Drinking To Cope With Depressed Mood In College And Non-College Young Adults

Co-occurring depressed mood and risky alcohol use are prevalent during emerging adulthood, a critical development period ranging from approximately 18 to 25 years of age linking adolescence and adulthood and characterized by identity exploration, instability, self-focus, and opportunity (Arnett, 2005).

Three-quarters of individuals with a lifetime history of mood disorders have their first onset by the age of 24 (Kessler et al., 2005), and emerging adulthood is associated with peak lifetime drinking risk (Patrick & Schulenberg, 2011; Sussman & Arnett, 2014). Depressed mood and risky drinking tend to co-occur. Depressed individuals are susceptible to consuming alcohol to avoid or regulate negative internal states (Abrams & Niaura, 1987; Maisto, Carey, & Bradizza, 1999)even though drinking to cope fails to effectively resolve problems and may contribute to chronic drinking problems over time (Baer, 2002; Littlefield, Sher, & Wood, 2010; Merrill & Read, 2010).

Although drinking to cope has emerged as a strong mediator in the relationship linking depressive symptoms with subsequent negative alcohol consequences among college students (Bravo, Pearson, Stevens, & Henson, 2016; Clerkin, Werntz, Magee, Lindgren, & Teachman, 2014; Gonzalez, Bradizza, & Collins, 2009; Kenney, Jones, & Barnett, 2015; Tomaka, Morales-Monks, & Shamaley, 2013; Vernig & Orsillo, 2015), research to date has largely neglected non-college emerging adults. Nationally, one in five eighth graders drop out of high school (Heckman & Lafontaine, 2010), and among high school graduates, less than half matriculate into 4-year colleges the following fall (Aud et al., 2011).

In the current study, we aimed to fill a prominent gap in the existing literature by examining if the pathways linking depressive symptoms with alcohol outcomes were similar when comparing 341 current college (65%) and non-college (35%) community-recruited emerging adult drinkers (mean age = 21; 51% male; 68% White). The results showed that college and non-college emerging adults reported similar levels of drinking, alcohol problems, and drinking to cope with negative affect, and drinking to cope was associated with alcohol-related problems in both samples. Moreover, consistent with the hypothesis and prior research (e.g., Kenney et al., 2015; Vernig & Orsillo, 2015), the relationship between depression and alcohol problems was mostly or fully mediated by the use of alcohol for coping among college students. However, drinking to cope did not mediate the pathway among non-college emerging adults.

It is possible that different situational contexts may uniquely impact individualsā€™ use of alcohol to alleviate negative mood states specifically. Drinking to cope in order to enhance mood may be particularly appealing for college students with fewer adult roles and ample opportunity to drink in a heavy drinking normative culture. Accessibility and availability of alcohol may make decisions to drink easier for depressed students. Given that students who drink to alleviate depressive symptoms face a heightened risk for alcohol-related negative consequences even though they do not necessarily drink at greater levels than non-depressed peers may indicate deficits in emotional regulation or volitional control. Protective behavioral skills training targeted at emerging adults who rely on drinking to cope may be helpful.

Still, drinking to cope was directly associated with alcohol-related problems among non-college participants. This finding highlights the need to examine predictors other than depressed mood in this population. Given that emerging adults without college degrees are more likely to have a history of adverse experiences than those with college degrees (Monnat & Chandler, 2015), examining the role of adverse experiences in non-college emerging adultsā€™ alcohol-related motivational pathways may be needed.

In sum, the current findings caution against extending college-based findings to non-college populations and underscore the need to better understand the role of coping motives and other intervening factors in pathways linking depressed mood and alcohol-related risk in non-college emerging adults.

These findings are described in the article entitled Drinking to cope mediates the relationship between depression and alcohol risk: Different pathways for college and non-college young adults, recently published in the journal Addictive Behaviors. This work was conducted by Shannon R. Kenney, Bradley J. Anderson, and Michael D. SteinĀ from Butler Hospital.Ā 

