Using data collected via handheld electronic diaries (EDs) we examined within-day associations be... more Using data collected via handheld electronic diaries (EDs) we examined within-day associations between early day negative moods and stress and subsequent time to drinking. A sample of 97 (n = 48 women) adults recruited to participate in a drinking-reduction intervention study used EDs to record mood and interpersonal problems at randomly selected times during each of three reporting intervals and drinking as it occurred each day for twenty-one days. Using multilevel hazard models, we tested associations between early-day stress/negative mood ratings and time to drinking as well as potential moderating effects of drinking to cope (DTC) motives on these associations. Whereas previous analyses of these data showed no associations between early-day negative moods and number of drinks consumed later in the day, here we found significant associations between negative moods and time to drinking. Associations involving negative moods, DTC, and hazard for drinking varied depending on time of day, and some mood effects were moderated by DTC. These findings suggest that time to drinking may be more sensitive to the effects of acute negative mood states than is drinking quantity.
Journal of Studies on Alcohol and Drugs, Sep 1, 2014
The goal of the present study was to examine whether within-person, episode-specifi c changes in ... more The goal of the present study was to examine whether within-person, episode-specifi c changes in drinking-to-cope (DTC) motivation from the previous evening were associated with concurrent daily mood and fatigue-related symptoms among college student drinkers (N = 1,421; 54% female). Method: We conducted an Internet-based daily diary study in which students reported over 30 days on their previous night's drinking level and motivation and their current mood (i.e., sadness, anxiety, anger/hostility, and positive mood) and fatigue-related symptoms. Hypotheses were tested using hierarchical linear models in which the current day's outcome was predicted by last night's levels of DTC motivation and drinking, controlling for drinking to enhance motivation, sex, current day's physical symptoms and drinking, and yesterday's level of the outcome. Subsequent models also predicted outcomes 2 days following the drinking event. Results: Relative increases in previous night's DTC motivation were associated with higher levels of current day negative mood and fatigue-related symptoms and lower levels of positive mood. Also, the association between episodespecifi c DTC motivation and negative mood was stronger in the positive direction when individuals reported higher levels of nonsocial drinking from the previous night. Last, episode-specifi c DTC showed similar associations with sadness and anger/hostility 2 days after the drinking event. Conclusions: The results are generally consistent with the posited attention allocation and ego-depletion mechanisms. Findings suggest that the deleterious effects of repeated episodes of DTC, over time, could help to explain the increased likelihood of alcohol-related problems seen in prior studies.
Journal of Studies on Alcohol and Drugs, Nov 1, 2008
This study was performed to examine whether a polymorphism (5-HTTLPR) in the serotonin transporte... more This study was performed to examine whether a polymorphism (5-HTTLPR) in the serotonin transporter gene was related to college students' reports of relief drinking (drinking-to-cope motives) and whether it moderated the associations between negative life events and drinking to cope. We examined reward drinking (drinkingto-enhance motives) as a comparison and to see whether these effects varied across gender. Method: Using an Internet-based survey, college students (N = 360; 192 women) self-reported on drinking motives and negative life events for up to 4 years. Study participants provided saliva for genotyping the triallelic (L A vs L G or S) variants of 5-HTTLPR. Results: Among men, individuals with two risk alleles (L G or S), compared with individuals with the L A /L A allele, displayed lower drinking-to-cope motives. Among women, individuals with one risk allele (either L G or S), compared with individuals with the L A /L A allele, displayed stronger drinking-to-enhance motives. The association between yearly changes in negative life events and drinking-to-cope motives varied across 5-HT-TLPR genotype and gender and was strongest in the positive direction for women with the L A /L A variant. Conclusions: Our fi ndings are not consistent with prior speculation that stronger positive associations between life stress and alcohol use among individuals with the L G or S allele are the result of increased use of alcohol as a method for coping with stress. The importance of examining gender differences in the relations between 5-HTTLPR, substance use, and related constructs is also noted.
Objective: Topiramate has been shown to reduce drinking and heavy drinking in alcoholdependent in... more Objective: Topiramate has been shown to reduce drinking and heavy drinking in alcoholdependent individuals whose goal was to stop drinking. The present study evaluated the efficacy and tolerability of topiramate in heavy drinkers whose treatment goal was to reduce drinking to safe levels. We randomly assigned 138 individuals (62.3% male) to receive 12 weeks of treatment with topiramate (N=67), at a maximal daily dosage of 200 mg, or matching placebo (N=71), both groups receiving brief counseling to reduce drinking and increase abstinent days. We hypothesized that topiramate-treated patients would be better able to achieve these goals and predicted that, based on prior research, the effects would be moderated by a single nucleotide polymorphism (rs2832407) in GRIK1, encoding the kainate GluK1 receptor subunit. The rate of treatment completion was 84.9% and equal by treatment group. Topiramate treatment significantly reduced heavy drinking days (p<0.001) and increased abstinent days
American Journal of Drug and Alcohol Abuse, Jul 16, 2019
Background: One-third of women who experience intimate partner violence (IPV) are identified as h... more Background: One-third of women who experience intimate partner violence (IPV) are identified as having alcohol use problems. Yet, little research has examined factors that may increase the risk of alcohol use among this high-risk population. Objectives: This study overcomes limitations of previous research by using micro-longitudinal methods to examine how fluctuations in PTSD symptoms throughout the day are associated with proximal drinking behavior and whether these associations are related to individuals' overall PTSD severity and race/ethnicity. Methods: Using phone-based interactive voice response, 244 female victims of current IPV reported their PTSD symptoms and drinking four times daily for 14 days. Results: Results indicated positive associations between PTSD symptom cluster severity and drinking level at the person, daily and within-day levels. The effects of within-person fluctuations in daily levels of PTSD severity on levels of drinking were stronger for individuals with lower PTSD severity. No evidence was found for within-person differences on time-lagged effects of PTSD on drinking or by racial/ethnic group. Further, in time-lagged models no evidence was found for reverse causation whereby alcohol use predicts increased PTSD symptom severity. Conclusions: Findings suggest that IPV-exposed women use alcohol to alleviate their PTSD symptoms at the micro-process level and that prevention and treatment efforts targeting PTSD symptoms may be useful in reducing alcohol use in this population. Further, these efforts should consider the overall severity of PTSD symptoms experienced given the differential findings among women with higher vs. lower PTSD symptom severity.
