Abstract
The present study sought to examine whether drinking motives (i.e., coping, social, conformity, and enhancement) moderated the relationship between physical, sexual, and psychological dating violence victimization and alcohol-related problems in a sample of drinking college women (N = 177). Results demonstrated that coping and social drinking motives moderated the relationship between sexual victimization and alcohol problems; conformity, social, and enhancement drinking motives moderated the relationship between alcohol-related problems and physical victimization; no significant findings were evident for psychological aggression victimization. Our results partially support the self-medication model of alcohol use, and this may be particularly relevant to sexual victimization.
Introduction
Intimate partner violence (IPV) is a pervasive problem with numerous deleterious consequences for both individuals and society. IPV is defined as physical, psychological, or sexual aggression toward a partner in a romantic relationship. Although the general prevalence of IPV is high, IPV among college students, commonly referred to as dating violence, occurs at particularly alarming rates (Shorey, Cornelius, & Bell, 2008). Approximately 16-30% of college women report being physically victimized by their partner, 80% report being psychologically victimized by their partner, and 16-41% report experiencing some form of sexual coercion by their partner each year (Bell & Naugle, 2007; Edwards et al., 2015). While dating violence affects both men and women, women report higher rates of lifetime victimization (Brieding, Black, & Ryan, 2008), and there is research to suggest that women experience more severe negative mental health outcomes following dating violence victimization (Caldwell, Swan, & Woodbrown, 2012). College women victimized by dating violence frequently experience symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety, and women are more likely to experience PTSD than men in response to dating violence (Amanor-Boandu et al., 2011).
Dating violence among college students is also consistently associated with alcohol use and alcohol-related problems. Research has demonstrated that women who experience dating violence are more likely to use alcohol than women who are not victimized (Amanor-Boandu et al., 2011) and are more likely to experience victimization on days that they use alcohol (Shorey, McNulty, Moore, & Stuart, 2015). Although research has demonstrated that women victimized by dating violence are at increased risk for alcohol use and problems (Shorey, Stuart, & Cornelius, 2011), minimal research has examined moderators of this relationship. Therefore, in the present study, we examined drinking motives as a moderator of the relationship between dating violence victimization and alcohol problems among college women.
Alcohol Use Motives
Previous research on alcohol use has examined individuals’ motives for use. Cox and Klinger (1988) defined alcohol use motives as conscious or unconscious reasons to consume alcohol based on the belief that the positive benefits of drinking alcohol will outweigh the negative effects of drinking alcohol. Drinking motives can be conceptualized into either internal or external processes, and used to either increase positive experiences or decrease negative experiences (Cox & Klinger, 1998). Evidence for Cox and Klinger’s (1998) theoretical fo ur-factor model of alcohol use motives has been supported by empirical research (Cooper, 1994; Martin, Ferreira, Hasse, Martins, & Coelho, 2016). These four motive factors include coping (i.e., drinking to reduce pain associated with internal negative affect), social (i.e., drinking to increase sociability and comfort in social situations), enhancement (i.e., drinking to increase enjoyable physical internal sensations arisen by the pharmaceutical effects of alcohol intoxication), and conformity (i.e., drinking to reduce discomfort due to peer pressure or concerns about fitting in). Recent research has confirmed that the original four-factor model of drinking motives remains relevant among college students (Martin et al., 2016), and has demonstrated that these drinking motives are distinct from one another and related to differing alcohol consumption patterns and alcohol-related problems (Grant, Stewart, O’Connor, Blackwell, & Conrod, 2007; Piasecki, Cooper, Wood, Sher, Shiffman, & Heath, 2014).
Several researchers have focused on negative outcomes related to alcohol use motivated by a desire to cope with problems (i.e., coping motives). For instance, coping motives have been linked to increased rates of alcohol dependence or heavy drinking (Armeli et al., 2014; Kuntsche & Labhart, 2012; Stojek & Fischer, 2013). Alcohol used to cope is often conceptualized as part of the self-medication model of substance use, which states that substances are used to cope with negative affect due to traumatic or stressful experiences (Khantzian, 1985). The self-medication model of substance use has encouraged increased attention on alcohol use patterns related to drinking to cope. Indeed, studies have demonstrated that drinking to cope with depression increases the risk for alcohol-related problems (e.g., Goldstein, Fleet, & Wekerle, 2010; Grant et al., 2007).
