Jennifer E. Merrill

Motivational pathways to unique types of alcohol consequences

Individuals consume alcohol for a variety of reasons (motives), and these reasons may be differentially associated with the types of drinking outcomes that result. The present study examined whether specific affect-relevant motivations for alcohol use (i.e., coping, enhancement) are associated with distinct types of consequences, and whether such associations occur directly, or only as a function of increased alcohol use. It was hypothesized that enhancement motives would be associated with distinct problem types only through alcohol use, whereas coping motives would be linked directly to hypothesized problem types. Regularly drinking undergraduates (N = 192, 93 female) completed self-report measures of drinking motives and alcohol involvement. Using structural equation modeling, we tested direct associations between coping motives and indirect associations between enhancement motives and eight unique alcohol problem domains: risky behaviors, blackout drinking, physiological dependence, academic/occupational problems, poor self-care, diminished self-perception, social/interpersonal problems, and impaired control. We observed direct effects of coping motives on three unique problem domains (academic/occupational problems, risky behaviors, and poor self-care). Both coping and enhancement motives were indirectly associated (through use) with several problem types. Unhypothesized associations between conformity motives and unique consequence types also were observed. Findings suggest specificity in the consequences experienced by individuals who drink to cope with negative affect versus to enhance positive affect, and may have intervention implications. Findings depict the coping motivated student as one who is struggling across multiple domains, regardless of levels of drinking. Such students may need to be prioritized for interventions.

Before the party starts: risk factors and reasons for "pregaming" in college students.

Abstract Objective: “Pregaming”—drinking alcohol prior to going out—is believed to be common, yet empirical examinations are scarce. In this study, we examined who is at risk for pregaming, consequences resulting from it, and motives behind it. Participants: Participants (N = 159, 52% female) were drinkers, aged 18 to 24, recruited from introductory psychology classes. Methods: In 2005 and 2006, interview measures of drinking and pregaming and self-report demographic, motivational, and reasons for pregaming measures were administered. Results: Two-thirds of students pregamed. Younger age, but not Greek affiliation, was associated with heavier pregaming drinking. We found minimal support for the prediction of pregaming by general drinking motives. Specific reasons for pregaming were identified, including saving money and obtaining alcohol when under 21. Conclusions: Findings highlight the risk associated with pregaming, due to selection effects and to event characteristics. The unique reasons for pregaming must be further understood and addressed in targeted interventions.

Trauma and Posttraumatic Stress Symptoms Predict Alcohol and Other Drug Consequence Trajectories in the First Year of College

OBJECTIVE College matriculation begins a period of transition into adulthood, one that is marked by new freedoms and responsibilities. This transition also is marked by an escalation in heavy drinking and other drug use as well as a variety of use-related negative consequences. Trauma and symptoms of posttraumatic stress disorder (PTSD) may affect alcohol and drug problems and, thus, may be a point of intervention. Yet, no studies have examined trauma, PTSD, and alcohol and drug problem associations during this developmental period. The present study provides such an examination. METHOD Matriculating college students (N = 997) completed surveys in September (Time 1) and at 5 subsequent time points (Time 2-Time 6) over their 1st year of college. With latent growth analysis, trajectories of alcohol- and drug-related consequences were modeled to examine how trauma (No Criterion A Trauma, Criterion A Only, No PTSD Symptoms) and PTSD (partial or full) symptom status predicted these trajectories. RESULTS Results showed substantial risk for alcohol- and other drug-related negative consequences that is conferred by the presence of PTSD at matriculation. Those with both partial and full PTSD started the year with more alcohol and drug consequences. These individuals showed a steeper decrease in consequences in the 1st semester, which leveled off as the year progressed. Both alcohol and drug consequences remained higher for those in the PTSD group throughout the academic year. Hyperarousal symptoms showed unique effects on substance consequence trajectories. Risk patterns were consistent for both partial and full PTSD symptom presentations. Trajectories did not vary by gender. CONCLUSIONS Interventions that offer support and resources to students entering college with PTSD may help to ameliorate problem substance use and may ultimately facilitate a stronger transition into college and beyond.