Objective-Women with posttraumatic stress disorder (PTSD) are at high risk for substance use and ... more Objective-Women with posttraumatic stress disorder (PTSD) are at high risk for substance use and intimate partner violence. Considering the effects of both PTSD and substance use such as poorer treatment outcomes and greater health/behavior problems, women experiencing intimate partner violence are a high-risk, under-researched group. Methods-We utilized a micro-longitudinal study design to assess daily drug and alcohol use over 21 days among 41 women experiencing intimate partner violence recruited from the community. Results-Participants were about 45 years old (M = 45.1, SD = 8.5) and mostly African American (n = 32, 78%). Co-occurrence of drug and alcohol use was reported on 19.0% of days, while drug use alone occurred on 13.4% of days and alcohol use on 12.1%. Fifteen percent of participants met current PTSD criteria, with a mean symptom severity rating of 15.90 (SD = 10.94, range 0 -47). Women with PTSD, compared to those without, were nearly 15 times more likely to have days of co-occurrence of drug and alcohol use (p = .037), and nearly 7 times more likely to have days of drug use alone (p = .044).
Despite evidence that African Americans are disproportionately affected by drinking to cope relat... more Despite evidence that African Americans are disproportionately affected by drinking to cope relative to European Americans, African-American college students' drinking motives remain understudied. Additionally, most research has only examined between-person differences in drinking to cope as a predictor of alcohol use, ignoring within-person variability. In the current daily diary study of 462 African-American undergraduates from a historically Black university, associations between episode-specific drinking to cope and alcohol use were tested, an approach more consistent with motivational theories of drinking. At baseline, students completed traditional global drinking motive measures; then for 30 days they reported the number of standard drinks they consumed the previous night, and, if they drank, their coping, enhancement, and social reasons for doing so. Students who reported higher mean levels of episode-specific coping motives, on average, consumed more alcohol on drinking evenings. Furthermore, mean episodespecific coping motives, but not global coping motives, predicted average levels of alcohol use. Additionally, coping motives were particularly important for predicting nonsocial (versus social) drinking. Finally, during evenings for which students reported higher than usual episode-specific coping motives, men consumed more alcohol in both social and nonsocial contexts; in contrast, women reporting higher than usual drinking-to-cope motives only consumed more nonsocial drinks. In conclusion, drinking among African-American college students was related to coping motives, particularly among men and in the context of nonsocial alcohol consumption. Moreover, motivational theories of alcohol use may be refined by measuring episode-specific drinking motives that more accurately capture the drinking-to-cope process.
Multiple theories posit that people with a history of depression are at higher risk for a depress... more Multiple theories posit that people with a history of depression are at higher risk for a depressive episode than people who have never experienced depression, which may be partly due to differences in stress-reactivity. Additionally, both the dynamic model of affect and the broadenand-build theory suggest that stress and positive affect interact to predict negative affect, but this moderation has never been tested in the context of depression history. The current study used multilevel modeling to examine these issues among 1549 college students with or without a history of depression. Students completed a 30-day online diary study in which they reported daily their perceived stress, positive affect, and negative affect (including depression, anxiety, and hostility). On days characterized by higher than usual stress, students with a history of depression reported greater decreases in positive affect and greater increases in depressed affect than students with no history. Furthermore, the relations between daily stress and both depressed and anxious affect were moderated by daily positive affect among students with remitted depression. These results indicate that students with a history of depression show greater stress-reactivity even when in remission, which may place them at greater risk for recurrence. These individuals may also benefit more from positive affect on higher stress days despite being less likely to experience positive affect on such days. The current findings have various implications both clinically and for research on stress, mood, and depression.
This study examined the association between history of depression and day-to-day coping with rheu... more This study examined the association between history of depression and day-to-day coping with rheumatoid arthritis (RA) pain. The sample was 188 RA-diagnosed participants, 73 of whom were identified by a structured clinical interview as having a history of major depression. None had current major depression. All participated in a 30-day prospective study in which they made end-of-day ratings of their arthritis pain, the strategies for how they coped with their pain, their appraisals of daily pain, and daily mood. Hierarchical linear models evaluated whether individuals with and without depression history differed in their average pain and the other daily measures; and separately, whether they differed in their within-person associations between pain and the daily measures (e.g., the day-to-day contingency between pain and mood). All analyses controlled for current mild depressive symptoms, neuroticism, and age. Previously depressed individuals were indistinguishable from their never depressed peers in their average pain and the other daily measures; however, the previously depressed exhibited significantly stronger associations between pain and several aspects of their daily emotional experience, suggesting more pain-contingent well-being. For individuals with a history of depression, increases in daily pain corresponded with more frequent efforts to cope with their pain by venting their emotions, significantly stronger impairments in mood, and, if they were also presently distressed, reduced perceptions of control over their pain, compared to the never depressed. Patterns suggest that formerly depressed individuals exhibit a hidden vulnerability in how they manage chronic pain. This vulnerability is best revealed by a daily process approach.