Other research has focused on negative alcohol-related consequences associated with enhancement drinking motives. College students who report drinking for enhancement motives report increased negative alcohol-related consequences (e.g., hangovers, blackouts, injuries; Kuntsche & Labhart, 2012; Norberg et al., 2011). This association is especially strong for women (Kenny, Jones, & Barnett, 2015; Loxton, Bunker, Dingle, & Wong, 2015). No previous research has found specific associations between social motives and alcohol-related problems in college women, but this may be related to the fact that women endorse social motives for drinking less frequently than men (Grant et al., 2007). However, some research suggests that social motives partially mediate the relationship between risky drinking behaviors (i.e., pregaming and drinking games) and subsequent alcohol-related problems in college students (Sheehan, Lau-Barraco, & Linden, 2013), and generally among college students, drinking in a social environment has been found to increase the occurrence of enhancement being a primary drinking motive (Mohr et al., 2013). Thus, social motives for engaging in alcohol use may be indirectly associated with increased alcohol-related problems through co-occurring enhancement motives and risky behaviors.
Similarly, the literature examining drinking motives has not demonstrated a clear association between conformity motives and alcohol-related problems. One study found that conformity motives were associated with drinking alcohol less frequently and in smaller amounts (Grant et al., 2007), which may explain fewer associated consequences. Conversely, similar to social motives, conformity motives may be indirectly associated with alcohol-related problems through pressure to engage in drinking games as a way to fit in with peers. Engaging in drinking games generally leads to increased alcohol intake and numerous consequences, including health problems and increased risk for sexual assault (Johnson & Sheets, 2004). Thus, conformity motives in this particular context may increase alcohol-related problems. However, this relationship remains unclear.
Alcohol Motives and Dating Violence Victimization
Despite the known connections between dating violence victimization and alcohol-related problems, and between motives for alcohol use and alcohol-related problems, previous research on whether alcohol use motives moderate the association between victimization and alcohol problems is scant. When research has examined such associations, analyses are restricted only to coping or enhancement motives and sexual assault experiences, and mediational analyses are frequently used. Indeed, coping motives for alcohol use can be deleterious to women with victimization histories; drinking to cope has been shown to mediate the association between alcohol use and increased trauma symptoms (Kaysen et al., 2007). In addition, drinking to cope following a sexual assault that involved alcohol has been found to increase the risk of subsequently experiencing similar sexual assaults in college women (Messman-Moore, Ward, Zerubavel, Chandling, & Barton, 2015). There is also evidence that coping motives may partially mediate the relationship between sexual coercion experiences in college men and women (Fossos, Kaysen, Neighbors, Lindgren, & Hove, 2011) and sexual assault experiences in college women (Lindgren, Neighbors, Blayney, Mullins, & Kaysen, 2012).
One limitation of previous research on drinking motives and victimization is a narrow focus on which alcohol motives are examined, such that studies have solely measured coping motives (Fossos et al., 2011; Messman-Moore et al., 2015) or coping and enhancement motives (Lindgren et al., 2012). Although it is likely that many women with victimization experiences drink to cope, it is also plausible that women with victimization histories have other motives for drinking as well. The burgeoning body of literature suggesting that conformity and social drinking motives may also be related to alcohol use problems indicates that it is plausible that alcohol motives beyond coping would moderate the relationship between dating violence and alcohol problems. Indeed, because alcohol use motives, regardless of type, are associated with problematic drinking behaviors among college women, it makes theoretical sense that there may be a synergistic relationship between dating violence victimization and any alcohol use motive in predicting alcohol use problems. As alcohol-related problems are prevalent and problematic among women who experience dating violence (Shorey et al., 2011), understanding potential moderators of this relationship is necessary to enhance clinical practice. However, no known study has examined whether various alcohol use motives impact the relationship between distinct types of dating violence victimization (i.e., psychological, physical, and sexual) and alcohol problems. Identifying whether specific alcohol motives moderate the relationship between dating violence victimization and alcohol-related problems may provide important information that could be used when treating this vulnerable population.
