trait urgency (i.e., a tendency to act rashly in response to heightened affect) may be especially vulnerable to heavy drinking. The current study examined 1) the influence of urgency on daily relations between affect and drinking to intoxication, and 2) whether urgency influenced the effectiveness of naltrexone (vs. placebo) for reducing alcohol use.

METHODS

This study is a secondary analysis of data from 126 (n=40 female) heavy drinking young adults, ages 18-25, enrolled in a double-blind, 8-week clinical trial comparing brief motivational intervention and either naltrexone or placebo. Multilevel models examined whether trait urgency moderated daily relations between positive and negative affect and drinking to intoxication, measured by an estimated blood-alcohol concentration (eBAC) at or above the legal limit (≥0.08g%). Person-level interactions examined whether naltrexone was more effective than placebo at reducing the odds of eBAC≥0.08g% for individuals with higher vs. lower trait urgency.

RESULTS

On days of greater within-person positive or negative affect, young adults with higher urgency were more likely to drink to intoxication than those with lower urgency. Naltrexone reduced the odds of drinking to intoxication significantly more than placebo, independent of positive or negative urgency.

CONCLUSIONS

Although naltrexone treatment reduced drinking overall, young adults with higher trait urgency were still at increased risk for hazardous drinking following times of strong positive or negative mood. Targeted interventions are needed to reduce the risk of heavy drinking among young adults with high trait urgency.

Effects of alcohol, rumination, and gender on the time course of negative affect

This study modelled associations between gender, ruminative cognitive style, alcohol use, and the time course of negative affect over the course of 43,111 random assessments in the natural environment. Participants (N   =   263) completed 49 days of experience sampling over 1.3 years. The data indicated that rumination at baseline was positively associated with alcohol dependence symptoms at baseline as well as higher negative affect over the course of the study. Consistent with negative reinforcement models, drinking served to decrease the persistence of negative affect from moment to moment. However, this ameliorative effect of drinking was evident only among women, suggesting an increased risk for negative reinforcement driven drinking behaviour. In addition, rumination appeared to counteract the desired effects of alcohol on mood among women. This suggests that women who ruminate more may be motivated to consume larger amounts of alcohol to achieve the desired effects. Overall, the results indicate that ruminative cognitive style and the persistence of negative affect from moment to moment may reflect an individual vulnerability for the development of alcohol use disorder especially among women.

Substance use to regulate intense posttraumatic shame in individuals with childhood abuse and neglect

Childhood abuse and neglect (CAN) is considered as a risk factor for substance use disorder (SUD). Based on the drinking to cope model, this study investigated the association of two trauma-relevant emotions (shame and sadness) and substance use. Using ecological momentary assessment we compared real-time emotion regulation in situations with high and low intensity of shame and sadness in currently abstinent patients with CAN and lifetime SUD (traumaSUD group), healthy controls with CAN (traumaHC group), and without CAN (nontraumaHC group). Multilevel analysis showed a positive linear relationship between high intensity of both emotions and substance use for all groups. The traumaSUD group showed heightened substance use in low, as well as in high, intensity of shame and sadness. In addition, we found an interaction between type of emotion, intensity, and group: the traumaHC group exhibited a fourfold increased risk for substance use in high intense shame situations relative to the traumaSUD group. Our findings provide evidence for the drinking to cope model. The traumaSUD group showed a reduced distress tolerance for variable intensity of negative emotions. The differential effect of intense shame for the traumaHC group emphazises its potential role in the development of SUD following CAN. In addition, shame can be considered a relevant focus for therapeutic preinterventions and interventions for SUD after CAN.

Daily associations between emotional functioning and alcohol involvement: Moderating effects of response inhibition and gender

BACKGROUND

Research has linked tonic and variable mood to problematic alcohol use, both between- and within-subjects. Indices of behavioral control have moderated these links, at least at the between-subjects level. The current study examines daily associations between indices of emotional functioning and alcohol involvement as a function of response inhibition.

METHODS

College student drinkers (n=74; 58.11% female) were enrolled in a study on emotion and alcohol use. Participants completed a stop-signal task as an index of response inhibition. They then carried a personal data device for 21 days, reporting daily on mood, alcohol use, and acute alcohol use disorder symptoms. Mood instability was the mean square of successive differences from daily mood assessments.

