This study investigated whether drinking to cope with anxiety among college students varied over time in response to fluctuations in anxiety levels. The researchers analyzed data from 125 undergraduate students who reported their drinking motives, anxiety, and alcohol consumption weekly for up to 7 times. Hierarchical linear modeling revealed that higher levels of state coping motives were associated with more drinks per week, and this relationship weakened as trait anxiety increased. The findings suggest individuals' use of alcohol to cope with anxiety depends on temporal changes in motives and anxiety characteristics.

1. Hierarchical Linear Modeling of Drinking to Cope with Anxiety Among College Students Old Dominion University Department of Psychology Bradley Wetzell ▪ Matthew R. Pearson, M.S. ▪ James M. Henson, Ph.D.

2. Background Current Research Method Analysis Results Discussion Drinking to Cope with Anxiety Overview

3. Alcohol use in teens / young adults (NIAAA, 2008) 72% 12th Graders 83% College Students Highest rates of problem drinking ages 18 – 24 Drinking to Cope with Anxiety Background

4. Drinking Motives Self-reported reasons for drinking Proximal precursors to alcohol consumption Previously assumed to have High between-persons variability (Traits) Low within-persons variability (States) Research suggests state drinking motive variability, especially with regard to coping with anxiety (Grant et al., 2007) Drinking to Cope with Anxiety Background

5. Drinking to Cope with Anxiety Historical Factors Personality characteristics Social/environmental influences Biological predisposition Current Factors Current emotional state Situational variables Mapping motivational influences for drinking (Cox & Klinger, 1988) Expected Effects Direct chemical effects Indirect instrumental effects Decision to Drink

6. Net result of the Cox & Klinger Model (Cooper, 1994) Decision to drink is motivated by Positive vs. negative reinforcement Internal vs. external cues Drinking to Cope with Anxiety Background Internal Cues External Cues Positive Reinforcement Enhancement Social Negative Reinforcement Coping Conformity

7. Drinking to Cope with Anxiety Background Enhancement Social Enhancement Social Coping Coping Conformity Conformity

8. Drinking Motives Questionnaire- Revised (DMQ-R) (Cooper, 1994) I.E., Drinking to enhance the current emotional state I.E., Drinking to positively affect social interaction I.E., Drinking to avoid a negative emotional state I.E., Drinking to avoid negative social outcomes Drinking to Cope with Anxiety Background Enhancement Social Coping Conformity

9. Drinking Motives Questionnaire- Revised (DMQ-R) (Cooper, 1994) Better accounted for consumption patterns Enhancement and Coping strong predictors for alcohol use, heavy drinking, problem drinking Each motive = Unique Consumption / Outcomes Social = Parties & friends with no problems Coping = Solitary consumption with problems Drinking to Cope with Anxiety Background

10. Drinking to Cope with Anxiety Background Modified DMQ – R(Grant et al., 2007) Enhancement Social Coping Conformity

11. Drinking to Cope with Anxiety Background Modified DMQ – R(Grant et al., 2007) Enhancement Social Coping Conformity

12. Drinking to Cope with Anxiety Background Modified DMQ – R(Grant et al., 2007) Coping Coping – Anxiety Coping - Depression

13. Drinking to Cope with Anxiety Background Modified DMQ – R(Grant et al., 2007) Coping – Anxiety Coping - Depression

14. Drinking to Cope with Anxiety Background Modified DMQ – R(Grant et al., 2007) Enhancement Social Coping - Anxiety Coping - Depression Conformity

15. Modified DMQ - R (Grant et al., 2007) More predictive than previous scale Two new dimensions were distinct Predicted different outcome patterns Contrary to Cooper Neither related drinking frequency Mild coping-depression drinks/occasion link Drinking to Cope with Anxiety Background

16. Modified DMQ - R (Grant et al., 2007) Next: Longitudinal Analysis High coping-depression = Increased no. drinks High coping-anxiety = Decreased no. drinks High coping-anxiety = Increased alcohol problems Consistent with other studies (Dawson et al., 2005; Morris et al. 2005) Due to within-persons variance? Drinking to Cope with Anxiety Background

17. Purpose Investigate whether coping-anxiety motives vary over time, allowing for differential consumption patterns in response to situational anxiety Drinking to Cope with Anxiety Current Research

18. Variables Drinking Motives Self-reported reasons for drinking Anxiety Self-reported negative affective state characterized by apprehension regarding the future Alcohol Consumption Drinking to Cope with Anxiety Current Research

19. Hypothesis The relationship between anxiety and drinking will change over time in response to variation in coping-anxiety motives Drinking to Cope with Anxiety Current Research

20. Participants 125 ODU Undergraduate Psychology Students > 18 years old, Median Age = 20 Mostly Caucasian females Participated in exchange for optional course credit Electronic notification statement Ethical compliance approved by IRB (HSC) Drinking to Cope with Anxiety Method

21. Measures Modified DMQ – R (Cooper, 1994; Grant et al., 2007) 5 dimensions, 23 items 5-point Likert scale Only coping-anxiety analyzed “When I drank in the last week, it was:” “Because it helps me when I feel nervous” “Because I feel more self-confident or sure of myself” Drinking to Cope with Anxiety Method

22. Measures Anxiety International Personality Item Pool (Goldberg et al., 2006) 10 items “I tend to get stressed out easily” “I tend to get wrapped up in my problems” 5-point Likert scale Drinking to Cope with Anxiety Method

