Real-Time Reports of Drinking to Cope: Associations With Subjective Relief From Alcohol and Changes in Negative Affect
Abstract
Introduction
Many individuals report using alcohol to cope or relieve negative affective states, but existing evidence is inconsistent regarding whether individuals experience negatively reinforcing effects after drinking [using alcohol] to cope (DTC).
Method
This study used ecological momentary assessment to examine the effects of DTC during daily-life alcohol use episodes in a sample of current alcohol users (N = 110; 52 individuals with borderline personality disorder and 58 community individuals). Multilevel models were used to test whether momentary and episode-level endorsement of DTC-depression and DTC-anxiety motives would be related to increased subjective alcohol-use-contingent relief and decreased depression and anxiety during alcohol use episodes.
Results
Momentary DTC-anxiety predicted greater subsequent alcohol-use-contingent relief, and greater episode-level DTC-anxiety and DTC-depression predicted greater alcohol-use-contingent relief during the episode. However, the study did not find decreased depression and anxiety following endorsement of DTC-depression and DTC-anxiety. Instead, the study found that greater episode-level DTC-depression was associated with increased depression.
Conclusion
Findings suggest that individuals’ negative affective states may not improve during DTC despite endorsing alcohol-use-contingent relief. This discrepancy warrants further attention because subjective relief likely reinforces DTC, whereas awareness of one’s change (or lack of change) in affect may provide valuable counterevidence for whether alcohol use is an effective coping strategy.
Research in context
In this study the researchers tested to see whether using alcohol to cope with anxious or depressive feelings actually relieved these negative feelings.
The researchers selected a sample with people from the general population as well as those with Borderline Personality Disorder (BPD). Those with BPD are known to have more alcohol use problems and experience more variable emotions, therefore more prone to use alcohol to cope. People with BPD were selected to capture as much variability in emotional states and proneness to alcohol problems as possible in their study.
What the researchers did was first administer a questionnaire to the participants. Then they were given an electronic diary. Participants received regular prompts to report on any alcohol consumption, and also to rate levels of various negative feelings, such as being jittery, nervous, downhearted and lonely.
When a participant reported having had alcohol, they were asked to rate the extent to which whether they’d done this to make them “feel less guilty or depressed” or “feel more relaxed and calm”. Over the following three hours, at different points, they then rated the extent to which they felt alcohol had “relieved unpleasant feelings or symptoms”, and also provided updated ratings of their levels of those various negative feelings.
What the researchers found was that the participants believed their negative feelings were relieved after using alcohol to cope but their own rating of those feelings showed that alcohol had not helped. Alcohol had no impact on anxiety scores. Depression related feelings actually increased after using alcohol to cope. The increases in negative feelings were higher for participants who had a previously diagnosed alcohol use disorder.
The findings show that using alcohol to cope is a fallacy. If someone expects alcohol to help, this could encourage them to believe that it has, even if their actual feelings have not changed, or even worsened.
