The Influence of Daily Stress on Impaired Control through Emotion Dysregulation and Drinking Motives

Abstract

Alcohol use disorder (AUD) can be explained by some emotion-based hypotheses such as the self-medication hypothesis and negative reinforcement model. Accordingly, the aim of this study was to explore the dynamic relationships between daily stress, emotion dysregulation and drinking motives in the prediction of impaired control to drink alcohol in a clinical male sample. Male patients with AUD (n= 193) were recruited from alcohol centers of four psychiatric hospitals in South Korea. All participants completed a questionnaire that included the Hassles and Uplifts Scale, the Difficulties in Emotion Regulation Scale (DERS), the Drinking Motives Questionnaire (DMQ), and the Impaired Control Scale (ICS). The serial multiple mediation model analyses showed that daily stress resulted in impaired control through emotional dysregulation and drinking motives in order. Specifically, both emotional dysregulation and drinking motives in turn had partial mediation effects on the relationship between daily stress and impaired control on alcohol. Moreover, when drinking motives were entered as a mediator individually, the size of the indirect effect for coping motives was larger than that of enhancement motives was, suggesting that there might be no gender difference related to drinking motives. These results suggest that daily stress as a precursor indirectly influences impaired control through emotion dysregulation and drinking motives among patients with AUD. Considering the connection between stress and impaired control on alcohol via emotion dysregulation and drinking motives, future interventions need to focus on providing an individualized intervention that includes stress management and adaptive emotion regulation strategies.

The regulation of emotions and problematic alcohol use: a review of literature

“…Compared to control group, patients with AUD reported greater use of response modulation and attentional deployment but less of cognitive change [50]. Difficulties in emotion regulation in those with AUD may be consistent with a concept called 'misregulation' of substance use, which emphasises the importance of patients attempting to exercise control in ways that do not produce the desired outcome [61].…”

“…It has been observed that momentary negative affect impairs the ability to discriminate negative emotions, whereas momentary positive affect facilitates the discrimination of positive emotions among individuals in early abstinence. The ability to differentiate emotions is thought to be a protective factor against relapse and alcohol-related problems [59,60], but emotion dysregulation may act as a relapse trigger even after a period of long-term sobriety [61]. Emotion and impulse management cji mogą działać jako wyzwalacz nawrotu nawet po okresie długotrwałej trzeźwości [61].…”

“…The ability to differentiate emotions is thought to be a protective factor against relapse and alcohol-related problems [59,60], but emotion dysregulation may act as a relapse trigger even after a period of long-term sobriety [61]. Emotion and impulse management cji mogą działać jako wyzwalacz nawrotu nawet po okresie długotrwałej trzeźwości [61]. W początkowym okresie abstynencji dużą rolę odgrywa stres związany z zarządzaniem emocjami i impulsami, który utrudnia skupienie się na długoterminowych priorytetach.…”

“…W porównaniu z grupą kontrolną pacjenci z AUD zgłaszali większe wykorzystanie modulacji odpowiedzi i rozmieszczenia uwagi, ale mniejsze wykorzystanie zmiany poznawczej [50]. Trudności w regulacji emocji u osób z AUD mogą być spójne z koncepcją zwaną "błędną regulacją" używania substancji, która podkreśla znaczenie podejmowania przez pacjentów prób sprawowania kontroli w sposób nieprzynoszący pożądanego rezultatu [61].…”

Emotion regulation in substance use disorders: a systematic review and meta‐analysis

“…Finally, severity of substance use was not measured in many of the studies included in our review. It has been found that higher DERS scores are associated with greater alcohol dependence severity [ 13 , 86 , 87 ] and experiencing more motives to drink alcohol [ 88 ]. In other studies, heavy cannabis users had higher DERS scores than less frequent cannabis users [ 89 ], and polydrug users had higher DERS scores than those only diagnosed with AUD [ 90 , 91 ].…”