Relationships Between Alcohol-Related Memory Association and Change in Mood
Relationships Between Alcohol-Related Memory Association and Change in Mood
Heavy alcohol use is common in undergraduates and is associated with health-risk behaviors, negative consequences, and increased risk for future alcohol dependence. Alcohol-related memory associations (AMAs) and mood changes are independently related to student drinking, but more research on how these variables interact is needed.
Aims: To examine (i) how AMAs predict drinking behavior after accounting for depression, and (ii) how changes in negative and positive mood predict AMAs among low- and high-risk drinkers.
Methods: Positive and negative moods were manipulated using a musical mood induction procedure immediately prior to completion of memory association measures. A bootstrapped structural equation model was tested, permitting a sampling distribution free of the requirement of normality.
Results: Negative mood changes predicted AMAs in high-risk drinkers but not in low-risk drinkers, and the opposite was found for positive mood changes.
Conclusion: The negative mood-AMA association appeared related to risky drinking, and these subtle implicit cognitive processes may warrant a special focus in intervention programs for high-risk drinkers.
In Western societies, alcohol consumption is a common feature of university undergraduate experience (e.g., Pihl et al., 1993; Maio et al., 1994; Roche and Watt, 1999; O'Malley and Johnston, 2002; Jones, 2003). Heavy episodic consumption (i.e., drinking five or more standard drinks per occasion; NHMRC, 1992) is also widespread among college students and is associated with a range of health-risk behaviors and negative consequences (Pihl et al., 1993; Maio et al., 1994; O'Malley and Johnston, 2002). In young people, heavy drinking is associated with injuries and motor vehicle accidents (McGinnis and Foege, 1993), unsafe sex (Weschler et al., 1994; Cooper, 2002), sexual and physical assault (Engs and Hanson, 1985), ethanol poisoning (Greenfield, 2001), smoking (Kelly and Jackson-Carroll, 2007; Kelly et al., 2006), and increased risk of developing alcohol dependence (Baer, 2002; Schulenburg and Maggs, 2002; Dawson et al., 2004).
Social-cognitive models of alcohol use have long emphasized the importance of explicit (conscious and considered) cognition in accounting for heavy drinking. A large body of literature supports the utility of alcohol expectancy and refusal self-efficacy models in explanations of drinking, though overall affects are modest (Leigh and Stacy, 1991). In more recent years, there have been challenges to the notion that explicit cognitive processes are the primary driver of drinking-related decisions (e.g., Stacy, 1995, 1997; Goldman, 1999; Kelly and Witkiewitz, 2003). Contemporary cognitive explanations of alcohol use emphasize the role of automatic information processing that may be more implicit (occurring outside awareness) than explicit in determining drinking outcomes (Tiffany, 1990; Greenwald and Banaji, 1995; Stacy, 1997; Tiffany and Conklin, 2000). Associative memory network theorists propose that alcohol-related information is interlinked in memory and that accessibility of these informational nodes is variable. A central assumption is that these alcohol-related networks contain representations of cues depending on the alcohol-related learning history of the individual (e.g., Stacy, 1995, 1997; Tiffany and Conklin, 2000). The informational nodes that increase the likelihood of drinking may vary from apparently irrelevant, or ambiguous, associations with alcohol (e.g., being tired, hot, or stressed) to strong associations with drinking (e.g., bars/pubs). People who drink heavily are proposed to be more likely to experience alcohol-related activation in response to ambiguous cues, compared to others.
To investigate the role of accessibility of alcohol-related memory associations (AMAs) in the prediction of drinking, researchers have previously used a cue-association paradigm (e.g., Stacy, 1995). In this paradigm, free associations are made to ambiguous alcohol-related homographs (e.g., pitcher, tap) embedded in a list of homographs not related to drinking (e.g., stair, field). Responses are then coded for alcohol-related references (see Stacy, 1997). This task is held to reflect implicit memory processes because respondents are not asked to introspect about outcomes and are not aware of the alcohol focus of the research. Studies utilizing cue-association measures have shown that AMAs cross-sectionally and longitudinally predict drinking in young adults (Stacy, 1995; Weingardt et al., 1996; Stacy, 1997; Palfai and Wood, 2001; Kelly et al., 2005). AMAs are associated with problem drinking among drug offenders (Ames and Stacy, 1998; Ames et al., 2002), and predict alcohol and marijuana use in high-risk adolescents (Ames et al., 2005).