RESULTS

There were 1309 person days (622 drinking days) available for analysis. Pre-drinking mood instability was positively associated the likelihood of drinking and drinks consumed on drinking days. The former association was diminished among women with high response inhibition. Pre-drinking positive mood was positively associated the likelihood of drinking and drinks consumed on drinking days. The latter association was diminished among women with high response inhibition. Pre-drinking negative mood was positively associated with drinks consumed on drinking days among women with low response inhibition. Finally, pre-drinking positive mood was associated with acute alcohol use disorder symptoms among those with low response inhibition.

CONCLUSIONS

These results suggest that interventions targeting positive mood may be particularly important. Further, developing ways to improve response inhibition control may broadly influence negative drinking outcomes by affecting multiple mood-drinking associations.

Does Alcohol or Delinquency Help Adolescents Feel Better Over Time? A Study on the Influence of Heavy Drinking and Violent/Property Offending on Negative Emotions

Conceptualizing adolescent drinking and delinquency as adaptations to strain, we explore whether they (a) decrease or increase the probability of feeling depression and anxiety later and (b) ameliorate or aggravate the effect of strain on the negative emotions over time. These relationships are also examined for gender differences by analyzing data separately for males and females as well as both combined. We conducted ordinary least squares regression analysis of panel data from the first two waves of the National Longitudinal Study of Adolescent to Adult Health. Heavy drinking and serious delinquency were found to increase the probability of feeling depression and anxiety later, whereas they tend to ameliorate the emotionally deleterious effect of strain for males and, to a lesser extent, females.

Prescription Drug Misuse Among College Students

Prescription drug misuse (PDM) is a well-documented trend among college students, with a rising prevalence in recent years. Motivations for PDM are an important aspect of the dynamics surrounding this behavior. Using a sample of undergraduate students taken from a large southern university ( N = 841), this study separates users based on their motives into typologies of instrumental, recreational, or mixed motive users and examines the differences between them using a number of social learning, social control, and strain-based risk factors while also comparing them with non-users. The results show that social learning risk factors, specifically those related to the concepts of differential association and differential reinforcement, as well as the use of other drugs, exert the greatest impact on likelihood of PDM between the motivational typologies.

Gender-Specific Effects of Mood on Alcohol-Seeking Behaviors: Preliminary Findings Using Intravenous Alcohol Self-Administration

BACKGROUND

Although negative mood has long been implicated in differences in alcohol seeking by men and women, little research has used precise, well-controlled laboratory experiments to examine how negative mood affects alcohol-seeking behaviors.

METHODS

A total of 34 (19 women) community-dwelling, alcohol-using adults aged 21 to 32 (mean age = 24.86, SD = 3.40, 74.3% Caucasian; Alcohol Use Disorders Identification Test [AUDIT] = 10.1, SD = 3.4) completed 2 counterbalanced intravenous alcohol self-administration sessions: one under negative mood and one under neutral mood. Fourteen individuals (9 women; mean age = 25.00, SD = 2.77) participated in an alcohol "liking" experiment (i.e., free access [FA] drinking) and 20 individuals (10 women; mean age = 24.77, SD = 3.73) participated in an alcohol "wanting" experiment, in which gaining access to alcohol required progressively effortful work. There was no significant difference between men and women on the AUDIT, t(32) = -0.38, p = 0.71.

RESULTS

Priming with negative mood induction caused a significant decrease in self-reported mood (mean change = -1.85, t(32) = -6.81, p < 0.001), as intended. In FA, negative mood was associated with a significantly increased peak breath alcohol concentration (BrAC; F = 9.41, p = 0.01), with a trend toward a greater effect in men than in women (F = 2.67, p = 0.13). Negative mood also had a significant effect on peak BrAC achieved in the progressive work paradigm (F = 5.28, p = 0.04), with a significantly stronger effect in men (F = 5.35, p = 0.03) than women; men also trended toward more consistent work for alcohol across both neutral and negative sessions.

CONCLUSIONS

These preliminary findings demonstrate a gender-specific response on how mood affects alcohol seeking and suggest gender-specific interventions to prevent mood-based alcohol consumption.