Experimental and Clinical Psychopharmacology, May 1, 2006
The authors examined whether the associations among daily positive and negative interpersonal eve... more The authors examined whether the associations among daily positive and negative interpersonal events, alcohol consumption, and affect varied as a function of naltrexone or placebo administered in a targeted (in anticipation of or in response to high-risk drinking situations) or daily fashion. Heavy drinkers (N ϭ 149) received 4 sessions of brief coping skills counseling in addition to 8 weeks of naltrexone treatment. They recorded for 8 weeks in structured nightly diaries their interpersonal interactions, affect, and alcohol consumption. The authors predicted that participants receiving naltrexone, compared with those taking placebo, would drink less in response to interpersonal encounters and that naltrexone administration would attenuate the link between positive interpersonal events and positive affective states. Results indicated that both positive and negative interpersonal interactions were associated with an increased probability of engaging in any drinking and that positive daily social celebratory events were associated with an increased probability of engaging in heavy drinking. Participants taking naltrexone in a targeted fashion showed the strongest positive association between the number of positive social celebratory events and drinking. Although this finding was inconsistent with the overall reduction in drinking that has been generally reported for those treated with naltrexone, positive social celebratory events occurred on only a minority of days. Participants taking naltrexone, compared with those taking placebo, showed weaker associations between positive social celebratory events and positive and negative affective states. Findings are discussed in terms of naltrexone's dampening effects on the rewarding properties of alcohol use and certain positively valenced stimuli.
Journal of Studies on Alcohol and Drugs, Mar 1, 2015
Research consistently shows a positive association between racial discrimination and problematic ... more Research consistently shows a positive association between racial discrimination and problematic alcohol use among African Americans, but little is known about the micro-processes linking this pernicious form of stress to drinking. One possibility is that the cumulative effects of discrimination increase individuals' likelihood of negative-mood-related drinking. In the current study, we examined whether individual differences in lifetime perceived racial discrimination among African American college students moderate relations between daily negative moods and evening alcohol consumption in both social and nonsocial contexts. Method: Data came from an online daily diary study of 441 African Americans (58% female) enrolled at a historically black college/university. Lifetime discrimination was measured at baseline. For 30 days, students reported the number of drinks they consumed the night before both socially and nonsocially, as well as their daytime level of negative mood. Results: In support of the hypotheses, only men who reported higher (vs. lower) lifetime discrimination showed a positive association between daily negative mood and that evening's level of nonsocial drinking. Contrary to expectation, women who reported higher (vs. lower) discrimination showed a negative association between daily negative mood and nonsocial drinking. Neither daily negative mood nor lifetime discrimination predicted level of social drinking. Conclusions: These findings provide further evidence that the cumulative impact of racial discrimination may produce a vulnerability to negative-mood-related drinking-but only for African American men. Importantly, these effects emerged only for nonsocial drinking, which may further explain the robust association between discrimination and problematic alcohol use.
To test whether individuals with at least one copy of the short (S) or long (L)(G) allele of the ... more To test whether individuals with at least one copy of the short (S) or long (L)(G) allele of the serotonin transporter polymorphism (5-HTTLPR) exhibit greater increases in anxiety, compared with L(A)L(A) individuals, under periods of high daily stress. Although this common polymorphism in the serotonin transporter gene has been identified as a vulnerability factor for anxiety, findings in the literature are mixed. Discrepant findings could be explained by recent research showing that 5-HTTLPR is functionally triallelic (L(A) versus L(G) or S), rather than biallelic (L versus S). Mixed findings could also result from a lack of attention to diathesis-stress models, whereby genetic vulnerability is considered latent until activated by stress (gene-environment interplay). Based on this model, we argue that genotype differences in anxiety should be stronger in the presence of stress. A total of 350 college students recorded their daily stressors and mood for two 30-day periods, separated by 1 year. Across both years, diathesis-stress patterns were observed for reports of anxious mood as a function of 5-HTTLPR. Individuals with at least one copy of the S or L(G) allele at 5-HTTLPR experienced elevated anxious mood on days with more intense stressors, as compared with those who were L(A) homozygotes. Genotype differences in anxiety were less apparent on low stress days. No consistent allelic association of 5-HTTLPR was observed with any other mood states, trait anxiety, or neuroticism. Our findings highlight the potential value of focusing on genetic vulnerability in the context of everyday environmental triggers.
The objectives of this study were to assess within-person hypotheses regarding temporal cognition... more The objectives of this study were to assess within-person hypotheses regarding temporal cognition-pain associations: (1) do morning pain flares predict changes in two afternoon adaptive and maladaptive pain-related cognitions, and (2) do these changes in afternoon cognitions predict changes in end-of-day pain reports, which in turn, carry over to predict next morning pain in individuals with fibromyalgia. Two hundred twenty individuals with fibromyalgia completed electronic assessments of pain intensity, pain catastrophizing, and pain coping efficacy three times a day for three weeks. Multilevel structural equation modeling established that afternoon catastrophizing and coping efficacy were parallel mediators linking late morning with end-of-day pain reports (controlling for afternoon pain), in line with prediction. Catastrophizing was a stronger mediator than coping efficacy. Moreover, afternoon cognitions and end-of-day pain reports served as sequential mediators of the relation b...
