Imbibing even one drink more than planned can leave a social drinker vulnerable to overindulging the next time, according to findings published in the September issue of APA's Journal of the Psychology of Addictive Behaviors (Vol. 19, No. 3). The research, funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), indicates a complex interplay among self-imposed limits, drinking behavior and mood, suggesting that although people tend to set their own individual limits for indulgence, breaching those limits can result in guilt and additional overconsumption. That, for some social drinkers, may pave the way for a spiral down into problem drinking or even alcoholism.
"Most people can enjoy alcohol without a problem," explains lead author Mark Muraven, PhD, of the University at Albany of the State University of New York (SUNY). "However, some people cannot. Our theory is that some people mis-regulate their mood with alcohol, which can set them up for problem drinking."
Muraven conducted the study with psychologist R. Lorraine Collins, PhD, and Elizabeth Morsheimer, of the Research Institute on Addiction of the University at Buffalo of SUNY, and Saul Shiffman, PhD, and Jean Paty, PhD, of the University of Pittsburgh.
Addiction researchers say the team's findings elucidate a contributing factor to downward spirals. "The authors have produced support for a phenomenon that is by no means obvious: 'the limit violation effect,'" says Mark Litt, PhD, a health psychologist with the University of Connecticut Health Center. "This effect is hypothesized to occur when a social drinker exceeds self-imposed limits on drinking, and consequently experiences feelings of guilt and resignation that may actually result in further drinking later."
In essence, the findings suggest that a morning-after evaluation of excessive drinking can draw social drinkers into a vicious cycle, leading them to drink to further excess the next time around, says Alan Marlatt, PhD, director of the Addictive Behaviors Research Center at the University of Washington. He explains, "This vicious cycle is more likely to occur when the drinker tries to enforce drinking limits by sheer willpower than by 'skill power,' the ability to use effective coping skills to both limit drinking in the first place and deal with the aftermath of overindulgence if it occurs."
Drinking, moment by moment
Suspecting the existence of such a cycle, Muraven and his colleagues wondered whether limit violation--individual awareness of failed self-control (it's not the number of drinks per se but whether that number goes over a personally determined line)--can turn bad feelings into yet more drinking. To find out, he and his colleagues followed the interaction between drinking and distress in social drinkers, defined as people who drink at least four drinks a week and have not experienced alcohol-related problems. Participants recorded their alcohol intake and their cognitive and emotional responses to that drinking on handheld computers. This emerging methodology, ecological momentary assessment (EMA), allows people to report what they're doing and feeling as they go through their days rather than provide a sometimes unreliable retrospective account.
In the first of two studies, the researchers trained 106 social drinkers between 18 and 20 years old with no signs of alcohol problems or misuse to use handheld personal digital assistants (PDAs) loaded with custom software. The nearly identical second study involved 38 social drinkers between 21 and 50 years old, average age 27.
Participants carried PDAs for two to three weeks each, during which they entered data about their feelings and drinking behavior several times a day: in the morning and evening, before and after drinking, and in four randomly programmed daily assessments.
Morning assessments included such questions as, "Do you plan to drink tonight?" and asked about the previous day's consumption, negative effects of drinking (such as nausea or headache), and whether they felt "bad" or "guilty" about consuming alcohol. The end-of-drinking assessment asked how many standard drinks they consumed, whether they were intoxicated and whether they drank more than intended. The researchers were especially interested in the relationship between the end-of-drinking assessment the previous day, the morning assessment that day and the end-of-drinking assessment that day.
Participants also filled out several measures that captured individual differences in alcohol consumption, including a general questionnaire for demographic characteristics and drinking information, and a Temptation and Restraint Inventory (TRI), which measured participants' consistent levels of temptation to drink and concerns about regulating alcohol intake. The TRI was co-developed by Collins, who has been studying a possible limit violation effect for more than a decade.
The data provided the first empirical, ecologically valid evidence that social drinkers may be subject to the effect. On mornings after drinking, those who had violated their self-imposed limits the day before reported significantly more guilt, even after controlling for acute negative symptoms of drinking and amount consumed. Thus the study is consistent with the theory, Litt notes, that slips may lead to a kind of learned helplessness in both social drinkers and full-blown alcoholics. He says the study reveals that violations do make drinkers feel bad, and those bad feelings change how much they drink later on.
Indeed, notes Robert Freeman, PhD, co-chair of behavioral and environmental interventions research at NIAAA, "Without denying the ultimate importance of genes or environment in the development of drinking careers, this work redirects our attention to the tensions in the minds of drinking individuals."
The researchers also point out that, consistent with the theory of self-regulation, individual differences moderated the relationships among limit violations, distress and drinking: Men and participants who planned to drink less felt more guilty when they went over that line. Women and participants with a higher bar had more room to over-consume without an emotional hangover.
Muraven and Collins hope to apply similar ecological approaches to studying people who want to cut back on their drinking or quit; they think such research is feasible thanks to evidence that even people drinking heavily in bars give fairly accurate responses on PDAs.
Litt, of the University of Connecticut Health Center, wants future research to pin down the magnitude of this effect. Seeing limit violation as perhaps just one slice in the causal pie, he adds, "The claim that limit violations may be 'critical' to later feelings of remorse is overstated."
However, Litt says the findings may help concerned social drinkers to regulate their drinking and stay below their defined limits, and soften the negative impact of limit-violation. He emphasizes the clinical value of drinkers' attributing their lapses--and their control over lapses--to internal, not external factors, to build stronger self-regulation.
Meanwhile, researchers are taking serious note of palmtop devices, which allow them to follow, according to Pace University social psychologist Stephen Armeli, PhD, the rapidly unfolding processes relating stress, coping behaviors, mood states and substance use.
"Research shows we have a hard time recalling details of our moods and behaviors after just a few days, such as our reasons for drinking a beer or smoking a cigarette," he says. "PDAs also time-stamp responses, so we know exactly when they were completed."
Yet PDAs require further research. Armeli explains, "There's the possibility that we might be altering individuals' thoughts or behaviors by questioning them in such an intensive fashion. There has been little systematic research examining this possibility."
Janet Polivy, PhD, a psychologist who studies self-regulation and overeating at the University of Toronto at Mississauga, adds that the study's results suggest that men, heavier drinkers and those more concerned about maintaining their limits are the most likely to respond to slips by feeling worse and drinking more--which suggests that treatment programs "should be targeting heavier drinkers and males, and incorporating strategies for coping with self-control failures into all treatment regimes."Rachel Adelson is a writer in Raleigh, N.C.
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