Social anxiety and vulnerability for problematic drinking in college students: the moderating role of post-event processing

Socially anxious college students are at increased risk for engaging in problematic drinking (i.e. heavy or risky drinking) behaviors that are associated with the development of an alcohol use disorder. The present study examined whether post-event processing (PEP), repeatedly thinking about and evaluating one’s performance in a past social situation, strengthens the association between social anxiety and vulnerability to problematic drinking among college students. Eighty-three college drinkers with high or low social anxiety participated in a social interaction task and were exposed to a manipulation that either promoted or inhibited PEP about the social interaction. Among participants randomized to the PEP promotion condition, those with high social anxiety exhibited a greater urge to use alcohol after the social interaction and greater motivation to drink to cope with depressive symptoms over the week following the manipulation than did those with low social anxiety. These findings suggest that targeting PEP in college drinking intervention programs may improve the efficacy of such programs for socially anxious students.     

Mindfulness,General Trust,and Social Support Among Trauma-Exposed College Students

The purpose of the present study was to examine whether mindfulness predicts general trust and social support among trauma-exposed college students, as well as to examine the potential moderating effect of posttraumatic stress on these relationships. Participants consisted of 536 trauma-exposed college students attending a public university in the southeast United States. After controlling for PTSD symptoms and type of trauma, mindfulness was positively associated with general trust and social support at low and mean levels of PTSD symptomatology; however, the relationships between mindfulness and these variables were nonsignificant at high levels of PTSD symptomatology.     

Social anxiety, reasons for drinking, and college students

Recent research suggests that social anxiety may be associated with higher rates of alcohol problems in women, yet may be associated with lower levels of drinking in men. The current study investigated putative mechanisms that may underlie potential gender differences in the social anxiety-alcohol relationship. One hundred and eighteen college students (61.0% women) completed an interview assessing drinking behaviors and questionnaires measuring social anxiety, drinking motives, and drinking situations. Although college men and women both reported similar frequencies of drinking in positive situations and to enhance positive emotions, women reported drinking more often in negative situations and to cope with aversive emotions than men. Mediated moderation analyses suggested that women with social anxiety may be at greater risk of encountering adverse consequences because of their likelihood to drink to conform or to cope with the aversive affect they experience in negative situations. Conversely, when men experience high rates of adverse consequences, it may be due to drinking greater quantities of alcohol in positive situations. Highly socially anxious college men may drink less alcohol and experience fewer adverse consequences than their nonanxious or mildly anxious counterparts because they may find themselves in positive situations and drinking to enhance positive feelings less often, potentially due to avoidant behavior. These findings may help to explain why social anxiety serves as a potential risk factor for alcohol-related problems for college women, but a protective factor for college men.     

Associations between depression, distress tolerance, delay discounting, and alcohol-related problems in European American and African American college students

Although levels of heavy drinking and alcohol-related problems are high in college students, there is significant variability in the number and type of problems experienced, even among students who drink heavily. African American students drink less and experience fewer alcohol-related problems than European American students, but are still at risk, and little research has investigated the potentially unique patterns and predictors of problems among these students. Depression, distress tolerance, and delay discounting have been implicated in adult substance abuse and may be important predictors of alcohol problem severity among college students. We examined the relationship between these variables and alcohol-related problems among African American and European American students (N = 206; 53% female; 68% European American; 28% African American) who reported recent heavy drinking. In regression models that controlled for drinking level, depression, distress tolerance, and delay discounting were associated with alcohol problems among African American students, but only depression was associated with alcohol problems among European American students. These results suggest that negative affect is a key risk factor for alcohol problems among college student drinkers. For African American students, the inability to tolerate negative emotions and to organize their behavior around future outcomes may also be especially relevant risk factors.     

Evidence for positive mood buffering among college student drinkers

Positive experiences play an important role in buffering the effects of negative experiences. Although this process can play out in a myriad of contexts, the college context is one of particular importance because of significant concerns about student stress levels and alcohol abuse. Building on evidence that at least some students drink in response to negative experiences, we considered the possibility that positive moods would moderate college student negative mood-drinking relationships. Using a Web-based daily process study of 118 (57% women) undergraduate student drinkers, the authors reveal that positive moods indeed buffer the effects of negative moods on student drinking, depending on the mood and drinking context. Furthermore, the buffering of ashamed mood appears to explain the buffering of other negative moods. Implications of these findings are considered in terms of the relationship between negative self-awareness and drinking to cope.     

