The relationship between perceived stress, craving, and exposure on alcohol

consumptionHannah Pickard

Dunya Latif-ArameshShanky Kumar

Jennifer O'ConnellSasha Nagra

BackgroundCraving and alcohol consumption:

Self-reported levels of craving are among individuals who had consumed greater levels of alcohol (Schoenmakers & Wiers, 2009).

Stress and alcohol consumption:

Keyes and colleagues (2011) found that stress contributes to higher alcohol consumption and has been suggested to lead to a development of alcohol use disorders.

However, a longitudinal study found no long-term effects of stressful life events on levels of alcohol consumption (Skaff et al. 1999).

Inconsistencies possible mediators interacting with stress on alcohol consumption.

Background 2

Craving, alcohol and stress:

In combination exposure to alcohol and stress leads to craving among alcohol dependent individuals.

Exposure and alcohol:

Alcohol related problems present within family setting is directly related to excessive levels of drinking among adolescents (Mares et al., 2011).

New items were created to investigate the effect of negative exposure, as this had been widely neglected throughout the alcohol literature.

Rationale

UK population’s alcohol consumption is increasing diminishment in ill-health and an increase in healthcare costs

Therefore, it is important to look at underlying mediators to prevent further amelioration.

Will self-report levels of alcohol craving and consumption in a non clinical population reveal similar findings present in clinical populations.

Hypothesis

1.Higher self-reported levels of perceived stress and craving will be independently related to greater levels of alcohol consumption.

2. There will be a interaction effect between craving and perceived stress on alcohol consumption

3.Greater exposure to negative family and peer experiences will be related to high levels of alcohol consumption.

Method

Participants Convenience sample of 117 participants, above 18

years of age -recruited online (29 excluded; 21 males; 67 females)

Inclusion Criteria: native speakers of English; lived in the UK for at least 3 years; and no diagnosis of any psychiatric disorders

Design 2 X 2 X 2 Factorial IV: Perceived Stress, Craving, Exposure DV: Alcohol Consumption

MEASURES

Perceived Stress Scale (Cohen, Kamarck and Mermelstein, 1983): 10 item measure; range 1 (never) to 5 (very often)

Adapted Alcohol Urge Questionnaire (Bohn et al., 1995) : 8 item measure; range 1 (Strongly disagree) to 5 (Strongly agree)

Alcohol Measure Questionnaire (AUDIT; Saunders et all 1993) : 3 items; Score of 5 indicates higher risk drinking

Exposure Questionnaire : 5 item measure; Yes or No responses

Procedure Consent form, demographic details Four questionnaires (random order),debrief form

Results

Gender Differences:

There was a significant difference between gender on alcohol consumption levels

Normality tests:

Normality was violated for craving and exposure and data for these scales were transformed using square-root transformation.

  Low Consumption

High Consumption

Low Exposure

High Exposure

Low Craving

High Craving

Low Stress

High Stress

N 50 38 47 41 47 41 46 42

Mean 6.84 10.24 6.34 8.63 14.60 19.83 22.59 33.14

SD 1.36 1.13 0.73 0.70 1.57 2.98 3.61 4.30

Mean Total Scores

Our sample had a high mean consumption level overall compared to standard guidelines.

Consumption= 8.31; Perceived Stress= 27.63; Exposure= 4.41; Craving= 17.03

Spearman's Correlations

  1 2 3 4 5 6 7 8

1. Low Consumption

- - .223 -.182 -.072 -.190 -.126 -.102

2.High Consumption

  - .203 .209 -.034 -.007 -.349 -.375

3.Low Exposure

    - - -.157 -.203 -.216 -.448*

4.High Exposure

      - -.476* -.113 .259 -.125

5.Low Craving

        - - -.189 .303

6.High Craving

          - -0.31 -.252

7.Low Stress             - -

8.High Stress               -

 

So, nothing was significant - this made our brain sad :’( 

There was no significant differences between any of our IVs.

BUT some approached significance!!

Low consumption group: Craving and exposure (p=0.068).

Exposure and perceived stress (p=0.061).

 A three-way interaction between craving, exposure, and perceived stress (p=0.061)

ANOVAS

Interpretation of Results

•Less negative exposure to alcohol > less likely to have high levels of stress*•More negative exposure to alcohol > less likely to have low levels of alcohol craving*•Some interaction p values approaching significance when alpha set to < .05 in low consumption group*•Accept null hypotheses: No relationship between stress, craving and negative exposure in consumption of alcohol in non-clinical sample?

Methodological Issues

• Adjusted scales – low internal consistency • Retrospective self report measures• Lack of experimental control over alcohol

consumption during/before participation• High levels of stress and alcohol consumption in

mostly student sample

Implications & Future Research • High levels of stress and alcohol consumption in

sample highlight need for interventions to reduce these• Findings of complicated relationships between

variables in non-clinical sample• Add to already mixed bag of results in literature• Highlight need for further research with more

experimental control...

• Look at effects of experimentally induced exposure and stress on craving and intentions to consume alcohol, using intentions as a predictor of behaviour?

References

Bohn, M. J., Krahn, D. D., & Staehler, B. B. (1995). Development and initial validation of a measure of drinking urges in abstinent alcoholics. Alcoholism: Clinical and Experimental Research, 19(3), 600–606.

Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385-396.

Keyes, K. M., Hatzenbuehler, M. L., & Hasin, D. S. (2011). Stressful life experiences, alcohol consumption, and alcohol use disorders: the epidemiologic evidence for four main types of stressors. Psychopharmacology, 218(1), 1-17.

Mares, S. H., van der Vorst, H., Engels, R. C., & Lichtwarck-Aschoff, A. (2011). Parental alcohol use, alcohol-related problems, and alcohol-specific attitudes, alcohol-specific communication, and adolescent excessive alcohol use and alcohol-related problems: An indirect path model. Addictive Behaviors, 36(3), 209-216.

Saunders, J. B., Aasland, O. G., Babor, T. F., & Grant, M. (1993). Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction, 88(6), 791-804.

Schoenmakers, T. M., & Wiers, R. W. (2009). Craving and attentional bias respond differently to alcohol priming: a field study in the pub. European Addiction Research, 16(1), 9-16.