Frequent solitary drinking mediates the associations between negative affect and harmful drinking in emerging adults.

INTRODUCTION Depression and anxiety are highly comorbid conditions that are associated with harmful drinking. Social learning theory proposes that depressed or anxious individuals learn that drinking can reduce negative affect, which makes them susceptible to harmful drinking. Consistent with theory, evidence suggests that negative affect increases risk for harmful drinking. But, less is known about mediators of negative affect-pathways to harmful drinking. Research has demonstrated that solitary drinking is an underlying mechanism of harmful drinking among emerging adults with high levels of negative affect. However, much of this work is cross-sectional. We conducted a longitudinal study to examine solitary drinking as a key explanatory variable in the negative-affect pathway to harmful drinking. METHODS Emerging adults (N = 308) completed online self-reports of depression and anxiety at Time 1 (the beginning of their first semester in university), and drinking context and harmful drinking at Time 2 (the end of their first semester of university). RESULTS Structural equation modeling supported indirect effects from negative affect to harmful drinking via solitary drinking. Specifically, emerging adults with high levels of negative affect at the beginning of their first semester engaged in frequent solitary drinking over the rest of the semester, and subsequently experienced increased harmful drinking (controlling for Time 1 solitary/social drinking and harmful use). Social drinking was not a mediator of this effect. CONCLUSIONS The findings reveal that solitary drinking uniquely mediated the relation between negative affect and harmful drinking. Reducing solitary drinking might mitigate negative affect-related risk for harmful drinking in emerging adults.

[1]  N. Marmorstein Longitudinal associations between alcohol problems and depressive symptoms: early adolescence through early adulthood. , 2009, Alcoholism, clinical and experimental research.

[2]  N. Pachana,et al.  Reliability, validity and factor structure of the CES-D in Iranian elderly. , 2015, Asian journal of psychiatry.

[3]  M. Keough,et al.  Shame mediates the relationship between depression and addictive behaviours. , 2018, Addictive behaviors.

[4]  Phil A. Silva,et al.  Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study. , 1998, Journal of abnormal psychology.

[5]  R. Collins,et al.  Solitary and social heavy drinking, suicidal ideation, and drinking motives in underage college drinkers. , 2009, Addictive behaviors.

[6]  Rex B. Kline,et al.  Principles and Practice of Structural Equation Modeling , 1998 .

[7]  D. Hasin,et al.  Drinking to cope with negative affect and DSM-IV alcohol use disorders: a test of three alternative explanations. , 1999, Journal of studies on alcohol.

[8]  Ronald L. Akers,et al.  Social learning and social structure : a general theory of crime and deviance , 1999 .

[9]  Monica C. Skewes,et al.  Solitary heavy drinking, social relationships, and negative mood regulation in college drinkers , 2013 .

[10]  N. Keiding,et al.  Effects of sample attrition in a longitudinal study of the association between alcohol intake and all-cause mortality. , 2008, Addiction.

[11]  C. Adams,et al.  A systematic review of studies of depression prevalence in university students. , 2013, Journal of psychiatric research.

[12]  A. Teo,et al.  Social Relationships and Depression: Ten-Year Follow-Up from a Nationally Representative Study , 2013, PloS one.

[13]  Robert L. Spitzer,et al.  Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7. Copyright: American Medical Association. , 2006 .

[14]  P. O'Connor,et al.  The prevalence and impact of alcohol problems in major depression: a systematic review. , 2005, The American journal of medicine.

[15]  M. Biehl,et al.  Trajectories of Depressed Mood from Early Adolescence to Young Adulthood: The Effects of Pubertal Timing and Adolescent Dating. , 2009 .

[16]  P. Kielholz Alcohol and depression. , 1970, The British journal of addiction to alcohol and other drugs.

[17]  R. Kessler,et al.  Twelve‐month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States , 2012, International journal of methods in psychiatric research.

[18]  J. Polivy,et al.  The four undergraduate years. Changes in weight, eating attitudes, and depression , 2013, Appetite.

[19]  D. Clark,et al.  Internet-Delivered Cognitive Therapy for Social Anxiety Disorder: A Development Pilot Series , 2013, Behavioural and cognitive psychotherapy.

[20]  R. Kessler,et al.  Epidemiology of DSM‐III‐R major depression and minor depression among adolescents and young adults in the national comorbidity survey , 1998, Depression and anxiety.

[21]  Tyler B. Wray,et al.  Trait-based affective processes in alcohol-involved "risk behaviors". , 2012, Addictive behaviors.

[22]  M. Olfson,et al.  National Trends in the Prevalence and Treatment of Depression in Adolescents and Young Adults , 2016, Pediatrics.

[23]  J. Mohanty,et al.  Factor structure of the CES-D scale among older adults in Chennai, India , 2013, Aging & mental health.

[24]  Nancy P Barnett,et al.  Predictors of alcohol use during the first year of college: implications for prevention. , 2007, Addictive behaviors.