References

  • Abrams, D., & Niaura, R. (1987). Psychological Theories of Drinking and Alcoholism. New York: The Guilford Press.
  • Arnett, J. J. (2005). The developmental context of substance use in emerging adulthood. The Journal of Drug Issues.
  • Aud, S., Hussar, W., kena, G., Bianco, K., Frohlich, L., Kemp, J., & Tahan, K. (2011). The condition of education 2011 (NCES 2011-033). Washington DC: Government Printing Office.
  • Baer, J. S. (2002). Student factors: understanding individual variation in college drinking. J Stud Alcohol Suppl(14), 40-53.
  • Bravo, A. J., Pearson, M. R., Stevens, L. E., & Henson, J. M. (2016). Depressive Symptoms and Alcohol-Related Problems Among College Students: A Moderated-Mediated Model of Mindfulness and Drinking to Cope. J Stud Alcohol Drugs, 77(4), 661-666.
  • Clerkin, E. M., Werntz, A. J., Magee, J. C., Lindgren, K. P., & Teachman, B. A. (2014). Evaluating age differences in coping motives as a mediator of the link between social anxiety symptoms and alcohol problems. Psychol Addict Behav, 28(3), 880-886. doi:10.1037/a0036813
  • Gonzalez, V. M., Bradizza, C. M., & Collins, R. L. (2009). Drinking to cope as a statistical mediator in the relationship between suicidal ideation and alcohol outcomes among underage college drinkers. Psychol Addict Behav, 23(3), 443-451. doi:10.1037/a0015543
  • Heckman, J. J., & Lafontaine, P. A. (2010). The American High School Graduation Rate: Trends and Levels. Rev Econ Stat, 92(2), 244-262. doi:10.1162/rest.2010.12366
  • Kenney, S. R., Jones, R. N., & Barnett, N. P. (2015). Gender Differences in the Effect of Depressive Symptoms on Alcohol Expectancies,
  • Coping Motives, and Alcohol Outcomes in the First Year of College. Journal Of Youth And Adolescence, 44(10), 1884-1897.
  • Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 593-602. doi:10.1001/archpsyc.62.6.593
  • Littlefield, A. K., Sher, K. J., & Wood, P. K. (2010). Do changes in drinking motives mediate the relation between personality change and “maturing out” of problem drinking? J Abnorm Psychol, 119(1), 93-105. doi:10.1037/a0017512
  • Maisto, S. A., Carey, K. B., & Bradizza, C. M. (1999). Psychological theories of drinking and alcoholism In K. E. Leonard & B. T. Howard (Eds.), Social Learning Theory(2nd ed., pp. 106-163). New York: Guilford Press.
  • Merrill, J. E., & Read, J. P. (2010). Motivational pathways to unique types of alcohol consequences. Psychol Addict Behav, 24(4), 705-711. doi:10.1037/a0020135
  • Monnat, S. M., & Chandler, R. F. (2015). Long Term Physical Health Consequences of Adverse Childhood Experiences. Sociol Q, 56(4), 723-752. doi:10.1111/tsq.12107
  • Patrick, M. E., & Schulenberg, J. E. (2011). How trajectories of reasons for alcohol use relate to trajectories of binge drinking: National panel data spanning late adolescence to early adulthood. Dev Psychol, 47(2), 311-317. doi:10.1037/a0021939
  • Sussman, S., & Arnett, J. J. (2014). Emerging Adulthood: Developmental Period Facilitative of the Addictions. Eval Health Prof, 37(2), 147-155. doi:10.1177/0163278714521812
  • Tomaka, J., Morales-Monks, S., & Shamaley, A. G. (2013). Stress and coping mediate relationships between contingent and global self-esteem and alcohol-related problems among college drinkers. Stress Health, 29(3), 205-213. doi:10.1002/smi.2448
  • Vernig, P. M., & Orsillo, S. M. (2015). Drinking motives and college alcohol problems: A prospective study. Journal of Substance Use, 20(5), 340-346.

About The Author

SK
Shannon Kenney

Dr. Kenney graduated with a B.A. from Bowdoin College, doctorate in Sociology from Brown University, and M.P.H. from Harvard University. Dr. Kenney began studying addiction as the Associate Director of the Heads Up Alcohol Research Lab and Visiting Assistant Research Professor in the Department of Psychology at Loyola Marymount University in Los Angeles. Dr. Kenney completed a fellowship at the Center for Alcohol and Addiction Studies at Brown University and has been the Principal Investigator of grants from the National Institutes of Health and the Foundation for Alcohol Research. Dr. Kenney has published over 60 peer-reviewed articles and six book chapters. Currently, Dr. Kenney researches opioid use disorders and young adult drinking-related sex risk as Assistant Professor of Psychiatry and Human Behavior at the Alpert Medical School of Brown University.

BA
Bradley Anderson

Bradley is a research scientist at Butler Hospital, with a specialization in General Internal Medicine.

Michael Stein

Based at Butler Hospital, professor of medicine, health services, policy & practice, Dr. Michael Stein directs a staff of 25 who work on changing risk-taking behaviors. Recognized among the top 1 percent of NIH-funded researchers in the last decade, Dr. Stein's work has focused primarily on substance use disorders, HIV disease, and HIV prevention. Dr. Steinā€™s interests span populations (young adults recruited through Facebook, persons seeking inpatient detoxification, persons seen in medical settings), substances (opioids, marijuana, alcohol, cigarettes), and outcomes (relapse prevention, retention in care, medication adherence, medical complications, acquisition of sexually transmitted infections). Dr. Stein is internationally known as a pioneer in developing therapies that combine cutting-edge pharmacotherapy and behavior change therapies. Related to these projects, Dr. Stein now spends much of his time mentoring young investigators and serving on training grants at Brown and other universities funded by the National Institutes of Health.

More recently, he has been working on projects related to sleep in older persons with diabetes and in young persons who smoke marijuana. With marijuana's growing availability, our understanding of its effects, and side effects, are being systematically studied for the first time. Many persons smoke marijuana expecting it to help with insomnia, but its not clear that this is the case for those who smoke heavily.

In addition, Dr. Stein's lab has been looking at non-pharmacological ways to increase the tolerability of pain and maintain daily activities in persons experiencing chronic pain. Working with psychologists at Butler and Brown, these studies include persons with histories of substance abuse and HIV.

Dr. Stein is also excited about working with the HealthPath program, an innovative collaboration between Care New England, Blue Cross, and The Providence Center which will strive to improve the lives of Rhode Islanders with mental health disorders and functional impairment. Offering a new array of mental health services, this pilot project--the first of its kind in the United States involving commerically-insured persons--seeks to reduce the burden of mental health disorders for individuals in our community.

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