The Bidirectionality of Impulsivity and Alcohol Use: An Ecological Momentary Examination Among Emerging Adults

Impulsivity is a robust risk factor for alcohol use among emerging adults (i.e., 18 to 25), 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. Consequently, the present research used a 14-day ecological momentary assessment (EMA) design to: (1) determine momentary impulsivity as a predictor of subsequent alcohol use and problems; (2) examine the influence of alcohol use on subsequent impulsivity; (3) test socio-cognitive mechanisms (motives, expectancies, and norms) as real-time mediators explaining the link between momentary impulsivity and alcohol use; and (4) test context and sex as moderators of the relationship between momentary impulsivity and alcohol use. Participants were 96 (63 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 (i.e., at the beginning and the end of their drinking). Multilevel modeling results indicated that greater levels of impulsivity experienced during the day was not associated with alcohol use or problems experienced that night. For bidirectional effects, alcohol use was associated with greater impulsivity reported at the end of the drinking occasion and greater alcohol use predicted greater impulsivity the next morning. Multilevel structural equation modeling revealed significant within-person mediation, such that on days when individuals reported greater than usual impulsivity, they also reported greater enhancement motives, positive expectancies, and negative expectancies, which in turn, was associated with greater alcohol consumption. Coping motives and norms did not mediate the association between impulsivity and alcohol use. A peer drinking context and sex were not significant moderators of the link between impulsivity and alcohol use. Overall, this study was the first to examine the bidirectional relationship between impulsivity and alcohol use as well as mechanisms and moderators using an EMA methodology. Findings supported impulsivity’s conceptualization as a state construct, and fluctuations in momentary states of impulsivity may coincide with alcohol use behaviors. Thus, findings from the present study contributed to conceptual daily process models of drinking by identifying how alcohol behaviors unfold in the real world. Future research is needed to examine other potential within-person mechanisms that may underlie or factors that may impact the examined relationships

Environmental Context Effects on Impulsivity and Subjective Craving in Caffeinated Alcohol Users

Caffeinated alcohol beverages (CAB) (e.g., vodka and Red Bull, rum and Coke) have become increasingly popular among young drinkers. Research indicates that consumption of caffeinated alcohol is associated with higher reports of injuries requiring medical attention, engaging in more risky behaviors, and achieving greater levels of intoxication. As such, consumers of CAB are a population that may be at a higher risk of experiencing alcohol-related harms. Although CAB drinkers have been shown to exhibit more impulsive behavior, little research has examined impulse control in this population or other mechanisms that may contribute to alcohol-related risks for these individuals. It has been suggested that environmental cues may trigger craving and drinking through the influence on impulsivity. Thus, a bar context may elicit greater impulsivity, which in turn, increases one’s craving for alcohol or CAB. Consequently, the present study sought: (1) to determine the influence of an environmental context (i.e., bar simulated lab) on subjective ratings of craving (i.e., alcohol craving, CAB-specific craving), and (2) to examine behavioral impulsivity as a mediator of the influence of environmental context on subjective cravings in a sample of moderate to heavy drinkers that consume CAB. Participants were 135 (66.7% female) college CAB drinkers. Using a between-subjects design, participants were randomized into either the experimental (i.e., simulated bar) condition or control (i.e., neutral context) condition and completed measures of alcohol use, CAB use, trait impulsivity, state impulsivity, and subjective craving for alcohol and CAB. Findings revealed that participants in the experimental condition, as compared to those in the neutral condition, reported more subjective craving for alcohol, but not for CAB. The association between environmental context and subjective craving for alcohol was not mediated by state-level changes in impulsivity. Trait impulsivity was positively associated with alcohol and CAB craving at each time point, in both conditions. Therefore, the current investigation suggests that consumers of CAB may be sensitive to alcohol-related cues as indicated by greater responses in alcohol craving. However, state impulsivity did not explain this association. Future research may benefit from examining other potential mechanisms that explain the relationship between context and craving among CAB consumers

Alcohol Expectancies Mediate the Relationship Between Age of First Intoxication and Drinking Outcomes in College Binge Drinkers

Background: While prior research has shown that age of first intoxication (AI) is associated with negative alcohol outcomes, limited research has examined factors accounting for this relationship. Alcohol expectancies, or beliefs about the effects of alcohol, may explain such associations as both positive and negative expectancies have been shown to be key predictors of drinking outcomes. Objective: The present study examined expectancies as mediators between early AI and alcohol-related outcomes. Method: Data collection occurred in 2012 and 2013. Participants were college students (N = 562, 65.8% women) who completed an online survey including measures of alcohol use history, alcohol expectancies, typical alcohol consumption, and alcohol-related problems. Structural equation modeling was used to test the hypothesized model. Results: Our findings support a model whereby AI is associated with drinking through its influence on both positive and negative expectancies. Specifically, an earlier AI was associated with stronger alcohol expectancies, which in turn, was associated with heavier alcohol use and alcohol-related problems. Conclusions/Importance: These findings are consistent with expectancy theory and previous research suggesting that more experienced drinkers hold stronger drinking-related beliefs, be it positive or negative, and these expectancies ultimately explain variability in alcohol use and problems. Our findings further support that expectancies play an important role in the initiation of drinking behavior