Aims-Economists debate whether changes in availability of alcohol or cannabis are positively or n... more Aims-Economists debate whether changes in availability of alcohol or cannabis are positively or negatively related to changes in use of the other substance. Implicit in these arguments are two competing, individual-level hypotheses-that people use alcohol and cannabis either as complements or substitutes for one another. This is the first study to test these hypotheses using micro-longitudinal data on individuals' alcohol and cannabis use on a given evening. Methods-United States college students who use alcohol and cannabis (n = 876) were selected from a larger sample who participated in a 30-day online daily diary study. At baseline, students reported their proclivity to use alcohol/drugs to cope with stress. Each day students reported their level of alcohol use from the prior evening as well as whether they had used cannabis. Results-Evening levels of alcohol use and mean levels of alcohol use positively predicted the likelihood of evening cannabis use, results indicative of complementary use. This relation, however, was moderated by coping style, such that students who were more likely to use alcohol/ drugs to cope were less likely to use cannabis as their evening or mean alcohol use levels increased, results indicative of substitution. Conclusions-Substance-using college students showed evidence for complementary alcohol and cannabis use at both the within-and between-person levels. Students with a proclivity toward using alcohol/drugs to cope, however, showed evidence of substitution. These findings suggest
We examined the within-person associations among positive and negative daily events, positive and... more We examined the within-person associations among positive and negative daily events, positive and negative affect, desire to drink, and alcohol consumption in a sample of heavy drinkers. Method: Forty-six subjects (25 men; mean [SD] age = 47.0 [9.3] years) who were enrolled in an 8-week treatment program for heavy drinkers were studied using a daily diary methodology. Results: Multilevel regression analyses indicated that individuals reported stronger desire to drink and greater consumption on days in which more positive and negative nonwork events occurred. Lower levels of desire to drink and number of drinks were reported on days with more positive work events. Negative work events had a marginal positive association with daily desire to drink. Daily positive and negative affect uniquely predicted greater daily consumption and desire to drink, but only weak evidence was found for their mediating role in the association between daily events and the criterion variables. Several of the within-person associations among affect and the criterion variables varied as a function of number of lifetime symptoms of alcohol dependence and treatment condition. Conclusions: These findings generally support the dual-process (i.e., tension-reduction and experience-enhancement) motivational model of alcohol consumption. However, the observed associations among events, affect and alcohol-related behavior suggests that these pathways are complex, with each being comprised of affective and cognitive subpathways. (J. Stud. Alcohol 61: 862-871, 2000) HE NOTION that individuals drink in response to positive and negative daily events and their corresponding affective states is at the core of motivational models
Research consistently shows a positive association between racial discrimination and problematic ... more Research consistently shows a positive association between racial discrimination and problematic alcohol use among African Americans, but little is known about the micro-processes linking this pernicious form of stress to drinking. One possibility is that the cumulative effects of discrimination increase individuals' likelihood of negative-mood-related drinking. In the current study, we examined whether individual differences in lifetime perceived racial discrimination among African American college students moderate relations between daily negative moods and evening alcohol consumption in both social and nonsocial contexts. Method: Data came from an online daily diary study of 441 African Americans (58% female) enrolled at a historically black college/university. Lifetime discrimination was measured at baseline. For 30 days, students reported the number of drinks they consumed the night before both socially and nonsocially, as well as their daytime level of negative mood. Results: In support of the hypotheses, only men who reported higher (vs. lower) lifetime discrimination showed a positive association between daily negative mood and that evening's level of nonsocial drinking. Contrary to expectation, women who reported higher (vs. lower) discrimination showed a negative association between daily negative mood and nonsocial drinking. Neither daily negative mood nor lifetime discrimination predicted level of social drinking. Conclusions: These findings provide further evidence that the cumulative impact of racial discrimination may produce a vulnerability to negative-mood-related drinking-but only for African American men. Importantly, these effects emerged only for nonsocial drinking, which may further explain the robust association between discrimination and problematic alcohol use.
This study examined the association between history of depression and day-today coping with rheum... more This study examined the association between history of depression and day-today coping with rheumatoid arthritis (RA) pain. The sample was 188 RA-diagnosed participants, 73 of whom were identified by a structured clinical interview as having a history of major depression. None had current major depression. All participated in a 30-day prospective study in which they made end-of-day ratings of their arthritis pain, the strategies for how they coped with their pain, their appraisals of daily pain, and daily mood. Hierarchical linear models evaluated whether individuals with and without depression history differed in their average pain and the other daily measures; and separately, whether they differed in their within-person associations between pain and the daily measures (e.g., the day-today contingency between pain and mood). All analyses controlled for current mild depressive symptoms, neuroticism, and age. Previously depressed individuals were indistinguishable from their never depressed peers in their average pain and the other daily measures; however, the previously depressed exhibited significantly stronger associations between pain and several aspects of their daily emotional experience, suggesting more pain-contingent well-being. For individuals with a history of depression, increases in daily pain corresponded with more frequent efforts to cope with their pain by venting their emotions, significantly stronger impairments in mood, and, if they were also presently distressed, reduced perceptions of control over their pain, compared to the never depressed. Patterns suggest that formerly depressed individuals exhibit a hidden vulnerability in how they manage chronic pain. This vulnerability is best revealed by a daily process approach.