Suicide Ideation,Alcohol Consumption,Motives, and Related Problems: Exploring the Association in College Students

Previous findings on the relationship between suicide ideation (SI) and alcohol misuse among college students are inconsistent, leading to conflicting clinical implications. We aimed to clarify this relationship in order to determine the utility of regarding alcohol misuse as a risk factor for SI in this population. Unselected college students (N = 545) completed an online survey including measures of alcohol consumption, problems, drinking motives, SI, and related variables. Our results suggest alcohol misuse is not a correlate of SI among college students; therefore, one should not assume that students who misuse alcohol are necessarily at increased risk for SI.     

Effects of depressed mood on drinking refusal self-efficacy: examining the specificity of drinking contexts

College students with elevated depressive symptoms are more likely to engage in risky drinking and experience alcohol-related negative consequences. Efforts to understand the association between depressed mood and alcohol use have begun to identify the role of cognitive-motivational processes. Drinking refusal self-efficacy is one such process that influences the decision to drink, but its relationship with depressed mood remains unclear. The current study sought to clarify the role of these processes using a depressed mood induction procedure in a sample of college student drinkers. Eighty-six students were randomized to a depressed or neutral mood induction and completed assessments of drinking refusal self-efficacy. Depressed mood significantly decreased self-efficacy in high-risk drinking contexts related to depression, whereas ratings of other high-risk contexts were unaffected. These findings suggest that the association between hazardous drinking and depressed mood may be due in part to the direct influence of mood state on one's self-efficacy to resist drinking in relevant contexts.     

Effects of Depressed Mood on Drinking Refusal Self-Efficacy: Examining the Specificity of Drinking Contexts

College students with elevated depressive symptoms are more likely to engage in risky drinking and experience alcohol-related negative consequences. Efforts to understand the association between depressed mood and alcohol use have begun to identify the role of cognitive-motivational processes. Drinking refusal self-efficacy is one such process that influences the decision to drink, but its relationship with depressed mood remains unclear. The current study sought to clarify the role of these processes using a depressed mood induction procedure in a sample of college student drinkers. Eighty-six students were randomized to a depressed or neutral mood induction and completed assessments of drinking refusal self-efficacy. Depressed mood significantly decreased self-efficacy in high-risk drinking contexts related to depression, whereas ratings of other high-risk contexts were unaffected. These findings suggest that the association between hazardous drinking and depressed mood may be due in part to the direct influence of mood state on one's self-efficacy to resist drinking in relevant contexts.     

A preliminary investigation of the relationship between emotion regulation difficulties and posttraumatic stress symptoms

This study examined the relationship between posttraumatic stress (PTS) symptoms and particular aspects of emotion regulation difficulties among trauma-exposed individuals. Participants were an ethnically diverse sample of 108 undergraduates from an urban university. PTS symptom severity was found to be associated with lack of emotional acceptance, difficulty engaging in goal-directed behavior when upset, impulse-control difficulties, limited access to effective emotion regulation strategies, and lack of emotional clarity. Further, overall difficulties in emotion regulation were associated with PTS symptom severity, controlling for negative affect. Finally, individuals exhibiting PTS symptoms indicative of a PTSD diagnosis reported greater difficulties with emotion regulation than those reporting PTS symptoms at a subthreshold level. The implications of these findings for research and treatment are discussed.     

Putting the relationship between social anxiety and alcohol use into context: A daily diary investigation of drinking in response to embarrassing events

The goal of this study was to clarify mixed findings regarding the association between dispositional social anxiety and drinking among college students by using a daily diary method to examine whether a within-person social-contextual event moderated the relationship between social anxiety and alcohol use. College students (n = 476) completed a measure of dispositional social anxiety and then for 30 days reported whether they experienced an embarrassing event in public and the amount of alcohol they drank each day. We examined whether experiencing an embarrassing event moderated the relationship between dispositional social anxiety and alcohol use for same-day, same-evening, next-day, and next-evening drinking. While there was a positive relationship between dispositional social anxiety and alcohol use on evenings when an embarrassing event occurred earlier that day, this appeared to be driven by a reduction in drinking among those low in social anxiety. Individuals with high social anxiety drank in the evening regardless of embarrassing event occurrence. Results suggest that people with low social anxiety show an adaptive response to embarrassing events by lowering drinking on such evenings, while those with high social anxiety may drink to reduce their already high levels of anxiety independent of daily social events.     

