When the Good Outweighs the Bad: Day-Level Interactions Between Positive and Negative Alcohol Consequences and Their Impact on Next-Day Alcohol Cognitions.

backgroundAlcohol consequences are among the most studied predictors of future drinking behavior, yet findings regarding the influence of negative consequences on subsequent alcohol use remain inconsistent. It is possible that the more frequent experience of positive consequences, which are more salient to drinking behavior, outweighs the impact of negative consequences. The current study examined how both domains of alcohol consequences and their co-occurrence influenced next-day evaluations of drinking episodes and subsequent drinking behavior among young adults.

methodEighty-four young adults (Mage = 22.73, SD = 1.54; 56% female at birth) enrolled in an 18-day ecological momentary assessment study. Across 1412 days (578 drinking days), participants completed morning reports assessing prior-day drinking behavior, prior-day positive and negative consequences, and evaluations of the drinking episode. Multilevel models tested indirect associations between alcohol consequences and next-day drinking via subjective evaluations, as well as the interaction between concurrent positive and negative consequences.

resultsExperiencing more positive consequences than usual was associated with more favorable evaluations of the drinking episode, including higher overall positivity ratings (b = 0.23, SE = 0.03, p < 0.001) and greater perceived worth (b = 0.16, SE = 0.02, p < 0.001), whereas greater-than-usual negative consequences predicted less favorable positivity ratings (b = -0.24, SE = 0.05, p < 0.001) and lower worth ratings (b = -0.16, SE = 0.05, p < 0.001). Positive consequences moderated the relation between negative consequences and overall evaluations (b = 0.06, SE = 0.03, p < 0.05), such that the impact of negative consequences on ratings of positivity was attenuated at higher levels of positive consequences. Although no prediction of the likelihood of next-day drinking was observed, more favorable evaluations predicted heavier next-day drinking quantity on drinking days (IRR = 1.22, 95% CI [1.07, 1.38]). Positive consequences also indirectly predicted heavier next-day drinking quantity via more favorable evaluations (b = 0.05, SE = 0.02, p < 0.01).

conclusionsFindings suggest that positive alcohol experiences may buffer the impact of negative consequences, highlighting the importance of subjective evaluations of drinking episodes in shaping subsequent drinking behavior.