Finally, it is important to note that prior research in this area has primarily examined alcohol motives as a mediator of the association between victimization and alcohol. A mediation variable accounts for the relationship between the predictor variable (i.e., violence) and the dependent variable (i.e., alcohol problems) whereas a moderator influences the direction or strength of the relationship between these variables (Baron & Kenny, 1986). Given the lack of support for full mediation and the theoretical nature of drinking motives’ varying influences on drinking behavior (Cooper, Russell, & George, 1988), it is theoretically plausible that alcohol motives may strengthen the relationship between alcohol problems and victimization (i.e., moderation) rather than accounting for the relationship between these two constructs (i.e., mediation). Indeed, some prior research has examined alcohol motives as a moderator between various environmental and traumatic events and alcohol use and problems. For example, one study examined all four drinking motives as moderators between number of friends present and heavy drinking behaviors on weekend evenings among college men and women (Smit, Groefsema, Luijten, Engels, & Kuntsche, 2015. Results of the study indicated that among college women, enhancement motives moderated number of drinks consumed, such that higher enhancement motives were associated with a greater number of drinks consumed. Results also indicated that enhancement, coping, and conformity motives moderated the relationship between number of friends present and drinks consumed, such that individuals with higher enhancement motives or coping motives drank more in situations with more friends present, and that individuals with higher conformity motives drank fewer drinks in situations with more friends present.
Another study examined coping motives as a moderator between PTSD symptoms and daily drinking patterns among a sample of community adults with PTSD to examine the self-medication model of alcohol use (Simpson, Stappenbeck, Luterek, Lehavot, & Kaysen, 2014). Results demonstrated that as PTSD symptoms increased, alcohol use increased to a larger extent among individuals high, relative to low, in coping motives. In summary, both studies found that drinking motives moderated the amount of alcohol consumed by participants. Based on these results, some authors have concluded that drinking motives are better understood as a moderating variable rather than a direct predictor of drinking habits (Smit et al., 2015). Thus, it is similarly plausible that drinking motives may serve as a moderating, rather than mediating, variable between dating violence victimization experiences and alcohol-related problems.
Current Study
The present study sought to address the gaps in the literature and expand upon prior research by examining whether drinking motives moderated the relationship between dating violence victimization (physical, sexual, and psychological) and alcohol-related problems among currently dating college women. We hypothesized that coping motives would moderate the relationship between physical, sexual, and psychological victimization and alcohol-related problems, such that the association between victimization and alcohol-related problems would be stronger at high levels of coping motives relative to low levels of coping motives. Due to the lack of previous research in this area, no a priori hypotheses were made for the moderating roles of enhancement, social, or conformity alcohol motives.
Method
Participants
Female undergraduate students recruited from psychology courses at a large Southeastern university participated in the current study (N = 177). To be eligible, students were required to be 18 years or older, in a current dating relationship of at least 1 month with a partner aged 18 or older; have consumed alcohol in the previous month; and have had an average of at least 2 days of face-to-face contact with their partner each week. In total, 284 students met the eligibility criteria and expressed interest in participating in the study. Of these eligible students, 194 (68.3%) agreed to participate in a 1-hr survey session (described below) with subsequent daily diary measures reported on elsewhere and not included in the present study (Shorey et al., 2015). Thus, 90 eligible students who initially expressed interest in the study ultimately declined study participation, and did not complete the baseline survey analyzed in the present study. The current sample is restricted to the 177 women who fully completed all measures of interest for the current study (i.e., 17 women did not complete all measures for the current study). The mean age of participants was 18.70 years (SD = 1.26), and the average length of participants’ dating relationship was 16.26 months (SD = 13.50). The majority of students were freshmen (68.9%), followed by sophomores (15.3%), seniors (8.5%), and juniors (7.3%). The majority of students identified as non-Hispanic Caucasian (85.9%); 8.5% identified as Black, and the remainder identified as “Other” (e.g., Hispanic, Asian American). The majority of students identified as being heterosexual (94.9%) and not currently living with their dating partner (96%). These demographics were representative of the university from which the data were collected.