Using data collected via handheld electronic diaries (EDs) we examined within-day associations be... more Using data collected via handheld electronic diaries (EDs) we examined within-day associations between early day negative moods and stress and subsequent time to drinking. A sample of 97 (n = 48 women) adults recruited to participate in a drinking-reduction intervention study used EDs to record mood and interpersonal problems at randomly selected times during each of three reporting intervals and drinking as it occurred each day for twenty-one days. Using multilevel hazard models, we tested associations between early-day stress/negative mood ratings and time to drinking as well as potential moderating effects of drinking to cope (DTC) motives on these associations. Whereas previous analyses of these data showed no associations between early-day negative moods and number of drinks consumed later in the day, here we found significant associations between negative moods and time to drinking. Associations involving negative moods, DTC, and hazard for drinking varied depending on time of day, and some mood effects were moderated by DTC. These findings suggest that time to drinking may be more sensitive to the effects of acute negative mood states than is drinking quantity.
Journal of Studies on Alcohol and Drugs, Sep 1, 2014
The goal of the present study was to examine whether within-person, episode-specifi c changes in ... more The goal of the present study was to examine whether within-person, episode-specifi c changes in drinking-to-cope (DTC) motivation from the previous evening were associated with concurrent daily mood and fatigue-related symptoms among college student drinkers (N = 1,421; 54% female). Method: We conducted an Internet-based daily diary study in which students reported over 30 days on their previous night's drinking level and motivation and their current mood (i.e., sadness, anxiety, anger/hostility, and positive mood) and fatigue-related symptoms. Hypotheses were tested using hierarchical linear models in which the current day's outcome was predicted by last night's levels of DTC motivation and drinking, controlling for drinking to enhance motivation, sex, current day's physical symptoms and drinking, and yesterday's level of the outcome. Subsequent models also predicted outcomes 2 days following the drinking event. Results: Relative increases in previous night's DTC motivation were associated with higher levels of current day negative mood and fatigue-related symptoms and lower levels of positive mood. Also, the association between episodespecifi c DTC motivation and negative mood was stronger in the positive direction when individuals reported higher levels of nonsocial drinking from the previous night. Last, episode-specifi c DTC showed similar associations with sadness and anger/hostility 2 days after the drinking event. Conclusions: The results are generally consistent with the posited attention allocation and ego-depletion mechanisms. Findings suggest that the deleterious effects of repeated episodes of DTC, over time, could help to explain the increased likelihood of alcohol-related problems seen in prior studies.
Journal of Studies on Alcohol and Drugs, Nov 1, 2008
This study was performed to examine whether a polymorphism (5-HTTLPR) in the serotonin transporte... more This study was performed to examine whether a polymorphism (5-HTTLPR) in the serotonin transporter gene was related to college students' reports of relief drinking (drinking-to-cope motives) and whether it moderated the associations between negative life events and drinking to cope. We examined reward drinking (drinkingto-enhance motives) as a comparison and to see whether these effects varied across gender. Method: Using an Internet-based survey, college students (N = 360; 192 women) self-reported on drinking motives and negative life events for up to 4 years. Study participants provided saliva for genotyping the triallelic (L A vs L G or S) variants of 5-HTTLPR. Results: Among men, individuals with two risk alleles (L G or S), compared with individuals with the L A /L A allele, displayed lower drinking-to-cope motives. Among women, individuals with one risk allele (either L G or S), compared with individuals with the L A /L A allele, displayed stronger drinking-to-enhance motives. The association between yearly changes in negative life events and drinking-to-cope motives varied across 5-HT-TLPR genotype and gender and was strongest in the positive direction for women with the L A /L A variant. Conclusions: Our fi ndings are not consistent with prior speculation that stronger positive associations between life stress and alcohol use among individuals with the L G or S allele are the result of increased use of alcohol as a method for coping with stress. The importance of examining gender differences in the relations between 5-HTTLPR, substance use, and related constructs is also noted.
Objective: Topiramate has been shown to reduce drinking and heavy drinking in alcoholdependent in... more Objective: Topiramate has been shown to reduce drinking and heavy drinking in alcoholdependent individuals whose goal was to stop drinking. The present study evaluated the efficacy and tolerability of topiramate in heavy drinkers whose treatment goal was to reduce drinking to safe levels. We randomly assigned 138 individuals (62.3% male) to receive 12 weeks of treatment with topiramate (N=67), at a maximal daily dosage of 200 mg, or matching placebo (N=71), both groups receiving brief counseling to reduce drinking and increase abstinent days. We hypothesized that topiramate-treated patients would be better able to achieve these goals and predicted that, based on prior research, the effects would be moderated by a single nucleotide polymorphism (rs2832407) in GRIK1, encoding the kainate GluK1 receptor subunit. The rate of treatment completion was 84.9% and equal by treatment group. Topiramate treatment significantly reduced heavy drinking days (p<0.001) and increased abstinent days
American Journal of Drug and Alcohol Abuse, Jul 16, 2019
Background: One-third of women who experience intimate partner violence (IPV) are identified as h... more Background: One-third of women who experience intimate partner violence (IPV) are identified as having alcohol use problems. Yet, little research has examined factors that may increase the risk of alcohol use among this high-risk population. Objectives: This study overcomes limitations of previous research by using micro-longitudinal methods to examine how fluctuations in PTSD symptoms throughout the day are associated with proximal drinking behavior and whether these associations are related to individuals' overall PTSD severity and race/ethnicity. Methods: Using phone-based interactive voice response, 244 female victims of current IPV reported their PTSD symptoms and drinking four times daily for 14 days. Results: Results indicated positive associations between PTSD symptom cluster severity and drinking level at the person, daily and within-day levels. The effects of within-person fluctuations in daily levels of PTSD severity on levels of drinking were stronger for individuals with lower PTSD severity. No evidence was found for within-person differences on time-lagged effects of PTSD on drinking or by racial/ethnic group. Further, in time-lagged models no evidence was found for reverse causation whereby alcohol use predicts increased PTSD symptom severity. Conclusions: Findings suggest that IPV-exposed women use alcohol to alleviate their PTSD symptoms at the micro-process level and that prevention and treatment efforts targeting PTSD symptoms may be useful in reducing alcohol use in this population. Further, these efforts should consider the overall severity of PTSD symptoms experienced given the differential findings among women with higher vs. lower PTSD symptom severity.
