Psyschology Study On Drinking

Abstract
In response to the need for research that incorporates multiple aspects of theory into a testable
framework, this study attempted to replicate and extend the results of Cooper, Russell, Skinner, Frone,
and Mudar (1992). A modified stressor vulnerability model of stress-related drinking was tested in a
homogeneous sample of 65 male and female undergraduate student drinkers. Total weekly consumption of
alcohol was used as the criterion measure, whereas family history of alcoholism (Adapted SMAST: Sher &
Descutner, 1986), alcohol outcome expectancies/valences (CEOA: Fromme, Stroot, & Kaplan, 1993),
perceived stress (PSS: Cohen, Kamarck, & Mermelstein, 1983), and coping dispositions (COPE: Carver,
Scheier, & Weintraub, 1989) were used as the predictor variables. The proposed modified model postulates
that expectancies play a proximal mediating role in stress-related drinking, whereas gender, family history
of alcoholism, and coping all play a distal moderating role. Hierarchical multiple regression procedures were
then performed to evaluate the model. The results failed to support the hypothesized model. Specifically,
expectancies emerged as a distal rather than proximal predictor of stress-related drinking, and family history
of alcoholism did not moderate stress-related drinking. In contrast, gender and coping styles emerged as the
most powerful predictors in the model. Despite the shortcomings of the proposed model, the present results
offer an alternative interpretation as to what constitutes the stressor vulnerability model of stress-related
drinking.

Introduction
Stress as a Causal Factor in Drinking
One of the common stereotypes about the effects of alcohol involves the drug’s capacity to act as a
stress antagonist. Conger (1956) has proposed a theory, known as the tension reduction hypothesis (TRH)
of drinking, to support this notion. Essentially the theory holds that alcohol’s sedative action on the
central nervous system serves to reduce tension, and because tension reduction is reinforcing, people drink
to escape it (Marlatt & Rohsenow, 1980). Strong evidence to support the validity of the theory comes
from epidemiological findings which indicate that the prevalence of anxiety disorders in alcoholics ranges
from 16 to 37%, compared to a rate of only 4-5% in the general population (Welte, 1985).
Notwithstanding, there seems to be a subset of people for whom the predictions of the TRH do not
hold. For instance, in a study conducted by Conway, Vickers, Ward, and Rahe (1981) it was found that the
consumption of alcohol among Navy officers during periods of high job demands was actually lower than the
consumption during low-demand periods. In addition, other studies (i.e., Mayfield, 1968; Mendlson, Ladou,
& Soloman, 1964) have shown that some drinkers actually consider alcohol as a tension generator rather
than a tension reducer.
Overall, when taking into account these conflicting findings, it seems prudent to find some middle
ground. The solution to this problem than is a modified version of the TRH, specifying the conditions under
which stress will lead to an increase in drinking.
Moderating and Mediating Factors in Stress Induced Drinking
In addition to stress, several other variables have been shown to be crucial in determining an individual’s
drinking behavior. These variables include gender of drinker (gender), coping behavior of drinker (coping),
and alcohol outcome expectancies of drinker (expectancies). In the following discussion, the importance of
each of these variables to drinking will be considered first, followed by an evaluation of these as potential
moderators or mediators of stress in drinking. 1
Differential Gender Drinking Behavior
It has been repeatedly demonstrated that significant differences exist between the drinking patterns of
men and women (Hilton, 1988). In a comprehensive survey of US drinking habits conducted by the US
National Center for Health Statistics in 1988, significant gender differences were found in three areas as
pointed out by Dawson and Archer (1992). The first significant difference pertained to the number of male
and female current drinkers. Roughly 64% of all men were current drinkers in comparison to 41% of all
women. The second and third significant differences concerned the quantity of alcohol consumed. Men
were more likely to (a) consume alcohol on a daily basis and (b) be classified as heavy drinkers. Men’s daily
average of ethanol intake (17.5 grams per day) was almost twice as high as women’s (8.9 grams per day).
Even when an adjustment for body weight was made (females require less ethanol than males to achieve a
similar increase in blood alcohol level), men’s consumption was still 53% greater than women’s. With
regards to drinking classification, males were classified substantially more often than females as heavy
drinkers (i.e. the number of males who drank five or more drinks a day was 88% greater than the
corresponding number of females). Furthermore, as the classification measures became stricter so did the
disparity between male and female heavy drinkers increase (i.e., the ratio of male to female heavy drinkers
increased by a factor of 3 as the definition of heavy drinker was changed from five drinks or more a day to
nine drinks or more a day).

