Psychometric analysis and validity of the daily alcohol-related consequences and evaluations measure for young adults

Beyond mediators: A critical review and methodological path forward for studying mechanisms in alcohol use treatment research

Understanding how treatments for alcohol use disorder (AUD) facilitate behavior change has long been recognized as an important area of research for advancing clinical care. However, despite decades of research, the specific mechanisms of change for most AUD treatments remain largely unknown because most prior work in the field has focused only on statistical mediation. Statistical mediation is a necessary but not sufficient condition to establish evidence for a mechanism of change. Mediators are intermediate variables that account statistically for the relationship between independent and dependent variables, whereas mechanisms provide more detailed explanations of how an intervention leads to a desired outcome. Thus, mediators and mechanisms are not equivalent. To advance mechanisms of behavior change research, in this critical review we provide an overview of methodological shortfalls of existing AUD treatment mechanism research and introduce an etiologically informed precision medicine approach that facilitates the testing of mechanisms of behavior change rather than treatment mediators. We propose a framework for studying mechanisms in alcohol treatment research that promises to facilitate our understanding of behavior change and precision medicine (i.e., for whom a given mechanism of behavior change operates and under what conditions). The framework presented in this review has several overarching goals, one of which is to provide a methodological roadmap for testing AUD recovery mechanisms. We provide two examples of our framework, one pharmacological and one behavioral, to facilitate future efforts to implement this methodological approach to mechanism research. The framework proposed in this critical review facilitates the alignment of AUD treatment mechanism research with current theories of etiologic mechanisms, precision medicine efforts, and cross-disciplinary approaches to testing mechanisms. Although no framework can address all the challenges related to mechanisms research, our goal is to help facilitate a shift toward more rigorous and falsifiable behavior change research.

Characterizing Alcohol Consumption and Positive and Negative Consequences During Simultaneous Alcohol and Cannabis Use Events

OBJECTIVE

Young adults who engage in simultaneous alcohol and cannabis use report heavy use of both substances. Event-level studies examining differences between consequences experienced on simultaneous use compared with single substance use days have been mixed. Although studies often control for alcohol use levels, few have examined how quantity of alcohol may influence consequences experienced on simultaneous use days. Furthermore, little research has examined the relationship between simultaneous use and positive consequences or explored individual consequences. This study examined differences in consequences experienced on simultaneous use versus single substance use days (alcohol-only, cannabis-only) including endorsement of specific consequences and examined the relationship among simultaneous use, consequences, and alcohol consumption.

METHOD

Young adults who engage in simultaneous use (N = 86) completed 30 days of daily surveys reporting substance use and positive and negative consequences.

RESULTS

Simultaneous use days were associated with more negative and positive consequences than single substance use (alcohol-only and cannabis-only) days. We also examined endorsement of specific positive and negative consequences on alcohol-only, cannabis-only, and simultaneous use days. The effect of day type (simultaneous use vs. alcohol-only) on consequences was moderated by alcohol quantity. On lighter drinking days, more positive and negative consequences were endorsed if it was a simultaneous use versus alcohol-only day. On heavier drinking days, number of consequences did not differ between simultaneous use and alcohol-only days.

CONCLUSIONS

Findings from this study point to simultaneous use as both reinforcing and high risk and highlight the importance of intervening even on lighter drinking simultaneous use occasions to reduce harms.

High-intensity drinking and hours spent drinking

BACKGROUND

High-intensity drinking (HID) is associated with negative consequences, but it remains unclear whether a time qualifier (i.e., time spent drinking) is needed to identify individuals at highest risk. To improve the measurement and conceptualization of HID, we examined the utility of adding a time qualifier to define what constitutes an occasion of HID using repeated daily surveys in a sample of young adults.

METHODS

Participants were selected from a nationally representative sample of 12th-grade students in the United States who participated in the Monitoring the Future (MTF) study in Spring 2018. In 2019 and 2020, young adults (at modal ages 19-20) responded to annual and daily (14 consecutive days per year) online surveys about their alcohol use.

RESULTS

When we compared moderate drinking days (less than 4/5 drinks for women/men), binge drinking days (4-7/5-9 drinks), and HID days (8+/10+ drinks), HID days had the longest duration of drinking (5.2 h), highest peak estimated blood alcohol concentration (eBAC, 0.30%), and greatest drinking pace (2.58 drinks/h). HID was associated with a greater number of negative consequences than either moderate or binge drinking; adjusting for time spent drinking did not impact this interpretation. HID was reported on 10.9% of days; when defined as 8/10+ drinks in 4 h or 2 h, HID was reported on 4.8% and 1.0% of days, respectively. Nearly all differences in eBAC and negative consequences persisted across drinking intensity despite the introduction of time constraints.

CONCLUSIONS

HID days were characterized by both a longer time spent drinking and a more rapid pace of drinking. Adding a time qualifier to the definition of HID would restrict variability by only describing the minority of days and does not improve the distinctions among levels of risk.

A Longitudinal Analysis of Monthly Changes in Substance Use in Relation to Negative Consequences From Alcohol and Cannabis Use in a Community Sample of Young Adults

OBJECTIVE

Experiencing negative substance use consequences may deter future use, alter patterns of substance use (e.g., substituting one substance for another, combining substances), or point to a sustained pattern of engaging in heavy or frequent use. We used monthly data to examine relationships between negative alcohol and cannabis use consequences experienced in one month and changes in use the following month.

METHOD

Data were from 508 individuals (59% female; ages 18-23 years at enrollment) who were surveyed monthly for 2 years and used both alcohol and cannabis during the study period. Multilevel models assessed within-person associations between monthly fluctuations in substance-related negative consequences and the next month's substance use (i.e., typical drinks per week, cannabis use frequency, and simultaneous alcohol and cannabis/marijuana [SAM] use), controlling for the prior month's substance use.

RESULTS

Positive associations were found between alcohol consequences and the following month's alcohol use and between cannabis consequences and subsequent cannabis use, although only the cannabis association was statistically significant. There was little evidence of effects of cannabis consequences on the next month's alcohol use or alcohol consequences on the next month's cannabis use. Cannabis consequences had a positive and statistically significant association with the next month's SAM use. Within-substance positive associations were strongest for physical alcohol consequences and cannabis consequences of low motivation, memory problems, and trouble breathing.

CONCLUSIONS

Experiencing negative cannabis use consequences predicted more frequent cannabis use and greater chance of SAM use 1 month later. Results point to negative consequences, along with prior use, indicating risk for future use.

