The Interactive Effects of Alcohol Cravings, Cue Reactivity, and Urgency on College Student Problematic Drinking.

Abstract

Introduction: Alcohol cravings have been inconsistently associated with problematic drinking. Two possible moderators are cue reactivity and urgency. Individuals high on urgency might be more likely to develop reactivity to alcohol cues due to their higher rates of drinking. This reactivity might produce greater alcohol cravings and might consequently increase problematic drinking. We hypothesized that alcohol cravings would be more strongly associated with problematic drinking at higher levels of cue reactivity and urgency. Method: In a sample of college students (n = 240), the current study tested three way interactions among cue reactivity, urgency, and alcohol cravings on problematic drinking. The sample was 70.7% female and 75% Caucasian, with a mean age of 19.37 (SD = 1.65). Urgency was measured using two UPPS Impulsive Behavior subscales. Problematic drinking was measured using the AUDIT. Alcohol cravings were measured using the Obsessive Compulsive Drinking Scale. Participants were presented with alcohol pictorial cues during the study, after which their cue reactivity was assessed using the Alcohol Urge Questionnaire. Interactions were tested using multiple regression and simple slope analyses. Results: The effect of alcohol cravings on problematic drinking was significant at low negative urgency and cue reactivity (b = 5.34, p = 0.001), low negative urgency and high cue reactivity (b = 8.69, p<0.001), high negative urgency and low cue reactivity (b = 5.53, p <0.001), and high negative urgency and cue reactivity (b = 4.71, p<0.001). A similar pattern of findings was present with positive urgency, but alcohol cravings were most strongly associated with problematic drinking at low cue reactivity and high positive urgency (b = 6.56, p<0.001). Discussion: These findings clarify the inconsistent alcohol cravings-problematic drinking associations in prior studies. These findings suggest the importance of considering cue reactivity and urgency in understanding how alcohol cravings create risk for problematic drinking.