Examining bidirectional associations between momentary impulsivity, alcohol consumption, and daily life contexts

Abstract

[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI--COLUMBIA AT REQUEST OF AUTHOR.] Longitudinal, cross sectional, and laboratory studies have examined the relationships between impulsivity and alcohol use. However, most studies so far have not examined temporal relationships between impulsivity and alcohol consumption, and few studies have been conducted examining these relationships in daily life. The current study examined the relationships between momentary ratings of impulsivity, alcohol consumption, and social contexts using ecological momentary assessment, where participants carried an electronic diary for 28 days and responded to prompts multiple times per day. Participants were 52 regular drinkers (26 with borderline personality disorder and 26 community drinkers). Multilevel models were used to examine the temporal relationships between self-reported momentary impulsivity and alcohol use, as well as social context and diagnostic group as potential moderators of these relationships. In all models, impulsivity and alcohol use were related at the same prompt. However, lagged impulsivity (rated at the prior prompt as well as the cumulative average of impulsivity so far on drinking days) was not associated with alcohol consumption. On the other hand, higher blood alcohol concentration estimates predicted increased subsequent momentary impulsivity ratings on drinking days, as did consuming any quantity of alcohol since the previous prompt for participants with BPD. These results suggest that impulsivity and alcohol use are related when measured in participants' daily lives, but when considered together, these findings do not provide sufficient support for the bidirectional influences of self-reported impulsivity and alcohol consumption. Rather, results demonstrate alcohol's influence on self-reported impulsivity during drinking days, consistent with previous laboratory findings. These findings highlight the importance of considering short-term, within-person relationships in impulsivity and alcohol consumption, and suggest a potential for intervention to prevent risky alcohol use.