Department of Psychology.
Harvard Medical School.
Psychol Addict Behav. 2018 Nov;32(7):792-799. doi: 10.1037/adb0000397. Epub 2018 Oct 4.
Heavy drinking among college students in the United States is common and results in a wide range of problems. Symptoms of depression are also common among college students and may exacerbate problems associated with heavy drinking, but to date most studies have been cross sectional and relied on an aggregate measure of alcohol problems. Further, depressive symptoms may also predict other elements of risk among heavy drinkers, including greater experience of substance-related reinforcement, and diminished experience of substance-free reinforcement. The current study examines depressive symptoms as a prospective predictor of changes in alcohol problem domains and reward variables in a sample of heavy drinking college students. Heavy drinking college students ( = 138) completed a survey assessing depressive symptoms, alcohol problems, and reinforcement at baseline and after a 12-month follow-up period. Multiple regressions examined the utility of depressive symptoms (DASS-21) in predicting alcohol problems, substance-related reinforcement, and substance-free reinforcement at the 12-month follow-up after controlling for baseline drinking level and the baseline level of the relevant outcome variable. Baseline depressive symptoms predicted 12-month alcohol problems related to impaired control (i.e., drinking more than planned), self-perception, and self-care. Depressive symptoms also predicted lower 12-month substance-free, but not substance-related, reinforcement. Finally, change in depressive symptoms was associated with total alcohol problems, impaired control, self-perception, self-care, academic/occupational, and physiological dependence problems at 12-month follow-up. Heavy drinkers with depressive symptoms may benefit from interventions targeting alcohol problems that also increase access to and engagement in rewarding alternative activities. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
美国大学生酗酒现象普遍，由此导致了一系列问题。抑郁症状在大学生中也很常见，可能会加重与酗酒相关的问题，但迄今为止，大多数研究都是横断面的，并且依赖于酒精问题的综合衡量。此外，抑郁症状也可能预测酗酒者的其他风险因素，包括与物质相关的强化体验增加，以及与物质无关的强化体验减少。本研究考察了抑郁症状在一组重度饮酒大学生的酒精问题领域和奖励变量变化中的前瞻性预测作用。重度饮酒大学生（n=138）在基线和 12 个月随访期间完成了一项调查，评估了抑郁症状、酒精问题和强化作用。多元回归分析考察了抑郁症状（DASS-21）在控制基线饮酒量和相关结果变量的基线水平后，对 12 个月随访时的酒精问题、物质相关强化作用和物质无关强化作用的预测能力。基线抑郁症状预测了 12 个月与控制受损（即饮酒量超过计划）、自我认知和自我护理相关的酒精问题。抑郁症状还预测了 12 个月物质无关但与物质相关的强化作用降低。最后，抑郁症状的变化与 12 个月随访时的总酒精问题、控制受损、自我认知、自我护理、学术/职业和生理依赖问题有关。有抑郁症状的重度饮酒者可能受益于针对酒精问题的干预措施，这些干预措施还可以增加获得和参与奖励性替代活动的机会。（PsycINFO 数据库记录（c）2018 APA，保留所有权利）。