Procedure
Participants enrolled in psychology courses were recruited through a website used exclusively by the psychology department at the institution where the study was conducted. Although all psychology instructors can choose to include research as a component of their course, regardless of course level, all students in introduction to psychology courses are given the option to either participate in research or complete another course project (e.g., research paper) at the institution where the study was conducted. Thus, freshman students are generally overrepresented in studies that utilize this recruitment website. Students had the opportunity to read a brief description of the study, informing them that they would be asked to complete a number of self-report surveys about their current dating relationship. Eligibility was determined using a brief screening measure (described above). Eligible students were then sent an electronic informed consent and a link to an online survey to complete the assessment. Informed consent and self-report measures were completed on SurveyMonkey.com. Participants received course credit in return for their participation, which was a set amount of credit based on the length of time required to complete the study that was determined by the psychology department. Thus, all students received the same amount of course credit for completing the survey. After this initial set of surveys, all women were invited to participate in a daily diary study, which has been described elsewhere (Shorey et al., 2015). All procedures were approved by the institutional review board where the study was conducted.
Measures
Alcohol problems
Alcohol problems were assessed using the Rutgers Alcohol Problem Index (RAPI; White & Labouvie, 1989). Participants completed this 23-item self-report measure that examines common problems associated with alcohol use, such as arguments, fights, and hangovers. Participants rated the number of times they had experienced each consequence of alcohol use (e.g., engaged in fights, passed out, became hung over) in the past year on a 4-point scale (0 = none; 3 = more than 5 times). All questions inquired directly about experiences related to alcohol (e.g., “How many times did you go to work or school drunk?”). Higher scores correspond to more frequent alcohol problems. The RAPI is one of the most widely used measures of alcohol problems among college students (e.g., Herschle, McChargue, Killop, Stoltenberg, & Highland, 2012; Kazemi, Sun, Nies, Dmochowski, & Walford, 2012) and has demonstrated good validity and reliability. RAPI items were recoded as dichotomous before being summed for a total score; thus, scores could range from 0-23. That is, all items rated as a “1” or higher indicating the participant had experienced the alcohol-related problem at least one time were recoded into a “1,” and all responses coded “0” indicated that the participant had not experienced this consequence This method has been shown to be a reliable and valid method of identifying alcohol problems in college students and helps to reduce skew and kurtosis (e.g., Neal, Corbin, & Fromme, 2006; Martens, Neighbors, Dams-O’Connor, Lee, & Larimer, 2006). Internal consistency for this scale in the current sample was good (α = .91).
Dating violence victimization
Psychological, physical, and sexual victimization experiences were measured using the Revised Conflict Tactics Scales (CTS2; Straus, Hamby, Boney-McCoy, & Sugarman, 1996). The CTS2 is a 78-item questionnaire that assesses the amount of negotiation, physical, sexual, and psychological aggression, sexual coercion, and injury that has occurred in an intimate relationship. The Psychological Victimization subscale includes eight questions (e.g., “my partner called me fat or ugly”), the Sexual Victimization subscale contains seven questions (e.g., “my partner used threats to make me have sex”), and the Physical Victimization subscale includes 12 questions (e.g., “my partner slammed me against a wall”). Participants were asked to rate on a 7-point scale (0 = never, 6 = more than 20 times) the number of times a particular behavior occurred in the previous year. Total scores for each subscale is obtained by summing the midpoints for each item (e.g., 3-5 times is recoded into 4, more than 20 times recoded into 25, an assumed midpoint determined by the scale developers; Straus, Hamby, & Warren, 2003). Due to high amounts of skewed data among nonviolence specific samples, such as college students, the developers of the CTS2 recommend scoring items at the midpoint before calculating total scores to enhance the utility of CTS2 subscale scores and account for a high volume of low frequency responses (Straus et al., 2003). Higher scores correspond to more frequent victimization. The CTS2 has demonstrated good construct and discriminant validity (Straus, Hamby, Boney-McCoy, & Sugarman, 1996) and is widely used among college students (e.g., Fossos et al., 2011; Shorey et al., 2011). The CTS2 has also demonstrated good reliability and validity among college student populations (Straus, 2004). Because perpetrators may not use multiple, different acts of violence, reports of victimization behaviors can vary widely and therefore may artificially decrease internal consistency (Ryan, 2013). Thus, we did not calculate internal consistencies for the CTS2.
