Negative Urgency, Distress Tolerance and Problematic Alcohol Use

1. Negative Urgency, Distress Tolerance and Problematic Alcohol Use Alison Kaiser, B.A., Karen Derefinko, Ph.D., Richard Milich, Ph.D., & Don Lynam, Ph.D.* Department of Psychology, University of Kentucky *Department of Psychological Sciences, Purdue University • Abstract • Purpose:This study aimed to explore the relations among Negative Urgency, Distress Tolerance and problematic alcohol use in first-year college students. Examining both variables together allows for testing of the incremental validity of considering impulsivity along with negative affect, because while both variables include a negative affect component, Negative Urgency includes an impulsivity component that Distress Tolerance does not. • Methods:Participants were 222 first-year college students enrolled in introductory psychology classes. During the study session, they completed questionnaires assessing personality variables and substance use, and a structured interview regarding their substance use history. • Results:Negative Urgency and Distress Tolerance both related to alcohol use problems, but not to level of alcohol use. The variables did not interact in predicting alcohol use problems. Although Distress Tolerance was significant in predicting alcohol use problems, when Negative Urgency is including in the regression equation it became non-significant. When Distress Tolerance was added into a regression equation predicting alcohol use problems beyond Negative Urgency, it was non-significant. • Discussion:The results are consistent with previous research finding relations among negative affect personality variables and problematic substance use. Tests of incremental validity suggest that Negative Urgency predicts problematic alcohol use beyond Distress Tolerance, but that Distress Tolerance provides no additional predictive power beyond Negative Urgency. Negative Urgency encompasses both negative affect and impulsivity, and these results suggest that the impulsivity component may be important to consider when examining the relation between negative affect personality variables and substance related problems. • Introduction • In previous research, personality traits related to negative affect and impulsivity have been found to relate to substance use and problems. Negative Urgency combines aspects of both negative affectivity and impulsivity, and is understood as the tendency to act impulsively while experiencing negative affect. Previous research has linked Negative Urgency to a number of maladaptive behaviors, including substance dependence and problems. Distress Tolerance is a conceptually related personality variable, which refers to one’s ability to tolerate psychological distress. Previous research suggests a link between low levels of Distress Tolerance and maladaptive behaviors such as self-injury, eating disorders and problematic substance use. • The present study seeks to examine how Negative Urgency and Distress Tolerance relate to alcohol use and problems in a sample of first year college students. Examining the two variables together may allow for an improved understanding of how negative affect personality variables impact substance abuse. Both variables include a distress component, but only Negative Urgency contains an impulsivity component. This will allow for exploration of the importance of impulsivity in the relation between negative affect personality variables and problematic alcohol use. The following questions are of interest: • 1.How do Negative Urgency and Distress Tolerance relate to alcohol use and problems? • 2. Do Negative Urgency and Distress Tolerance interact in predicting alcohol-use problems? • 3. Does Negative Urgency predict alcohol-use problems beyond Distress Tolerance? Does Distress Tolerance predict alcohol-use problems beyond Negative Urgency? • Methods • Participants: • Participants (N = 222) were first year students enrolled in introductory psychology classes at the University of Kentucky. • Procedure: • Participants were administered the experiment individually, with the whole protocol lasting roughly 2.5 hours. During this time they completed computer-based questionnaires, computer-based behavioral tasks, and a structured interview assessing substance use. • Measures: • UPPS Impulsive Behavior Scale (UPPS; Whiteside and Lynam ,2001). The UPPS is a 44 item, self-report measure which assesses four facets of impulsivity: Negative Urgency, (lack of) Premeditation, (lack of) Perseverance, and Sensation Seeking. Scores of the Negative Urgency scale were of interest for the present analyses. • Distress Tolerance Scale(DTS; Simons & Raher, 2005). The DTS is a 15 item, self-report measure used to assess an individual’s ability to tolerate psychological distress. Although the DTS consists of four subscales, for the present analyses the full scale score was used. • Alcohol Use Disorders Identification Test (AUDIT; Saunders et al., 1993). The AUDIT is a 10 item screening instrument for identifying individuals at risk for hazardous drinking. Questions assess alcohol consumption, drinking behavior, adverse psychological reactions and drinking-related consequences. In the present analyses, the AUDIT composite score were used as an outcome measure of problematic drinking. • Life History Calendar (LHC; Caspi et al., 1996). The LHC a method used to obtain reliable retrospective data regarding life events, and can be modified to fit the purpose of an individual study. In the present research, it was used to assess participants’ usage of a variety of different substances, beginning at age thirteen. The LHC was filled out in collaboration with an experimenter and assessed participants’ use of various substances and the time periods of use, frequency of use, average amount used, and highest amount used. Alcohol variables of interest for the present study were the current average use, current highest use, average weekly use, total time periods of use, and total time periods of high average use (i.e. 5 or more drinks on average). • Results • 1. Both Negative Urgency and Distress Tolerance related to alcohol-use problems but not to current use. • Both variables were significantly correlated with AUDIT scores. • Neither variable correlated significantly with current average alcohol use, current highest use, and average weekly use, as measured by the LHC. • Negative Urgency correlated with total time periods of alcohol use and periods of high average alcohol use (defined as an average of 5 drinks or more per occasion) on the LHC, but Distress Tolerance did not. • 2. Negative Urgency and Distress Tolerance did not interact in predicting alcohol-related problems, as measured by the AUDIT. • 3. Negative Urgency predicted alcohol-related problems beyond Distress Tolerance. When Negative Urgency was included in a regression equation predicting AUDIT scores from Distress Tolerance, overall predictive ability increased and Distress Tolerance was no longer a significant predictor. • Table 1. Correlations of Negative Urgency and Distress Tolerance with Alcohol Use Variables • ** Correlation is significant at the 0.01 level • * Correlation is significant at the 0.05 level • Note: Problems= Total AUDIT score, Avg. Amount = Average number of drinks per occasion for the current time period; Highest Amount = Highest number of drinks on one occasion for the current time period; Avg. Weekly Use = Average number of drinks per week for the current time periods; Periods of Use = Total time periods of any alcohol use; Periods of High Use = Total time periods with an average of 5 or more drinks per occasion • Discussion • The purposes of the study were to explore how two negative affect variables relate to substance use, and to examine how the inclusion of an impulsivity component impacts the relations. Despite their conceptual similarity, patterns of relations differed for Negative Urgency as compared to Distress Tolerance. • 1. Both variables showed significant relations with alcohol related problems, suggesting the importance of negative-affect variables in predicting problematic alcohol use. • 2. Negative Urgency predicted problematic alcohol use beyond Distress Tolerance, which supports the importance of considering impulsivity when examining relations between negative affect variables and problematic use. • 3. Neither variable predicted current alcohol use. That is, individuals with the traits of interest do not differ from their peers in the amount of alcohol used, but are still more likely to experience alcohol-related problems. • Acknowledgements • This research was supports by NIDA grant DA005312. • Presented at the RSA annual conference in San Antonio, TX, June 2010