Although research indicates a univariate association between AMAs and alcohol consumption, there is limited research exploring the potential role of affect in moderating/mediating the AMA-drinking behavior relationship. The basis for incorporation of affect into AMA models is strong given that negative and positive affect have long been implicated in drinking behavior. For example, depressed affect increases self-reported craving and motivation to drink among recreational drinkers (Willner et al., 1998). Nervous mood predicts increased drinking among social drinkers (Swendsen et al., 2000), and negative affect is a frequently endorsed antecedent to relapse in treated drinkers (Strowig, 2000). Drinking to enhance positive mood is a commonly endorsed motive for drinking among university undergraduates (e.g., Stewart et al., 1996). Positive mood enhancement motives have also predicted alcohol-related problems in college students (Carey and Correia, 1997) and are a frequent motivator for drinking in social situations (Kilty, 1990; Fromme and Dunn, 1992). In experimental research (involving the systematic manipulation of mood) there is good evidence of a main affect of mood on alcohol consumption. Negative mood induction produces higher ratings of urges to drink among alcohol-dependent people and undergraduates, relative to neutral mood (Cooney et al., 1997; Willner et al., 1998).
There is a strong theoretical basis for exploring the role of affect in mediating/moderating the AMA-drinking behavior association. According to the affect-priming principle (Bower, 1981), affective states have specific nodes in memory that are linked to other nodes containing memories of events where that emotion was aroused. Affect can therefore prime the kind of associations elicited by a stimulus, and the greater the availability of mood-consistent associations, the greater the constructive interpretation of ambiguous details (Bower, 1991; Clark and Waddell, 1983). For people with a history of alcohol consumption, reliable links between certain affect states and alcohol events are established. When ambiguous (potentially alcohol-related) stimuli are encountered during affect priming, the drinker is more likely to construct responses potentially related to alcohol, than otherwise. Consistent with this principle, negative mood-related words facilitated priming for alcohol targets in problem drinkers with high levels of psychiatric distress (Zack et al., 1999). In college students, priming with negative mood phrases reduced reaction time to alcohol target words while positive mood phrases did not (Zack et al., 2003).
Traditional linear modeling in alcohol-related associative memory research is hampered by the common non-normality of AMA and drinking variables (Kelly et al., in press). Ordinary least squares (OLS) regression and maximum likelihood methods assume that the errors are independently and identically distributed as a Gaussian (or normal) probability distribution, and that data are continuous and multivariate normal (Byrne, 2001). However, AMAs and young adult substance-abuse data are often in the form of counts and are zero inflated, so probability distributions are typically positive and non-normal (Kelly et al., in press; Kelly and Jackson-Carroll, 2007). In structural equation modeling, this can result in spuriously large χ values, failure to converge, and spuriously low standard errors (the latter resulting in regression paths that are statistically significant though these may be unreplicable; Byrne, 2001; Yung and Bentler, 1996). Bootstrapping is a way of increasing the robustness of SEM to violations of normality. Bootstrapping is a resampling procedure in which the original sample is presumed to represent the population, and multiple subsamples are randomly drawn with replacement, permitting an evaluation of the stability of parameter estimates and indices of fit (Zhu, 1997).
The overall aim of the present study was to explore the affect of altered mood state on accessibility of AMAs in undergraduate student drinkers. Given the covariance of various alcohol consumption indicators (e.g., frequency of drinking (days/week), quantity consumed per session, frequency of binge drinking, and alcohol-related problems), Hypothesis 1 was that a measurement model of drinking behavior that incorporates these indicators would show a good fit to the data and these indicators would each significantly load on the latent variable. Given established univariate associations between AMAs and drinking (e.g., Kelly et al., 2005; Stacy, 1995, 1997), Hypothesis 2 was that AMAs would significantly predict drinking behavior after accounting for trait-like depression and changes in mood following experimental manipulation. The core hypothesis of the study (Hypothesis 3) was that increases in negative mood would predict increased alcohol-related memory associations among high-risk drinkers compared to low-risk drinkers. Hypothesis 4 was that increases in positive mood would predict increased alcohol-related memory associations among high-risk drinkers compared to low-risk drinkers. Differential predictions of how changes in positive/negative mood might impact on AMAs were not made, given the evidence that induced changes in a variety of moods (happy, sad, anxious) induce craving among heavy drinkers (Rubonis et al., 1994).
