Depressive symptoms, ruminative thinking, drinking motives, and alcohol outcomes: A multiple mediation model among college students in three countries
Introduction
Among college students, depressive symptoms has been found to be a robust risk factor associated with increased alcohol consumption (see Pedrelli, Borsari, Lipson, Heinze, & Eisenberg, 2016 for an overview) and negative alcohol-related consequences (Armeli, Conner, Cullum, & Tennen, 2010; Armeli et al., 2014; Dennhardt & Murphy, 2011). Drinking to cope motives has been found to be a robust psychosocial mechanism that explains (i.e., mediates) the associations between depressive symptoms and negative alcohol-related consequences among college students (Bravo & Pearson, 2017; Kenney, Jones, & Barnett, 2015; Kenney, Merrill, & Barnett, 2017). Despite the extensive support of depressive symptoms relating to negative alcohol-related consequences via drinking to cope motives, few studies have examined psychosocial factors that may explain why individuals engage in drinking to cope when dealing with depressive symptoms and how this may lead to increased negative alcohol-related consequences.
Ruminative thinking is one construct that has been recently proposed as a mechanism linking depressive symptoms to drinking to cope motives and in turn to negative alcohol-related consequences. Supporting Response Styles Theory (Nolen-Hoeksema, 1991; Nolen-Hoeksema, Wisco, & Lyubormisky, 2008), rumination has been shown to be a robust risk factor for alcohol use/misuse (Ciesla, Dickson, Anderson, & Neal, 2011; Nolen-Hoeksema & Harrell, 2002; Nolen-Hoeksema, Stice, Wade, & Bohon, 2007). Ciesla et al. (2011) concluded, “It is possible that individuals may drink in order to interrupt the repetitive, obsessive thoughts which exacerbate and prolong negative moods, rather than simply drinking due to the affective state itself” (pg. 149). Recently, Bravo, Pearson, and Henson (2017) tested this assertion by examining whether four distinct facets of rumination (i.e., problem-focused thoughts, counterfactual thinking, repetitive thoughts, and anticipatory thoughts) mediated the associations between depressive symptoms and drinking to cope motives, which in turn relate to negative alcohol-related consequences. The researchers found only one significant double-mediated association such that elevated depressive symptoms was associated with higher problem-focused thoughts (i.e., consistent thinking of causes, consequences, and symptoms of negative affect), which was associated with higher drinking to cope motives, which in turn was associated with higher negative alcohol-related consequences. Taken together, this study provides preliminary support for ruminative thinking as a mechanism linking depressive symptoms to drinking to cope motives.
Although an important preliminary study, the present study sought to cross-culturally replicate and extend these findings by examining, in a multicultural sample, four distinct research questions: a) are the effects they found in the double-mediation model extendible to alcohol consumption as an outcome, b) to what extent are the effects they found in the double-mediation model replicable when other drinking motives are introduced into the model (hypothesized mediation model), c) do rumination facets mediate the relationship between depressive symptoms and other drinking motives (comprehensive model), and d) are these models invariant across sex and different cultures/countries. Based on findings from Bravo et al. (2017), we expected that problem-focused thoughts would emerge as the strongest facet most relevant in the pathway to problematic alcohol consumption.
Section snippets
Participants & procedures
College students from four distinct universities (n = 1864) across the U.S. (two universities; one located in the southeast and the other in the southwest), Argentina, and Spain participated in an online survey study regarding personal mental health, personality traits, and alcohol use behaviors (for more information on recruitment procedures, see Bravo et al., in press). For the present study, we only used data from students who completed the rumination measure and consumed alcohol at least once
Results
The measurement model and all multi-group models (including constrained models) provided acceptable-to-excellent fit based on fit criteria suggested by Hu and Bentler and the minimal changes in CFI/TFI and RMSEA indicated measurement/model invariance across countries and sex (see Table 1). Based on these results, we present results of all our models within the total sample. Bivariate correlations, descriptive statistics, and reliability coefficients of all study variables for the total sample
Discussion
The central goals of the present study were to cross-culturally test whether four rumination facets uniquely mediate the relationships between depressive symptoms and drinking to cope motives (replication of Bravo et al.’s (2017) model) as well as other drinking motives (extension of Bravo et al.’s (2017) model) and in turn account for an increase in alcohol consumption and negative alcohol-related consequences among a multicultural sample of college-student drinkers in Spain, Argentina, and
Role of funding sources
There was no direct funding for this study. However, Dr. Bravo is supported by a training grant (T32-AA018108) from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) in the United States and Dr. Pearson is supported by a career development grant (K01-AA023233) from the NIAAA. NIAAA had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication. Data collection in Spain was supported,
Contributors
Dr. Bravo organized the research study and coordinated the efforts of the research team, conceptualized the research questions, conducted the analyses, drafted the introduction, statistical analyses, and results sections (including tables and figures). Dr. Pilatti wrote the abstract, method section, and part of the discussion section. Dr. Pearson assisted with the statistical analyses, wrote the clinical implications section, and edited the introduction, method, and results sections of the
Conflict of interest
No conflict declared.
Acknowledgments
No acknowledgments declared.
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