Solitary and social heavy drinking, suicidal ideation, and drinking motives in underage college drinkers
Introduction
Although few studies have examined the consequences associated with solitary drinking, it is typically viewed as pathological or harmful and is conventionally believed to be associated with alcoholism (Demers & Bourgault, 1996). A study of solitary drinking among adults in Montreal, Canada, found that individuals who engaged in solitary drinking did not have increased drinking problems (Bourgault & Demers, 1997). However, individuals who engaged in solitary heavy drinking (5 or more drinks per occasion) were significantly higher in alcohol-related problems. Bourgault and Demers (1997) suggest that it is not solitary drinking per se that is problematic, but rather solitary intoxication that is associated with greater alcohol problems.
College students evidence high rates of heavy episodic drinking and alcohol problems, with underage drinkers being at particular risk (Knight et al., 2002, O'Malley and Johnston, 2002, Wechsler et al., 2002). While drinking among college students is typically for social reasons (Kuntsche et al., 2005, LaBrie et al., 2007, Stewart et al., 1996) and in social contexts (Christiansen et al., 2002, Mohr et al., 2001, Wechsler et al., 1995), drinking in response to negative experiences and affect has been associated with drinking in solitary contexts. A daily process study of drinking in social or solitary contexts found that among students high in the tendency to experience negative emotional states (neuroticism), days with greater negative interpersonal experiences predicted solitary drinking (Mohr et al., 2001). In contrast, days with greater positive personal experiences were associated with drinking more in social contexts, regardless of level of neuroticism (Mohr et al., 2001). Similarly, students who engage in solitary heavy drinking episodes (i.e., 4 or more drinks at one time while alone for women, 5 or more for men) have been found to be higher in depression and to have more alcohol problems than students who drink heavily only in social contexts (Christiansen et al., 2002). Together these studies suggest that the relationship between negative affect and drinking may be context specific, with solitary drinking contexts being particularly associated with depression and related constructs, while social drinking appears not to be affected by negative emotions.
Drinking context also may be important in the well-documented relationship between drinking and suicidality (ideation, attempts, and deaths). Alcohol use just prior to a completed suicide or to a nonfatal suicide attempt is common, as are alcohol use disorders among suicide attempters and completers (Cherpitel et al., 2004, Hufford, 2001, Powell et al., 2001, Wilcox et al., 2004). Suicidal ideation is relatively common among young college students, with 11% of 18- to 24-year-old students reporting seriously considering suicide in the previous year (Brener, Hassan, & Barrios, 1999). Among students, suicidal ideation is associated with heavy episodic drinking, more frequent alcohol use, and greater alcohol problems (Brener et al., 1999, Gonzalez et al., in press, Levy and Deykin, 1989, Stephenson et al., 2006). The role of drinking context in relation to suicidality has not previously been explored. However, the strong relationship between depression and suicidality (e.g., Konick and Gutierrez, 2005, Walker et al., 2008) and the finding that solitary heavy drinking is associated with increased depression among college students (Christiansen et al., 2002) suggest that drinking context also may be important in the relationship between heavy drinking and suicidality among college students.
Drinking motives are thought to play a role in drinking context. According to motivational models of alcohol use, drinking to enhance positive emotions or to reduce negative emotions represents psychologically distinct and strategically motivated behaviors (Cooper, Frone, Russell, & Mudar, 1995). Drinking to cope with negative emotions is motivated by efforts to escape, avoid, or lessen negative affect, while enhancement motives involve the use of alcohol to increase positive affective states (Cooper et al., 1995). Of the drinking motives, enhancement motives demonstrate the strongest association with collegiate heavy drinking (see Kuntsche et al., 2005 for a review). However, it has been suggested that drinking to cope with negative affect may motivate heavy drinking among college students in the absence of the social influences commonly associated with collegiate heavy drinking (Christiansen et al., 2002). In addition, Cooper, Russell, Skinner, and Windle (1992) examined the associations of drinking motives with drinking behavior in various contexts among a general sample of adults. They found that drinking to cope with negative affect was positively associated with drinking alone, while social and enhancement motivates were positively associated with social drinking contexts.
Drinking motives have been shown to be more proximal to drinking behavior than alcohol expectancies and to mediate the relationship between alcohol expectancies and drinking behavior (Cooper et al., 1995). Thus, although few studies have examined the relationships of drinking motives and drinking in particular contexts, findings regarding alcohol expectancies provide useful insights regarding these possible relationships. Adolescents who engaged in solitary alcohol use have been shown to hold stronger beliefs regarding alcohol's ability to enhance positive or relieve negative affect (Tucker, Ellickson, Collins, & Klein, 2006). Similarly, college students who engaged in solitary heavy drinking were higher in alcohol negative mood regulation expectancies and expectancies that alcohol could reduce social distress than were students who drank heavily only in social contexts (Christiansen et al., 2002). Although actual motives for drinking were not examined, Christiansen et al.'s results suggest that solitary heavy drinkers may be motivated by attempts to cope. However, these authors also found that solitary drinkers were higher in all of the expectancies examined (i.e., personal and social enhancement), bringing into question whether there is a particular relationship between coping expectancies and solitary heavy drinking episodes.