Reasons for not drinking among young adults with simultaneous alcohol and cannabis use: A latent class analysis applied to daily diary data

Simultaneous alcohol and cannabis use (i.e., simultaneous use) is prevalent among young adults and often associated with negative consequences. Understanding reasons for not drinking (RND) may provide insight into a key intervention target for reducing negative consequences associated with simultaneous use. RND may vary on a day-to-day level, and multiple RND may be endorsed on a given day. Latent class analysis (LCA) of daily diary data is a nuanced approach that can identify complex patterns of daily RND as well as its day- and person-level covariates. The current study was a secondary data analysis of daily diary data from young adults who engaged in heavy drinking and recent simultaneous use (n = 154). We aimed to: (1) characterize daily RND, (2) use LCA to classify day-level patterns of RND, and (3) compare latent classes on same-day variables (i.e., positive and negative affect, day of the week), previous-day variables (i.e., substance use, intoxication level, consequences), and person-level characteristics (i.e., age, sex, baseline substance use frequency, simultaneous use motives). Participants completed up to 14 consecutive diaries. Multilevel LCA identified four classes of heterogeneous daily RND profiles. Daily RND classes significantly differed in terms of day of the week, previous day quantity of cannabis use, and several baseline variables (age, typical substance use, simultaneous use motives). Study findings offer preliminary support for heterogeneous RND classes among young adults engaging in simultaneous use and suggest multiple avenues for future research.

"Wake-and-bake" cannabis use: Predictors and cannabis-related outcomes of use shortly after waking

BACKGROUND

Given recent historical increases in young adults frequent cannabis use and changes in cannabis policies throughout the United States, there is a need to examine high-risk patterns of use. This paper examined predictors and cannabis-related outcomes of "wake-and-bake" cannabis use, operationalized as use within 30min of waking.

METHODS

Participants were 409 young adults (M_age=21.61 years, 50.8% female) enrolled in a longitudinal study on simultaneous alcohol and cannabis use (i.e., using alcohol and cannabis at the same time such that their effects overlap). Eligibility criteria included reporting alcohol use 3+ times and simultaneous alcohol and cannabis use 1+ times in the past month. Participants completed twice-daily surveys for six 14-day bursts across two calendar years. Aims were tested using multilevel models.

RESULTS

Analyses were limited to cannabis use days (9406 days; 33.3% of all sampled days), and thereby to participants who reported using cannabis (384 participants; 93.9% of the sample). Wake-and-bake use was reported on 11.2% of cannabis use days and at least once by 35.4% of participants who used cannabis. On wake-and-bake use days, participants were high for more hours and had greater odds of driving under the influence of cannabis, but did not experience more negative consequences, relative to non-wake-and-bake cannabis use days. Participants who reported more cannabis use disorder symptoms and those reporting higher average social anxiety motives for cannabis use reported more frequent wake-and-bake use.

CONCLUSIONS

Wake-and-bake cannabis use may be a useful marker of high-risk cannabis use, including driving under the influence of cannabis.

A Scoping Review on the Role of Sexual Orientation and Gender Identity Microaggressions in Substance Use

Objectives

Disparities in substance use patterns and outcomes are evident among sexual and gender minority groups. Sexual orientation and gender identity (SOGI) microaggression, or the subtle forms of aggression experienced by lesbian, gay, bisexual, transgender, gender non-conforming/non-binary, and gender diverse individuals, has recently been explored as a mechanism that leads to negative adjustment outcomes, including substance use. In this study we examined extant literature on the association between SOGI microaggression and substance use, and the intermediary factors that mediate or moderate this relationship.

Method

Scoping review method was used to systematically map the literature base using database aggregators (e.g., Scopus, EBSCO) following the PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines.

Results

We found that SOGI microaggression is positively associated with substance use and negative consequences, and this relationship is mediated or moderated by motivational, relational, and identity processes.

Conclusion

These findings suggest the need to consider microaggression experience when working with clients of diverse sexual and gender identities. Likewise, additional studies are needed on other intermediary factors and effects of microaggression on substances other than alcohol. Most importantly, this study underscores the need for understanding the link between microaggression and substance use in greater efforts to promote sexual well-being and building competence in fostering the trifecta of sexual health, sexual rights, and sexual pleasure.

Young Adult Physical, Social, and Temporal Contexts of Simultaneous Alcohol and Marijuana Use

OBJECTIVE

Simultaneous alcohol and marijuana (SAM) use is reported to be associated with heavier alcohol and marijuana use and more negative consequences, but less is known about the social, physical, and temporal contexts of SAM use.

METHOD

Young adults (N = 326, 51.2% male, 49.1% White non-Hispanic) who reported past-month SAM use completed up to 14 daily surveys across five bursts that assessed SAM use and negative consequences and social, physical, and temporal contexts. We used multilevel models to examine SAM use contexts' associations with alcohol/marijuana quantity and consequences.

RESULTS

The social context of alone only (vs. with others only) was associated with consuming fewer drinks. Physical contexts that included using both at home and outside the home (vs. only at home) were associated with greater alcohol and marijuana quantity and negative consequences (but not after controlling for alcohol quantity); use outside the home only (vs. only at home) was associated with more alcohol use, more alcohol consequences (but not after controlling for alcohol quantity), and fewer marijuana consequences (even after controlling for marijuana quantity). The temporal context of first engaging in SAM use before 6 P.M. (vs. after 9 P.M.) was associated with greater alcohol and marijuana quantity and more marijuana consequences (but not after controlling for number of hours high), and first engaging in SAM use between 6 and 9 P.M. was associated with more hours high.

CONCLUSIONS

SAM use contexts such as using with others, using outside the home, and using earlier in the evening are typically associated with greater alcohol/marijuana quantity and consequences.

Negative but Not Positive Alcohol-Related Consequences Tend to Occur Above the Heavy Episodic Drinking Threshold: A Daily Study of Young Adult Heavy Drinkers

AIMS

This study used event-level data to identify the threshold (i.e. number of standard alcoholic drinks) at which specific negative and positive alcohol-related consequences are likely to occur.

METHODS

Ninety-six college students aged 18-20 reporting weekly heavy episodic drinking (HED) or at least one negative alcohol-related consequence in the past 2 weeks completed ecological momentary assessment over 28 days. Participants reported number of standard drinks consumed and negative (e.g. nausea) and positive (e.g. new friend) alcohol-related consequences on 492 drinking nights. The area under the receiver operating characteristic (AUROC) curve measured the ability of an increasing number of drinks consumed to discriminate between nights with versus without a given consequence. The Youden Index method was used to identify the optimal threshold of drinks for each consequence. Thresholds were examined for each consequence by participants' biological sex and heavy drinking status.

RESULTS

Across subgroups, most consequences occurred on nights where participants reported higher consumption levels relative to nights where consequences did not occur. Thresholds for negative consequences ranged between four and nine drinks and thresholds for positive consequences were between three and six drinks.

CONCLUSIONS

Many negative consequences are likely to occur following the traditional HED threshold of 4+/5+ drinks (females/males), with more severe consequences occurring at slightly higher thresholds. Positive consequences are likely to occur at lower thresholds. There may be an optimal number of drinks that maximize positive while minimizing negative consequences for heavy drinking college students.

Planned versus unplanned drinking and cannabis use: Do facets of trait impulsivity influence daily risk?

OBJECTIVE

Planned and unplanned substance use have been examined as predictors of heavier alcohol and cannabis use and problems at the between-person level. However, it remains unclear whether planned versus unplanned use is riskiest at the day-level, and for whom. The present study tested whether day-level planned versus unplanned alcohol and cannabis use were associated with higher alcohol and cannabis consumption and negative consequences that day and whether two impulsive traits, lack of premeditation and positive urgency, moderated associations.

