Implicit alcohol associations, especially drinking identity, predict drinking over time.

Abstract

Objective There is considerable excitement about implicit alcohol associations (IAAs) as predictors of college student hazardous drinking; however, few studies have investigated IAAs prospectively, included multiple assessments, or controlled for previous drinking. Doing so is essential to show their utility as a predictor and, ultimately, target for screening or intervention. Therefore, three IAAs (drinking identity, alcohol approach, alcohol excitement) were evaluated as prospective predictors of drinking in first- and second-year US undergraduates. Method A sample of 506 undergraduates completed eight online assessments of IAAs, explicit measures of the IAA constructs, and hazardous drinking (consumption, problems, and risk of alcohol use disorders) every three months over a 21-month period. Retention rates, ordered by follow-up points were 90%, 76%, 76%, 77%, 72%, 67%, and 66%, respectively. Fifty percent of participants were non-drinkers at baseline; 21% were above clinical cutoffs for hazardous drinking. Results Drinking identity and alcohol excitement associations predicted future alcohol consumption and problems after controlling for previous drinking and explicit measures; drinking identity also predicted future risk of alcohol use disorder. Relative to the other IAAs, drinking identity predicted alcohol consumption for the longest duration (i.e., 21 months). Alcohol approach associations rarely predicted variance in drinking. Conclusions IAAs vary in their utility as prospective predictors of college student hazardous drinking. Drinking identity and, to a lesser extent, alcohol excitement emerged as robust prospective predictors of hazardous drinking. Intervention and screening efforts could likely benefit from targeting those associations.

Moderators of implicit and explicit drinking identity in a large US adult sample

“…The Drinking identity BIAT measures how strongly individuals implicitly associate themselves with being a drinker (versus abstainer). Prior research has used an IAT version of the task (Lindgren et al, 2013b, 2014; 2015b). During the task, participants sort words into superordinate categories as quickly as possible.…”

“…Both implicit and explicit measures of drinking identity uniquely predict drinking behaviors, cross-sectionally (Lindgren et al, 2013a; 2013b) and longitudinally (Gray, LaPlante, Bannon, Ambady, & Shaffer, 2011; Lindgren et al, 2015b). It is important to identify factors that attenuate or intensify the drinking identity—problematic drinking relationship and to establish whether drinking identity is associated with drinking in a more demographically diverse sample.…”

“…Findings from longitudinal and cross-sectional studies of undergraduates indicate that implicit and explicit drinking identity are modestly correlated and that both predict unique variance in drinking behavior (Lindgren, 2013b; 2015b). Further, studies focusing on implicit drinking identity compared to other implicit alcohol cognitions (e.g., alcohol approach associations) found that drinking identity was the most consistent, and often the only unique, predictor of undergraduates’ problematic drinking (Lindgren et al, 2013b; 2013b; 2015b).…”

“…Further, studies focusing on implicit drinking identity compared to other implicit alcohol cognitions (e.g., alcohol approach associations) found that drinking identity was the most consistent, and often the only unique, predictor of undergraduates’ problematic drinking (Lindgren et al, 2013b; 2013b; 2015b). Moreover, implicit drinking identity predicted risky drinking practices prospectively, even after controlling for baseline drinking behavior (see Gray et al, 2011; Lindgren et al, 2015b).…”

“…Further, studies focusing on implicit drinking identity compared to other implicit alcohol cognitions (e.g., alcohol approach associations) found that drinking identity was the most consistent, and often the only unique, predictor of undergraduates’ problematic drinking (Lindgren et al, 2013b; 2013b; 2015b). Moreover, implicit drinking identity predicted risky drinking practices prospectively, even after controlling for baseline drinking behavior (see Gray et al, 2011; Lindgren et al, 2015b). Analogously, two studies evaluating explicit measures of identity related to alcohol dependence and/or recovery found they predicted recovery self-efficacy and rates of relapse (Beckwith, Best, Dingle, Perryman, & Lubman, 2015) and treatment retention (Buckingham, Frings, & Albery, 2013).…”