Impaired Control (Both Attempts to Control Drinking and Failed Control) as Prospective Predictors of Negative Outcomes Among Young Adults Who Drink Heavily

Abstract

Objective: Impaired control over alcohol is a hallmark of addiction relevant to young adults, but additional prospective findings are needed, particularly in samples reporting heavy drinking. Further, we lack understanding of how attempts and failed efforts to control drinking relate to each other in predicting outcomes. We hypothesized that attempted and failed control would prospectively predict outcomes, with endorsement of both being especially problematic.

Method: We used data from young adults reporting heavy drinking who enrolled in laboratory alcohol self-administration studies (n = 109). Mixed-effects models were used to predict drinks per drinking day, heavy drinking, and negative consequences across baseline and 6- and 12-month follow-ups. Interactions by time and between attempted and failed control were tested.

Results: Higher failed control was associated with steeper declines in consequences and heavy drinking over time compared with lower failed control. However, higher attempted or failed control was still associated with more consequences and alcohol use than lower impaired control at multiple time points. A significant interaction indicated that the combination of higher attempted and failed control was associated with the most drinks per drinking day. There was also a significant Attempted × Failed Control interaction for heavy drinking.

Conclusions: These findings provide further evidence supporting impaired control over alcohol use as a risk factor among young adults. Those reporting both higher attempted and failed control drank the most per day. Either attempted or failed control was associated with negative consequences. Those reporting both higher attempted and failed control may be in greatest need of intensive intervention.

FIGURE 1A.

Part 1 Impaired Control Scale (ICS) (Attempted Control) × Time interaction for past-3-month modified Young Adult Alcohol Consequences Questionnaire (YAACQ) score outcome. Higher attempted control was defined as 1 SD (3.69) above the mean, and lower attempted control was defined as 1 SD below the mean (-3.69).

FIGURE 1B.

Part 2 Impaired Control Scale (ICS) (Failed Control) × Time interaction for past-3-month modified Young Adult Alcohol Consequences Questionnaire (YAACQ) score outcome. Higher failed control was defined as 1 SD (6.23) above the mean, and lower attempted control was defined as 1 SD below the mean (-6.23).

FIGURE 2.

Part 1 Impaired Control Scale (ICS) (Attempted Control) × Time interaction for past-month drinks per drinking day outcome. Higher attempted control was defined as 1 SD (3.69) above the mean, and lower attempted control was defined as 1 SD below the mean (-3.69).

FIGURE 3.

Part 1 Impaired Control Scale (ICS) (Attempted Control) × Part 2 ICS (Failed Control) interaction for past-month drinks per drinking day outcome. Higher attempted control was defined as 1 SD (3.69) above the mean, and lower attempted control was defined as 1 SD below the mean (-3.69). Higher failed control was defined as 1 SD (6.23) above the mean, and lower failed control was defined as 1 SD below the mean (-6.23).

FIGURE 4A.

Part 1 Impaired Control Scale (ICS) (Attempted Control) × Time interaction for past-month frequency of heavy drinking days outcome. Higher attempted control was defined as 1 SD (3.69) above the mean, and lower attempted control was defined as 1 SD below the mean (-3.69) or lower.

FIGURE 4B.

Part 2 Impaired Control Scale (ICS) (Failed Control) × Time interaction for past-month frequency of heavy drinking days outcome. Higher failed control was defined as 1 SD (6.23) above the mean, and lower attempted control was defined as 1 SD below the mean (-6.23).

FIGURE 5.

Part 1 Impaired Control Scale (ICS) (Attempted Control) × Part 2 ICS (Failed Control) interaction for past-month frequency of heavy drinking days outcome. Higher attempted control was defined as 1 SD (3.69) above the mean, and lower attempted control was defined as 1 SD below the mean (-3.69). Higher failed control was defined as 1 SD (6.23) above the mean, and lower failed control was defined as 1 SD below the mean (-6.23).