Alcohol consumption, contexts, and consequences across the transition to legal drinking: A longitudinal EMA burst design

About This Grant

Abstract/Project Summary Alcohol consumption, contexts, and consequences across the transition to legal drinking: A longitudinal EMA burst design Heavy alcohol use accounts for approximately 178,000 deaths each year in the U.S., where the annual economic cost of excessive drinking is estimated to be over $249 billion. There is considerable evidence that excessive alcohol use patterns often begin in late adolescence or early adulthood. A crucial event in young adulthood is the transition to the legal drinking, which occurs at 21 years of age in all U.S. States. The transition to legal drinking is associated with changes in patterns of alcohol use and can introduce substantial and abrupt changes in the context in which consumption occurs and the consequences associated with excessive consumption. We propose an intensive longitudinal study of 20-year-olds, using a population-based sample, and employing a longitudinal burst design covering the 6 months before and after each participant’s 21st birthday. Specifically, participants will be sampled from a Driver’s License data-base of those born and resident in Missouri rural or small metro areas (see Recruitment and Retention for maps), with dates of birth 2005-2008. Participants (50% woman-identifying, 12% Black American) will complete five repeated 2-week EMA bursts at roughly 3-month intervals, over 12 months. We will use ecological momentary assessment (EMA), including self-report, smartphone breathalyzers, and smartphone sensors, to study alcohol use, contexts, and correlates. We focus on four core addiction constructs: cognitive control/executive functioning; reward; negative affect/valence; and response to alcohol. These constructs are central to current theoretical frameworks for understanding alcohol addiction. Each is hypothesized to influence substance use, in part, through in-the- moment processes (e.g., cue-elicited craving, alcohol-induced increases in impulsivity), and are therefore ideal foci for EMA investigations and potential therapeutic targets. The proposed project has three major Aims: Aim 1. Characterize changes in drinking context (e.g., where, with whom, what others are drinking, and how much) across the transition to legal drinking. Aim 2. Characterize changes in drinking topography (frequency of drinking, speed of drinking, type of alcohol, timing of drinking) and in frequency of alcohol consequences across the transition. Aim 3. Test person × environment interactions in the prediction of event-level drinking topography and consequences. This aim will examine how drinking contexts, and changes in contexts across the transition to legal drinking, constrain or exacerbate the influence of core person-level constructs on drinking topography and consequences. The proposed work can provide insights into risk for significant alcohol consequences and the development alcohol use disorder in young adults that cannot be achieved using traditional approaches. We can examine drinking patterns across time, within bursts, and within participants and can inform intervention approaches that prevent or target maladaptive drinking patterns.