Childhood Traumatic Experiences and Negative Alcohol-Related Consequences in Adulthood: A Cross-Cultural Examination of Distress Tolerance and Drinking to Cope.

Background: Prior research has established that Adverse Childhood Experiences (ACEs) predict harmful alcohol use outcomes. However, underlying mechanisms that could explain these associations are less clear. The present study examined if ACEs are indirectly related to alcohol negative consequences through their associations with distress tolerance and drinking to cope. Method: A sample of 3,763 (71.9% female) college students who drink alcohol from seven countries (U.S., Argentina, Canada, Uruguay, Spain, South Africa, and England) completed online surveys. Path analysis was performed within the whole sample testing the serial unique associations between ACEs→distress tolerance→drinking to cope→negative alcohol-related consequences. Multi-group analysis was performed to determine if the proposed pathways were invariant across gender and countries. Results: Both distress tolerance and drinking to cope uniquely accounted for the relationship between ACEs and negative alcohol-related consequences. Additionally, a significant double-mediation effect was found illustrating that a higher endorsement of ACEs was associated with lower distress tolerance, which in turn was associated with higher drinking to cope, which in turn was associated with more negative alcohol-related consequences. These effects were invariant across countries and gender groups. Conclusions: These findings provide support for the relevance of distress tolerance and coping motives as potential factors in linking ACEs to problematic alcohol use across nations. Our data are consistent with the idea that intervening on distress tolerance and drinking motives could mitigate downstream alcohol-related consequences related to ACEs in college student populations around the world.

Delaying Gratification's role in the relationship between facets of mindfulness and substance use outcomes.

The present study examined whether five facets of mindfulness (acting with awareness, describing, observing, non-judging of inner experience, and non-reactivity to inner experience) relate to alcohol and cannabis outcomes (quantity of use and negative consequences) via delaying gratification. Participants were college students across seven universities who used alcohol (n = 1467) and/or cannabis (n = 647) in the last 30 days. For the alcohol analytic sample, the majority of students identified as being female (71.1%) and reported a mean age of 20.04 (Median = 19.00; SD = 3.47) years. For the cannabis analytic sample, the majority of students identified as being female (69.7%) and reported a mean age of 19.63 (Median = 19.00; SD = 2.85). Within our model, significant indirect effects were only found for two mindfulness facets. Specifically, the indirect effects from acting with awareness (alcohol indirect ß = -0.026, SE = 0.006; cannabis indirect ß = -0.019, SE = 0.008) and observing (alcohol indirect ß = -0.017, SE = 0.005; cannabis indirect ß = -0.015, SE = 0.007) to consequences via delaying gratification and quantity were significant for both the alcohol and cannabis models, such that acting with awareness and observing were associated with higher delaying gratification; which in turn was associated with lower quantity of use, which in turn was associated with fewer consequences for both the cannabis and alcohol models. Our findings suggest that delaying gratification is important to understanding the relationship between specific mindfulness facets (i.e., acting with awareness and observing) and alcohol and cannabis outcomes. Mindfulness interventions aimed at reducing substance use may benefit from targeting delaying gratification through increasing acting with awareness and observing.