Negative Affect and Drinking Drivers: A Review and Conceptual Model Linking Dissonance, Efficacy and Negative Affect to Risk and Motivation for Change

Abstract

This review summarizes evidence on negative affect among drinking drivers. Elevations in negative affect, including depressed mood, anxiety and hostility, have long been noted in convicted drinking drivers, and recent evidence suggests an association between negative affect and driving after drinking in the general population. Previous efforts to understand the significance of this negative affective state have ranged from suggestions that it may play a causal role in drinking driving to suggestions that it may interfere with response to treatment and remedial interventions. Recent studies have uncovered an important paradox involving negative affect among convicted drinking drivers (hereafter DUI offenders). DUI offenders with high levels of negative affect recidivated more frequently following a DUI program than did those reporting no or minimal negative affect. However, when a brief supportive motivational intervention was added to the program, offenders with high negative affect levels showed lower recidivism rates than did those with no or minimal negative affect. The review includes studies from the general literature on alcohol treatment in which the same negative affect paradox was reported. In an attempt to understand this paradox, we present a conceptual model involving well-established psychological processes, with a focus on salient discrepancy, the crucial component of cognitive dissonance. In this model, negative affect plays an important role in motivating both continued high-risk drinking as well as therapeutic change. This model suggests that links between motivational states and negative affective processes may be more complex than previously thought. Implications for intervention with DUI offenders are discussed.

Examining Factors in the Research Institute on Addictions Self-Inventory (RIASI): Associations with Alcohol Use and Problems at Assessment and Follow-Up

“…The observations on the Negative Affect factor are consistent with a growing body of literature on the importance of negative affect for understanding drinking drivers (e.g., [29]), and recently investigators have begun to consider the importance of this factor for remedial and rehabilitative efforts [28–31]. It is interesting to note here that this factor included items reflecting depressed mood, but also other states including anxiety, hostility and sensation seeking.…”

“…A similar pattern was observed at follow-up, with some interesting and important exceptions. Higher levels of Negative Affect and Alcohol Problems predicted fewer drinking days in the 6-month follow-up interview, which supports recent suggestions that higher levels of indicators like Negative Affect at the beginning of a treatment intervention could be a positive prognostic indicator under some circumstances [28,29]. These results suggest that responses on the RIASI are, first of all, valid indicators of alcohol use and related problems.…”

Impact of Ontario’s Remedial Program for Drivers Convicted of Drinking and Driving on Substance Use and Problems

“…Finally, these results provide the first evaluation of the effects of remedial program participation on the use of drugs other than alcohol, and the findings suggest that these programs may reduce drug use and problems as well. Further work to improve the impact of these programs, including evaluating innovative program approaches (e.g., Wells-Parker et al, 2009;Brown, Dongier, Ouimet, Tremblay, Chanut, Legault, and Kin 2012) should be considered a priority.…”

“…Early research suggested they had little beneficial effect or could even increase adverse outcomes (Preusser, Ulmer, and Adams 1978). However, recent research provides more consistent evidence of beneficial effects when remedial programs are used to supplement licensing actions (Mann, Vingilis, and Stewart 1988;Mann, Anglin, Wilkins, Vingilis, MacDonald, and Sheu 1994;Wells-Parker, Bangert-Drowns, McMillen, and Williams 1995;Wells-Parker, Mann, Dill, Stoduto, Shuggi, and Cross 2009;Wickens, Butters, Flam-Zalcman, Stoduto, and Mann 2013). Nevertheless, the evidence for the beneficial impact of these programs is not always consistent, perhaps due to differences in program types and evaluation methods (e.g., Brown and Ouimet 2013;Mann et al 1988).…”

Evidence from regression‐discontinuity analyses for beneficial effects of a criterion‐based increase in alcohol treatment

“…Substantial evidence demonstrates that these programs have beneficial effects on measures of substance use, health and traffic safety (e.g. Dill and Wells‐Parker, ; Macdonald et al ., ; Mann et al ., , ; Wells‐Parker et al ., , ). Severity‐based assignment schemes are commonly seen as an appropriate basis for these programs (e.g.…”