METHOD

Young adults (N = 409; 50.9% female) completed five bursts of daily surveys, each consisting of a morning and afternoon report across 14 consecutive days. During a baseline session, participants reported their impulsivity (UPPS-P). During afternoon surveys, participants reported their plans to use alcohol/cannabis that night. During morning surveys, participants reported number of drinks consumed/hours spent high yesterday and negative consequences experienced.

RESULTS

Planned drinking days were associated with a greater number of drinks and negative consequences, whereas planned cannabis use days were associated with more hours spent high but not negative consequences. In the drinking quantity model, there was a significant interaction for planned versus unplanned drinking by positive urgency. Planned drinking was associated with heavier alcohol consumption across levels of positive urgency; however, unplanned drinking was associated with heavier consumption for individuals with higher (vs. lower) levels of positive urgency.

CONCLUSIONS

Day-level planned drinking and cannabis use are important factors to target in just-in-time interventions. However, interventions focused on planned and unplanned drinking may be particularly effective for individuals with higher levels of positive urgency. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Daily impulsivity and alcohol expectancies: A multilevel examination of the acquired preparedness model

BACKGROUND

The acquired preparedness model (APM) integrates personality traits and psychosocial learning to posit amechanism whereby individuals initiate and continue alcohol use. The present study examined within-person associations between impulsivity, alcohol expectancies, alcohol use, and alcohol problems to inform daily process models of drinking and test the APM.

METHODS

Participants were 89 college student drinkers who completed momentary reports (three random and two user-initiated reports) for 14 days. Multilevel mediation analyses examined whether daily associations between impulsivity and alcohol use and problems were mediated by positive and negative expectancies.

RESULTS

Daily impulsivity was positively associated with daily positive expectancies, prior to drinking. Greater daily positive expectancies were associated with more alcohol consumed and alcohol problems that day. The indirect effects were significant, indicating greater than usual impulsivity was associated with greater alcohol use and alcohol problems through greater positive expectancies. Impulsivity was positively associated with negative expectancies at the within-subject and between-subject levels, but negative expectancies did not serve as a mediator between impulsivity and either alcohol outcome.

CONCLUSIONS

This is the first study to test the APM at the day level. Findings supported daily fluctuations in beliefs regarding the positive effects of alcohol as a salient mechanism explaining the link between daily impulsivity and level of alcohol use. Because impulsivity was linked to changes in expectancy states that were proximal to drinking that day, this information may be used to develop prevention and intervention programs to reduce alcohol harms.

Occasion-level investigation of playing drinking games: Associations with cognitions, situational factors, alcohol use, and negative consequences among adolescents and young adults

The present study examined occasion-level associations between cognitions (willingness to drink, descriptive norms, and injunctive norms) and situational factors (familiarity with people and locations) with playing drinking games (DGs) among adolescents and young adults. Further, this study tested the associations between playing DGs, the number of drinks consumed, and the negative consequences experienced at the occasion level. Participants were 15-25-year-olds (N = 688; 43% male, 47% White, Non-Hispanic, Mean age = 21.18) who were part of a longitudinal ecological momentary assessment (EMA) study on cognitions and alcohol use. The study design consisted of a 3-week EMA burst design (8 surveys per week) that was repeated quarterly over the 12-month study (up to 2x/day) per participant. Multilevel models showed that occasion-level risks (higher willingness, higher descriptive norms, and less familiarity with people) were associated with playing DGs. When examining the within-person associations between DGs and number of drinks, results showed that playing DGs was associated with consuming more drinks. For consequences, DGs were not uniquely predictive of experiencing more consequences and riding in a vehicle with a driver who had been drinking. This study contributes to the literature by examining associations between cognitions and situational factors with DGs and the role DGs play in experiencing negative consequences among a diverse sample of adolescents and young adults.

Hours high as a proxy for marijuana use quantity in intensive longitudinal designs

BACKGROUND

Measuring marijuana use quantity in survey research is complicated due to wide variation in the types (e.g., flower, edibles) and potency of marijuana products and in the modes (e.g., smoking, dabbing) used to consume products. There is currently no gold standard marijuana use quantity measure for survey research. This study examined whether number of hours high can be used as a proxy for marijuana use quantity in survey research, particularly in intensive longitudinal designs.

METHODS

Participants came from a community sample of young adults participating in a longitudinal study on simultaneous alcohol and marijuana use that used a longitudinal measurement-burst design in which participants completed surveys on up to 14 consecutive days in up to five bursts across nearly two calendar years. Those who reported using marijuana on at least one sampled day were included in present analyses (N = 379; Mage = 21.6; 50.7 % female). Hypotheses were tested using Poisson multilevel models and a logistic regression.

RESULTS

Within persons, mode-specific marijuana use quantity variables predicted same-day number of hours high indicating evidence of initial criterion validity. In turn, hours high predicted same-day negative marijuana-related consequences indicating evidence of proximal predictive validity. Between persons, participants' average number of hours high was positively associated with their odds of possible cannabis use disorder following the last burst demonstrating distal predictive validity.

CONCLUSIONS

Number of hours high may be a parsimonious proxy for measuring marijuana use quantity (regardless of mode of use) in survey research, particularly in intensive longitudinal designs.

Motives and Consequences of Alcohol Use in People With Social Anxiety Disorder: A Daily Diary Study

People with social anxiety disorder (SAD) are at increased risk for alcohol-related problems. Most research exploring social anxiety and alcohol use has examined negative drinking consequences, with less consideration of positive consequences-namely positive social experiences-that may reinforce alcohol use. In this daily diary study, we examined how adults diagnosed with SAD (N = 26) and a psychologically healthy control group (N = 28) experienced positive drinking consequences in naturally occurring drinking episodes during the study period. For 14 consecutive days, participants answered questions about alcohol use, motives for drinking, and positive consequences of drinking. On days when participants drank, those with SAD were more likely than healthy controls to perceive a reduction in anxiety, but the two groups did not differ in their likelihood of experiencing positive social drinking consequences. For both groups, on days when they were more motivated to drink to enhance social experiences (affiliation motives) or cope with distress (coping motives), they were more likely to obtain positive consequences from drinking. Compared to controls, participants with SAD endorsed stronger trait and daily coping motives (anxiety-coping, social anxiety-coping, and depression-coping). Results are discussed in the context of reinforcement mechanisms that may maintain social anxiety and alcohol use.

