Dispositional drinking motives: associations with appraised alcohol effects and alcohol consumption in an ecological momentary assessment investigation.

Alcohol abuse exacts staggering costs from our society, underscoring a pressing need to identify effective methods for reducing problematic drinking (Bouchery, Harwood, Sacks, Simon, & Brewer, 2011; Rehm, 2011). Assessments indexing individual differences in reasons for drinking may contribute to attainment of these goals by serving as a basis for delivering targeted prevention or clinical interventions, providing clues about promising intervention strategies, or serving as outcome or process measures in applied research (e.g., Coffman, Patrick, Palen, Rhoades, & Ventura, 2007; Conrod et al., 2000, Doyle, Donovan, & Simpson, 2012; Neighbors, Larimer, & Lewis, 2004; Watt, Stewart, Brich, & Benrier, 2006). Contemporary motivational models assume that alcohol use can be understood as a strategic behavior in which people choose to drink based on the anticipated affective changes produced by drinking relative to those produced by alternative behaviors (Cox & Klinger, 1988; 1990). According to these models, a person decides to drink as a function of anticipated affective consequences and whether these are thought to outweigh those of not drinking. Theorists have identified two related but distinguishable psychological constructs involved in this process. Drinkers differ with respect to both their alcohol outcome expectancies (beliefs concerning the probability that drinking will produce certain effects), and their drinking motives (the expected effects the individual hopes to obtain by drinking). Measures of drinking motives statistically mediate the relation between alcohol outcome expectancies and drinking, indicating that motives are the more proximal determinant of alcohol use (Cooper, Frone, Russell, & Mudar, 1995; Cooper, Russell, & George, 1988; Kuntsche, Wiers, Janssen, & Gmel, 2010). According to Cox and Klinger (1988; 1990), drinking motives can be conceptualized as varying independently along two underlying dimensions -- approach vs. avoidance and internal vs. social. In other words, people are motivated to drink in order to attain positive incentives or to avoid negative ones, and the incentives themselves may be internal to the individual (i.e., self-focused) or external and social in nature. Thus, Cox and Klinger identify four main categories or types of motives: (1) self-focused approach motivations, such as drinking to enhance physical or emotional pleasure or for excitement (i.e., enhancement motives); (2) self-focused avoidance motives, such as drinking to cope with negative emotions (i.e., coping motives); (3) social approach motives, such as drinking as a way to bond with others or improve social gatherings (i.e., social/affiliative motives); and (4) social avoidance motives, such as drinking to avoid social censure or gain another's approval (i.e., approval or conformity motives). Based on an extensive review of the literature, Cooper and colleagues (in press) concluded that people drink for each of these four reasons; that each drinking motive is embedded in a distinct etiologic or nomologic network; and that the nature of these networks can be understood with respect to the two dimensions hypothesized to underlie and give rise to the individual motives. Of greatest relevance to the present study, there is persuasive evidence that drinking to cope and drinking to enhance are embedded in negative and positive emotion pathways, respectively. For example, people high (vs. low) in coping motives report higher levels of neuroticism-linked traits, including negative emotionality, depression, anxiety, emotional instability, and punishment sensitivity (Cooper, et al., in press). They also hold stronger beliefs about alcohol's capacity to reduce dysphoric mood states (Cooper, et al., 1995; Kuntsche, et al., 2010), and have been shown in at least some diary studies to be more likely to drink or to drink more heavily on days characterized by elevated negative mood or stress (Mohr, et al., 2005; Todd, et al., 2005), as well as to start drinking sooner following a negative mood or stressful experience (Armeli, Todd, Conner, & Tennen, 2008; Hussong, 2007; Todd, Armeli, & Tennen, 2009). In contrast, people high (vs. low) in enhancement motives report higher levels of extraversion-linked traits (especially reward sensitivity, excitement seeking, and surgency; see Cooper et al., in press), and hold stronger beliefs about alcohol's capacity to promote or enhance positive affective experiences (Cooper, et al., 1995; Kuntsche, et al., 2010). Test validation involves accumulating evidence that supports interpretation of test scores for particular purposes (AERA, APA, & NCMEE, 1999; Messick, 1995). As described above, measures of drinking motives are expected to be useful for prevention and clinical efforts because test scores will provide information about the functional role of alcohol use in a given drinker's experience. Although considerable research has investigated how drinking motives are related to affective antecedents of drinking and alcohol outcome expectancies, we know surprisingly little about how motives scores relate to the actual experienced effects of alcohol use. Do those who say they drink to enhance their mood actually feel pleasure as a result of drinking? Do those who say they drink to relieve dysphoria actually feel relief? Research probing whether the experienced consequences of drinking align with self-reported motives addresses a basic and important gap in the evidence base concerning the interpretation of drinking motives scores in functional terms. To investigate this foundational issue, the present study used Ecological Momentary Assessment (EMA; Shiffman, Stone, & Hufford, 2008) data collected during actual drinking episodes to determine if individuals who score high on specific drinking motives, as assessed by the Drinking Motives Questionnaire-Revised (DMQ-R; Cooper, 1994) systematically differ with respect to their explicit appraisals of the effects of recently consumed drinks. The DMQ-R was specifically developed to assess the four dimensions of drinking motivation identified by the Cox and Klinger (1988; 1990) model and is the most widely used measure of drinking motives in contemporary alcohol research (Kuntsche, Knibbe, Gmel & Engels, 2005). We expected that self-focused motives (enhancement, coping) would be more strongly related to drink appraisals compared to external motives (social, conformity). Persons who drink for self-focused reasons are presumably seeking specific alcohol-contingent outcomes. In contrast, those motivated by external or social factors presumably consume alcohol in pursuit of valued interpersonal goals rather than alcohol effects per se. Based on both empirical and theoretical links between expectations of relief from aversive mood states and coping motives, we hypothesized that individuals high (vs. low) in coping motives would report stronger relief from drinking. Similarly, based on links between expectations of pleasure and enhancement motives, we expected those high (vs. low) in enhancement motives would report experiencing stronger pleasure from alcohol. As a secondary focus, we also examined relations between dispositional drinking motives and alcohol consumption. In prior research (for a review, see Cooper, et al., in press), enhancement motives have been consistently linked to heavier alcohol consumption, presumably reflecting the appetitive nature of drinking to enhance and the desire to experience pleasant sensations associated with being “high.” Drinking to cope, on the other hand, has been associated with elevated rates of drinking problems that cannot be explained by consumption alone. Both social and conformity motives have been consistently linked with light to moderate consumption, mostly in social settings. However, most of this research has used retrospective measures of typical consumption aggregated over long time intervals, such as the past 30 days (Cooper, et al., in press). The current research extends the literature by examining whether motives predict consumption in particular real-world drinking episodes. Based on the existing literature, we hypothesized that enhancement motives would be most strongly predictive of the amount of alcohol consumed per episode.