Gender as a Moderating Factor of Stress
To understand why men and women drink differently requires an understanding of the prevailing
socialization practices (Dohrenwend ; Dohrenwend, 1976; Horwitz ; White, 1987). According to this
sociological view, “women have been socialized to internalize distress, whereas men have been socialized to
externalize distress” (Cooper, Russell, Skinner, Frone, ; Mudar, 1992; P. 140). Therefore, women tend to
cope with stress by utilizing personal (internal) devices such as emotion, rather than impersonal (external)
devices such as alcohol, which are used more often by men. In addition, men and women also hold
differential expectations about the effects of drinking. Several studies (i.e. Abrams ; Wilson, 1979; Sutker,
Allain, Brantly, ; Randall, 1982; Wilson ; Abrams, 1977) have shown that “although pharmacological
effects appear to be similarly stress reducing for both sexes, the belief that alcohol has been consumed may
actually increase distress among women” (Cooper et al. , 1992; P. 140). Therefore, it seems plausible that
females actually expect to experience some form of distress from drinking as opposed to males’ expectation
to experience tension reduction from drinking (Rohsenow, 1983).

Differential Coping Styles in Drinking
Considerable evidence has been accumulated in support of the notion that certain methods of coping are
more likely to be associated with problem drinking than others (Moos, Finney, & Chan, 1981). This has
led to the development of social learning theory which postulates that abusive drinkers differ from relatively
healthy drinkers in (a) their capacity to effectively cope with stressors and (b) in their beliefs about drinking
(Abrams & Niaura, 1987).
In general, two types of coping responses have been shown to predominate in most situations (Folkman
& Lazarus, 1980). The first type, problem-focused coping (also known as approach coping), is directed at
either solving the presenting problem or altering the source of the stress (Carver, Scheier, & Weintraub
1989). The second type, emotion-focused coping (also known as avoidance coping ), attempts to reduce the
unpleasant emotional feelings which accompany the stressor (Carver et al. , 1989). Even though people
usually use both methods in response to a given stressor, the former type will tend to predominate when
people feel that the situation is changeable, whereas the latter type will tend to predominate when people
appraise the situation as unchangeable (Folkman & Lazarus, 1980).
People who predominantly resort to avoidance coping have been shown to display pathological drinking
behavior much more than those who utilize approach coping (Cooper, Russell, & George, 1988; Cooper et
al. , 1992). Those who typically resort to avoidance coping (a group which consists of up to 25% of all
drinkers), report that they do so in order to regulate negative emotions (Cahalan, Cisin, & Crossley, 1969;
Mullford & Miller, 1963; Polich & Orvis, 1979). The strongest evidence to support this contention
comes from studies which have investigated post-treatment relapse in alcoholics. In three such studies
(Marlatt, & Gordon, 1979; Moos et al. , 1981; Moos, Finney, & Gamble, 1982), it was found that
individuals were more likely to relapse in situations which elicited unpleasant emotional states.