Measuring subjective alcohol effects in daily life using contemporary young adult language

Young adults' subjective feelings of alcohol's effects are a key predictor of engagement in risky behavior such as deciding whether to drive after drinking. To best inform prevention messaging and tailor intervention techniques that target high-risk drinking, it is critical that our measurement best captures subjective feelings. Standard sliding scales (0-100 rating of, "how drunk do you feel?") may have some challenges with distinguishing between levels of subjective responses to alcohol. The current daily diary study compared the utility of the standard sliding scale to a newly developed sliding scale that uses contemporary, crowd-sourced language from young adults as evenly spaced anchors (slightly buzzed, tipsy/"happy," drunk, and wasted) along a continuum of subjective effects of alcohol. Participants were 154 young adult substance users (58% women) who completed up to 14 consecutive daily reports of their substance use behavior. The four-anchored sliding scale performed similarly well as the standard scale in predicting alcohol use outcomes while showing the advantages of recording higher mean values/standard deviations and demonstrating that participants used the anchors to denote varying degrees of subjective effects. Findings suggest that the four-anchored subjective alcohol effects sliding scale is a viable alternative to the standard scale. By providing evenly spaced anchors that reflect incremental differences in language young adults use to describe their subjective states, the proposed scale may provide a guide for participants to indicate how they feel after drinking and may better capture variability in alcohol's effects. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Daily impulsivity is associated with alcohol use and problems via coping motives, but not enhancement motives

BACKGROUND

The present study sought to determine daily associations between impulsivity, coping and enhancement motives, alcohol use, and alcohol problems in the natural environment.

METHODS

Participants were 89 (47 women) heavy drinking, college students from a university in the southeastern U.S. who completed a 14-day ecological momentary assessment study. Each day, participants completed three random reports of momentary impulsivity and indicators of drinking motives and two additional reports at the beginning and end of any drinking occasions.

RESULTS

A series of multilevel mediation models were tested to examine indirect effects from impulsivity to alcohol use and alcohol problems through coping and enhancement motives. At the within-person level, results revealed that greater than usual impulsivity experienced prior to drinking was associated with greater coping motives, and this in turn was associated with greater number of drinks consumed that day (all p values <0.001). A similar indirect effect was revealed when impulsivity predicted alcohol problems that day through coping motives (p values range: <0.001 to .01). Greater enhancement motives than usual were associated with greater number of drinks consumed and alcohol problems experienced that day (p values range: <0.001 to.001), but associations with impulsivity were nonsignificant.

CONCLUSIONS

Findings supported daily fluctuations in drinking to cope motives as a salient mechanism explaining the link between daily impulsivity and level of alcohol use and alcohol problems. Fluctuations in daily impulsivity were associated with changes in motivations to drink which may benefit efforts aimed at reducing alcohol harms among young adults.

Pre-game drinking among young adults and its association with positive and negative alcohol consequences

BACKGROUND

Pre-gaming, or drinking before going out, is common among young adults and associated with heavier drinking and negative consequences. However, findings have been mixed as to whether a unique, day-level association between pre-gaming and negative consequences exists independent of alcohol intake. It is also unknown whether young adults experience more positive consequences of alcohol use on days they engage in pre-gaming. This study tested day-level associations between pre-gaming and positive and negative consequences, controlling for same-day alcohol intake, as well as whether these associations were moderated by person- and day-level variables.

METHODS

Participants were 148 young adult heavy drinkers (M_age = 20.30, SD_age = 1.45, 57.4% female) who reported past-month simultaneous alcohol and marijuana use. For up to 14 consecutive days, participants completed electronic surveys asking about their drinking behaviors and consequences the previous day.

RESULTS

Prior to adjusting for alcohol intake, Poisson multilevel models showed that participants reported more negative and positive consequences on days they pre-gamed and those who reported pre-gaming more often throughout the study also experienced more negative and positive consequences overall. After controlling for alcohol intake, a positive, day-level association between pre-gaming and positive consequences remained. There was no evidence of moderation of study associations by person- or day-level variables.

CONCLUSION

The unique association between pre-gaming and positive consequences may help explain why pre-gaming is linked with heavy drinking and other risky behaviors as positive consequences have been shown to reinforce such behaviors. Findings suggest pre-gaming may be a useful intervention point for alcohol reduction programs.

Testing daily-level drinking and negative consequences as predictors of next-day drinking cognitions

OBJECTIVE

Limited research has examined how alcohol use and related consequences affect drinking-related cognitions, which is important as these cognitions may contribute to future drinking. The current study examines daily associations between alcohol use and alcohol-related negative consequences with next-day Prototype Willingness Model (PWM) social reaction pathway cognitions.

METHOD

Participants ages 15-25 years (N = 124, Mean age 18.7, SD = 2.87) completed daily surveys for up to three weeks (i.e., up to 11 surveys/week) using an ecological momentary assessment design. Linear mixed models and Poisson generalized mixed models were conducted to examine whether number of alcoholic drinks or number of negative alcohol-related consequences were associated with next-day PWM social reaction cognitions, including perceived vulnerability, descriptive normative perceptions of number of drinks consumed and the percentage of friends who drink, prototype favorability, prototype similarity, and willingness (i.e., openness) to drink.

RESULTS

Within-person results indicated more alcohol use on a given day was associated with lower next-day normative perceptions of the percentage of friends who drink on that day of the week and higher prototype similarity. Furthermore, within-person results indicated that experiencing more negative alcohol-related consequences on a given day was associated with higher perceived vulnerability and lower willingness to drink the next day.

CONCLUSIONS

Findings showed that next-day social reaction PWM cognitions were associated with prior day alcohol use and negative alcohol-related consequences, suggesting that an intervention might be timed to target drinking cognitions the morning following a drinking event, particularly after experiencing negative alcohol-related consequences.

Unplanned versus planned simultaneous alcohol and marijuana use in relation to substance use and consequences: Results from a longitudinal daily study

Objective: The current study expands the literature on simultaneous alcohol and marijuana (SAM) use by focusing on the distinction between unplanned and planned SAM use to identify potential intervention targets. This study explored whether unplanned or planned SAM use was associated with differences in alcohol and/or marijuana use and consequences. Method: A community sample of young adults (aged 18-25) with recent alcohol and SAM use was recruited [N = 409; mean (SD) = 21.61 (2.17) years; 50.9% female; 48.2% non-Hispanic/Latinx White]. Participants completed five 2-week bursts of online daily surveys (2 ×/day; 81.99% of morning and 82.23% of afternoon surveys completed) and reported on substance use intentions and behavior. Results: Descriptive findings showed that among days on which participants reported SAM use, 41.85% of the days were unplanned SAM use days. Based on daily-level results from multilevel models, on days with unplanned SAM use, young adults reported consuming fewer drinks, fewer hours high from marijuana, and lower subjective intoxication/high, compared to planned SAM use days, thus indicating that planned SAM use was riskier. Unplanned SAM use was not significantly associated with positive or negative consequences related to alcohol or marijuana, after accounting for the number of drinks or hours high from marijuana. Conclusions: Current findings suggest that interventions should target days on which young adults are planning to engage in SAM use. Future work is needed to identify factors that predict planned SAM use on specific occasions and also to disentangle the potential role of unplanned heavy use. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Do alcohol-related consequences and how they are evaluated predict consumption during and days until the next drinking event?

