Urgency traits moderate daily relations between affect and drinking to intoxication among young adults

Abstract

Background: Young adults with higher trait urgency (i.e., a tendency to act rashly in response to heightened affect) may be especially vulnerable to heavy drinking. The current study examined 1) the influence of urgency on daily relations between affect and drinking to intoxication, and 2) whether urgency influenced the effectiveness of naltrexone (vs. placebo) for reducing alcohol use.

Methods: This study is a secondary analysis of data from 126 (n=40 female) heavy drinking young adults, ages 18-25, enrolled in a double-blind, 8-week clinical trial comparing brief motivational intervention and either naltrexone or placebo. Multilevel models examined whether trait urgency moderated daily relations between positive and negative affect and drinking to intoxication, measured by an estimated blood-alcohol concentration (eBAC) at or above the legal limit (≥0.08g%). Person-level interactions examined whether naltrexone was more effective than placebo at reducing the odds of eBAC≥0.08g% for individuals with higher vs. lower trait urgency.

Results: On days of greater within-person positive or negative affect, young adults with higher urgency were more likely to drink to intoxication than those with lower urgency. Naltrexone reduced the odds of drinking to intoxication significantly more than placebo, independent of positive or negative urgency.

Conclusions: Although naltrexone treatment reduced drinking overall, young adults with higher trait urgency were still at increased risk for hazardous drinking following times of strong positive or negative mood. Targeted interventions are needed to reduce the risk of heavy drinking among young adults with high trait urgency.

Keywords: Affect; Alcohol; Drinking; Impulsivity; Mood; Urgency.

Figure 1

Positive urgency moderates relations between daily positive affect and drinking. Note: Individuals high in positive urgency were more likely to drink to intoxication on days with higher than usual levels of positive affect. Positive affect is centered at the subject mean. Positive urgency is graphed at 2 standard deviations (SD) above the mean (solid line), the mean (dashed line), and 2 SD below the mean (dotted line).

Figure 2

Negative urgency moderates relations between daily negative affect and drinking. Note: Individuals high in negative urgency were more likely to drink to intoxication on days with higher than usual levels of negative affect. Negative affect is centered at the subject mean. Negative urgency is graphed at 2 standard deviations (SD) above the mean (solid line), the mean (dashed line), and 2 SD below the mean (dotted line).

Figure 3

Relations Between Urgency and Drinking to Intoxication by Medication Condition. Note: Naltrexone significantly reduced the odds of drinking to intoxication more than placebo, independent of positive or negative urgency traits. The effect of urgency is graphed at low (2 SD below the mean), average (mean), and high (2 SD above the mean) values. Dashed lines represent positive urgency, solid lines represent negative urgency. Black lines indicate naltrexone, grey lines indicate placebo.