Heavy Alcohol Use in EmergingAdults Is Due to Impulsivity Alone: True or False?According to Hall (1904), adolescenceis a time of “storm and stress” as children transit to adulthood. A common stereotypehas labelled adolescence as the difficult age of impulsivity (Chan, et al.
, 2012), which refers to thetendency to engage in behaviors rapidly without considering potential negativeconsequences. This stereotype may be formed based on the predominant traitsfound within adolescents (Fishman, 1956),such as facing the highest risk for initiation and alcohol use (Kandel & Logan, 1984). The frequency ofheavy alcohol use is also found to reach the peak during emerging adulthood (Windle, Mun, & Windle, 2005). However, therelevance of these characteristics may also be exaggerated or faultyassumptions towards adolescents and emerging adults (Banaji, Hardin, & Rothman, 1993).
Therefore, this paper servesto examine whether heavy alcohol use in emerging adults, age 18 to 25 (Arnett, 2000), is due to impulsivity alone. The Role of Impulsivity in Alcohol UseSeveral studies have considered impulsivity as a single construct and foundthat impulsivity is positively related to alcohol use, however, few studiesfocused on the relationship between different impulsivity traits and alcoholuse in emerging adulthood. Thus, Shin et al.
(2012)examined how four aspects of impulsivity based on the Five Factor Model ofpersonality: (a) urgency, (b) premeditation, (c) perseverance, and (d) sensationseeking, are related to different alcohol use outcomes: (a) frequency ofalcohol use, (b) alcohol-related problems, (c) binge drinking, and (d) alcoholuse disorders (AUDs), after controlling for age, gender, socio-economic status,psychological distress, peer alcohol use and parental alcoholism. This studyserves to aid in the development of personality-targeted interventions on preventionand treatment. In relation to past findings, urgency and sensation seeking areassociated to AUDs, while sensation seeking are related to the frequency ofalcohol use. There is no prediction of any relationships between the remainingfactors. Methodology Participants.190 individuals aged 18 to 25, without major medical conditions, were recruitedthrough advertisements.
Among the participants, 61% were females, 56% werecollege students, and 65.8% were white. 25.2% had less than enough, 50% hadenough, while 24.8% had more than enough money for family needs. Impulsivity.
The Urgency, Premeditation, Perseverance, and Sensation Seeking (UPPS)Impulsive Behavior Scale (Whiteside & Lynam,2001) was used to measure the four impulsivity traits mentioned above. Alcohol Use. The frequency of alcohol was determined by the number of days oneconsumed alcohol per month in the past year. Past year alcohol-related problemswere assessed using the Rutgers Alcohol Problem Index (White & Labouvie, 1989). Binge drinking was measured by thenumber of days one had five or more drinks continuously for males, or four ormore drinks continuously for females, at least two to three days per month inthe past year (Wechsler, Davenport, Dowdall,Moeykens, & Castillo, 1994). AUDs were evaluated using alcoholsection in the Composite International Diagnostic Interview (Cottler, et al.
, 1991). Psychological distress was assessed by the Brief Symptom Inventory 18 (Derogatis, 1993). Peer alcohol usewas determined by the number of friends who drink currently.
Parentalalcoholism was measured by the 6-item Children of Alcoholics Screening Test (Hodgins, Maticka-Tyndale, El-Guebaly, & West,1993, 1995).ResultsAnalysis for the four impulsivity traits was done using the Poissonregression on the frequency of alcohol use and alcohol-related problems, aswell as the logistic regression analysis on binge drinking and alcohol usedisorders. It was found that participants with higher scores on urgency andsensation seeking, scored higher on all four constructs of alcohol use. Those whoscored lower on premeditation also had higher frequency alcohol use. Norelationship was found between perseverance and the constructs of alcohol use. Discussion Different impulsivity traits, specificallyurgency, sensation seeking, and premeditation, are related to alcohol useduring emerging adulthood.
