A Problematic Cascade: Implicit Alcohol Attitudes And Heavy Drinking Reinforce Each Other In Emerging Adulthood

Newswise — A new study has reinforced the importance of implicit attitudes toward alcohol in escalating risk for heavy drinking as a young person transitions from adolescence to adulthood. Alcohol use peaks in emerging adulthood, with many associated health risks and negative consequences, so understanding risk and protective pathways to heavy drinking in this age group is a critical public health issue. In contrast to conscious information processing, implicit information processing occurs spontaneously, without deliberation or awareness. Although implicit alcohol attitudes are considered important in prompting alcohol use and maintaining heavy drinking, previous studies have provided mixed support for the association between positive (i.e. favorable) implicit alcohol attitudes and greater drinking. This may be partly attributable to difficulties in measuring implicit attitudes. A further complication is that associations between implicit alcohol attitudes and heavy drinking may be reciprocal: not only may positive implicit alcohol attitudes precipitate drinking, but positive drinking experiences may in turn contribute to positive alcohol attitudes. Most studies to date have evaluated attitudes and drinking at only a single timepoint, and so have been unable to explore these relationships over time. The current study, reported in Alcoholism: Clinical and Experimental Research, aimed to clarify the association between implicit attitudes and heavy drinking by addressing these methodological limitations.

Over three consecutive years, 300+ emerging adults provided annual information on their drinking behavior, and completed a computer task (the Single Category Implicit Association Task; SC-IAT) aimed at measuring their implicit alcohol attitudes. The research team applied novel statistical models to the data from the IAT to better evaluate the implicit attitudes over time and to test for any bidirectional associations with heavy drinking.

The researchers found that within individuals, higher-than-usual levels of positive implicit alcohol attitudes did indeed predict higher-than-usual levels of heavy drinking for the young person, and increased heavy drinking predicted further increases in positive implicit alcohol attitudes. In other words, individuals who had a more positive implicit attitude at one assessment than was typical for them tended to engage in heavier drinking than expected (given their average levels of drinking) at their next assessment; and those who drank more heavily at one assessment than was typical for them had a more positive implicit attitude than expected (given their average levels of positive implicit attitudes) at the next assessment. These findings are consistent with the landscape of emerging adulthood, a time in which the socially rewarding aspects of alcohol intensify as parental monitoring weakens and the importance of peer relationships increases; thus, the context of emerging adult drinking provides more opportunities to experience the positive aspects of alcohol, thereby strengthening positive implicit alcohol attitudes. Of note, however, the study did not find that positive implicit attitudes were related to high levels of heavy drinking when comparing between individuals; it may be that reciprocal relationships between implicit attitudes and heavy drinking operate more strongly at the level of individual change.

Overall, the findings suggest that positive implicit alcohol attitudes and heavy drinking reinforce each other in a negative cascade within individuals over time. This highlights the importance of alcohol interventions that aim to target implicit alcohol attitudes in young people. The methodological advantages of the models and study design used in this research will also inform and facilitate future studies in this field.

Reciprocal associations between implicit attitudes and drinking in emerging adulthood. K. J. Paige, A. Weigard, C. R. Colder (pages xxx).

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