Objective: Alcohol-related consequences are most often examined as outcomes of alcohol use. However, it is also possible that experiencing consequences may predict future drinking behavior. The predictive power of consequences on future drinking behavior may involve both objective experiences of consequences and subjective evaluations of those consequences (i.e., how positive, how negative). The purpose of the present study was to understand how positive and negative alcohol-related consequences-and evaluations of those consequences-predict elements of the next drinking event among college students. Method: 96 participants reported alcohol use and related consequences over a 28-day daily assessment period. Results: Survival analysis and multilevel modeling were used to examine the influence of positive and negative consequences from a given drinking event on latency to and number of drinks consumed at the next drinking event. Contrary to hypotheses, subsequent drinking was not impacted by recent consequences nor how they were perceived. Conclusions: Though theoretically, experiencing alcohol consequences may impact proximal drinking behavior, findings suggest that, in the current sample, other factors have greater importance in the latency between drinking events and amount of alcohol consumed. Future work should continue to identify event-level predictors that impact behavior at the next drinking event, and ways drinkers attempt to avoid repetition of drinking consequences other than simply drinking less (e.g., protective behavioral strategies), as such factors would be valuable targets for intervention. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Drinking Motives and Drinking Consequences across Days: Differences and Similarities between Moderate, Binge, and High-Intensity Drinking

BACKGROUND

The current study examined the extent to which within-person variation in drinking motives differentiates moderate, binge, and high-intensity drinking; and independent associations of motives and drinking intensity with alcohol use consequences in a sample of young adult drinkers from across the United States.

METHODS

Participants were past 30-day drinkers in the U.S. nationally representative Monitoring the Future 12th grade sample in 2018, who also reported alcohol use during a 14-day data collection burst 1 year later (N = 484 people, mean age 19.3 [SD 0.40], 43% female; N = 1042 drinking days) as part of the Young Adult Daily Life Study in 2019. Weighted multilevel modeling estimated within- and between-person associations of drinking motives, drinking intensity (i.e., moderate [women 1-3, men 1-4 drinks], binge [women 4-7, men 5-9 drinks], and high-intensity drinking [women 8+, men 10+ drinks]), and number of positive and negative alcohol consequences.

RESULTS

On days participants reported greater enhancement and social motives, they were more likely to engage in high-intensity (vs. binge) drinking and binge (vs. moderate) drinking and experience more positive alcohol consequences. On days participants reported greater enhancement and coping motives, they experienced more negative alcohol consequences. Binge (vs. moderate) drinking on a given day was associated with more positive and negative alcohol consequences; high-intensity (vs. binge) drinking on a given day was associated with more negative alcohol consequences that day. Moderation analyses indicated that social motives were associated with high-intensity (vs. binge) drinking only among college students.

CONCLUSIONS

Stronger drinking motives on a given day were associated with drinking intensity (enhancement and social motives) and negative consequences (enhancement and coping). High-intensity (vs. binge or moderate) drinking was associated with more negative consequences but not more positive consequences. These results underscore that high-intensity drinking and consequences vary across days and time-varying, occasion-specific risks such as current motivational context are appropriate targets for intervention.

Social interaction anxiety and perceived coping efficacy: Mechanisms of the association between minority stress and drinking consequences among sexual minority women

Sexual minority women (SMW; individuals who identify as women and as lesbian, bisexual, or with another sexual minority identity) are at increased risk for problematic alcohol use compared to their heterosexual counterparts. This increased risk has been attributed to minority stress. However, longitudinal research examining associations between minority stress and alcohol use outcomes is extremely limited and examinations of these associations at the daily level are nearly non-existent. Further, few longitudinal studies have examined mechanisms through which minority stress may impact alcohol use. We utilized data from a 14-day daily diary study of 98 SMW to examine daily-level associations between experiences of minority stress, alcohol consumption and consequences, and two proposed mediators of these associations (perceived coping efficacy, social interaction anxiety). Results indicated that on days when participants experienced minority stress events, they experienced lower coping efficacy, higher social interaction anxiety, and more drinking consequences than usual. Minority stress was not associated with same-day alcohol consumption. Perceived coping efficacy and social interaction anxiety mediated the same-day association between minority stress and drinking consequences. No prospective associations were significant, suggesting that studies with multiple assessments per day may be necessary to detect immediate effects of minority stress. Findings highlight the potential impact of daily experiences of minority stress on alcohol consequences and provide evidence that two general psychological processes may be mechanisms through which minority stress impacts alcohol consequences. These results provide evidence of a need for interventions that teach SMW skills for coping with minority stress and its psychological consequences.

How much and how fast: Alcohol consumption patterns, drinking-episode affect, and next-day consequences in the daily life of underage heavy drinkers

BACKGROUND

Understanding how alcohol consumption patterns are associated with negative and positive outcomes can inform efforts to reduce negative consequences through modification of those patterns. This is important in underage drinkers, many of whom drink heavily despite negative consequences. Most work has focused on the amount of alcohol consumed, but amount provides limited information about consumption patterns compared to rate of consumption, or how fast individuals drink. We therefore examined associations of both amount and rate of consumption with negative and positive outcomes (immediate affective states and next-morning consequences) in daily life.

METHOD

Ninety-five college students aged 18-20 years completed ecological momentary assessment over 28 days. Participants reported number of standard drinks consumed and positive and negative affect hourly within drinking episodes. Estimated blood alcohol concentration (eBAC) values were used to create amount and rate of consumption indicators. Each morning after drinking, participants reported negative (e.g., blackout, hangover) and positive (e.g., new friend, making others laugh) consequences.

RESULTS

Within drinking episodes, multilevel models showed faster consumption was associated with reduced negative affect and both larger amount and faster consumption were associated with greater positive affect. Further, amount and rate were both associated with greater likelihood of a negative consequence the next morning. Rate, but not amount, was associated with more positive consequences.

CONCLUSIONS

Not only how much but also how fast individuals drink may be important for the positive and negative outcomes they experience. Interventions to reduce negative alcohol-related outcomes should consider not only amount, but also rate of consumption.

Momentary patterns of impulsivity and alcohol use: A cause or consequence?

BACKGROUND

Impulsivity is a robust risk factor for alcohol use, but significant gaps remain in our understanding of the way that impulsivity relates to alcohol harms. Most prior research has been limited to between-level differences; thus, within-person variability in impulsivity at the momentary level and its bidirectional association with alcohol use has not been examined. The present research used a 14-day ecological momentary assessment (EMA) design to determine the bidirectionality of impulsivity and alcohol use and alcohol problems.

METHODS

Participants were 89 (47 women) heavy-drinking college students. The mean age was 19.80 (SD = 1.76) years. Participants completed a baseline questionnaire and 14 consecutive days of momentary reports sent in the morning, afternoon, and evening; participants also completed two user-initiated reports during a drinking occasion at the beginning and the end of their drinking.

RESULTS

Multilevel modeling results indicated that greater levels of impulsivity experienced during the day was not associated with alcohol use or problems experienced that night. However, level of alcohol use and the number of alcohol problems experienced predicted greater variability in impulsivity the next day.

CONCLUSIONS

Overall, this study was the first to examine the bidirectional relationship between impulsivity and alcohol use using EMA. Findings supported impulsivity's conceptualization as a state construct and fluctuations in alcohol use behaviors coinciding with states of impulsivity the next day after drinking. Findings from the present study contributed to conceptual daily process models of drinking by identifying how alcohol behaviors unfold in the real world.