Coping as a Moderating Factor of Stress
The key to understanding the differential impact of avoidance and approach coping on drinking lies in
the availability of an effective coping response to a given stressor (Cooper et al. , 1992). By definition,
people who utilize approach coping mechanisms to deal with their stress, engage in concrete problem
solving which serves to actively reduce the amount of stress. By contrast, people who rely on avoidance
coping may manage to reduce their distress, but they tend to do so by distracting themselves from the stress.
Therefore, it is not surprising that drinking should appeal more to those who predominately use avoidance
coping, because the consumption of alcohol serves as a substitute action which can distract from the stress.
When viewed from a social learning perspective (Abrams & Niaura, 1987), it can be seen that “alcohol use
serves as a general coping mechanism invoked when other presumably more effective coping responses are
unavailable” (Cooper et al. , 1992; P. 140). Evidence to support this idea comes from studies (i.e., Higgins
& Marlatt, 1975; Hull & young 1983; Marlatt, Kosturn, & Lang, 1975) which have investigated drinking in
response to negative affects, when no coping alternative was present. For instance, Marlatt et al. (1975)
have shown that drinkers who were provoked and were unable to retaliate drank significantly more at a
subsequent taste rating task than drinkers who had the option to retaliate (Cooper et al. , 1988).
Differential Expectancies About Drinking
Alcohol outcome expectancies (AOE) can be thought of as the beliefs people hold about the effects of
drinking (Goldman, Brown, & Christiansen, 1987). These expectancies first develop in childhood as indirect
learning experiences (e.g., media, family modeling, peer influence ) and, as a result of increased direct
experiences with the pharmacological effects of alcohol, become more refined (Christiansen, Goldman, &
Inn, 1982; Christiansen & Goldman, 1983; Christiansen, Goldman, & Brown 1985; and Miller, Smith, &
Goldman, 1990).
The expectancies that people hold about alcohol have been shown to predict alcohol consumption in a
variety of settings (Goldman, Brown, & Christiansen 1987). Brown, Goldman, Inn, and Anderson (1980)
have shown that light drinkers typically hold global expectancies about alcohol (i.e. alcohol affects multiple
factors), whereas heavy drinkers typically hold more specific expectancies, such as alcohol’s ability to
increase sexual and aggressive behavior. Furthermore, Brown (1985a) has shown that people who hold the
expectancy that alcohol enhances social experience are less likely to be problem drinkers than people who
drink with the expectancy of tension reduction. It is important to note, however, that AOE may “vary with
learning context, personal characteristics of the drinker, amount of alcohol consumed, and other addiction
risk factors” (Brown, 1993; P. 58).
Expectancies as a Mediating Factor of Stress
Although it is well established that AOE differentially predict drinking behavior (Brown, 1993), very little
is known about how they exert their effects. To date, most of the research suggests that AOE (gender
specific) directly predict alcohol consumption and, as such, are thought to play a mediational role (Brown,
1993). Intuitively, it makes sense that people who hold the expectancy that alcohol can alleviate their stress
should drink more than people who do not hold this expectancy. However, little research has been
conducted thus far to support this contention. Prior to Cooper et al. (1992), only one study (McKirnan ;
Peterson, 1988) investigated the role of expectancies in stress-induced drinking. The study tested a stress-
vulnerability model among homosexual men, who show culturally specific stressors and vulnerability (i.e.,
homophobic discrimination). It was found that tension reduction expectancies significantly predicted
drinking among individuals who experienced “negative affectivity” stress (i.e., low self-esteem).Although
the Mckirnan and Peterson (1988) study found that expectancies exacerbated stress, the utility of the
findings is limited because of the use of a non-representative sample of gay males, and non-standard
measures of stress (Cooper et al. , 1992).

The Synthesis of Gender, Coping ; Expectancies in Stress-Related Drinking
As was discussed previously, gender, coping, and expectancies are thought to play a significant role in
stress-related drinking. Nevertheless, the bulk of literature in this area has typically investigated these
factors in isolation from each other (at best, only two of these factors have been combined simultaneously).
Since stress-related drinking , however, is such a complex phenomenon (recall that the tension reduction
hypothesis of drinking does not apply universally) it is necessary to integrate these factors in order to gain a
complete, holistic picture.
The only study which has combined all three factors simultaneously was the landmark study of Cooper et
al. (1992). The study tested an interactional model of stress-related drinking which postulated that
“exposure to environmental stressors is most strongly related to alcohol use and abuse among vulnerable
individuals”, such that, “Vulnerable individuals are more likely to be male, to hold strong positive
expectancies for alcohol’s effects, and to have limited adaptive coping responses” (Cooper et al. , 1992; P.
141). The results supported a stressor vulnerability model of drinking. As expected, it was found that men
were more likely to drink than women by virtue of their gender role socialization. More importantly,
however, it was also found that, for problem drinking to occur in men, a second vulnerability factor must
often be present. In particular, men who either held strong positive expectancies or relied on avoidant forms
of coping were more likely to be problem drinkers than men who did not possess these attributes. (Cooper
et al. , 1992). With respect to expectancies, it was shown again that both men and women who held strong
positive AOE, drank significantly more then men and women who did not. Much more important, however,
was the finding that “expectancies appeared to function as stressor vulnerability factor among men but not
among women” (Cooper et al. , 1992; P. 148).
Finally, with regards to coping, it was confirmed that coping styles play an important role in problem
drinking. However, significant interactions with gender and expectancies were also indicated. Men who
relied on avoidant forms of coping were more likely than women to be vulnerable to stress induced drinking.

