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Momentary associations between stress and alcohol craving in the naturalistic environment: differential associations for Black and White young adults
Author(s) -
Pedersen Sarah L.,
Kennedy Traci M.,
Holmes Jordan,
Molina Brooke S. G.
Publication year - 2022
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.15740
Subject(s) - psychology , craving , young adult , demography , clinical psychology , psychiatry , developmental psychology , addiction , sociology
Abstract Background and Aims Black drinkers compared with White drinkers experience more alcohol‐related problems. Examination of social determinants of inequities in alcohol problems is needed. The current study measured (1) associations between acute stress and alcohol craving in the naturalistic environment for self‐identified Black and White individuals who drink alcohol and (2) whether a history of attention deficit hyperactivity disorder (ADHD) moderated these associations. Design and Setting Observational study using ecological momentary assessment (EMA) to collect data from participants at six semi‐random time‐points throughout the day during a 10‐day period. A series of three‐level multi‐level models examined between‐ and within‐person associations for stress and alcohol and tested if these associations differed for Black and White adults. Participants Participants were 229 adult drinkers (aged 21–35 years) who completed a larger study examining alcohol response for Black and White adults with and without a history of childhood ADHD. Measurements Momentary stress and alcohol craving, ADHD history and socio‐demographic characteristics (i.e. racial identity, sex, age, current education level, household income) were assessed. Participants were required to self‐identify as either ‘African American or Black’ or ‘European American or White’. Findings Significant racial identity × stress interactions indicated that associations between stress and craving were stronger for Black compared with White adults across the 10‐day period (between‐person: B = 0.14, P = 0.007), concurrently within a given EMA time‐point (within‐person: B = 0.04, P = 0.001) and prospectively from time‐point to time‐point (within‐person: B = 0.05, P = 0.001). Results remained while accounting for income × stress interactions. Conclusions Acute stress appears to be more strongly related to alcohol craving in self‐identified Black compared with self‐identified White individuals. This provides support for policy changes to eliminate structural inequities that increase stress exposure and the development of just‐in‐time culturally responsive interventions focused on coping with acute stress for Black individuals.