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

Abstract

Drinking identity (viewing oneself as a drinker) is a potential risk factor for problematic drinking in US undergraduate samples. Whether that risk extends to a broader, more general US sample is unknown. Additionally, there are critical, unanswered questions with respect to moderators of the drinking identity–problematic drinking relationship; an important issue for designing prevention efforts. Study aims were to assess the unique associations and interactive effects of implicit and explicit measures of drinking identity on problematic drinking, and to evaluate age and sex as potential moderators of the drinking identity–problematic drinking relationship. A sample of 11,320 adults aged 18–98 completed measures of implicit and explicit drinking identity and problematic drinking (the Alcohol Use Disorder Identification Test; AUDIT). Implicit and explicit drinking identity had positive, significant associations with AUDIT scores, as expected. Moderation analyses indicated small, but significant, interactions. There was an implicit by explicit identity interaction consistent with a synergistic effect: lower implicit and explicit identity was linked to a greater probability of being a non-drinker. Age moderated explicit but not implicit identity: lower drinking identity appeared to be more protective for younger individuals. Sex moderated implicit but not explicit identity: a weaker positive association with implicit identity and AUDIT scores was observed among men, potentially reflecting stigma against women’s drinking. Findings suggest that drinking identity’s potential as a risk factor for problematic drinking extends to a more general US sample and that both implicit and explicit identity should be targeted in prevention efforts.

A review of implicit and explicit substance self-concept as a predictor of alcohol and tobacco use and misuse

“…Explicit measures of alcohol self-concept have been added to prominent theoretical models of drinking (e.g., the Theory of Planned Behavior) and have been found to improve them (45). Recent studies have examined moderators of the relationship between explicit alcohol self-concept and drinking outcomes and have demonstrated that explicit alcohol self-concept is a stronger predictor of drinking outcomes among younger individuals (46) as well as in individuals high in individualism (47), high in levels of self-control (48), and low in motivation to reduce their drinking (49). Finally, explicit alcohol self-concept appears to mediate the positive relationship between drinking motives and alcohol consumption (49).…”

“…Both IATs have good psychometrics and predict unique variance in multiple alcohol-related outcomes among college student and adult samples, including self-report and lab-based alcohol consumption, problems, harm, cravings, and behavioral economic indices of alcohol demand (9,20,41,46,50–53). The Drinker Identity IAT also predicted unique variance in drinking after controlling for explicit alcohol self-concept, other well-validated alcohol-related IATs (9,20,39), and other well-validated cognitive factors (e.g., alcohol expectancies, drinking motives, social norms) associated with drinking outcomes (40).…”

“…Preliminary evidence suggests both alcohol self-concept IATs prospectively predict risky alcohol behaviors and consumption, and that they do so after controlling for current drinking (39,40,50). Studies investigating moderation effects have found that implicit alcohol self-concept is a slightly stronger predictor of hazardous drinking for women, and may have small synergistic effects with explicit alcohol self-concept such that individuals who are low in both are especially unlikely to be drinkers (46). …”

“…This suggests that even if a stimulus item (e.g., partier) is less relevant to individuals who are older and/or have more severe alcohol problems, the overall IAT would still be a valid measure of implicit drinker self-concept. Second and more directly, recent studies with large samples (< 10,000 individuals) that include a broad age range (18 to 80+) and the full range of scores on a measure of alcohol use disorder, indicate that the drinking identity IAT is a robust predictor of risk of an alcohol use disorders (46,53). Thus, while additional work with older and clinical samples is needed, preliminary evidence suggests that findings may generalize.…”

Hazardous drinking has unique relationships with implicit and explicit drinking identity

“…These deficits could have implications for understanding how hazardous drinking may be differentially associated with implicit/explicit drinking identity. Specifically, conscious self-awareness is believed to be necessary for the measurement of explicit, but not necessarily implicit, drinking identity (Lindgren, Gasser, et al, 2016). Thus, at low levels of hazardous drinking, when there would presumably be few to no deficits in self-awareness, implicit and explicit drinking identity would become stronger as hazardous drinking increases.…”