Development and initial validation of a measure of motives for pregaming in college students

OBJECTIVE Pregaming (i.e., drinking alcohol prior to going out) is a common and risky drinking practice on college campuses. Yet, little is known about what motivates students to pregame as no motives measure exists specifically targeting pregaming. The current study describes the development and initial validation of a measure to assess motives for pregaming and to evaluate associations between these motives and pregaming behavior. METHOD In a multi-stage process using three different college samples, both qualitative (i.e., focus groups) and quantitative methods were used to derive the Pregaming Motives Measure (PGMM). After initial item generation (Stage I: N=43, 74% male) and refinement with exploratory factor analysis (Stage II: N=206, 61% male), a confirmatory factor analysis was performed to establish the structure of the PGMM (Stage III: N=321, 34% male). The pattern of associations of the derived factors, pregaming behavior, and general drinking motives was explored to provide evidence for initial construct validity. Last, the indirect effect of pregaming motives on alcohol problems via pregaming behavior was assessed. RESULTS Findings indicated that the PGMM differed both in content from general drinking motives and that the PGMM items generated load on factors labeled Inebriation/Fun, Instrumental, and Social Ease. Moreover, the Inebriation/Fun and Instrumental motives were significantly associated with pregaming behavior. PGMM motives also both directly and indirectly predicted alcohol-related consequences. CONCLUSIONS Findings corroborate other data on pregaming, suggesting that this behavior may be driven by desires for quick inebriation and conviviality and related to problems only via increased drinking. The PGMM offers targeted assessment of pregaming and other social drinking behavior that can lead to deleterious outcomes.

Positive alcohol expectancies mediate the influence of the behavioral activation system on alcohol use: a prospective path analysis.

Grays (1975, 1987) behavioral activation (BAS) and behavioral inhibition systems (BIS) are thought to underlie sensitivity to reinforcement and punishment, respectively. Consistent with Grays theory and the Acquired Preparedness model, BAS may facilitate the learning of positive alcohol expectancies (PAEs) over time, leading to increases in drinking. Yet, no prospective tests of this pathway have been reported. The present study investigated whether BAS prospectively predicted PAEs and whether PAEs mediated the association between BAS and subsequent alcohol use. We hypothesized that BAS would influence drinking specifically via enhancement-related PAEs. We also explored the role of BIS in PAEs and drinking. College students (N=557) completed online BAS, PAE, and alcohol use measures in September of their first (T1), second (T2), and third (T3) years of college. We conducted autoregressive path analyses with three BAS subscales and BIS (T1) as predictors, four PAE types (T2) as mediators, and quantity and frequency of drinking (T3) as outcomes. The BAS Fun-Seeking scale was prospectively associated with PAEs, and there was a significant indirect path from Fun-Seeking to alcohol use mediated specifically through activity enhancement PAEs. BIS was positively associated with some PAE types, but did not have indirect effects on drinking. Findings are consistent with both the theory of the BAS and the Acquired Preparedness model, as individuals high on BAS Fun-Seeking may find the rewarding properties of alcohol more reinforcing, leading to stronger enhancement PAEs and increased drinking over time. The prospective design helps establish the temporal association between BAS and alcohol-related learning, and points to the need for prevention efforts that target these at-risk students.

Dimensions and severity of marijuana consequences: Development and validation of the Marijuana Consequences Questionnaire (MACQ)

The Marijuana Consequences Questionnaire (MACQ) is a 50-item self-report measure modeled after the Young Adult Alcohol Consequences Questionnaire (YAACQ). College students (n=315) completed questionnaires online. A confirmatory factor analysis supported the hypothesized 8-factor structure. The results indicate good convergent and discriminant validity of the MACQ. A brief, unidimensional, 21-item version (B-MACQ) was developed by a Rasch model. Comparison of item severity estimates of the B-MACQ items and the corresponding items from the YAACQ indicates that the severity of alcohol- and marijuana-problems is defined by a relatively unique pattern of consequences. The MACQ and B-MACQ provide promising new alternatives to assessing marijuana-related problems.

Interactions between adaptive coping and drinking to cope in predicting naturalistic drinking and drinking following a lab-based psychosocial stressor.

Using alcohol to cope (i.e., coping motivation) and general coping style both are theorized and demonstrated empirically to lead to problematic drinking. In the present study, we sought to examine whether these factors interact to predict alcohol use, both retrospectively reported and in the lab following a stressor task. Social drinkers (N=50, 50% women) received the Trier Social Stress Test (TSST), and then consumed beer under the guise of a taste test. A Timeline Followback interview to assess past month alcohol use, the Drinking Motives Questionnaire (DMQ), and the COPE (to assess adaptive coping) were administered prior to the laboratory challenge. Multiple regression models were used to examine DMQ coping motives, adaptive coping, and their interaction as predictors of milliliters (mls) of beer consumed in a clinical laboratory setting. The association between coping motives and mls beer was positive at both high and low levels of adaptive coping, but at low levels of adaptive coping, this association was stronger. In contrast, there was no interaction between adaptive coping and coping motives in predicting quantity and frequency of drinking in the prior month. Findings suggest that stronger coping motives for drinking predict greater alcohol consumption following a stress provocation to a greater extent when an individual is lacking in adaptive coping strategies. As both general coping skills and coping motives for alcohol use are responsive to intervention, study of the conditions under which they exert unique and interactive effects is important.

