(PS1-59) When Do Depressive Symptoms Amplify the Relation Between Anxiety Sensitivity, Drinking to Cope, and Alcohol-related Consequences?

Harmful drinking is a public health concern in undergraduates, with 1 in 4 reporting academic consequences and 15% meeting criteria for alcohol use disorder (NIAAA, 2024). Thus, there is a need to investigate relations between factors influencing alcohol use consequences. These include anxiety sensitivity (fear of one’s anxiety-related sensations; Taylor et al.,2007), coping drinking motives (a negative internal reinforcement motive to reduce distress; Cooper, 1994), and depression. Negative reinforcement motives mediate the relation between anxiety sensitivity and drinking behaviors (Stewart et al., 2001), and depression influences relations between anxiety sensitivity and alcohol use problems (Lechner et al., 2014). Yet, less is known about how these variables operate in conjunction. 

Undergraduates at a midwestern university (N=2734; Mean age=19.32[SD=1.40]; 88.3% White, 66.1% female) participated in a campus-wide survey. They completed the Anxiety Sensitivity Index-3 (Taylor et al., 2007), the Drinking Motives Questionnaire-Revised (Cooper, 1994), the Patient Health Questionnaire-9 (Kroenke et al., 2001), and the Rutgers Alcohol Problems Index (White & Labouvie, 1989). 

Hayes Process Model 59 (Hayes, 2017) tested if there was an indirect effect of coping motives on the relation between anxiety sensitivity and alcohol-related consequences, and whether depression moderated the effects on each pathway. We hypothesized that depression would moderate the relation between 1) anxiety sensitivity and drinking to cope, 2) drinking to cope and alcohol use consequences, and 3) anxiety sensitivity and alcohol use consequences. There was an indirect effect of coping motives on the relation between anxiety sensitivity and alcohol use consequences. Contrary to hypotheses, there was no interaction between anxiety sensitivity and depression in relation to coping motives (t[2036]=-1.33, p=.18, 95%CI=-.001.,.0001). Likewise, there was no interaction between anxiety sensitivity and depression in relation to alcohol use consequences (t[2034]=-1.67, p=.09, 95%CI =-.001,.0004), though trends suggested that anxiety sensitivity was related to alcohol use consequences at low (effect =.04, p=.01, 95% CI =.01,.07), but not high (effect=.01, p=.48, 95%CI =-.02,.04) depression levels. In line with hypotheses, the relation between coping motives and alcohol use consequences was moderated by depression (t[2034]=4.00, p< .001, 95%CI=.05,.15). Those with higher depression levels reported a greater effect of coping motives on alcohol-related consequences (effect=3.86, 95%CI=3.47,4.26), compared to those with lower levels (effect = 2.64, 95%CI=2.05, 3.23). 

Findings suggest the importance of targeting depression when considering the relation between drinking to cope and alcohol use problems. Given recent work in those with comorbid anxiety and alcohol use disorder showing that treatment outcomes were related more to anxiety sensitivity reductions rather than coping motives (Wolitzky-Taylor et al., 2018), future work on treatments targeting anxiety sensitivity and coping motives should consider the unique role depression may play in the relation between coping motives and alcohol use problems.