Assessment of Alcohol Use and Consequences: Comparison of Data Collected Via Timeline Followback Interview and Daily Reports

OBJECTIVE

The aim of this study was to compare data on both alcohol use and alcohol-related consequences between intensive longitudinal data collection and the retrospective Timeline Followback (TLFB) interview.

METHOD

Heavy drinking college students (n = 96; 52% women) completed daily reports across a 28-day period to assess alcohol use and positive and negative consequences of drinking. They returned to the lab at the end of this period to complete a TLFB assessing behavior over those same 28 days. First, t tests were used to compare variables aggregated across the full 28 days at the between-person level. Next, hierarchical linear modeling was used to examine within-person differences between methods for each variable in weekly and daily increments.

RESULTS

Many alcohol use and consequence variables were significantly different when derived from self-reports during TLFB versus daily reports. In contrast to prior work, we found that higher estimates of drinking were reported retrospectively on the TLFB than on the daily reports. In addition, discrepancies were greater on some variables for heavier drinkers and when more time had elapsed between the end of the daily reporting period and TLFB collection.

CONCLUSIONS

Recall of drinking behavior during TLFB and daily reports may differ in systematic ways, with discrepancies varying based on participant and methodological characteristics.

Cross-fading motives for simultaneous alcohol and marijuana use: Associations with young adults' use and consequences across days

BACKGROUND

Many young adults engage in simultaneous alcohol and marijuana (SAM) use so that their effects overlap. Little is known about motivations for dual substance use and associations with use and consequences. This study examined daily-level associations between cross-fading motives and levels of alcohol and marijuana use and consequences.

METHODS

Young adults who reported SAM use in the month prior were surveyed in two 14-day bursts. Data included 1049 SAM use days from 281 young adults (age 18-25; M age = 21.80, SD = 2.16; 50 % women). Multilevel models assessed between- and within-person effects of cross-fading motives (i.e., to enhance the effects of marijuana and/or alcohol use by using them simultaneously) on alcohol and marijuana use and consequences, after adjusting for general enhancement, social, coping, and conformity motives and the amount of alcohol and marijuana used that day.

RESULTS

On 76 % of SAM use days, participants endorsed cross-fading motives (i.e., to enhance the effect of alcohol or marijuana or to get drunk and high at the same time). Having stronger cross-fading motives was associated with greater alcohol use, perceived intoxication, and positive alcohol consequences at the between- and within-person levels. In addition, between-person, individuals who reported stronger cross-fading motives on average reported more negative alcohol consequences and positive marijuana consequences on average. Cross-fading motives on a given day were not associated with marijuana use or marijuana consequences that day.

CONCLUSIONS

Cross-fading motives were common and varied from day to day. Understanding the motivational context for dual substance use may support future interventions for cross-fading.

Alcohol demand assessed daily: Validity, variability, and the influence of drinking-related consequences

BACKGROUND

Alcohol demand, typically assessed at the trait-level, via single administration, reflects individualized alcohol value. We examined correspondence between baseline trait-level and daily brief measures of alcohol demand, and whether demand changes day-to-day in response to recent drinking-related consequences. Understanding whether consequences influence demand fluctuations may provide insight into when demand can be reduced in the context of intervention.

METHODS

Heavy drinking college students (n = 95, age 18-20, 52% female) completed a baseline 14-item alcohol purchase task (APT). Observed demand indices were: intensity (consumption at zero cost), O_max (maximum expenditure), and breakpoint (cost whereby consumption is suppressed to zero). Participants subsequently completed 28 daily reports including a 3-item APT (one item corresponding to each baseline index) and prior day drinking and consequences.

RESULTS

Intraclass correlations revealed within-person variability (i.e., day-to-day change) across daily demand indices. In hierarchical linear models (HLM), each daily demand index was significantly predicted by its corresponding baseline full APT index, when all three baseline indices were entered, suggesting convergent validity of the daily measure. Lower day-level intensity was predicted by more prior day negative consequences, controlling for several day- and person-level variables in HLM. Recent positive consequences did not impact intensity, and daily O_max and breakpoint were not predicted by any tested day- or person-level variables.

CONCLUSIONS

APT indices collected daily map on well to traditional single-administration APT metrics and change in response to recent consequences. Intensity demonstrated the greatest within-person variability, the strongest association with its corresponding full APT index, and theoretically-consistent prediction by negative consequences of drinking.

Personalized Models of Psychopathology

The personalized approach to psychopathology conceptualizes mental disorder as a complex system of contextualized dynamic processes that is nontrivially specific to each individual, and it seeks to develop formal idiographic statistical models to represent these individual processes. Although the personalized approach draws on long-standing influences in clinical psychology, there has been an explosion of research in recent years following the development of intensive longitudinal data capture and statistical techniques that facilitate modeling of the dynamic processes of each individual's pathology. Advances are also making idiographic analyses scalable and generalizable. We review emerging research using the personalized approach in descriptive psychopathology, precision assessment, and treatment selection and tailoring, and we identify future challenges and areas in need of additional research. The personalized approach to psychopathology holds promise to resolve thorny diagnostic issues, generate novel insights, and improve the timing and efficacy of interventions.

The relationship between unplanned drinking and event-level alcohol-related outcomes

Alcohol misuse among college students is a persistent public health problem. Identifying the circumstances which influence alcohol misuse can inform the development of interventions to reduce risk for adverse outcomes in this population. Prior research suggests that people who engage in unplanned drinking report more alcohol-related consequences, and that unplanned heavy drinking is associated with consequences at the within-person level. The present study involved exploration of the within-person relationship between drinking events that were unplanned (vs. planned) in the morning and later quantity consumed, negative and positive consequences, and overall event evaluations. College student drinkers (N = 96) provided data on their drinking experiences each morning during a 28-day ecological momentary assessment study. Hierarchical linear models revealed that unplanned drinking events were associated with lower alcohol quantity, fewer alcohol-related consequences, and lower ratings on how "worth it" the drinking event was, compared to planned events. In contrast to prior work highlighting the risk associated with unplanned heavy drinking, our findings indicate that drinking events that are planned (vs. unplanned) are related to increased consumption and the experience of negative consequences. Additional research is needed to more definitively assess the differences between planned and unplanned drinking events and their relationship to adverse alcohol-related outcomes among college students. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Simultaneous alcohol and marijuana use in daily life: Implications for level of use, subjective intoxication, and positive and negative consequences

Simultaneous alcohol and marijuana (SAM) use is prevalent among young adult drinkers and associated with increased risk for harms. Less understood about SAM use is whether increased risk is incurred on SAM use occasions relative to occasions in which individuals used only 1 substance. From a sample of young adult SAM users, we compared occasions in which individuals simultaneously used alcohol and marijuana so that the effects overlapped ("SAM days"), occasions involving only alcohol ("alcohol days"), and occasions involving only marijuana ("marijuana days") on level of use, level of subjective intoxication, and negative and positive consequences. Eligible participants (N = 154; 57.8% female, 72.7% non-Hispanic/Latinx White) were 18-25 years old, reported past-month SAM use, and reported past 2-week binge drinking. Participants completed up to 14 daily assessments on their substance use behavior. Multilevel models indicated that, relative to alcohol days, SAM days had more negative consequences. SAM and alcohol days were not statistically different on level of use, level of subjective alcohol intoxication, or positive consequences. Relative to marijuana days, SAM days had more negative consequences and more positive consequences. Level of use (number of hits) and level of marijuana intoxication were not statistically different. In addition to SAM users being a more at-risk group, SAM occasions are associated with greater risk within this vulnerable population. Fine-grained ecological momentary assessments are needed to better understand perceptions and behavior throughout a SAM use episode. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