Testing a Model of Caffeinated Alcohol-Specific Expectancies

Introduction- The present study sought to further understand the association between caffeinated alcoholic beverage (CAB) use and alcohol-related risks. In particular, we focused on the role of two identified expectancies specific to CAB use: intoxication enhancement and avoidance of negative consequences. Although outcome expectancies are consistent predictors of substance use, limited research has examined expectancies related to CAB use and their association with alcohol-related behaviors, such as protecting themselves from alcohol-related harms. Consequently, the present study examined CAB-specific expectancies and protective behavioral strategies (PBS) as mediators of CAB use and negative consequences. Methods- Participants were 322 (219 women) college drinkers who completed self-report measures of typical CAB and alcohol use, CAB-specific expectancies, PBS use, and alcohol-related harms. Results- Structural equation modeling revealed, after controlling for typical non-CAB heavy alcohol use, a significant indirect effect of CAB use to alcohol-related problems through avoidance of negative consequences CAB expectancies and PBS use. However, intoxication enhancement expectancies did not mediate this association. Conclusions- Our findings indicate that heavier CAB use was associated with stronger expectations that drinking CABs can help avoid negative consequences. These beliefs were related to using fewer PBS when drinking and a greater likelihood of experiencing problems. Given that these expectancies may be underlying mechanisms of CAB use, their inclusion in existing alcohol interventions may be beneficial

A Latent Profile Analysis of Drinking Patterns Among Nonstudent Emerging Adults

Research indicates that nonstudent emerging adults, as compared to their college-attending peers, are at higher risk for experiencing alcohol-related problems, including alcohol use disorders. The present study sought to extend the limited research on nonstudent drinking by (1) identifying sub-groups of nonstudent drinkers based on their drinking patterns and (2) determining the extent to which social-cognitive between-person factors related to drinking (i.e., social expectancies, perceived drinking norms, social drinking motivations) distinguish these sub-groups. Participants were 195 (65.1% men) nonstudent emerging adult heavy episodic drinkers recruited from the community. Mean age was 21.88 (SD = 2.08) years and 45.4% were unemployed. Latent profile analysis identified two classes based on drinking across 30 days. The moderate drinkers group (n = 143; 73.3%) reported consuming 10-11 drinks weekly and drinking two to three times per week, on average. The heavy drinkers class (n = 52; 26.7%) reported consuming 42-43 drinks weekly and drinking six to seven days per week. Both groups exhibited a cyclic pattern of drinking whereby weekday drinking was lower, with increases on the weekend; the heavy drinkers class had stronger weekend increases starting earlier. Heavy drinkers reported greater volume, frequency, and problematic drinking behaviors, as compared to the moderate drinkers. The heavy drinkers class also endorsed stronger social motives and perceived their peers to drink more. The present study offered unique insights into nonstudent emerging adult drinking patterns by identifying sub-populations of drinkers based on their past 30-day use. Knowledge gained from this study could aide in tailoring existing alcohol interventions to nonstudents to reduce alcohol-related harms

Identifying Patterns of Situational Antecedents to Heavy Drinking Among College Students

Background- Emerging adults have the highest prevalence of heavy drinking as compared to all other age groups. Given the negative consequences associated with such drinking, additional research efforts focused on at-risk consumption are warranted. The current study sought to identify patterns of situational antecedents to drinking and to examine their associations with drinking motivations, alcohol involvement, and mental health functioning in a sample of heavy drinking college students. Method- Participants were 549 (65.8% women) college student drinkers. Results- Latent profile analysis identified three classes based on likelihood of heavy drinking across eight situational precipitants. The High Situational Endorsement\u27 group reported the greatest likelihood of heavy drinking in most situations assessed. This class experienced the greatest level of alcohol-related harms as compared to the Low Situational Endorsement\u27 and Moderate Situational Endorsement\u27 groups. The Low Situational Endorsement class was characterized by the lowest likelihood of heavy drinking across all situational antecedents and they experienced the fewest alcohol-related harms, relative to the other classes. Class membership was related to drinking motivations with the High Situational Endorsement\u27 class endorsing the highest coping- and conformity-motivated drinking. The High Situational Endorsement\u27 class also reported experiencing more mental health symptoms than other groups. Conclusions- The current study contributed to the larger drinking literature by identifying profiles that may signify a particularly risky drinking style. Findings may help guide intervention work with college heavy drinkers

Socio-Cognitive Factors and Perceived Consequences Associated With Alternative Forms of Alcohol Use