Drinking motives
Drinking motives were assessed using the Drinking Motives Questionnaire (DMQ; Cooper, 1994). This scale consists of 20 self-report items that examine the reasons for one’s use of alcohol. Participants are asked to rate how often they engage in drinking for reasons listed on a 1-6 scale (1 = never, 6 = always). Responses on the DMQ can be categorized into four different motives for alcohol use, including social, coping, enhancement, and peer pressure motives. Higher scores on each subscale correspond to higher levels of drinking motivations pertaining to that category. All questions asked directly about the participants’ reasons for drinking alcohol (e.g., coping: “How often do you drink to forget about your problems?”; enhancement: “How often do you drink because it gives you a pleasant feeling?”; conformity: “How often do you drink because your friends pressure you to drink?”; social: “How often do you drink to celebrate a special occasion with friends?”). The DMQ demonstrated excellent internal consistency for Social (α = .94), Enhancement (α = .93), Conformity (α = .91), and Coping (α = .91) subscales. The factor structure of the DMQ has been validated among college students (Cooper, 1994; Martens, Rocha, Martin, & Serrao, 2008; Martin et al., 2016), and the DMQ has demonstrated good reliability and validity among college women (Martens et al., 2008).
Data Analytic Strategy
We first examined variables for skew and kurtosis. Consistent with prior work, all dating violence victimization subscales were positively skewed and kurtotic and, thus, were log-transformed prior to analyses. Bivariate correlations were first conducted to examine relationships between study variables. Multiple regression analyses were then conducted to test possible moderating effects of alcohol use motives on the association between psychological, physical, and sexual victimization and alcohol-related problems. Independent variables (e.g., victimization, motives) were mean centered to aid in the interpretation of effects and reduce multicollinearity (Aiken, West, & Reno, 1991). Once all independent variables were centered, three steps were used to examine potential interactions. First, main effects of independent variables were entered into the regression model. Second, a two-way interaction term between the independent variables (victimization and drinking motives) was added to the model. Finally, if significant interactions were identified, independent variables were probed at low (−1 SD) and high (+1 SD) levels (Aiken et al., 1991). To control for known correlates of IPV, age and length of relationship were entered as covariates in each model, as prior research has demonstrated their consistent association with dating violence (Dardis, Dixon, Edwards, & Turchik, 2015; Hammock & O’Hearn, 2002; Ortiz, Shorey, & Cornelius, 2015). These analyses were conducted separately for each type of victimization and alcohol motive.
Results
Descriptive Analyses
Bivariate correlations between study variables are presented in Table 1. All predictors were mean centered to reduce multicollinearity. The tolerance and variance inflation factors (VIFs) for each predictor were close to one, indicating no presence of multicollinearity. As displayed in Table 1, alcohol-related problems were positively and statistically significantly associated with all drinking motives, psychological victimization, and sexual victimization, and were also negatively and statistically significantly associated with relationship length. In addition, all drinking motives were positively and statistically significantly associated with sexual victimization. Finally, coping motives were positively and statistically significantly associated with psychological victimization.
Bivariate Correlations, Means, and Standard Deviations Among Study Variables.
p < .05. **p < .01.