Heavy alcohol use is common in undergraduates and is associated with health-risk behaviors, negative consequences, and increased risk for future alcohol dependence. Alcohol-related memory associations (AMAs) and mood changes are independently related to student drinking, but more research on how these variables interact is needed.
Aims: To examine (i) how AMAs predict drinking behavior after accounting for depression, and (ii) how changes in negative and positive mood predict AMAs among low- and high-risk drinkers.
Methods: Positive and negative moods were manipulated using a musical mood induction procedure immediately prior to completion of memory association measures. A bootstrapped structural equation model was tested, permitting a sampling distribution free of the requirement of normality.
Results: Negative mood changes predicted AMAs in high-risk drinkers but not in low-risk drinkers, and the opposite was found for positive mood changes.
Conclusion: The negative mood-AMA association appeared related to risky drinking, and these subtle implicit cognitive processes may warrant a special focus in intervention programs for high-risk drinkers.
In Western societies, alcohol consumption is a common feature of university undergraduate experience (e.g., Pihl et al., 1993; Maio et al., 1994; Roche and Watt, 1999; O'Malley and Johnston, 2002; Jones, 2003). Heavy episodic consumption (i.e., drinking five or more standard drinks per occasion; NHMRC, 1992) is also widespread among college students and is associated with a range of health-risk behaviors and negative consequences (Pihl et al., 1993; Maio et al., 1994; O'Malley and Johnston, 2002). In young people, heavy drinking is associated with injuries and motor vehicle accidents (McGinnis and Foege, 1993), unsafe sex (Weschler et al., 1994; Cooper, 2002), sexual and physical assault (Engs and Hanson, 1985), ethanol poisoning (Greenfield, 2001), smoking (Kelly and Jackson-Carroll, 2007; Kelly et al., 2006), and increased risk of developing alcohol dependence (Baer, 2002; Schulenburg and Maggs, 2002; Dawson et al., 2004).
Social-cognitive models of alcohol use have long emphasized the importance of explicit (conscious and considered) cognition in accounting for heavy drinking. A large body of literature supports the utility of alcohol expectancy and refusal self-efficacy models in explanations of drinking, though overall affects are modest (Leigh and Stacy, 1991). In more recent years, there have been challenges to the notion that explicit cognitive processes are the primary driver of drinking-related decisions (e.g., Stacy, 1995, 1997; Goldman, 1999; Kelly and Witkiewitz, 2003). Contemporary cognitive explanations of alcohol use emphasize the role of automatic information processing that may be more implicit (occurring outside awareness) than explicit in determining drinking outcomes (Tiffany, 1990; Greenwald and Banaji, 1995; Stacy, 1997; Tiffany and Conklin, 2000). Associative memory network theorists propose that alcohol-related information is interlinked in memory and that accessibility of these informational nodes is variable. A central assumption is that these alcohol-related networks contain representations of cues depending on the alcohol-related learning history of the individual (e.g., Stacy, 1995, 1997; Tiffany and Conklin, 2000). The informational nodes that increase the likelihood of drinking may vary from apparently irrelevant, or ambiguous, associations with alcohol (e.g., being tired, hot, or stressed) to strong associations with drinking (e.g., bars/pubs). People who drink heavily are proposed to be more likely to experience alcohol-related activation in response to ambiguous cues, compared to others.
To investigate the role of accessibility of alcohol-related memory associations (AMAs) in the prediction of drinking, researchers have previously used a cue-association paradigm (e.g., Stacy, 1995). In this paradigm, free associations are made to ambiguous alcohol-related homographs (e.g., pitcher, tap) embedded in a list of homographs not related to drinking (e.g., stair, field). Responses are then coded for alcohol-related references (see Stacy, 1997). This task is held to reflect implicit memory processes because respondents are not asked to introspect about outcomes and are not aware of the alcohol focus of the research. Studies utilizing cue-association measures have shown that AMAs cross-sectionally and longitudinally predict drinking in young adults (Stacy, 1995; Weingardt et al., 1996; Stacy, 1997; Palfai and Wood, 2001; Kelly et al., 2005). AMAs are associated with problem drinking among drug offenders (Ames and Stacy, 1998; Ames et al., 2002), and predict alcohol and marijuana use in high-risk adolescents (Ames et al., 2005).