Individuals with high urgency may be motivated toconsume alcohol to relieve negative emotions, which may escalate to long-term alcoholdependency due to the negative reinforcement. As for individuals with highsensation seeking, initial alcohol use may serve as an exploration of adultidentity, which may be a confusing process (Arnett, 2005) that leads to alcoholdependency. This may also be due to the inability to control stimulatingbehaviors that generates positive emotions (Castellanos-Ryan,Rubia, & Conrod, 2011). Furthermore, individuals lackingpremeditation tend to fail in taking into account for the negative consequencesof alcohol use. Overall, the four impulsivity traits have varying effects on thedifferent alcohol outcomes in emerging adults.Limitations and Future Directions This was a cross-sectional study thatwas unable to cover the changes in impulsivity traits over time due todevelopment or alcohol use (Quinn, Stappenbeck, & Fromme,2011). Hence,longitudinal studies can be employed to determine the causal relationship andtemporal order of impulsivity and alcohol use from adolescence into emergingadulthood.
Additionally, self-report measures for alcohol use in this study maybe subjected to recall bias, social desirability bias, and acquiescence bias. InteractionBetween Impulsivity and Stress on Alcohol Use On the other hand, alcoholism maynot be related to the effects of impulsivity alone. Studies have shown thatstress is also related to alcohol use, yet few have explored its interactionwith impulsivity in influencing alcoholism. Hence, Fox et al. (2010) examined how cumulativestress and impulsivity influence alcohol use and alcohol-related problems.
Thisstudy also served to assist the development of preventive interventions onalcohol abuse. Based on past findings, recent life stress(Rutledge & Sher, 2001),cumulative traumatic stress (Lloyd & Turner, 2008), and traumatic life experiences(Reed, Anthony, & Breslau, 2007), are positively related to varyingincrements of alcohol use. Inability to delay gratification and inhibitorycontrol are also related to compulsive alcoholism (Rubio,et al., 2007). Geneticresearch has also identified common genetic markers between alcohol use and stress(Covault, et al., 2007), as well as impulsivity (Wagner,Baskaya, Lieb, Dahmen, & Tasi? André, 2009). Methodology Participants.
130 individualsaged 18 to 50, without major medical conditions,DSM-IVTR psychiatric disorders, or drug dependence, excluding nicotine andalcohol, were recruited through advertisements. 58% of the participants werefemales. Stress. Cumulative stress wasassessed using the Cumulative Stress/Adversity Checklist (CSC, Turner& Wheaton, 1995), including recent life stress, major life stress,traumatic stress, and chronic stress. Impulsivity. Impulsivity was measured usingthe Barratt Impulsiveness Scale (BIS-11; Patton, Stanford, & Barratt,1995) by summing the scores for attentional impulsivity, motor impulsivity, andnon-planning impulsivity.
Alcohol Use. The Alcohol Use DisordersIdentification Test (AUDIT; Babor, Higgins-Biddle, Saunders,& Monteiro, 2001)was used to measure alcohol consumption and its negative consequences. Results Multiple regressions were used todetermine the individual and interaction effects of cumulative stress andimpulsivity, as well as their specific components on alcohol use. This studyfound that recent life stress, traumatic stress, overall impulsivity,attentional impulsivity, motor impulsivity, and non-planning impulsivity wererelated to AUDIT scores, and the strongest relationship was with traumaticstress. An interaction was found between high cumulative stress and highimpulsivity in predicting high AUDIT scores. Discussion This study showed that differentcomponents of stress and impulsivity are associated with alcohol use. Additionally,high stressful events and moderate to high impulsivity may be related to theescalation of alcohol use over time, leading to long-term alcohol dependency.
Thismay be because stress, especially traumatic stress, may weaken the physiologicalprocesses of the brain (McEwen, 2007) and its cognitivemechanisms, such as decreasing self-regulation (Muraven& Baumeister, 2000),thereby increasing impulsive behaviors. Limitations and Future DirectionsThiswas also a cross-sectional study which was unable to cover the changes instress, impulsivity, and alcohol use over time. Thus, longitudinal research isrequired to assess the temporal directionality of the relationship betweenthese three variables, especially the influence of early traumatic life eventsin the development of impulsivity.
In addition to the self-report measures usedin this study, further studies could also employ comparative subjective,biological, and behavioral markers of stress and impulsivity.Conclusion Overall, these two studies provided differentperspectives on whether heavy alcohol use in emerging adults is due toimpulsivity alone, or due to the interaction effect of impulsivity with otherfactors, such as stress.