Difficulties with emotion regulation and drinking during the COVID-19 pandemic among undergraduates: the serial mediation of COVID-related distress and drinking to cope with the pandemic

As the coronavirus disease 2019 (COVID-19) continues to spread rapidly across the U.S., the impact of the pandemic on behavioral and mental health remain unclear. Although it is normative to experience anxiety and fear in the face of an on-going health threat such as the COVID-19 pandemic, some individuals may be more vulnerable to experiencing COVID-related distress, and this distress could place them at risk for alcohol misuse. Alcohol is commonly used as a coping measure, and emerging data suggest that rates of alcohol consumption have increased since the virus first appeared in the U.S. in March 2020. Indeed, Nielsen (2020) reported a 54% increase in alcoholic beverage sales during the week of March 21, 2020 compared to the same week the year before.

 Although alcohol use has increased during the pandemic, no known studies have identified transdiagnostic risk factors related to greater drinking in response to COVID-related distress. One potential factor related to a variety of mental and behavioral health problems, including anxiety and alcohol use, is difficulty with emotion regulation, which refers to deficits in one’s ability to effectively manage emotional states. Emerging research indicates that difficulty with emotion regulation is associated with greater pandemic-related anxiety (Jungmann & Witthoft, 2020) and greater quantity and frequency of alcohol use, alcohol-related problems, and notably, coping-motivated drinking (Kim & Kwon, 2020). It follows that individuals with difficulties with emotion regulation may experience more COVID-related distress and may use alcohol to cope with this elevated distress. This could lead to greater overall drinking during the pandemic, which is problematic given the public health concerns associated with alcohol misuse.

Given its influence on both pandemic-related anxiety and problematic alcohol use, we conducted this study to determine whether difficulties with emotion regulation served as a transdiagnostic risk factor for greater alcohol consumption during the pandemic. Specifically, we hypothesized that difficulty with emotion regulation would be related to more drinking during the COVID-19 pandemic indirectly via the serial effects of COVID-related worry and then drinking to cope with the pandemic.

The findings revealed that individuals with difficulty engaging in goal-directed behaviors (a specific emotion regulation facet) reported greater alcohol consumption. Importantly, this relation was mediated by the sequential effects of COVID-related worry and drinking to cope with the pandemic. These findings suggest that not only are individuals with greater difficulty with goal-directed behaviors reporting more COVID-related worry, but greater COVID-related worry is related to more drinking to cope with the pandemic which in turn is related to greater overall alcohol consumption during the pandemic. 

In light of the widespread and ongoing national COVID-related safety measures (such as social distancing, masking, and in some states curfews and other restrictions aimed at slowing the spread of the virus) our finding that difficulty with goal-directed behavior is related to more drinking during the pandemic at least in part due to COVID-related worry and drinking to manage COVID-related distress is important, with implications for intervention efforts geared to addressing risky drinking. The COVID-19 pandemic has resulted in increases in stress, distress, and worry and some individuals (such as those with difficulties with emotion regulation) are especially vulnerable to experiencing distress in response to the pandemic. As such, efforts to promote adaptive emotion regulation skills, especially engaging in goal-directed behavior, may be an important clinical target for decreasing risky drinking during the pandemic. Further, teaching individuals more adaptive coping strategies for COVID-related worry may be another important next step to reduce reliance on alcohol to manage pandemic-related distress.

Read the full paper: Julia D. Buckner, Elizabeth M. Lewis, Cristina N. Abarno, Paige E. Morris, Nina I. Glover & Michael J. Zvolensky (in press). Difficulties with emotion regulation and drinking during the COVID-19 pandemic among undergraduates: the serial mediation of COVID-related distress and drinking to cope with the pandemic. Cognitive Behaviour Therapy. doi:10.1080/16506073.2020.1861084

References

  • Jungmann, S. M., & Witthoft, M. (2020, Jun). Health anxiety, cyberchondria, and coping in the current COVID-19 pandemic: Which factors are related to coronavirus anxiety? Journal of Anxiety Disorders, 73. https://doi.org/10.1016/j.janxdis.2020.102239
  • Kim, S., & Kwon, J. H. (2020). Moderation effect of emotion regulation on the relationship between social anxiety, drinking motives and alcohol related problems among university students. BMC Public Health, 20(1). https://doi.org/10.1186/s12889-020-08776-5

Photo By: Garry Knight

Pictured: Julia Buckner, PhD

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