[25]  Michael J. A. Wohl,et al.  Where Did All the Pathological Gamblers Go? Gambling Symptomatology and Stage of Change Predict Attrition in Longitudinal Research , 2011, Journal of Gambling Studies.

[26]  M. L. Cooper,et al.  Motivations for alcohol use among adolescents: development and validation of a four-factor model , 1994 .

[27]  Alice T. Sawyer,et al.  The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. , 2010, Journal of consulting and clinical psychology.

[28]  V. Karpyak,et al.  Sex and gender-related differences in alcohol use and its consequences: Contemporary knowledge and future research considerations. , 2015, Drug and alcohol dependence.

[29]  P. Lewinsohn,et al.  Comorbidity between major depression and alcohol use disorder from adolescence to adulthood. , 2014, Comprehensive psychiatry.

[30]  John B. Carlin,et al.  Bias and efficiency of multiple imputation compared with complete‐case analysis for missing covariate values , 2010, Statistics in medicine.

[31]  Emmanuel Kuntsche,et al.  Why do young people drink? A review of drinking motives. , 2005, Clinical psychology review.

[32]  A. Mokdad,et al.  Binge drinking among US adults. , 2003, JAMA.

[33]  J. Sareen,et al.  The association between social isolation and DSM-IV mood, anxiety, and substance use disorders: wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. , 2011, The Journal of clinical psychiatry.

[34]  R. Dahl,et al.  Factors associated with the development of substance use disorder in depressed adolescents. , 1999, Journal of the American Academy of Child and Adolescent Psychiatry.

[35]  D. Watson,et al.  Positive and negative affectivity and their relation to anxiety and depressive disorders. , 1988, Journal of abnormal psychology.

[36]  Jacob Cohen The earth is round (p < .05) , 1994 .

[37]  K. Sher,et al.  Heavy drinking across the transition to college: predicting first-semester heavy drinking from precollege variables. , 2007, Addictive behaviors.

[38]  Jennifer E. Merrill,et al.  Motivational pathways to unique types of alcohol consequences. , 2010, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[39]  A. Abbey,et al.  The relationship between reasons for drinking alcohol and alcohol consumption: an interactional approach. , 1993, Addictive behaviors.

[40]  D. Fergusson,et al.  Alcohol and depression. , 2011, Addiction.

[41]  D. Hermans,et al.  Negative Bias in the Perception of Others’ Facial Emotional Expressions in Major Depression: The Role of Depressive Rumination , 2006, The Journal of nervous and mental disease.

[42]  O. Aasland,et al.  Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. , 1993, Addiction.

[43]  B. Löwe,et al.  A brief measure for assessing generalized anxiety disorder: the GAD-7. , 2006, Archives of internal medicine.

[44]  Matthew S. Fritz,et al.  PSYCHOLOGICAL SCIENCE Research Article Required Sample Size to Detect the Mediated Effect , 2022 .

[45]  J. Arnett Emerging adulthood. A theory of development from the late teens through the twenties. , 2000, The American psychologist.

[46]  Roisin M O'Connor,et al.  Interactive Effects of the BIS and the BAS on Trajectories of Alcohol Misuse after University Graduation , 2015, Substance abuse : research and treatment.

[47]  Henry Wechsler,et al.  Attendance and alcohol use at parties and bars in college: a national survey of current drinkers. , 2002, Journal of studies on alcohol.

[48]  A. Aleman,et al.  Impaired Attribution of Emotion to Facial Expressions in Anxiety and Major Depression , 2010, PloS one.

[49]  S. Sherry,et al.  Context counts: solitary drinking explains the association between depressive symptoms and alcohol-related problems in undergraduates. , 2015, Addictive behaviors.

[50]  M. Pinquart,et al.  Meta-analysis of depression and substance use among individuals with alcohol use disorders. , 2009, Journal of substance abuse treatment.

[51]  R. Lalonde,et al.  Do alcohol expectancies become intoxicated outcomes? A test of social-learning theory in a naturalistic bar setting. , 2003, Addictive behaviors.

[52]  Charles Lambdin,et al.  Significance tests as sorcery: Science is empirical—significance tests are not , 2012 .

[53]  Larry J. Nelson,et al.  Distinguishing Features of Emerging Adulthood , 2005 .

[54]  M. Höfler,et al.  The natural course of social anxiety disorder among adolescents and young adults , 2012, Acta psychiatrica Scandinavica.

[55]  A Rogier T Donders,et al.  Unpredictable bias when using the missing indicator method or complete case analysis for missing confounder values: an empirical example. , 2010, Journal of clinical epidemiology.

[56]  S. Gortmaker,et al.  Depressive Symptoms as a Longitudinal Predictor of Sexual Risk Behaviors Among US Middle and High School Students , 2006, Pediatrics.

[57]  P. Vik,et al.  College student heavy drinking in social contexts versus alone. , 2002, Addictive behaviors.

[58]  R. Morrison,et al.  Predicting psychological distress in college students: the role of rumination and stress. , 2005, Journal of clinical psychology.