Similarly, stressors were much more likely to elicit problem drinking among individuals who were both high
in avoidance coping and positive AOE, than amongst individuals who were only high in avoidance coping.

(Cooper et al. , 1992).

Purpose of the present study
The purpose of the present study is to extend and modify the work of Cooper et al. (1992) in an attempt
to clarify the role of stress in alcohol consumption, with respect to the interactional stressor vulnerability
model of drinking. Specifically, the Cooper et al. (1992) study was limited to the investigation of gender,
coping, and expectancies in stress-related drinking. Given that Family history of alcoholism (FH) has been
shown to play a significant role in drinking (i.e., Cotton, 1979; Goodwin, 1988; Hill, Nord, ; Blow 1992;
Ohannessian ; Hesselbrock, 1993), it is appealing to investigate the role of FH as an additional vulnerability
factor [as suggested by Cooper et al. (1992)]. Moreover, the Cooper et al. (1992) study conceptualizes
gender, coping, and expectancies as moderators of stress-related drinking. Given that expectancies directly
predict alcohol consumption (as discussed previously), a modified interactional model is proposed such that
gender, coping, and family history play an indirect moderational role in predicting stress-related drinking;
whereas expectancies play a direct mediational role as conceptualized by Figure 1 below.
Figure 1. Proposed Modified Stressor Vulnerability Model of Drinking
Gender
STRESSExpectanciesDRINKING
Coping
Family History
Method
Subjects
All subjects in this study were undergraduate psychology students from a large Canadian university. The
initial sample consisted of 84 volunteers. For the purpose of this study, only those subjects who drank at
least once a weak were included. A total of 65 out of 84 subjects (77.4%), aged 19 years and over,
successfully met this criterion. The sample consisted of a roughly equal number of 31males (47.7%) and 34
females (52.3%), who were predominantly Caucasian (64.6%). More than three-quarters (75.4%) of the
subjects were in their first year of studies, and were mostly employed part-time (60.0%). Nearly three-
quarters (72.3%) of those who were employed received an annual income smaller than $ 10,000. The mean
age at which subjects first consumed alcohol was 14.7, whereas the mean age at which they began to drink
regularly was 17.9. Subjects total weekly consumption of alcohol averaged 11.1 drinks.

Measures
Measures used in the present study were embedded in a general assessment battery that was a part of a
larger research project. For the purpose of the present study, the following measures, administered in a fixed
order, were employed to assess the variables of interest.

Weekly Alcohol Consumption. Subjects were given a chart which contained the days of the week. For
each day they were instructed to indicate the number of standard alcoholic drinks and the amount of time it
would take to consume these drinks in a typical week. A standard alcohol drink was defined as either a
regular size can/bottle of beer, 1.5 ounce shot of liquor, or a 5 ounce glass of wine. Subjects who drank less
than once a month were instructed to skip this section. The total number of drinks in one week was summed
and used as the dependent variable.

Adapted Short Michigan Alcoholism Screening Test (Adapted SMAST). The adapted SMAST (Sher ;
Descutner, 1986) is a 13 item self-report questionnaire designed to measure family history of alcoholism.
Specifically, the questionnaire assesses the extent of an individual’s mother’s and father’s alcohol abuse.

Assessment is based on a two point scale consisting of 0=no and 1=yes. For the purpose of the present
study only 10 items were used, and the mother/father answer categories were extended to biological mother/
father and step or adoptive mother/father.
Comprehensive Effects of Alcohol (CEOA). The CEOA (Fromme, Stroot, & Kaplan, 1993) is a 38 item
self-report questionnaire designed to assess alcohol outcome expectancies and their subjective valence. It is
composed of seven expectancy scales, four positive (sociability, tension-reduction, liquid-courage, and
sexuality) and three negative (cognitive-behavioral impairment, risk and aggression, and self perception).
Expectancy assessment is based on a four point scale from 1=disagree to 4=agree. The valence of these
expectancies is assessed on a five point scale from 1=bad to 5=good. Both items and instructions were
carefully worded to ensure that the elicited expectancies were neither dose-specific, nor situation specific.