Although research indicates a univariate association between AMAs and alcohol consumption, there is limited research exploring the potential role of affect in moderating/mediating the AMA-drinking behavior relationship. The basis for incorporation of affect into AMA models is strong given that negative and positive affect have long been implicated in drinking behavior. For example, depressed affect increases self-reported craving and motivation to drink among recreational drinkers (Willner et al., 1998). Nervous mood predicts increased drinking among social drinkers (Swendsen et al., 2000), and negative affect is a frequently endorsed antecedent to relapse in treated drinkers (Strowig, 2000). Drinking to enhance positive mood is a commonly endorsed motive for drinking among university undergraduates (e.g., Stewart et al., 1996). Positive mood enhancement motives have also predicted alcohol-related problems in college students (Carey and Correia, 1997) and are a frequent motivator for drinking in social situations (Kilty, 1990; Fromme and Dunn, 1992). In experimental research (involving the systematic manipulation of mood) there is good evidence of a main affect of mood on alcohol consumption. Negative mood induction produces higher ratings of urges to drink among alcohol-dependent people and undergraduates, relative to neutral mood (Cooney et al., 1997; Willner et al., 1998).
There is a strong theoretical basis for exploring the role of affect in mediating/moderating the AMA-drinking behavior association. According to the affect-priming principle (Bower, 1981), affective states have specific nodes in memory that are linked to other nodes containing memories of events where that emotion was aroused. Affect can therefore prime the kind of associations elicited by a stimulus, and the greater the availability of mood-consistent associations, the greater the constructive interpretation of ambiguous details (Bower, 1991; Clark and Waddell, 1983). For people with a history of alcohol consumption, reliable links between certain affect states and alcohol events are established. When ambiguous (potentially alcohol-related) stimuli are encountered during affect priming, the drinker is more likely to construct responses potentially related to alcohol, than otherwise. Consistent with this principle, negative mood-related words facilitated priming for alcohol targets in problem drinkers with high levels of psychiatric distress (Zack et al., 1999). In college students, priming with negative mood phrases reduced reaction time to alcohol target words while positive mood phrases did not (Zack et al., 2003).
Traditional linear modeling in alcohol-related associative memory research is hampered by the common non-normality of AMA and drinking variables (Kelly et al., in press). Ordinary least squares (OLS) regression and maximum likelihood methods assume that the errors are independently and identically distributed as a Gaussian (or normal) probability distribution, and that data are continuous and multivariate normal (Byrne, 2001). However, AMAs and young adult substance-abuse data are often in the form of counts and are zero inflated, so probability distributions are typically positive and non-normal (Kelly et al., in press; Kelly and Jackson-Carroll, 2007). In structural equation modeling, this can result in spuriously large χ values, failure to converge, and spuriously low standard errors (the latter resulting in regression paths that are statistically significant though these may be unreplicable; Byrne, 2001; Yung and Bentler, 1996). Bootstrapping is a way of increasing the robustness of SEM to violations of normality. Bootstrapping is a resampling procedure in which the original sample is presumed to represent the population, and multiple subsamples are randomly drawn with replacement, permitting an evaluation of the stability of parameter estimates and indices of fit (Zhu, 1997).
The overall aim of the present study was to explore the affect of altered mood state on accessibility of AMAs in undergraduate student drinkers. Given the covariance of various alcohol consumption indicators (e.g., frequency of drinking (days/week), quantity consumed per session, frequency of binge drinking, and alcohol-related problems), Hypothesis 1 was that a measurement model of drinking behavior that incorporates these indicators would show a good fit to the data and these indicators would each significantly load on the latent variable. Given established univariate associations between AMAs and drinking (e.g., Kelly et al., 2005; Stacy, 1995, 1997), Hypothesis 2 was that AMAs would significantly predict drinking behavior after accounting for trait-like depression and changes in mood following experimental manipulation. The core hypothesis of the study (Hypothesis 3) was that increases in negative mood would predict increased alcohol-related memory associations among high-risk drinkers compared to low-risk drinkers. Hypothesis 4 was that increases in positive mood would predict increased alcohol-related memory associations among high-risk drinkers compared to low-risk drinkers. Differential predictions of how changes in positive/negative mood might impact on AMAs were not made, given the evidence that induced changes in a variety of moods (happy, sad, anxious) induce craving among heavy drinkers (Rubonis et al., 1994).
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