In the present study, we examined social and solitary heavy drinking in a sample of underage college drinkers who reported a history of at least mild passive suicidal ideation. Although solitary drinkers have been found to also engage in social drinking (Demers & Bourgault, 1996), the extent to which solitary heavy drinkers are engaging in social heavy drinking has not been examined. Little also is currently known about solitary heavy drinkers' frequency of engaging in this behavior. Therefore in this study, we examined the rate of solitary heavy drinking and how often this behavior occurred relative to social heavy drinking among heavy drinkers.
To further knowledge regarding the associations among heavy episodic drinking context, suicidal ideation and drinking motives, we examined four specific hypotheses. Our first and second hypotheses were that level of suicidal ideation would be positively associated with the frequency of solitary heavy drinking (hypothesis 1), but not with the frequency of social heavy drinking (hypothesis 2). These hypotheses are supported by previous findings that college students who engaged in solitary heavy drinking were higher in depression than students who engaged in heavy drinking only in social contexts. Given the strong association between suicidal ideation and depression, we included depression as a control variable in the regression models that explored the associations between suicidal ideation and heavy drinking. This allowed us to examine the unique relationships of suicidal ideation to drinking context. Our third hypothesis was that solitary heavy drinking would be associated with drinking to cope motives. This hypothesis is supported by the predictions of motivational theories of drinking, the higher levels of depression and drinking problems among students who drink heavily in solitary contexts, and the positive association between drinking to cope and drinking alone in a general sample of adults. Our fourth hypothesis was that heavy drinking in social contexts would be primarily associated with enhancement drinking motives (cf. Kuntsche et al., 2005). Along with our fourth hypothesis, we also examined whether solitary and social heavy drinkers differed in their motivation for social heavy drinking. Given the relationship between depression and solitary heavy drinking, we thought that it would be possible that solitary heavy drinkers would be more likely to engage in heavy drinking, even in social contexts, because of drinking to cope motives. It also was possible that when drinking in social settings solitary heavy drinkers have similar motives as their peers, with their focus being on regulating their affect by attempting to increase their positive affect (i.e., enhancement motives).
Section snippets
Participants
Participants were 91 underage (between 18 and 20 years old) female (52.7%, n = 48) and male (47.3%, n = 43) college drinkers attending a large public university in New York State. All participants were current drinkers and had a history of at least passive suicidal ideation (see Procedures for further detail). The average age of the study sample was 19 years (SD = .74) and 100% were single (never married). The sample was 75.8% White/European American, 12.6% Asian American, 4.2% Black/African American,
Results
During the past year, 48.4% (n = 44) of the sample drank alone on one or more days a month. Nearly half of these individuals (n = 21) reported drinking moderate amounts when alone, while 25.3% (n =23) of the sample (slightly more than half of individuals that reported any solitary drinking) reported heavy drinking when alone at least once on a typical month. All solitary heavy drinkers and nearly all (97.1%, n = 66) individuals who did not report solitary heavy drinking engaged in social heavy
Discussion
This is the first study, to our knowledge, to explore the role of drinking context in the relationship of suicidal ideation to alcohol use. Our findings suggest that drinking context plays an important role in the relationship between suicidal ideation and heavy episodic drinking among underage college students. As hypothesized, we found that higher levels of suicidal ideation were associated with greater frequency of solitary heavy drinking, but not with frequency of social heavy drinking.
Acknowledgements
This research was supported by funds provided through the University at Buffalo Research Institute on Addictions Research Development Program and a National Institute of Alcohol Abuse and Alcoholism grant (T32-AA007583).
References (41)
- et al.
College student heavy drinking in social contexts versus alone
Addictive Behaviors
(2002) - et al.
Is gender relevant only for problem alcohol behaviors? An examination of correlates of alcohol use among college students
Addictive Behaviors
(2008) Alcohol and suicidal behavior
Clinical Psychology Review
(2001)- et al.
Why do young people drink? A review of drinking motives
Clinical Psychology Review
(2005) - et al.
Evaluation of a depression-related model of alcohol problems in 430 probands from the San Diego prospective study
Drug and Alcohol Dependence
(2006) - et al.
Relations between personality and drinking motives in young adults
Personality Individual Differences
(2000) - et al.
Examination of a three-dimensional drinking motives questionnaire in a young adult university student sample
Behaviour Research and Therapy
(1996) - et al.
Association of alcohol and drug use disorders and completed suicide: An empirical review of cohort studies
Drug and Alcohol Dependence
(2004) - et al.
Suicide ideation among US college students: Associations with other injury risk behaviors
Journal of American College Health
(2000) - et al.
Manual for the Beck Depression Inventory
(1996)
Solitary drinking: A risk factor for alcohol-related problems?
Addiction
Suicidal ideation among college students in the United States
Journal of Consulting and Clinical Psychology
Stress, depression, irrational beliefs, and alcohol use and problems in a college student sample
Alcoholism: Clinical and Experimental Research
Acute alcohol use and suicidal behavior: A review of the literature
Alcoholism: Clinical and Experimental Research
Motivation for alcohol use among adolescents: Development and validation of a four-factor model
Psychological Assessment
A motivational perspective on risky behaviors: The role of personality and affect regulatory processes
Journal of Personality
Drinking to regulate positive and negative emotions: A motivational model of alcohol use
Journal of Personality and Social Psychology
Development and validation of a three-dimensional measure of drinking motives
Psychological Assessment
Changing society, changing drinking: Solitary drinking as a non-pathological behaviour
Addiction
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