by Michael D. Anestis, M.S.
A behavior can often look very different across different individuals. Some individuals differ in the frequency of a particular behavior whereas others differ on the severity of that behavior. As we have discussed in reference to non-suicidal self-injury (NSSI), some individuals also differ on why they engage in a behavior. This point is relevant to all behaviors, although research on this last point - motivation for a behavior - has proven especially fruitful in understanding alcohol consumption. In an effort to better understand motivations for alcohol use, Cooper (1994) created the Drinking Motives Questionnaire - Revised (DMQ-R), which breaks alcohol use into four motivational components:
- Drinking to cope with negative affect
- Drinking to enhance positive affect
- Drinking to be sociable
- Drinking to conform to a group
If you read our earlier article on Nock and Prinstein's (2004) functional model of NSSI, you might notice a fairly strong overlap with these categories. The first two motives would correspond to intrapersonal negative and positive reinforcement respectively, whereas the second two would loosely correspond to interpersonal positive and negative reinforcement respectively. Importantly, each of these motivations for drinking predicts different outcomes and corresponds differently to different DSM-IV-TR disorders. In other words, the act of drinking is important on its own; however, the motivation for drinking provides additional pivotal information regarding the potential outcomes of drinking, severity and duration of drinking, and vulnerability to particular mental illnesses. A summary of all of the research that has utilized the DMQ-R would be beyond the scope of this particular article, but I would like to provide a basic explanation of what we know regarding different alcohol consumption motives.
In an early experiment examining the impact of drinking motives, Birch and colleagues (2004) found that motives heavily impact individuals' expectations for the potential effects of alcohol consumption. Specifically, they found that individuals who drink to cope with negative affect experienced an increased belief that alcohol is capable of performing this function when they took part in a negative mood induction. Similarly, individuals who drink to enhance positive affect experienced an increase in their belief that alcohol consumption could perform this function when they took part in a positive mood induction. In a later study examining a similar phenomenon, Birch and colleague (2008) found that, after taking part in a positive mood induction, individuals who drink to enhance positive affect demonstrated increased implicit alcohol cognitions. Field and Powell (2007), meanwhile, found that individuals who drink to cope demonstrated an attentional bias for alcohol cues when experiencing stress. As such, an individual's motives for drinking alcohol appear to impact thoughts and attention at a basic level during high levels of stress and emotion.
Drinking motives have also been linked to personality variables. Theakston, Stewart, Dawson, Knowlden-Loewen, and Lehman (2004) found that drinking to cope with negative affect was predicted by low emotional stability, whereas drinking to enhance positive affect was predicted by high levels of extraversion and low levels of conscientiousness. Similarly, Cyders and Smith (2007) found that positive urgency - the tendency to act rashly when experiencing positive emotions - predicted enhancement motives whereas negative urgency - the tendency to act rashly when experiencing negative emotions - predicted coping motives. Anestis, Selby, and Joiner (2007) found that residual change in negative urgency over six weeks predicted residual change in coping motives. Personality types are known to be fairly stable, highly heritable variables. As such, if specific personality types increase the likelihood of individuals maintaining particular drinking motives, vulnerability to problematic motives may be established long before an individual ever takes his or her first drink.
Chalder, Elgar, and Bennett (2006) examined whether having an alcoholic parent influenced the drinking motives of adolescent drinkers. They found that adolescents with alcoholic parents were more likely to drink to cope with negative affect. Similarly, Agrawal and colleagues (2007) examined the degree to which drinking motives are heritable. The authors found that, while there is no evidence of heritability in drinking to enhance positive affect, conformity, social, and coping motives for drinking are all highly genetically based. These are important findings because drinking to cope with negative affect is predictive of more problematic drinking outcomes (Cooper, Russell, Skinner, & Windle, 1992). Specifically, whereas enhancement motives predict the greatest levels of frequency and quantity of alcohol consumption, coping motives predict the greatest level of alcohol abuse symptoms. As such, certain individuals might be genetically predisposed to consuming alcohol for problematic reasons.
Alcohol motives have also been implicated in specific DSM-IV-TR diagnoses. Tragesser, Trull, Sher, and Park (2008) found that enhancement motives mediated the relationship between cluster B personality disorder (borderline, narcissistic, histrionic, and antisocial personality disorders) symptoms and alcohol use disorders. In other words, while there was a significant relationship between symptoms of cluster B personality disorders and alcohol use disorders, this relationship was explained by the high rates of enhancement motives in that particular population.
Perhaps the most frequently researched diagnosis with respect to drinking motives is social anxiety disorder; however, the research on this has yielded conflicting results. Lewis and colleagues (2008) found that both coping motives and conformity motives mediated the relationship between social anxiety disorder and negative consequences of drinking. Additionally, Stewart, Morris, Mellings, and Komar (2006) found that both coping motives and conformity motives mediated the relationship between fear of negative evaluation (the primary symptom of social anxiety disorder) and drinking problems. In contrast, Buckner, Schmidt, and Eggleston (2006) found that enhancement motives mediated the relationship between social anxiety and alcohol problems. Ultimately, more research on this topic is needed before we can fully understand the role of specific drinking motives in social anxiety disorder.
As the above mentioned findings hopefully make clear, an individual's motivation for drinking provides a substantial amount of information regarding that person's personality, likely style of drinking, response style to emotional experiences, and vulnerability to particular mental illnesses. As such, just knowing that an individual drinks, even if that person drinks often and heavily, might not be enough. Consider this from a standpoint of treatment. If an individual drinks heavily, but does so to enhance positive emotions, might he respond differently to different treatments than would an individual who drinks to reduce negative emotions? Hopefully future research will answer this very question. In the meantime, considerations of drinking motives will likely continue to be the subject of considerable research and we look forward to reading the results of such studies.
It is important to consider that these are not the only findings on drinking motives, but rather, a short summary of findings that have utilized a specific measure: the DMQ-R. Research has shown that this measure is a valid assessment tool for drinking motives across a variety of cultures (Kuntshe, Stewart, & Cooper, 2008), thus indicating that it is an ideal candidate for use in studies seeking to examine this concept. Some researchers have suggested that coping motives should be parsed into two separate factors - coping-depression and coping-anxiety - so the scale itself may evolve in coming years (Grant, Stweart, O'Connor, Blackwell, & Conrod, 2007); however, the basic structure is unlikely to change substantially.
If you would like to learn more about alcohol use disorders and their treatment, we recommend the following products, all of which are available through our online store:
Books:
- Motivational Interviewing, Second Edition: Preparing People for Change
- Addiction and Change: How Addictions Develop and Addicted People Recover (The Guilford Substance Abuse Series)
- Rethinking Substance Abuse: What the Science Shows, and What We Should Do about It
- Cognitive Therapy of Substance Abuse
DVD:
- Motivational Interviewing with William R. Miller (Individual Version)
Mike Anestis is a doctoral candidate in the clinical psychology department at Florida State University.
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