Momentary subjective responses to alcohol as predictors of continuing to drink during daily-life drinking episodes. (1st December 2022)

• Record Type: Journal Article
• Authors: Wycoff, Andrea M.; Motschman, Courtney A.; Griffin, Sarah A.; Freeman, Lindsey K.; Trull, Timothy J.
• Is Part Of: Drug and alcohol dependence. Volume 241(2022)
• Publication Date: 2022-12-01
• Subjects: Subjective response -- Stimulation -- Sedation -- Alcohol use -- Ecological momentary assessment -- Craving; Drug abuse -- Periodicals; Alcoholism -- Periodicals; 616.86
• DOI: 10.1016/j.drugalcdep.2022.109675
• Languages: English
• ISSNs: 0376-8716

Abstract

Abstract: Purpose: Subjective response to alcohol's stimulating and sedating effects is a person-level risk factor for heavy drinking and alcohol use disorder. Longitudinal and laboratory studies have demonstrated that at-risk individuals experience greater stimulation and lower sedation while drinking. While between-person subjective responses inform risk and etiology, in-the-moment assessments during daily-life drinking may elucidate the within-person processes by which stimulation and sedation may lead to heavier drinking. We aimed to characterize these momentary processes by testing momentary stimulation and sedation during drinking as predictors of subsequently continuing to drink during densely sampled, daily-life drinking episodes. Procedures: 113 adults (54 with borderline personality disorder and 59 community participants; 77.9% female) completed ecological momentary assessment for 21 days, reporting momentary subjective stimulation and sedation throughout drinking episodes and momentary alcohol use after drink initiation (i.e., continued drinking). Findings: GLMMs demonstrated that greater day-level stimulation ( OR =1.48, 95% CI =[1.20, 1.82], p <.001), greater person-level stimulation ( OR =1.63, 95% CI =[1.05, 2.53], p =.031), and lower momentary sedation ( OR =0.54, 95% CI =[0.41, 0.71], p <.001) predicted continued drinking. Conclusions: Although greater stimulation and lower sedation have been conceptualized as individual-level risk factors for heavy drinking, our findings suggest that these associations are accompanied by processes that operate within person. Our results suggest that greater stimulation may confer risk for heavy drinking at the level of the drinking episode, possibly acting as positive reinforcement that may contribute to heavier drinking during future episodes. In contrast, lower sedation may primarily confer in-the-moment risk by contributing to momentary decisions to keep drinking within an episode. Highlights: Subjective stimulation and sedation when drinking predict heavy drinking and AUD. We tested whether daily-life subjective responses predict continued drinking. Greater day-level stimulation predicted continued drinking. Lower momentary sedation predicted continued drinking. Low sedation during drinking may serve as an internal cue to keep drinking.