Moderation Analysis
Sexual victimization
As displayed in Table 2, a statistically significant interaction was found between sexual victimization and social motives. When this interaction was decomposed, analyses revealed that sexual victimization was not related to alcohol problems at low levels of social motives (β = −.01, p > .05) but was related to alcohol problems at high levels of social motives (β = .29 p < .001). Similarly, a statistically significant interaction was found with coping motives. Specifically, at low levels of coping motives, sexual victimization was not related to alcohol problems (β = −.02, p>.05) but was associated with alcohol problems at high levels of coping motives (β=.23, p < .01). As there were no statistically significant interactions between sexual victimization and conformity and enhancement motives, main effects models for these analyses are interpreted (Aiken et al., 1991). Sexual victimization, conformity motives, and enhancement motives were all positively and statistically significantly associated with alcohol problems in these main effects models.
Multiple Regression Analyses With Sexual Victimization and Drinking Motives Predicting Alcohol Problems.
Note. Age and relationship length were included as covariates in all models but are not presented for clarity.
p < .05. **p < .01. ***p < .001.
Physical victimization
As displayed in Table 3, a statistically significant interaction was found between physical victimization and conformity motives. Specifically, physical victimization was not related to alcohol problems at low levels of conformity motives (β = −.06, p > .05) but was related to alcohol problems at high levels of conformity motives (β = .35 p < .01). Similarly, a statistically significant interaction was found with enhancement motives. Specifically, at low levels of enhancement motives, physical victimization was not related to alcohol problems (β = .03, p > .05) but was associated with alcohol problems at high levels of enhancement motives (β = .38, p < .01). A statistically significant interaction was also found between physical victimization and social motives. Specifically, at low levels of social motives, physical victimization was not related to alcohol problems (β = −.06, p > .05) but was associated with alcohol problems at high levels of social motives (β = .53, p < .01). As there was no statistically significant interaction between physical victimization and coping motives, the main effect model is interpreted. For the coping motives model, only coping motives was positively and statistically significantly associated with alcohol problems.
Multiple Regression Analyses With Physical Victimization and Drinking Motives Predicting Alcohol Problems.
Note. Age and relationship length were included as covariates in all models but are not presented for clarity.
p < .05. **p < .01. ***p < .001.
Psychological victimization
While no interactions were statistically significant between drinking motives and psychological victimization, several main effects emerged (see Table 4). Coping motives, enhancement motives, and social motives were all statistically significantly related to alcohol problems. Psychological victimization was also positively and statistically significantly associated with alcohol problems in all main effects models.
Multiple Regression Analyses With Psychological Victimization and Drinking Motives Predicting Alcohol Problems.
Note. Age and relationship length were included as covariates in all models but are not presented for clarity.
p < .05. **p < .01. ***p < .001.
Discussion
The present study is the first to examine four alcohol motives as moderators of the relationship between dating violence victimization and alcohol problems among college women. Previous work in this area has focused exclusively on internal drinking motives, with primary focus on coping motives (Fossos et al., 2011; Kaysen et al., 2007; Messman-Moore & Ward, 2014) and some focus on enhancement motives (Goldstein et al., 2010; Grayson & Nolen-Hoeksema, 2005; Lindgren, Neighbors, Blaney, Mullins, & Kaysen, 2012). The primary rationale for the focus of previous research on coping motives was based on the self-medication model of substance use in response to victimization (Khantzian, 1985). The results of this study moved beyond self-medication and demonstrated that, depending on the type of dating violence examined, all four alcohol motives moderated the relationship between victimization and alcohol problems.
In regard to sexual victimization, a statistically significant interaction was found between sexual victimization and social motives, such that the association between sexual victimization and alcohol problems was significant for women with high, but not low, social motives. This finding is particularly noteworthy given the paucity of research regarding social alcohol use motives and victimization. One possible explanation for this finding could be that women with victimization histories initiate drinking to improve socialization experiences, but some research suggests that women victimized by a partner experience a decline in social functioning (Laffaye, Kennedy, & Stein, 2003). Thus, it is plausible that these women could have difficulty obtaining the social benefits they seek from drinking due to reduced social functioning at the start or drinking, and therefore use more alcohol than intended in pursuit of social benefits, which could lead to problematic drinking and increased alcohol use problems. However, more research is needed to clarify the nature of this relationship, and future research should examine additional factors that may be related to women’s social drinking experiences.
