Interactive effects of cumulative stress and impulsivity on alcohol consumption

Abstract

Background: Alcohol addiction may reflect adaptations to stress, reward, and regulatory brain systems. While extensive research has identified both stress and impulsivity as independent risk factors for drinking, few studies have assessed the interactive relationship between stress and impulsivity in terms of hazardous drinking within a community sample of regular drinkers.

Methods: One hundred and thirty regular drinkers (56M/74F) from the local community were assessed for hazardous and harmful patterns of alcohol consumption using the Alcohol Use Disorders Identification Test (AUDIT). All participants were also administered the Barratt Impulsiveness Scale (BIS-11) as a measure of trait impulsivity and the Cumulative Stress/Adversity Checklist (CSC) as a comprehensive measure of cumulative adverse life events. Standard multiple regression models were used to ascertain the independent and interactive nature of both overall stress and impulsivity as well as specific types of stress and impulsivity on hazardous and harmful drinking.

Results: Recent life stress, cumulative traumatic stress, overall impulsivity, and nonplanning-related impulsivity as well as cognitive and motor-related impulsivity were all independently predictive of AUDIT scores. However, the interaction between cumulative stress and total impulsivity scores accounted for a significant amount of the variance, indicating that a high to moderate number of adverse events and a high trait impulsivity rating interacted to affect greater AUDIT scores. The subscale of cumulative life trauma accounted for the most variance in AUDIT scores among the stress and impulsivity subscales.

Conclusions: Findings highlight the interactive relationship between stress and impulsivity with regard to hazardous drinking. The specific importance of cumulative traumatic stress as a marker for problem drinking is also discussed.

Fig. 1

Line graphs illustrating the effects of Total Stress × Total Impulsivity on AUDIT scores. (A) The simple slopes of the regression of trait impulsivity on AUDIT score at high, medium, and low levels of stress. (B) The simple slopes of the regression of stress on AUDIT score at high, medium, and low levels of trait impulsivity.

Fig. 2

Bar graphs illustrating the effects of Total Stress × Total Impulsivity on AUDIT scores. (A) Bar graphs showing AUDIT scores by low, moderate, and high total Stress and total Impulsivity scores: impulsivity groups shown on x-axis. (B) Bar graphs showing AUDIT scores by low, moderate, and high total Stress and Total Impulsivity scores: stress groups shown on x-axis. Footnote: low, moderate, and high groups (divided based on tertiles) were used only to better display the interaction term. Multiple regressions were performed on continuous data.