Objective-Women with posttraumatic stress disorder (PTSD) are at high risk for substance use and ... more Objective-Women with posttraumatic stress disorder (PTSD) are at high risk for substance use and intimate partner violence. Considering the effects of both PTSD and substance use such as poorer treatment outcomes and greater health/behavior problems, women experiencing intimate partner violence are a high-risk, under-researched group. Methods-We utilized a micro-longitudinal study design to assess daily drug and alcohol use over 21 days among 41 women experiencing intimate partner violence recruited from the community. Results-Participants were about 45 years old (M = 45.1, SD = 8.5) and mostly African American (n = 32, 78%). Co-occurrence of drug and alcohol use was reported on 19.0% of days, while drug use alone occurred on 13.4% of days and alcohol use on 12.1%. Fifteen percent of participants met current PTSD criteria, with a mean symptom severity rating of 15.90 (SD = 10.94, range 0 -47). Women with PTSD, compared to those without, were nearly 15 times more likely to have days of co-occurrence of drug and alcohol use (p = .037), and nearly 7 times more likely to have days of drug use alone (p = .044).
Despite evidence that African Americans are disproportionately affected by drinking to cope relat... more Despite evidence that African Americans are disproportionately affected by drinking to cope relative to European Americans, African-American college students' drinking motives remain understudied. Additionally, most research has only examined between-person differences in drinking to cope as a predictor of alcohol use, ignoring within-person variability. In the current daily diary study of 462 African-American undergraduates from a historically Black university, associations between episode-specific drinking to cope and alcohol use were tested, an approach more consistent with motivational theories of drinking. At baseline, students completed traditional global drinking motive measures; then for 30 days they reported the number of standard drinks they consumed the previous night, and, if they drank, their coping, enhancement, and social reasons for doing so. Students who reported higher mean levels of episode-specific coping motives, on average, consumed more alcohol on drinking evenings. Furthermore, mean episodespecific coping motives, but not global coping motives, predicted average levels of alcohol use. Additionally, coping motives were particularly important for predicting nonsocial (versus social) drinking. Finally, during evenings for which students reported higher than usual episode-specific coping motives, men consumed more alcohol in both social and nonsocial contexts; in contrast, women reporting higher than usual drinking-to-cope motives only consumed more nonsocial drinks. In conclusion, drinking among African-American college students was related to coping motives, particularly among men and in the context of nonsocial alcohol consumption. Moreover, motivational theories of alcohol use may be refined by measuring episode-specific drinking motives that more accurately capture the drinking-to-cope process.
Multiple theories posit that people with a history of depression are at higher risk for a depress... more Multiple theories posit that people with a history of depression are at higher risk for a depressive episode than people who have never experienced depression, which may be partly due to differences in stress-reactivity. Additionally, both the dynamic model of affect and the broadenand-build theory suggest that stress and positive affect interact to predict negative affect, but this moderation has never been tested in the context of depression history. The current study used multilevel modeling to examine these issues among 1549 college students with or without a history of depression. Students completed a 30-day online diary study in which they reported daily their perceived stress, positive affect, and negative affect (including depression, anxiety, and hostility). On days characterized by higher than usual stress, students with a history of depression reported greater decreases in positive affect and greater increases in depressed affect than students with no history. Furthermore, the relations between daily stress and both depressed and anxious affect were moderated by daily positive affect among students with remitted depression. These results indicate that students with a history of depression show greater stress-reactivity even when in remission, which may place them at greater risk for recurrence. These individuals may also benefit more from positive affect on higher stress days despite being less likely to experience positive affect on such days. The current findings have various implications both clinically and for research on stress, mood, and depression.
This study examined the association between history of depression and day-to-day coping with rheu... more This study examined the association between history of depression and day-to-day coping with rheumatoid arthritis (RA) pain. The sample was 188 RA-diagnosed participants, 73 of whom were identified by a structured clinical interview as having a history of major depression. None had current major depression. All participated in a 30-day prospective study in which they made end-of-day ratings of their arthritis pain, the strategies for how they coped with their pain, their appraisals of daily pain, and daily mood. Hierarchical linear models evaluated whether individuals with and without depression history differed in their average pain and the other daily measures; and separately, whether they differed in their within-person associations between pain and the daily measures (e.g., the day-to-day contingency between pain and mood). All analyses controlled for current mild depressive symptoms, neuroticism, and age. Previously depressed individuals were indistinguishable from their never depressed peers in their average pain and the other daily measures; however, the previously depressed exhibited significantly stronger associations between pain and several aspects of their daily emotional experience, suggesting more pain-contingent well-being. For individuals with a history of depression, increases in daily pain corresponded with more frequent efforts to cope with their pain by venting their emotions, significantly stronger impairments in mood, and, if they were also presently distressed, reduced perceptions of control over their pain, compared to the never depressed. Patterns suggest that formerly depressed individuals exhibit a hidden vulnerability in how they manage chronic pain. This vulnerability is best revealed by a daily process approach.