A similar finding was demonstrated for coping motives, such that the association between sexual victimization and alcohol problems was statistically significant for women high, but not low, in coping motives, supporting our hypothesis. Theoretically, it is believed that the association between victimization and alcohol use is due to alcohol being used to cope with the negative repercussions of violence (i.e., self-medication hypothesis; Khantzian, 1985). Importantly, these results are consistent with past research on similar topics; previous research has demonstrated that, in women with sexual assault victimization histories, drinking to cope precedes revictimization and future alcohol involved sexual assault (Messman-Moore et al., 2015). Thus, this study adds to a growing body of research demonstrating that women with a tendency to drink to cope are at increased risk for negative outcomes, particularly women with a history of victimization.
For physical violence victimization, findings showed statistically significant interactions between physical victimization and conformity, social, and enhancement drinking motives in predicting alcohol problems. For these three types of motives, the association between physical victimization and alcohol problems was statistically significant at high, but not low, levels of each motive. However, contrary to our hypothesis, coping motives were not found to moderate this relationship. These findings highlight the importance of examining a variety of drinking motives in research on dating violence victimization and alcohol, including motives that are focused on increasing positive experiences with alcohol or related to external motivations to drink (i.e., conformity, social), rather than limiting research to coping motives exclusively. Although our findings should be considered preliminary until they are replicated, results suggest that women who are physically victimized who also hold maladaptive alcohol motives are at increased risk for alcohol-related problems.
While using alcohol to cope with negative emotions and experiences has been established as problematic, the results of this study indicate that other drinking motives are problematic as well. This may be attributed to specific motivations for drinking (e.g., to increase social enjoyment; due to external peer pressure to drink to “fit in”), being unsuccessful (e.g., individual has a bad time socializing; individual still does not feel like he or she fits in), and encouraging maladaptive drinking patterns (e.g., drinking more to continue trying to enhance socialization, or drinking to cope with negative emotions associated with failed socialization) and subsequently alcohol-related consequences. Women with victimization histories are vulnerable to a myriad of mental health problems, including alcohol misuse (Amanor-Boandu et al., 2011), and it is theoretically plausible that women with specific reasons to drink may be more vulnerable to developing alcohol problems through motivations of achieving unrealistic coping, social, and enhancement goals. Future research is needed to ascertain the complex relationship between drinking motives, individual characteristics (e.g., mental health problems, decreased social functioning), and drinking behavior among women with physical violence victimization histories. In addition, the present study was cross-sectional in nature and thus did not examine the interplay of drinking motives across time. Future research is needed to increase understanding of how drinking motives may interact and change over time.
Interestingly, the relationship between psychological aggression victimization and alcohol problems was not moderated by drinking motives. However, psychological victimization was statistically significantly associated with alcohol problems, consistent with previous research (Shorey et al., 2011). We are unaware of any theoretical reason why drinking motives would not moderate this relationship, and thus these findings should be considered preliminary until they are replicated.
Directions for Future Research and Clinical Implications
Given the paucity of research on this topic, future research is needed to clarify the moderating relationship between drinking motives and alcohol-related problems in response to dating violence victimization. Future research should focus on developing a measure that examines drinking motives specifically related to dating violence victimization and use a longitudinal design to elucidate how these motives relate to alcohol problems in women with victimization histories. Future research should also examine drinking motives in regard to other mental health problems related to dating violence victimization and alcohol use. For example, some research has investigated drinking to cope and PTSD symptoms in a community sample of women with general trauma histories, and found that PTSD symptoms moderated the relationship between drinking motives and alcohol use problems (Stappenbeck, Bedard Gilligan, Lee, & Kaysen, 2013). In addition, one study found that for a community sample of women with dating violence histories, the relationship between drinking and PTSD symptoms was mediated by drinking to cope (Kaysen et al., 2007). Thus, research suggests that PTSD symptoms may be related to the function of drinking motives in relation to alcohol-related problems for women with victimization and trauma histories. This research should be expanded to include enhancement, social, and conformity motives and additional mental health characteristics associated with dating violence victimization (e.g., depression, social functioning).