A Daily-Level Analysis of Moderators of the Association between Alcohol Expectancies and Alcohol Use among College Student Drinkers

Background: Alcohol expectancies, or the perceived likelihood of experiencing certain effects after consuming alcohol, are associated with college student drinking such that heavier drinkers expect a greater likelihood of positive effects. However, less is known as to whether day-to-day within-person deviations in expectancies are associated with drinking that same day and for whom and when these associations may be strongest. Objectives: The aim of this study was to examine daily-level associations of positive and negative alcohol expectancies with alcohol use, and whether associations differed according to demographic characteristics and additional alcohol-related constructs. Methods: College student drinkers (N = 327, 53.8% female) participated in an intensive longitudinal study that captured daily-level data. Alcohol use and expectancy measures were utilized from a baseline session and at the daily-level using Interactive Voice Response (IVR). Results: Results found that on days when participants reported stronger positive and negative expectancies than their average, they were more likely to drink as well as consume more alcohol when drinking. Moderation analyses revealed that positive expectancies were more positively associated with the likelihood of any drinking for women relative to men, and more positively associated with the quantity of alcohol consumption for younger students, students with lower baseline rates of drinking, and students with greater overall positive alcohol expectancies. Conclusions/Importance: The findings demonstrate that alcohol expectancies fluctuate within-person across days and these fluctuations are meaningful in predicting same-day drinking. Interventions that seek to modify expectancies proximal to drinking events may be considered to reduce college student drinking.

Self-fulfilling prophecies: Documentation of real-world daily alcohol expectancy effects on the experience of specific positive and negative alcohol-related consequences

Alcohol expectancies are consistently associated with alcohol use in cross-sectional and longitudinal studies. However, little research has examined whether alcohol expectancies on specific drinking occasions are associated with reported consequences on those days, particularly when controlling for the amount of alcohol consumed, thus differentiating the extent to which reported consequences may have resulted from alcohol or an "expectancy effect." This study examined consequence-specific daily expectancy effects. College students (N = 342; mean age 19.7 [standard deviation (SD) = 1.25], 52.9% female) participated in a longitudinal measurement burst study. During four 2-week intervals, participants used mobile phones to respond to 3 surveys per day via automated telephone interviews. The results showed that on days when college students had higher-than-average expectancies for specific subjective positive consequences (e.g., feeling more relaxed, being in a better mood), they were more likely to report experiencing those same consequences as a result of their alcohol use that day, even after controlling for how much they actually drank on that day. The same held true for subjective interpersonal negative consequences (e.g., becoming aggressive, rude, or obnoxious; embarrassing oneself), but not for less subjective physical/cognitive negative consequences (e.g., having a hangover, vomiting, getting hurt/injured, forgetting). The results suggest that one's expectations about the particular effects of alcohol tend to be self-fulfilling for subjective effects of alcohol even when they are not directly tied to the physiological effects of alcohol. The findings underscore the important role of alcohol expectancies, particularly the expectation of subjective positive social and tension-reduction/relaxation effects, in understanding problematic alcohol use. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

A systematic review of event-level measures of risk-taking behaviors and harms during alcohol intoxication

Alcohol intoxication is associated with transient increases in risk-taking behaviors which can lead to harm. Certain assessment and intervention evaluation approaches require measurement of risk behaviors and associated harms at the event-level (i.e., within a single drinking session). This systematic review aimed to identify measures solely assessing risk-taking behaviors and harms while intoxicated and identify evidence of their reliability and validity. EMBASE, Medline, PsycINFO, and PsycTESTs were searched for articles published between 1997 and 2019. Articles were selected based on use of a scale with one or more items measuring risk-taking behaviors and harms (to the individual or others around them) occurring while intoxicated. Additional searches were run to identify studies reporting estimates of reliability and validity for identified measures. Nineteen measures were identified containing at least one relevant item. Most measures indexed both acute and chronic risk behaviors and consequences, mainly with the intent of screening for established patterns of problematic use. No individual measure was identified exclusively quantifying risk-taking behavior and harms which had occurred within a drinking session (with the exception of one scale measuring tendency to engage in risk behaviors), yet three measures had a subscale meeting this criterion. These measures demonstrated good validity and reliability. This gap represents an opportunity for scale development, designed for use in ecological momentary assessment and evaluation of structural interventions targeting risk behaviors and harms whilst intoxicated.

Examining the ecological validity of the prototype willingness model for adolescent and young adult alcohol use

The present study is the first ecologically valid, daily level test of the prototype willingness model (PWM), a model previously tested with hypothetical scenarios to investigate the social reaction and reasoned pathways toward engaging in health-risk behavior. The purpose of the present study is to examine whether days with elevated alcohol-favorable PWM cognitions are also associated with greater intentions and willingness to drink and increased drinking behavior on that day. Participants included 15-25-year-olds (N = 124; 57.3% female; M_age =18.7; SD = 2.87) who were part of an ecological momentary assessment study on drinking cognitions (including willingness, intentions, perceived vulnerability, social norms, prototype favorability) and alcohol use, reported across 3 weeks. Analyses accounted for the multilevel structure of the data and the various outcome distributions. Findings supported and advanced the PWM by using real-time, real-world daily data that captured within-person variation of PWM cognitions across days and showed daily level associations between PWM cognitions and alcohol use and negative consequences among adolescents and young adults, thus supporting the social reaction and reasoned pathways at the daily level. Current results may improve interventions by precisely informing the use of technology to bring interventions to adolescents and young adults in moments when they are at highest risk (i.e., days with higher than usual PMW alcohol cognitions). (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Event-Level Correlates of Drinking Events Characterized by Alcohol-Induced Blackouts

BACKGROUND

Prior research identifies a range of potential predictors of blackouts and suggests that blackouts increase risk for additional negative consequences. However, these studies are based on epidemiological work that allows us to draw conclusions about groups of people but not within-person processes. The present study examined within-person, event-level correlates of blackouts.

METHODS

Ninety-six heavy drinking college students (52% female) completed 28 days of daily reports of alcohol use and consequences, including blackouts. Thirty-three participants reported 56 blackouts. Hierarchical linear modeling compared morning reports of drinking events on which participants did versus did not report a blackout, controlling for total drinks at the event.

RESULTS

Blackout likelihood increased as a function of total drinks consumed and of crossing thresholds for heavy episodic drinking (4+/5+ drinks for women/men) and high-intensity drinking (8+/10+). Participants reported a higher total number of additional negative consequences on blackout events. Specific consequences that were more likely included embarrassing oneself and hangover. Blackouts were associated with morning ratings of less positive mood and a less favorable drinking event. Motives for drinking and simultaneous use of marijuana were not associated with blackouts.