Experimental and Clinical Psychopharmacology, May 1, 2006
The authors examined whether the associations among daily positive and negative interpersonal eve... more The authors examined whether the associations among daily positive and negative interpersonal events, alcohol consumption, and affect varied as a function of naltrexone or placebo administered in a targeted (in anticipation of or in response to high-risk drinking situations) or daily fashion. Heavy drinkers (N ϭ 149) received 4 sessions of brief coping skills counseling in addition to 8 weeks of naltrexone treatment. They recorded for 8 weeks in structured nightly diaries their interpersonal interactions, affect, and alcohol consumption. The authors predicted that participants receiving naltrexone, compared with those taking placebo, would drink less in response to interpersonal encounters and that naltrexone administration would attenuate the link between positive interpersonal events and positive affective states. Results indicated that both positive and negative interpersonal interactions were associated with an increased probability of engaging in any drinking and that positive daily social celebratory events were associated with an increased probability of engaging in heavy drinking. Participants taking naltrexone in a targeted fashion showed the strongest positive association between the number of positive social celebratory events and drinking. Although this finding was inconsistent with the overall reduction in drinking that has been generally reported for those treated with naltrexone, positive social celebratory events occurred on only a minority of days. Participants taking naltrexone, compared with those taking placebo, showed weaker associations between positive social celebratory events and positive and negative affective states. Findings are discussed in terms of naltrexone's dampening effects on the rewarding properties of alcohol use and certain positively valenced stimuli.
Journal of Studies on Alcohol and Drugs, Mar 1, 2015
Research consistently shows a positive association between racial discrimination and problematic ... more Research consistently shows a positive association between racial discrimination and problematic alcohol use among African Americans, but little is known about the micro-processes linking this pernicious form of stress to drinking. One possibility is that the cumulative effects of discrimination increase individuals' likelihood of negative-mood-related drinking. In the current study, we examined whether individual differences in lifetime perceived racial discrimination among African American college students moderate relations between daily negative moods and evening alcohol consumption in both social and nonsocial contexts. Method: Data came from an online daily diary study of 441 African Americans (58% female) enrolled at a historically black college/university. Lifetime discrimination was measured at baseline. For 30 days, students reported the number of drinks they consumed the night before both socially and nonsocially, as well as their daytime level of negative mood. Results: In support of the hypotheses, only men who reported higher (vs. lower) lifetime discrimination showed a positive association between daily negative mood and that evening's level of nonsocial drinking. Contrary to expectation, women who reported higher (vs. lower) discrimination showed a negative association between daily negative mood and nonsocial drinking. Neither daily negative mood nor lifetime discrimination predicted level of social drinking. Conclusions: These findings provide further evidence that the cumulative impact of racial discrimination may produce a vulnerability to negative-mood-related drinking-but only for African American men. Importantly, these effects emerged only for nonsocial drinking, which may further explain the robust association between discrimination and problematic alcohol use.
To test whether individuals with at least one copy of the short (S) or long (L)(G) allele of the ... more To test whether individuals with at least one copy of the short (S) or long (L)(G) allele of the serotonin transporter polymorphism (5-HTTLPR) exhibit greater increases in anxiety, compared with L(A)L(A) individuals, under periods of high daily stress. Although this common polymorphism in the serotonin transporter gene has been identified as a vulnerability factor for anxiety, findings in the literature are mixed. Discrepant findings could be explained by recent research showing that 5-HTTLPR is functionally triallelic (L(A) versus L(G) or S), rather than biallelic (L versus S). Mixed findings could also result from a lack of attention to diathesis-stress models, whereby genetic vulnerability is considered latent until activated by stress (gene-environment interplay). Based on this model, we argue that genotype differences in anxiety should be stronger in the presence of stress. A total of 350 college students recorded their daily stressors and mood for two 30-day periods, separated by 1 year. Across both years, diathesis-stress patterns were observed for reports of anxious mood as a function of 5-HTTLPR. Individuals with at least one copy of the S or L(G) allele at 5-HTTLPR experienced elevated anxious mood on days with more intense stressors, as compared with those who were L(A) homozygotes. Genotype differences in anxiety were less apparent on low stress days. No consistent allelic association of 5-HTTLPR was observed with any other mood states, trait anxiety, or neuroticism. Our findings highlight the potential value of focusing on genetic vulnerability in the context of everyday environmental triggers.
The objectives of this study were to assess within-person hypotheses regarding temporal cognition... more The objectives of this study were to assess within-person hypotheses regarding temporal cognition-pain associations: (1) do morning pain flares predict changes in two afternoon adaptive and maladaptive pain-related cognitions, and (2) do these changes in afternoon cognitions predict changes in end-of-day pain reports, which in turn, carry over to predict next morning pain in individuals with fibromyalgia. Two hundred twenty individuals with fibromyalgia completed electronic assessments of pain intensity, pain catastrophizing, and pain coping efficacy three times a day for three weeks. Multilevel structural equation modeling established that afternoon catastrophizing and coping efficacy were parallel mediators linking late morning with end-of-day pain reports (controlling for afternoon pain), in line with prediction. Catastrophizing was a stronger mediator than coping efficacy. Moreover, afternoon cognitions and end-of-day pain reports served as sequential mediators of the relation b...