Mood and Implicit Alcohol Expectancy Processes: Predicting Alcohol Consumption in the Laboratory

BACKGROUND Implicit positive alcohol expectancy (PAE) processes are thought to respond phasically to external and internal stimuli-including mood states-and so they may exert powerful proximal influences over drinking behavior. Although social learning theory contends that mood states activate mood-congruent implicit PAEs, which in turn lead to alcohol use, there is a dearth of experimental research examining this mediation model relative to observable drinking. Moreover, an expectancy theory perspective might suggest that, rather than influencing PAEs directly, mood may moderate the association between PAEs and drinking. To test these models, this study examined the role of mood in the association between implicitly measured PAE processes (i.e., latency to endorse PAEs) and immediate alcohol consumption in the laboratory. Gender differences in these processes also were examined. METHOD College students (N = 146) were exposed to either a positive, negative, or neutral mood induction procedure, completed a computerized PAE reaction time (RT) task, and subsequently consumed alcohol ad libitum. RESULTS The mood manipulation had no direct effects on drinking in the laboratory, making the mediation hypothesis irrelevant. Instead, gender and mood condition moderated the association between RT to endorse PAEs and drinking in the laboratory. For males, RT to tension reduction PAEs was a stronger predictor of volume of beer consumed and peak blood alcohol concentration in the context of general arousal (i.e., positive and negative mood) relative to neutral mood. RT to PAEs did not predict drinking in the laboratory for females. CONCLUSIONS The results show that PAE processes are important determinants of immediate drinking behavior in men, suggesting that biased attention to mood-relevant PAEs-as indicated by longer RTs-predicts greater alcohol consumption in the appropriate mood context. The findings also highlight the need to consider gender differences in PAE processes. This study underscores the need for interventions that target automatic cognitive processes related to alcohol use.

Gender and Depression Moderate Response to Brief Motivational Intervention for Alcohol Misuse Among College Students

OBJECTIVE Brief motivational interventions (BMIs) effectively reduce problematic drinking in college students. However, not all students benefit, and little is known about the subgroups of students for whom BMIs are most effective. In the present study, we examined 2 factors that may influence BMI efficacy: gender and depression. METHOD We reanalyzed data from a clinical trial in which heavy drinking students (N = 330; 65% female) were randomized to a BMI (n = 165) or an assessment only control (n = 165). Depression was assessed at baseline; past-month typical drinks per week, heavy drinking frequency, and consequences were assessed at baseline and 1 month. Three- and 2-way interactions among intervention condition (BMI vs. control), gender (male vs. female), and depression (low vs. high) were tested. RESULTS We observed 3-way interaction effects on 2 outcomes: (a) typical drinks per week and (b) frequency of heavy drinking at 1 month. Relative to controls and adjusting for baseline drinking, low-depression women reduced their drinking more after a BMI whereas high-depression women did not show differential improvement. In contrast, high-depression men showed significant reductions in weekly drinks following the BMI whereas low-depression men did not show differential improvement. In addition, higher levels of depression were associated with higher levels of consequences at follow-up across conditions. CONCLUSIONS BMIs are indicated for heavy drinking, depressed men, consistent with recommendations for implementing screening and brief intervention in mental health settings. However, BMIs may need to be refined to enhance their efficacy for depressed women.

Posttraumatic Stress Symptoms and Alcohol Problems: Self‐Medication or Trait Vulnerability?

BACKGROUND AND OBJECTIVES Posttraumatic stress symptoms (PTSD) and problem alcohol use (ALC) commonly co-occur, but the nature of this co-occurrence is unclear. Self-medication explanations have been forwarded, yet traits such as tendency toward negative emotionality and behavioral disconstraint also have been implicated. In this study we test three competing models (Self-Medication, Trait Vulnerability, Combined Dual Pathway) of PTSD-ALC prospectively in a college sample. METHOD Participants (N=659; 73% female, M age=18) provided data at college matriculation (Time 1) and 1 year later (Time 2). RESULTS Structural equation models showed disconstraint to meditate the path from PTSD symptoms to alcohol problems, supporting a trait vulnerability conceptualization. Findings regarding negative emotionality and self-medication were more mixed. Negative emotionality played a stronger role in cross-sectional than in prospective analyses, suggesting the importance of temporal proximity. CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE Self-regulation skills may be an important focus for clinicians treating PTSD symptoms and alcohol misuse disorders concurrently.