Objective: Popular media have highly publicized alternative forms of alcohol use (eg, eyeballing, inhaling alcohol vapor) among college students as a growing concern, possibly associated with severe health risks. Formative research indicates rarity of use. Participants and Methods: College students (Study 1: n = 411; Study 2: n = 687) completed an online survey. Results: Findings confirmed infrequent use of alternative methods of alcohol use and low likelihood of trying them in the future (Study 1). Participants indicated varied reasons for possibly trying each alternative form of alcohol use, but consistently perceived consequences for all forms (ie, health concerns), as well as very low perceived approval from close friends (Study 2). Social and environmental contextual factors associated with possible use were also explored. Conclusions: College students in the current sample have low prevalence and future likelihood of alternative forms of alcohol use. This information can be used by campus health practitioners to promote accurate normative data for alternative forms of alcohol use. However, with increased perceptions of approval and media presence, future trends could change. Findings revealed important risk factors for these potentially hazardous forms of alcohol use

Differences in Weekday Versus Weekend Drinking Among Nonstudent Emerging Adults

In the current investigation, we sought to examine day-of-the-week drinking of an at-risk sample of nonstudent emerging adults and whether specific factors are associated with differential drinking patterns. Our study aims were to (a) identify differences in weekday versus weekend drinking, and (b) examine specific expectancies (i.e., sociability, tension reduction) and demographic factors (e.g., age, sex) relating to weekend versus weekday drinking after controlling for harmful drinking and holiday drinking. Participants were heavy-drinking noncollege attenders recruited from the community (N = 238; 63.4% men, 35.7% women; M age = 21.92 years). They reported daily drinking for the previous 30 days and completed measures of harmful drinking, alcohol expectancies, and demographic information. Results showed that more drinks were consumed on the weekends (i.e., Thursday to Saturday) than weekdays, with 63% of drinks consumed on weekends. Multilevel modeling analyses indicated that weekday drinking was associated with tension-reduction expectancies, social expectancies, sex, and age. Weekend-drinking increases were related to social expectancies, but not tension-reduction expectancies. Our final model indicated that, after controlling for the effect of holiday drinking, the within-person weekday-weekend distinction explained 18% of the total variance. In general, our findings highlight the importance of alcohol expectancies and drinking contexts in understanding the drinking behaviors of nonstudents. The differential role of tension-reduction and social-facilitation expectancies on drinking throughout the week imply that different cognitive pathways are involved in weekday versus weekend drinking, and both types of expected alcohol effects should be targets of risk-reduction efforts with nonstudent drinkers

Alcohol Use Variability in a Community-Based Sample of Nonstudent Emerging Adult Heavy Drinkers

BACKGROUND: While nonstudent emerging adults are at elevated risk for experiencing alcohol-related problems, there remains a paucity of research devoted specifically to addressing drinking in this group. OBJECTIVES: The present study sought to offer unique insights into nonstudent drinking by examining drinking variability across 30 days using a retrospective diary method. Specific aims were to: (1) compare within- and between-person variability in alcohol use across 30 days, and (2) determine the extent to which central social-cognitive between-person factors (i.e., social expectancies, perceived drinking norms, social drinking motivations) predict between-person alcohol use as well as within-person variability in drinking. METHODS: Participants were 195 (65.1% men) nonstudent emerging adults recruited from the community with a mean age of 21.9 (SD = 2.1) years. RESULTS: Findings showed that a substantial portion of variation in daily alcohol consumption was attributable to the within-person (83%) rather than between-person (17.2%) level. Social expectancies, perceived drinking norms, and social motives were found to influence variability in daily alcohol consumption. CONCLUSION: Our findings contribute to knowledge that could guide efforts to design and tailor intervention strategies to minimize the harms experienced by an understudied and at-risk population of drinkers

Faster Self-Paced Rate of Drinking for Alcohol Mixed with Energy Drinks Versus Alcohol Alone

The consumption of alcohol mixed with energy drinks (AmED) has been associated with higher rates of binge drinking and impaired driving when compared with alcohol alone. However, it remains unclear why the risks of use of AmED are heightened compared with alcohol alone even when the doses of alcohol consumed are similar. Therefore, the purpose of this laboratory study was to investigate if the rate of self-paced beverage consumption was faster for a dose of AmED versus alcohol alone using a double-blind, within-subjects, placebo-controlled study design. Participants (n = 16) of equal gender who were social drinkers attended 4 separate test sessions that involved consumption of alcohol (1.97 ml/kg vodka) and energy drinks, alone and in combination. On each test day, the dose assigned was divided into 10 cups. Participants were informed that they would have a 2-h period to consume the 10 drinks. After the self-paced drinking period, participants completed a cued go/no-go reaction time (RT) task and subjective ratings of stimulation and sedation. The results indicated that participants consumed the AmED dose significantly faster (by approximately 16 minutes) than the alcohol dose. For the performance task, participants\u27 mean RTs were slower in the alcohol conditions and faster in the energy-drink conditions. In conclusion, alcohol consumers should be made aware that rapid drinking might occur for AmED beverages, thus heightening alcohol-related safety risks. The fast rate of drinking may be related to the generalized speeding of responses after energy-drink consumption