Aims-Economists debate whether changes in availability of alcohol or cannabis are positively or n... more Aims-Economists debate whether changes in availability of alcohol or cannabis are positively or negatively related to changes in use of the other substance. Implicit in these arguments are two competing, individual-level hypotheses-that people use alcohol and cannabis either as complements or substitutes for one another. This is the first study to test these hypotheses using micro-longitudinal data on individuals' alcohol and cannabis use on a given evening. Methods-United States college students who use alcohol and cannabis (n = 876) were selected from a larger sample who participated in a 30-day online daily diary study. At baseline, students reported their proclivity to use alcohol/drugs to cope with stress. Each day students reported their level of alcohol use from the prior evening as well as whether they had used cannabis. Results-Evening levels of alcohol use and mean levels of alcohol use positively predicted the likelihood of evening cannabis use, results indicative of complementary use. This relation, however, was moderated by coping style, such that students who were more likely to use alcohol/ drugs to cope were less likely to use cannabis as their evening or mean alcohol use levels increased, results indicative of substitution. Conclusions-Substance-using college students showed evidence for complementary alcohol and cannabis use at both the within-and between-person levels. Students with a proclivity toward using alcohol/drugs to cope, however, showed evidence of substitution. These findings suggest
We examined the within-person associations among positive and negative daily events, positive and... more We examined the within-person associations among positive and negative daily events, positive and negative affect, desire to drink, and alcohol consumption in a sample of heavy drinkers. Method: Forty-six subjects (25 men; mean [SD] age = 47.0 [9.3] years) who were enrolled in an 8-week treatment program for heavy drinkers were studied using a daily diary methodology. Results: Multilevel regression analyses indicated that individuals reported stronger desire to drink and greater consumption on days in which more positive and negative nonwork events occurred. Lower levels of desire to drink and number of drinks were reported on days with more positive work events. Negative work events had a marginal positive association with daily desire to drink. Daily positive and negative affect uniquely predicted greater daily consumption and desire to drink, but only weak evidence was found for their mediating role in the association between daily events and the criterion variables. Several of the within-person associations among affect and the criterion variables varied as a function of number of lifetime symptoms of alcohol dependence and treatment condition. Conclusions: These findings generally support the dual-process (i.e., tension-reduction and experience-enhancement) motivational model of alcohol consumption. However, the observed associations among events, affect and alcohol-related behavior suggests that these pathways are complex, with each being comprised of affective and cognitive subpathways. (J. Stud. Alcohol 61: 862-871, 2000) HE NOTION that individuals drink in response to positive and negative daily events and their corresponding affective states is at the core of motivational models
Research consistently shows a positive association between racial discrimination and problematic ... more Research consistently shows a positive association between racial discrimination and problematic alcohol use among African Americans, but little is known about the micro-processes linking this pernicious form of stress to drinking. One possibility is that the cumulative effects of discrimination increase individuals' likelihood of negative-mood-related drinking. In the current study, we examined whether individual differences in lifetime perceived racial discrimination among African American college students moderate relations between daily negative moods and evening alcohol consumption in both social and nonsocial contexts. Method: Data came from an online daily diary study of 441 African Americans (58% female) enrolled at a historically black college/university. Lifetime discrimination was measured at baseline. For 30 days, students reported the number of drinks they consumed the night before both socially and nonsocially, as well as their daytime level of negative mood. Results: In support of the hypotheses, only men who reported higher (vs. lower) lifetime discrimination showed a positive association between daily negative mood and that evening's level of nonsocial drinking. Contrary to expectation, women who reported higher (vs. lower) discrimination showed a negative association between daily negative mood and nonsocial drinking. Neither daily negative mood nor lifetime discrimination predicted level of social drinking. Conclusions: These findings provide further evidence that the cumulative impact of racial discrimination may produce a vulnerability to negative-mood-related drinking-but only for African American men. Importantly, these effects emerged only for nonsocial drinking, which may further explain the robust association between discrimination and problematic alcohol use.
This study examined the association between history of depression and day-today coping with rheum... more This study examined the association between history of depression and day-today coping with rheumatoid arthritis (RA) pain. The sample was 188 RA-diagnosed participants, 73 of whom were identified by a structured clinical interview as having a history of major depression. None had current major depression. All participated in a 30-day prospective study in which they made end-of-day ratings of their arthritis pain, the strategies for how they coped with their pain, their appraisals of daily pain, and daily mood. Hierarchical linear models evaluated whether individuals with and without depression history differed in their average pain and the other daily measures; and separately, whether they differed in their within-person associations between pain and the daily measures (e.g., the day-today contingency between pain and mood). All analyses controlled for current mild depressive symptoms, neuroticism, and age. Previously depressed individuals were indistinguishable from their never depressed peers in their average pain and the other daily measures; however, the previously depressed exhibited significantly stronger associations between pain and several aspects of their daily emotional experience, suggesting more pain-contingent well-being. For individuals with a history of depression, increases in daily pain corresponded with more frequent efforts to cope with their pain by venting their emotions, significantly stronger impairments in mood, and, if they were also presently distressed, reduced perceptions of control over their pain, compared to the never depressed. Patterns suggest that formerly depressed individuals exhibit a hidden vulnerability in how they manage chronic pain. This vulnerability is best revealed by a daily process approach.
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