A diary study of implicit self-esteem, interpersonal interactions and alcohol consumption in college students

A 30-day daily diary study examined the relations among implicit self-esteem, interpersonal interactions, and alcohol consumption in college students. Multilevel analyses revealed that students with low implicit self-esteem drank more on days when they experienced more negative interpersonal interactions. In contrast, students with high implicit self-esteem drank more on days when they experienced more positive interpersonal interactions. Spending time with people who were drinking mediated both the low implicit self-esteem by negative interpersonal events interaction and the high implicit self-esteem by positive interpersonal events interaction. These findings suggest that people with low implicit self-esteem may unintentionally drink as a way to regulate unfulfilled needs for acceptance. On the other hand, people with high implicit self-esteem may drink as a way to enhance positive interpersonal experiences.     

Drinking to cope and alcohol use and abuse in unipolar depression: a 10-year model

This study examined drinking to cope with distress and drinking behavior in a baseline sample of 412 unipolar depressed patients assessed 4 times over a 10-year period. Baseline drinking to cope operated prospectively as a risk factor for more alcohol consumption at 1-, 4-, and 10-year follow-ups and for more drinking problems at 1- and 4-year follow-ups. Findings elucidate a key mechanism in this process by showing that drinking to cope strengthened the link between depressive symptoms and drinking behavior. Individuals who had a stronger propensity to drink to cope at baseline showed a stronger connection between depressive symptoms and both alcohol consumption and drinking problems.     

Standardized measures of alcohol-related problems: a review of their use among college students

College students' alcohol consumption has received considerable attention in the scientific literature and the media for its impact on students and the college community. Misuse of alcohol can lead to a wide range of consequences, the most severe being alcohol abuse, dependence, and death. Researchers have struggled to develop effective methods to assess problems related to alcohol, and the literature on college drinking lacks a strong theoretical framework for such assessment. The authors contend that measures of alcohol-related problems for college students should assess specific dimensions pertaining to 3 main domains: alcohol abuse, alcohol dependence, and what the authors define as risky drinking. The authors examined how existing measures fit into this model. In a comprehensive review of the college literature, the authors identified 9 measures (and their revised versions) assessing alcohol-related problems. Their analysis revealed that most measures do not assess comprehensively the domains outlined, and instead provide only partial assessments of the potential consequences of drinking for college students. The authors include directions for future research so that measurement of drinking consequences for college students can be refined.     

Restrained drinking and cognitive control among adolescents

The present study investigated restrained drinking and self-control in relation to alcohol consumption and problem drinking in a sample of adolescents. One hundred ninety-eight high school students (97 males and 101 females; mean age = 16.45 years) completed questionnaires that assessed levels of alcohol consumption, problem drinking, restrained drinking, and cognitive self-control. The findings were similar for males and females: higher levels of restrained drinking, as measured by cognitive emotional preoccupation (CEP), predicted higher levels of alcohol consumption and problem drinking. Moreover, it was high CEP in combination with a low score on a general measure of cognitive self-control that differentiated problem drinking from high levels of drinking. The results are consistent with previous research on young adults. The findings are discussed in relation to Baumeister and Heatherton's (1996) model of self-regulation failure.     

The associations between adult attachment,posttraumatic symptoms,and posttraumatic growth

Background and Objectives: Individual differences after trauma vary considerably and can range from posttraumatic stress disorder (PTSD) to posttraumatic growth (PTG). Current theoretical models cannot fully explain this variability. Therefore, we integrated attachment theory with Ehlers and Clark's model of PTSD to understand whether attachment style is associated with negative appraisals of a traumatic event(s), posttraumatic stress symptoms (PTS), and PTG. Our aim was to test this integrated model PTSD in an analog sample who had experienced at least one traumatic event. Design: We used structural equation modeling to test the association of adult attachment and posttraumatic cognitions (self and world/others) with PTS and PTG using a cross-sectional, correlational design. Methods: The sample comprised 393 university staff and students (Range_Age= 18–49, 85% females) who completed online measures. Results: Attachment anxiety and negative posttraumatic self-cognitions were positively associated. Negative posttraumatic self-cognitions were positively associated with PTS. Attachment anxiety had an indirect effect (via negative posttraumatic self-cognitions) on PTS, whereas attachment avoidance predicted more negative posttraumatic world cognitions and lower perceived PTG. Conclusions: The study highlights the importance of considering how attachment styles influence posttraumatic emotion regulation and cognitive processing of the trauma to determine posttraumatic mental health.     