CONCLUSIONS

Event-level findings of this study document that events leading to alcohol-induced memory loss are associated with other adverse experiences relative to drinking events that do not result in blackout, and offer potentially motivational levers for preventive interventions.

Learning From Experience? The Influence of Positive and Negative Alcohol-Related Consequences on Next-Day Alcohol Expectancies and Use Among College Drinkers

OBJECTIVE

The purpose of the present study was to examine daily-level associations between alcohol-related consequences and next-day expectancies and alcohol use among frequently drinking college students using a measurement-burst daily diary study.

METHOD

College students (N = 327; mean age = 19.7 years, SD = 1.26; 53.4% female) participated in a yearlong study in which they completed computerized interviews daily via mobile phones for 2 weeks in each academic quarter. Multilevel modeling was used to examine whether positive and negative consequences were associated with next-day alcohol expectancies and alcohol consumption.

RESULTS

Experiencing positive consequences from drinking was significantly associated with higher positive expectancies and a greater number of drinks consumed on the following day. The within-person association between daily consequences and next-day positive expectancies was stronger for those who were in fraternities/sororities compared with those who were not. Negative consequences were significantly associated with higher negative expectancies the next day but were not associated with number of drinks consumed the next day.

CONCLUSIONS

Results of this study highlight the role of direct drinking experiences in influencing future expectations and drinking behavior using a method that enables analysis of both between- and within-person associations.

Unplanned Heavy Episodic and High-Intensity Drinking: Daily-Level Associations With Mood, Context, and Negative Consequences

OBJECTIVE

Underestimating how much one will drink has been associated with greater alcohol-related consequences. Elevated mood or drinking context may relate to drinking more than planned (or intended) among college students. The aims of the current study were to test (a) whether positive and negative mood and contextual factors on a given day were associated with the likelihood of unplanned heavy drinking (defined as unplanned heavy episodic or high-intensity drinking), and (b) whether days with unplanned heavy drinking were associated with more negative consequences.

METHOD

The analytic sample included 352 college students (53.4% female; 71.3% non-Hispanic White) who completed daily assessments via automated telephone interviews. Multilevel models were used to test predictors of unplanned heavy drinking (Aim 1) and predictors of consequences (Aim 2).

RESULTS

Almost a third (29.60%) of drinking days were unplanned heavy drinking days. Individuals with higher average positive mood across the sampled days had lower odds of unplanned heavy drinking. No significant associations were observed between negative mood and unplanned heavy drinking. Weekend days and days with special occasions were associated with lower odds of unplanned heavy drinking. Unplanned heavy drinking was associated with more negative consequences on that day.

CONCLUSIONS

Students were frequently not able to accurately predict the amount of alcohol they would consume on that day, which conferred an increased risk of negative consequences. Interventions could incorporate strategies that help students anticipate their alcohol consumption in order to employ protective behavioral strategies in high-risk contexts.

Unplanned Heavy Episodic and High-Intensity Drinking: Daily-Level Associations With Mood, Context, and Negative Consequences

OBJECTIVE

Underestimating how much one will drink has been associated with greater alcohol-related consequences. Elevated mood or drinking context may relate to drinking more than planned (or intended) among college students. The aims of the current study were to test (a) whether positive and negative mood and contextual factors on a given day were associated with the likelihood of unplanned heavy drinking (defined as unplanned heavy episodic or high-intensity drinking), and (b) whether days with unplanned heavy drinking were associated with more negative consequences.

METHOD

The analytic sample included 352 college students (53.4% female; 71.3% non-Hispanic White) who completed daily assessments via automated telephone interviews. Multilevel models were used to test predictors of unplanned heavy drinking (Aim 1) and predictors of consequences (Aim 2).

RESULTS

Almost a third (29.60%) of drinking days were unplanned heavy drinking days. Individuals with higher average positive mood across the sampled days had lower odds of unplanned heavy drinking. No significant associations were observed between negative mood and unplanned heavy drinking. Weekend days and days with special occasions were associated with lower odds of unplanned heavy drinking. Unplanned heavy drinking was associated with more negative consequences on that day.

CONCLUSIONS

Students were frequently not able to accurately predict the amount of alcohol they would consume on that day, which conferred an increased risk of negative consequences. Interventions could incorporate strategies that help students anticipate their alcohol consumption in order to employ protective behavioral strategies in high-risk contexts.

Uncovering general, shared, and unique temporal patterns in ambulatory assessment data

Intensive longitudinal data provide psychological researchers with the potential to better understand individual-level temporal processes. While the collection of such data has become increasingly common, there are a comparatively small number of methods well-suited for analyzing these data, and many methods assume homogeneity across individuals. A recent development rooted in structural equation and vector autoregressive modeling, Subgrouping Group Iterative Multiple Model Estimation (S-GIMME), provides one method for arriving at individual-level models composed of processes shared by the sample, a subset of the sample, and a given individual. As this algorithm was motivated and validated for use with neuroimaging data, its performance is less understood in the context of ambulatory assessment data. Here, we evaluate the performance of the S-GIMME algorithm across various conditions frequently encountered with daily diary (compared to neuroimaging) data; namely, a smaller number of variables, a lower number of time points, and smaller autoregressive effects. We demonstrate, for the first time, the importance of the autoregressive effects in recovering data-generating connections and directions, and the ability to use S-GIMME with lengths of data commonly seen in daily diary studies. We demonstrate the use of S-GIMME with an empirical example evaluating the general, shared, and unique temporal processes associated with a sample of individuals with borderline personality disorder (BPD). Finally, we underscore the need for methods such as S-GIMME moving forward given the increasing use of intensive longitudinal data in psychological research, and the potential for these data to provide novel insights into human behavior and mental health. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

When do college students have less favorable views of drinking? Evaluations of alcohol experiences and positive and negative consequences

College students experience numerous positive and negative consequences from drinking alcohol, although the extent to which these consequences influence perceptions of their drinking experiences is poorly understood. A better understanding of the impact of experiencing specific consequences, and how they are evaluated, on college students' perceptions of the overall drinking experience and subsequent alcohol use is crucial for advancing intervention efforts. The current study used daily data to examine (a) whether experiencing specific consequences and (b) whether ratings of the most favorable and most aversive consequences predicted overall evaluations of the drinking experience and perceptions that drinking was worth it; and (c) whether overall evaluations and perceptions that drinking was worth it predicted next-day drinking. College student drinkers (N = 349, 53.3% female) completed daily reports on drinking, consequences, evaluations of consequences, and evaluations of the drinking experience during four 2-week periods across 1 year. Findings from generalized estimating equations demonstrated that experiencing any of the positive consequences predicted more favorable overall evaluations and perceptions that drinking was worth it, whereas the majority of the negative consequences predicted less favorable overall evaluations. Ratings of the most favorable positive consequence and the most aversive negative consequence were also associated with overall evaluations. Perceiving that drinking was more worth it was associated with an increased likelihood of next-day drinking. Current findings reinforce the need to address the experience of both positive and negative consequences in interventions, while simultaneously considering the extent to which students perceived the negative consequences as aversive. (PsycINFO Database Record