Perceived Stress Scale (PSS). The PSS (Cohen, Kamarck, & Mermelstein, 1983) is a 14 item self-report
questionnaire designed to assess the degree to which situations in one’s life are appraised as stressful. An
equal number of 7 positive and 7 negative statements make up the questionnaire. Assessment is based on a
five point scale from 0=never to 4=very often. Scores are obtained by reversing the scores on the seven
positive items (i.e., 0=4, 1=3, 2=2, etc.), and then summing across all 14 items.
COPE. The COPE (Carver et al., 1989) is a 53 item self-report questionnaire designed to assess
individual coping dispositions. The questionnaire is comprised of 14 scales which are categorized into three
coping styles: Problem-Focused Coping (Active coping, Planning, Suppression of competing activities,
Seeking social support for instrumental reasons, and Restraint coping), Emotion-Focused Coping
(Acceptance, Seeking social support for emotional reasons, Positive reinterpretation, Turning to religion,
and Focus on and venting of emotion), and Less than Useful Coping (Denial, Behavioral Disengagement,
and Mental Disengagement). For the purpose of the present study the Alcohol-drug disengagement scale
was excluded from these categories, and was treated as a separate category called Drinking to Cope.
Assessment is based on a four point scale from1=I usually don’t do this at all to 4=I usually do this a lot.
Both items and instructions were worded such that dispositional , rather than situational, styles of coping
were assessed.
Procedure
All participants were recruited from undergraduate psychology courses at York University. The
questionnaire was administered in a classroom setting. Participants completed the questionnaire in a
group format of mixed sex ranging in size from 10 to 30 individuals. Informed consent was obtained
from all participants, and a phone number was provided in case any concerns arose. The complete
questionnaire required approximately 40 minutes to administer. Respondents were compensated for their
time by being entered in a lottery with a 1 in 50 chance of winning $ 50.00.
Results
Correlational Analyses
Table 1 presents zero-order correlations, computed for all relevant study variables. Conceptually
variables may be grouped into one of five categories: weekly drinking (variable 1), perceived stress
(variable 2), family history of alcoholism (variable 3), coping variables (Variables 4-7), and expectancy
variables (variables 8-21). Examining the pattern of correlations between these variables suggests several
conclusions.
First, family history of alcoholism was neither significantly correlated with perceived stress nor with
weekly drinking, suggesting that family history of alcoholism is not important in stress-induced drinking.
Second, several coping variables were significantly correlated with either weekly drinking and/or
perceived stress. Specifically, drinking to cope was significantly positively correlated with both weekly
drinking (r = .420) and perceived stress (r = .310), less useful coping was significantly positively correlated
(r = .674) with stress, and problem focused coping was significantly negatively correlated (r = -.327) with
weekly drinking. These findings suggest that coping variables play an important role in stress-related
drinking.

Finally, only one expectancy variable, the valence expectancy for cognitive and behavioral impairment,
was significantly correlated (r = .340) with weekly drinking, but not with perceived stress. However, several
expectancy variables were significantly positively correlated (.357 < r < .517) with drinking to cope. These
findings suggest that expectancies are more likely be a distal, rather than a proximal predictor of stress-
related drinking.
Estimating the Model
Hierarchical multiple regression analyses were employed to test the model depicted in Figure 1. Table 2
contains summary statistics for the stepwise regression used to identify the predictor variables of weekly
drinking. As can be seen from Table 2, gender emerged as the most important predictor variable accounting
for over 28% of the variance. The coping variables of drinking to cope and problem-focused drinking were
also significant, and accounted for an additional 12% and 8% of the variance, respectively. Further multiple
regression analyses were used to determine which variables predicted drinking to cope, and problem-focused
coping, respectively. Table 3 shows that the expectancy for risk accounted for over 26% of the variance in
predicting drinking to cope, with the expectancy for tension and perceived stress accounting for an
additional 16%. Table 4 shows that emotion-focused coping accounted for over 34% of the variance in
predicting problem-focused drinking, with the expectancy valence for self perception accounting for an
additional 8%. Figure 2 summarizes the direct effects estimated in the foregoing series of multiple
regression analyses.

