An ecological momentary assessment of affect, mental health symptoms, and decisions to drink among first-year college women

Abstract

College women experience more consequences (e.g., blacking out, unprotected/unwanted sex) on days when they engage in their heaviest drinking. To inform prevention efforts, research is needed to understand decision-making processes that influence women's drinking behaviors at the event level. The present study used ecological momentary assessment (EMA) methods to examine: (1) associations between positive affect (PA) and negative affect (NA) and decision-making processes on days leading up to, during, and following heavy drinking events; and (2) mental health symptoms as moderators of these associations. Female undergraduate drinkers (N = 57) completed a 14-day EMA protocol on their smartphones, which included three daily assessments of PA, NA, and willingness and intentions to drink. Trait anxiety and depressive symptoms were measured before the EMA protocol and assessed as moderators. Time-varying effect models were used to examine covariation among PA, NA, and willingness and intentions to drink on the days leading up to participants' heaviest drinking events, the day of the event itself, and the days following the event. Results revealed PA was positively associated with willingness to drink the 2 days before, the day of, and the day after the heaviest drinking event. Similar effects were observed for PA and intentions to drink. Trait anxiety moderated the association between PA and intentions to drink. Findings underscore that positive affect may influence drinking-related decision-making processes surrounding heavy drinking events, particularly in those college women low in anxiety. Results identify potential entry points for real-time intervention efforts targeting college women during times of elevated PA.