Depression, Environmental Reward, Coping Motives and Alcohol Consumption During the COVID-19 Pandemic

Abstract

Increases in the incidence of psychological distress and alcohol use during the COVID-19 pandemic have been predicted. Environmental reward and self-medication theories suggest that increased distress and greater social/environmental constraints during COVID-19 could result in increases in depression and drinking to cope with negative affect. The current study had two goals: (1) to clarify the presence and direction of changes in alcohol use and related outcomes after the introduction of COVID-19 social distancing requirements, and; (2) to test hypothesized mediation models to explain individual differences in alcohol use during the early weeks of the COVID-19 pandemic. Participants (n = 1127) were U.S. residents recruited for participation in an online survey. The survey included questions assessing environmental reward, depression, COVID-19-related distress, drinking motives, and alcohol use outcomes (alcohol use; drinking motives; alcohol demand, and solitary drinking). Outcomes were assessed for two timeframes: the 30 days prior to state-mandated social distancing (‘pre-social-distancing’), and the 30 days after the start of state-mandated social distancing (‘post-social-distancing’). Depression severity, coping motives, and frequency of solitary drinking were significantly greater post-social-distancing relative to pre-social-distancing. Conversely, environmental reward and other drinking motives (social, enhancement, and conformity) were significantly lower post-social distancing compared to pre-social-distancing. Time spent drinking and frequency of binge drinking were greater post-social-distancing compared to pre-social-distancing, whereas typical alcohol quantity/frequency were not significantly different between timeframes. Indices of alcohol demand were variable with regard to change. Mediation analyses suggested a significant indirect effects of reduced environmental reward with drinking quantity/frequency via increased depressive symptoms and coping motives, and a significant indirect effect of COVID-related distress with alcohol quantity/frequency via coping motives for drinking. Results provide early evidence regarding the relation of psychological distress with alcohol consumption and coping motives during the early weeks of the COVID-19 pandemic. Moreover, results largely converged with predictions from self-medication and environmental reinforcement theories. Future research will be needed to study prospective associations among these outcomes.

Risk factors for elevations in substance use and consequences during the COVID-19 pandemic among sexual and gender minorities assigned female at birth

“…Self-medication theory posits that stress may overburden individuals’ coping resources and increase reliance on substances to cope, which in turn contributes to the development of problematic use ( Khantzian, 1997 ). Consistent with self-medication theory, COVID anxiety and elevations in anxious and depressive symptoms during the pandemic have been linked to elevations in SU and coping motives ( Lechner et al, 2020 ; McPhee et al, 2020 ). While these studies provide important insights, they have not examined how COVID anxiety and anxious/depressive symptoms may prospectively predict further elevations in SU, coping motives, or consequences of use as the pandemic progresses.…”

Trends in US Alcohol Consumption Frequency During the First Wave of the SARS‐CoV‐2 Pandemic

“…Time‐invariant covariates were gender (Grucza et al, 2018), having children under the age of 18 at home (Wardell et al, 2020), race (categorized as White, Black, Asian, or other), and Hispanic ethnicity (Meyers et al, 2017). Time‐varying covariates were respondents’ age (Grucza et al, 2018), employment status (Collins, 2016; Frone, 2008), and a dichotomous measure of whether or not they reported avoiding public spaces to avoid disease risk at the time of each survey, as social distancing may be related to frequency of consumption (McPhee et al, 2020). We additionally include two mental health covariates, depression and anxiety, both of which are associated with alcohol consumption (Marmorstein, 2009; McHugh and Weiss, 2019; Smith and Randall, 2012).…”

“…A sample of US college students—a population normally at elevated risks of alcohol consumption—endorsed higher levels of alcohol consumption after university closure due to COVID‐19 than in the weeks before, with students reporting anxiety and depression symptomology reporting the highest increases (Lechner et al, 2020). Further, solitary drinking (i.e., drinking alone rather than with other people) increased among people who reported social distancing—that is, decreasing the frequency of contact and increasing the physical space between individuals—compared with retrospective recall of their drinking behaviors prior to social distancing (McPhee et al, 2020). Regarding coping, findings from a Canadian sample showed that alcohol consumption frequency and solitary drinking increased during the pandemic relative to the month prior to the pandemic and that drinking as a way to cope with stress was a major contributor to these changes (Wardell et al, 2020).…”

Effects of the COVID-19 pandemic and lockdown on alcohol use disorders and complications

“…A summary of studies from different countries (China, Finland, Belgium, Chile, US, Poland) reports increased alcohol consumption during lockdown compared to prelockdown [ 22 , 24 , 26 – 30 ]. Specifically, many studies report an increase in binge drinking, as well as solitary drinking [ 27 , 29 , 31 , 32 ▪ , 33 , 34 ]. Although some studies observed an increase in drinking among women [ 27 , 35 ], others did not observe gender differences in alcohol use patterns [ 36 ].…”