Future research should also focus on determining whether drinking motives are a malleable factor and could be targeted in programming to reduce alcohol-related problems in women, and specifically in women affected by dating violence who are at higher risk of developing alcohol-related problems. The results of this study imply that certain drinking motives increase the strength of the relationship between victimization and alcohol problems. Thus, drinking motives could be a potential marker for women with victimization histories who are at a higher risk for developing alcohol problems. Therefore, interventions that target drinking motives are needed and could be included in treatment programs for victims of dating violence. Some initial studies have promising implications for targeting drinking motives in alcohol use intervention. For instance, in a pilot study with 124 Italian college students, researchers found that a computerized intervention that targeted drinking motives, in addition to personalized feedback on students’ drinking behavior, was more effective at reducing the frequency of alcohol use in heavy drinkers than personalized feedback alone (Canale, Vieno, Santinello, Chieco, & Andriolo, 2015). One study with male and female college students found that mindfulness skills were negatively associated with coping and conformity drinking motives, suggesting that mindfulness training may be one pathway to inhibit drinking to cope or conform (Reynolds, Keough, & O’Connor, 2015). Thus, more research is needed to determine how drinking motives can be changed and what type of intervention would be best to implement among female victims of dating violence.
Limitations
The present study had several limitations. Participants in this study were homogeneous in terms of ethnic diversity and sexual orientation. Thus, the results of this study may not generalize to more diverse populations or sexual minorities. Future research should include diverse samples and nonheterosexual couples, as research has shown rates of IPV among college students are higher among sexual minorities (e.g., Edwards et al., 2015). In addition, the current study only examined college women experiencing dating violence composed mostly of younger students (i.e., 97.2% of the participants were 21 years or younger), and thus these findings may not extrapolate to women of other ages who experience IPV. Future research is needed to determine if these results generalize to men and women in other life stages or settings.
The sampling method may also reduce generalizability of findings. The nature of the study design necessitated that women self-select into the study after being deemed eligible. In addition, several participants who were eligible to participate and expressed initial interest in participating ultimately declined to participate in the study and did not complete the survey or any other study measures, which may have been related to the longitudinal nature of the daily diary surveys not reported in this study. Because demographic information and dating violence victimization histories of women who were eligible but did not participate is unknown, it is unclear if there were group differences among the women who chose to participate and those who did not. The cross-sectional design of this study was also problematic as we were unable to determine the temporal relationship of drinking motives and dating violence victimization, and we are unable to determine whether the women in this study were drinking in response to victimization. In addition, the measure used to assess drinking motives did not specifically assess motives to drink following victimization. Future research should utilize longitudinal designs and use a measure that directly assesses drinking motives specific to dating violence victimization.
Conclusion
Overall, our findings partially supported our hypothesis that coping motives would moderate the relationship between dating violence victimization and alcohol problems. Thus, our findings may also partially support the self-medication model of substance use (Khantzian, 1988), specifically for sexual victimization. The results of the present study are consistent with previous research and suggest that drinking motives among women with dating violence victimization experiences are related to problematic alcohol use and confirm the need for continued research on this topic. The present study also contributed new evidence demonstrating that other drinking motives, including social, enhancement, and conformity, moderated the relationship between physical victimization and alcohol problems. However, because the results of this study are cross-sectional and not causal in nature, longitudinal research is needed to replicate and expand these findings.
Footnotes
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported, in part, by grants F31AA020131 and K24AA019707 from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) awarded to Dr. Shorey and Dr. Stuart, respectively.
