Value-based choice and compulsion theories of addiction offer distinct explanations for the persistence of alcohol use despite harms. Choice theory argues that problematic drinkers ascribe such high value to alcohol that costs are outweighed, whereas compulsion theory argues that problematic drinkers discount costs in decision making. The current study evaluated these predictions by testing whether alcohol use disorder (AUD) symptom severity (indexed by the AUDIT) was more strongly associated with the intensity item (maximum alcohol consumption if free, indexing alcohol value) compared to the breakpoint item (maximum expenditure on a single drink, indexing sensitivity to monetary costs) of the Brief Assessment of Alcohol Demand (BAAD) questionnaire, in student (n = 579) and community (n = 120) drinkers. The community sample showed greater AUD than the student sample (p = .004). In both samples, AUD severity correlated with intensity (students, r = 0.63; community, r = 0.47), but not with breakpoint (students, r = -0.01; community, r = 0.12). Similarly, multiple regression analyses indicated that AUD severity was independently associated with intensity (student, ΔR2 < 0.20, p < .001; community, ΔR2 = 0.09, p = .001) but not breakpoint (student, ΔR2 = 0.003, p = .118; community ΔR2 = 0.01, p = .294). There was no difference between samples in the strength of these associations. The value ascribed to alcohol may play a more important role in AUD severity than discounting of alcohol-associated costs (compulsivity), and there is no apparent difference between student and community drinkers in the contribution of these two mechanisms. Assessments: Data were collated across a number of experiments and in all cases questionnaires were delivered at baseline and followed the same order. Demographic measures (age and gender) were collected. AUD severity was assessed using the ten-item Alcohol Use Disorders Identification Test (AUDIT) (Babor et al. 2001). The AUDIT total score ranges from 0-40, and can be divided into categories: low-risk (0–7), hazardous (8–15), harmful (16–19) and possibly dependent (20–40). Cronbach’s alpha for the AUDIT was .78 in the student and .81 in the community sample. The AUDIT has two subscales, measuring alcohol consumption and alcohol-related consequences (Doyle et al. 2007). Value and cost insensitivity constructs were measured with the Brief Assessment of Alcohol Demand (BAAD) questionnaire (Owens et al. 2015). The BAAD has three items. The first item indexes intensity of demand (‘If drinks were free, how many would you have in a single session?’), with possible responses ranging from 0 to 10+ drinks in increments of 1. The second item indexes Omax (‘What is the maximum total amount you would spend on drinks for yourself in a single session?’), with responses ranging from £0 to £40 in £4 increments. The final item indexes breakpoint (‘What is the maximum you would pay for a single drink?’) with responses ranging from £0 to £20 in £2 increments.The first aim of the fellowship was to build on my PhD research to develop a novel brief intervention for hazardous drinking young people. My proposed intervention combines a number of elements with prior evidence of efficacy in hazardous alcohol use. High-risk individuals will be provided with personalised feedback regarding the specific negative emotions which trigger their drinking (for example, anger, sadness, boredom) (Blevins and Stephens 2016) and encouraged to generate individualised alternative coping strategies (Conrod et al. 2013). Crucially, individuals will also be instructed in functional imagery training, a promising technique used to encourage adoption of adaptive behaviours in high-risk scenarios. The two pilot studies proposed in clinical populations in this project are on hold due to COVID-19 restrictions. However, development of this intervention has continued and online pilot testing in student populations is ongoing. Data will be uploaded as and when these projects are complete. Additional aims of the fellowship included: 1) To publish completed research demonstrating that a brief, 6 minute mindfulness training procedure can reduce drinking under stress in students. This research has been published in the journal Addictive Behaviours and a full dataset is uploaded here. 2) To publish research validating a novel measure of negative coping motives (the Coping Motives Checklist). This measure will be used to identify specific negative triggers to alcohol use - and to provide personalised feedback on these motives - in my proposed novel intervention. Initial data linkage and analysis is ongoing and data will be uploaded when this is finalised. 3) Validation of a measure of alcohol valuation - the Brief Assessment of Alcohol Demand (BAAD) - to be used as a brief screening tool to identify those at risk of dependence. This research has been published in Addictive Behaviours and a full dataset is uploaded here.
Participants: The student sample included 579 students (42.3% male), all of whom reported drinking in the last month, recruited at the University of Exeter in the UK. All procedures were undertaken in a lab setting at the university. The community sample included 120 adults (60% male) recruited from Exeter pubs between the hours of 1 and 8 pm. Participants who reported being ‘very intoxicated’ were not invited to participate. Participants were tested at an individual table in the pub with the laptop screen facing the wall to preserve privacy and confidentiality. Ethical approval was obtained from the University of Exeter research ethics committee and all participants provided written informed consent. All samples were collected via convenience sampling.