[59]  B. Löwe,et al.  Validation and Standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the General Population , 2008, Medical care.

[60]  Jennifer E. Merrill,et al.  Drinking motives in the prospective prediction of unique alcohol-related consequences in college students. , 2014, Journal of studies on alcohol and drugs.

[61]  A. Bandura Social Foundations of Thought and Action: A Social Cognitive Theory , 1985 .

[62]  A. Pumariega,et al.  Alcohol Misuse among College Athletes: Self-Medication for Psychiatric Symptoms? , 2002, Journal of drug education.

[63]  Libby N Brockman,et al.  Associations between displayed alcohol references on Facebook and problem drinking among college students. , 2012, Archives of pediatrics & adolescent medicine.

[64]  H. Jabbour,et al.  Insomnia and Relationship with Anxiety in University Students: A Cross-Sectional Designed Study , 2016, PloS one.

[65]  Ronald Gangnon,et al.  Validity of the alcohol use disorders identification test in college students. , 2004, Alcoholism, clinical and experimental research.

[66]  Timothy A Brown,et al.  A proposal for a dimensional classification system based on the shared features of the DSM-IV anxiety and mood disorders: implications for assessment and treatment. , 2009, Psychological assessment.

[67]  M. Wong,et al.  Distress tolerance in social versus solitary college student drinkers. , 2015, Addictive behaviors.

[68]  N. Williams The GAD-7 questionnaire , 2014 .

[69]  S. Penckofer,et al.  Factors predictive of depression in first-year college students. , 2015, Journal of psychosocial nursing and mental health services.

[70]  J. Markowitz,et al.  The epidemiology of chronic major depressive disorder and dysthymic disorder: results from the National Epidemiologic Survey on Alcohol and Related Conditions. , 2010, The Journal of clinical psychiatry.

[71]  S. Stewart,et al.  Solitary drinking is associated with specific alcohol problems in emerging adults. , 2018, Addictive behaviors.

[72]  L. Radloff The CES-D Scale , 1977 .

[73]  Craig K. Enders,et al.  Applied Missing Data Analysis , 2010 .

[74]  S. Gilbody,et al.  Brief case finding tools for anxiety disorders: validation of GAD-7 and GAD-2 in addictions treatment. , 2012, Drug and alcohol dependence.

[75]  J. Buckner,et al.  Social anxiety and alcohol-related impairment: The mediational impact of solitary drinking. , 2016, Addictive behaviors.

[76]  P. Bentler,et al.  Cutoff criteria for fit indexes in covariance structure analysis : Conventional criteria versus new alternatives , 1999 .

[77]  Kenneth H Beck,et al.  Social context of drinking and alcohol problems among college students. , 2008, American journal of health behavior.

[78]  David H. Barlow,et al.  Anxiety and its disorders : the nature and treatment of anxiety and panic , 1988 .

[79]  S. Sherry,et al.  Getting the party started--Alone: Solitary predrinking mediates the effect of social anxiety on alcohol-related problems. , 2016, Addictive behaviors.

[80]  M. Kushner,et al.  The relationship between anxiety disorders and alcohol use disorders: a review of major perspectives and findings. , 2000, Clinical psychology review.

[81]  C. Segrin Social skills deficits associated with depression. , 2000, Clinical psychology review.

[82]  Kasey G. Creswell,et al.  Solitary Alcohol Use in Teens Is Associated With Drinking in Response to Negative Affect and Predicts Alcohol Problems in Young Adulthood , 2014, Clinical psychological science : a journal of the Association for Psychological Science.

[83]  Richie Poulton,et al.  Depression and Generalized Anxiety Disorder: Cumulative and Sequential Comorbidity in a Birth Cohort Followed Prospectively to Age 32 Years , 2009 .

[84]  Klara Hradilova Selin Test-retest reliability of the alcohol use disorder identification test in a general population sample. , 2003, Alcoholism, clinical and experimental research.

[85]  J. Buckner,et al.  Social anxiety and problematic alcohol consumption: the mediating role of drinking motives and situations. , 2006, Behavior therapy.

[86]  E. Benotsch,et al.  Alcohol mixed with energy drinks are robustly associated with patterns of problematic alcohol consumption among young adult college students. , 2015, Addictive behaviors.

[87]  J. Bodenlos,et al.  Mindfulness and Alcohol Problems in College Students: The Mediating Effects of Stress , 2013, Journal of American college health : J of ACH.

[88]  K. Durkin,et al.  COLLEGE STUDENTS AND BINGE DRINKING: AN EVALUATION OF SOCIAL LEARNING THEORY , 2005 .

[89]  Julia D Buckner,et al.  Problematic alcohol and cannabis use among young adults: the roles of depression and discomfort and distress tolerance. , 2007, Addictive behaviors.

[90]  J. Neff Solitary drinking, social isolation, and escape drinking motives as predictors of high quantity drinking, among Anglo, African American and Mexican American males. , 1997, Alcohol and alcoholism.