The Role of Obsessive Passion in the Experience of Negative Alcohol Use Outcomes Among Underage Risky Drinkers

Background and Purpose: Evidence supports the application of the Dualistic Model of Passion to addictive behaviors such as marijuana and alcohol use. For example, studies among marijuana users and risky and non-risky drinkers have shown that obsessive passion (i.e., substance use is compelling and conflicts with other life activities/values) is consistently associated with frequency of substance use and consequences. Recent evidence also found that obsessive passion and coping motives (i.e., using a substance to cope with difficult emotional experiences) are both related to marijuana use and consequences, with obsessive passion being more strongly related to these outcomes. However, no study to date has attempted to characterize what factors contribute to obsessive passion among underage (< 21 years old) risky drinkers, or to ascertain the extent to which obsessive passion and coping motives differentially predict a variety of risk indicators. Theoretically, impulsivity and emotion regulation may be associated with using alcohol to cope with challenging emotions, and could also contribute to the degree to which drinking is an obsessive passion. Therefore, the present study aims to examine impulsivity and emotion regulation as factors associated with obsessive passion and coping motives for alcohol use, and to determine whether obsessive passion and coping motives differentially predict frequency of drinking, history of overdose, and a positive screen for an alcohol use disorder (AUD). Methods: We analyzed cross-sectional baseline data collected as part of an ongoing randomized controlled trial of underage risky drinkers (n=257; M_age=17.7, SD=1.3, range 16-20; 55% female; 63% White non-Hispanic; AUDIT-C score: ≥ 3 females, ≥ 4 males for ages 16-17; ≥ 4 females, ≥ 5 males for ages 18-20) recruited nationally via Facebook and Instagram advertisements. Sampling included procedures to recruit individuals from diverse ethnic and racial backgrounds to increase representativeness in the sample. Results: While controlling for age and correlations among all independent and dependent variables, a path analysis showed that greater emotion dysregulation and impulsivity were positively related to greater obsessive passion and coping motives. Only greater obsessive passion (not coping motives) was related to greater frequency of alcohol use, likelihood of screening positive for an AUD, and likelihood of a prior overdose. Obsessive passion also mediated the relationship between greater impulsivity and greater emotion dysregulation and more alcohol consequences, screening positive for an AUD, and overdose. Conclusions & Implications: Obsessive passion may be a relevant intervention target among underage risky drinkers. The Dualistic Model of Passion could also be a worthwhile way to conceptualize alcohol use as the relationship one has to drinking. Specifically, in terms of whether use is consistent with one’s values and other life activities, regardless of whether someone meets criteria for an alcohol use disorder. Such an approach is consistent with acceptance and commitment-based approaches and motivational interviewing, which may be especially helpful for underage risky drinkers who are often ambivalent about changing their alcohol use. Future longitudinal analyses will examine change over time in obsessive passion, and whether it is as moderator of intervention outcomes.