Drinking not thinking: A prospective study of personality traits and drinking motives on alcohol consumption across the first year of university

The aim of this 3-wave prospective study was to test impulsivity-related and anxiety-related traits and drinking motives as predictors of alcohol consumption during Orientation Week (O-Week), and the first six months of university life in on-campus college residents. Students from two residential colleges (N = 255, 34.5% female) completed surveys of drinking frequency and quantity for the week prior to university entry, during O-Week, 3 and 6 months later. A brief personality screen for impulsivity, sensation-seeking, anxiety sensitivity and hopelessness was administered along with measures of drinking motives and alcohol consumption. Using moderated mediation analyses and multilevel modeling, impulsivity was found to be the best predictor of drinking variability at O-Week with enhancement motives mediating the effect. This mediated effect was moderated by gender with the indirect effect only occurring for women. Impulsivity was also predictive of drinking change over 6 months, with high impulsive students maintaining heavier levels of drinking (even when controlling for gender). The findings of this study further supports impulsivity as a consistent predictor of student alcohol misuse, even in environments with strong pro-drinking cultures.     

Student Service Members/Veterans’ Mental Health: Who Is at a Greater Risk for Posttraumatic Stress Symptoms on College Campuses?

Using a cross-sectional design, this study surveyed 144 students on campus who are service members and veterans to determine whether posttraumatic stress (PTS) symptoms are significantly correlated with demographic factors (e.g., age, race and marital status), risk factors (e.g., military branch and combat exposure), and resources (e.g., social support and religiosity). The results confirm previous findings on correlates of PTS symptoms, provide new information about service members on campus that are at a greater risk for PTS and highlight resources that are associated with reduced PTS symptoms. These findings not only give institutions of higher learning insight into identifying specific demographics that are at a greater risk for PTS symptoms on college campuses, but also point to ways of supporting student service members/veterans by accurately targeting existing resources to the most affected populations.     

Concurrent drinking and smoking among college students: An event-level analysis

Cigarette smoking and drinking commonly co-occur among college students, a population that is at high risk for developing alcohol and nicotine use disorders. Several studies have been conducted that have examined predictors of drinking or smoking to gain a better understanding of the antecedents of engaging in these behaviors. Yet, few studies have examined specific factors that influence concurrent smoking and drinking in this population. The current study used data from a 21-day electronic diary-based study of college students (n=86) who engaged in concurrent drinking and smoking to examine event-level associations between alcohol use and cigarette smoking in the student's natural environment. We specifically focused on within-person analyses of contexts in which students reported smoking and drinking simultaneously in comparison to contexts in which students reporting drinking without smoking. Situational contexts included environmental setting, whether s/he was alone or with others, and changes in stress and urges to smoke before initiating drinking. Results indicated that students drank more while smoking and smoked three times as many cigarettes, on average, during drinking episodes. Being with others at a party or a bar was associated with increased odds of smoking while drinking. Likewise, increased stress since the prior assessment predicted a greater likelihood of smoking while drinking. Based on the findings from the present study, it is important for future prevention and intervention efforts to consider social settings and heightened stress among students as potential risk factors for engaging in concurrent drinking and smoking.     

Drinking motives in alcohol use disorder patients with and without social anxiety disorder

The high comorbidity of alcohol use disorders (AUD) and social anxiety disorder (SAD) is often explained by excessive drinking in social situations to self-medicate social anxiety. Indeed, the motive to drink alcohol to lower social fears was found to be elevated in socially anxious persons. However, this social anxiety specific motive has not been directly investigated in primarily alcohol dependent individuals. We explored social anxiety, the motivation to drink alcohol in order to cope with social fears, and social anxiety as a consequence of drinking in AUD with and without comorbid SAD. Male AUD inpatients with (AUD+SAD group, N=23) and without comorbid SAD (N=37) completed a clinical interview and a questionnaire assessment. AUD+SAD patients reported higher levels of depression and an elevated motive to drink due to social anxiety but did not experience more social fears as a consequence of drinking. Previous results concerning alcohol drinking motives in order to relieve social fears could be replicated in a clinical AUD sample. Additionally, our findings suggest comorbid AUD+SAD patients to be more burdened regarding broader psychopathological symptoms. Thus, accessibility to SAD-specific screening and treatment procedures may be beneficial for primary AUD patients.