Table 1.Zero-Order Correlations Among Relevant Study Variables
______________________________________________________________________________________
Measure 123456789
1. Weekly Drinking—.143-.072-.327* -.232 -.206 .420**.016.240
2. Perceived Stress– .001.198.138.674** .310* -.069 -.074
3. Family History of Alcoholism —.186-.111 -.002-.211-.003 -.128
4. Problem-Focused Coping–.491** .170-.044-.132 -.112
5. Emotion-Focused Coping –.166.062.111.107
6. Less Useful Coping–.223-.073-.017
7. Drinking to Cope–.234 .412**
Alcohol Expectancy Outcomes
8. Sociability–.262
9. Tension Reduction —
10. Liquid Courage
11. Sexuality
12. Cognitive & Behavioral Impairment
13. Risk & Aggression
14. Self Perception
Alcohol Expectancy Valence
15. Sociability
16. Tension Reduction
17. Liquid Courage
18. Sexuality
19. Cognitive & Behavioral Impairment
20. Risk & Aggression
21. Self Perception
* p < .01; ** p < .001
Table 1. (Continued) Zero-Order Correlations Among Relevant Study Variables
______________________________________________________________________________________
Measure10 11 12 13 14 15 16 17 18
1. Weekly Drinking.116-.008-.141.173-.037 -.083.185-.062.194
2. Perceived Stress-.041-.069.133.213.039.044.196 .058 -.038
3. Family History of Alcoholism -.052.018-.082-.121.069.040.089 .028.007
4. Problem-Focused Coping.035.012.175.141.218 -.097-.075.052 -.035
5. Emotion-Focused Coping.044.295*.218.154.151 -.230 -.084-.053 -.055
6. Less Useful Coping-.178-.006.238.066.059.016.096-.025.072
7. Drinking to Cope.371* .225-.017 .517** -.009 .066.357*.115.178
Alcohol Expectancy Outcomes
8. Sociability .697** .488** -.120 .433** -.160 .569** .469** .174.289
9. Tension Reduction .233.263 .041.180.006 .202.282.132.222
10. Liquid Courage –.509**.032 .622** .046 .433** .436** .381* .245
11. Sexuality–.260 .522** .276 .118.161-.025.149
12. Cognitive & Behavioral Impairment –.221.354* -.227 -.241-.171 -.061
13. Risk & Aggression– .236 .158.304*.106 -.001
14. Self Perception—.335* -.175-.089 -.247
Alcohol Expectancy Valence
15. Sociability– .510** .499**.490**
16. Tension Reduction –.412**.409**
17. Liquid Courage — .541**
18. Sexuality–
19. Cognitive & Behavioral Impairment
20. Risk & Aggression
21. Self Perception
* p < .01; ** p < .001
Table 1. (Continued) Zero-Order Correlations Among Relevant Study Variables
______________________________________________________________________________________
Measure 192021
1. Weekly Drinking .340* .026.197
2. Perceived Stress-.164.065 -.139
3. Family History of Alcoholism -.229.045.009
4. Problem-Focused Coping -.289 -.053 -.357*
5. Emotion-focused Coping -.122 -.123 -.135
6. Less Useful Coping-.262 -.054 -.322
7. Drinking to Cope .119.166-.054
Alcohol Expectancy Outcomes
8. Sociability .141.170.135
9. Tension Reduction.196.166.015
10. Liquid Courage.123.278.138
11. Sexuality -.271 -.152 -.160
12. Cognitive & Behavioral Impairment -.396**-.217-.097
13. Risk & Aggression-.038 -.019-.138
14. Self Perception-.363*-.274-.220
Alcohol Expectancy Valence
15. Sociability .249 .482** .113
16. Tension Reduction.150 .227-.131
17. Liquid Courage.375*.717** .219
18. Sexuality.162 .515** .181
19. Cognitive & Behavioral Impairment–.544**.539**
20. Risk & Aggression–.517**
21. Self Perception —
* p < .01; ** p