23. Measures Alcohol Use 7-day grid No. drinks/day for previous week Composite Score = Weekly sum (Total drinks per week) Drinking to Cope with Anxiety Method

24. Measures Standard Demographics Age Gender Race / Ethnicity Marital Status Housing Status Greek Membership Status Drinking to Cope with Anxiety Method

25. Procedure Scheduled via SONA, groups of 4 Campus lab Standard desktop computers Assessments via computer Approx. 1 hour Follow-ups via weekly email Assessments via internet Approx. 15 minutes each, up to 7 times Drinking to Cope with Anxiety Method

26. Data include follow-ups where P’s drank at least once during previous week (N = 293) Preliminary analysis D.V. Plotted with histogram Unipolar Skewness = 1.43 Kurtosis = 2.03 Multivariate outliers Cook’s – D Mahalanobis distances Drinking to Cope with Anxiety Analysis

27. Hierarchical Linear Modeling (HLM) Level-1 (State, or within-persons) Predictors = State coping-anxiety motives, state anxiety levels Group mean-centered Criterion = Total drinks /week Level-2 (Trait, or between-persons) Predictors = Gender, trait (avg.) coping-anxiety motives, trait (avg.) anxiety levels Grand mean-centered (except gender) Criterion = Avg. drinks / week Drinking to Cope with Anxiety Analysis

28. Hypothesis The relationship between anxiety and drinking will change over time in response to variation in anxiety coping motives Drinking to Cope with Anxiety Results

29. Typical man during typical week drinks 6.5 more drinks than a typical woman (β01 = -6.47, t(122) = -3.31, p < .01) Drinking to Cope with Anxiety Results

30. One-unit increase in between-persons (trait) coping-anxiety motives = 2.31 more drinks/week (β02 = 2.31, t(122) = 2.82, p < .01) One-unit increase in within-persons (state) coping-anxiety motives = 2.38 more drinks/week (β10 = 2.38, t(123) = 2.38, p < .05) Drinking to Cope with Anxiety Results

31. The relationship between state coping-anxiety motives and total drinks per week decreased as trait anxiety levels increased (β11 = -0.36, t(123) = -2.39, p < .05) Drinking to Cope with Anxiety Results

32. Hypothesis Supported Temporal variation in drinking/state anxiety-coping relationship = state coping-anxiety motives did not remain stable Drinking to Cope with Anxiety Discussion One-unit increase in within-persons (state) coping-anxiety motives = 2.38 more drinks/week (β10 = 2.38, t(123) = 2.38, p < .05)

33. Drinking to Cope with Anxiety The relationship between state coping-anxiety motives and total drinks per week decreased as trait anxiety levels increased

34. Future research Why do participants with high trait anxiety levels tend not to drink as much in response to state coping-anxiety motives vs. those with lower trait anxiety? Do certain personality traits contribute to fluctuations? Do demographic variables (other than gender) contribute to fluctuations? Do other motives exhibit same fluctuations? Drinking to Cope with Anxiety Discussion

35. Implications Perhaps individuals with higher trait anxiety levels have found better coping methods How individuals use alcohol to cope with anxiety is important for effective intervention Changes in drinking motives may make individuals more at risk for alcohol problems while specific stimuli present Drinking to Cope with Anxiety Discussion

36. Cooper, M. L. (1994). Motivations for alcohol use among adolescents: Development and validation of a four-factor model. Psychological Assessment, 6(2), 117-128. doi: 10.1037/1040-3590.6.2.117 Cox, W. M., & Klinger, E. (1988). A motivational model of alcohol use. Journal of Abnormal Psychology, 97(2), 168-180. doi: 10.1037/0021-843X.97.2.168 Dawson, D. A., Grant, B. F., Stinson, F. S., & Chou, P. S. (2005). Psychopathology associated with drinking and alcohol use disorders in the college and general adult populations. Drug and Alcohol Dependence, 77(2), 139-150. doi: 10.1016/j.drugalcdep.2004.07.012 Goldberg, L. R., Johnson, J. A., Eber, H. W., Hogan, R., Ashton, M. C., Cloninger, C. R., et al. (2006). The international personality item pool and the future of public-domain personality measures. Journal of Research in Personality, 40(1), 84-96. doi: 10.1016/j.jrp.2005.08.007 Grant, V. V., Stewart, S. H., O'Connor, R. M., Blackwell, E., & Conrod, P. J. (2007). Psychometric evaluation of the five-factor Modified Drinking Motives Questionnaire--Revised in undergraduates. Addictive Behaviors, 32(11), 2611-2632. doi: 10.1016/j.addbeh.2007.07.004 Morris, E. P., Stewart, S. H., & Ham, L. S. (2005). The relationship between social anxiety disorder and alcohol use disorders: A critical review. Clinical Psychology Review, 25(6), 734-760. doi: 10.1016/j.cpr.2005.05.004 National Institute on Alcohol Abuse and Alcoholism. (2008). Research Findings on College Drinking and the Minimum Legal Drinking Age. Last Updated: October, 2008. Retrieved July 19, 2009, from http://www.niaaa.nih.gov/NR/rdonlyres/F099FF68-37B3-4EBC-8573-93CC768A74AA/0/CollegeDrinkingMLDA.pdf. Drinking to Cope with Anxiety References

37. Hierarchical Linear Modeling of Drinking to Cope with Anxiety Among College Students Old Dominion University Department of Psychology Bradley Wetzell ▪ Matthew R. Pearson, M.S. ▪ James M. Henson, Ph.D.