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. 2017 Apr 4;52(4):496–505. doi: 10.1093/alcalc/agx016

Associations Between Personality and Drinking Motives Among Abstinent Adult Alcoholic Men and Women

Susan Mosher Ruiz 1,2, Marlene Oscar-Berman 1,2,3, Maaria I Kemppainen 1,2, Mary M Valmas 1,2, Kayle S Sawyer 1,2,*
PMCID: PMC6322439  PMID: 28379312

Abstract

Aims

Men and women differ in personality characteristics and may be motivated to use alcohol for different reasons. The goals of the present study were to characterize personality and drinking motives by gender and alcoholism status in adults, and to determine how alcoholism history and gender are related to the associations between personality traits and drinking motivation.

Methods

Personality characteristics were assessed with the Eysenck Personality Questionnaire, which includes Extraversion, Neuroticism, Psychoticism and Lie (Social Conforming) scales. To evaluate drinking motivation, we asked abstinent long-term alcoholic men and women, and demographically similar nonalcoholic participants to complete the Drinking Motives Questionnaire, which includes Conformity, Coping, Social and Enhancement scales.

Results

Patterns of personality scale scores and drinking motives differed by alcoholism status, with alcoholics showing higher psychopathology and stronger motives for drinking compared with controls. Divergent gender-specific relationships between personality and drinking motives also were identified, which differed for alcoholics and controls.

Conclusion

Alcoholic and control men and women differed with respect to the associations between personality traits and motives for drinking. A better understanding of how different personality traits affect drinking motivations for alcoholic men and women can inform individualized relapse prevention strategies.

Short Summary

Men and women differed in their personality traits and their motivations for drinking, and these relationships differed for abstinent alcoholic and control groups. Additionally, alcoholics scored higher on Neuroticism and Psychoticism personality traits, and had lower Enhancement and Social Conformity drinking motives than nonalcoholic controls.

Introduction

Alcoholism causes serious personal and societal harm, and adversely affects millions of lives. In order to reduce the negative effects of alcoholism (Oscar-Berman et al., 2014), it is important to understand the reasons for problem drinking. In the prediction of alcohol use, drinking motives have proven an important construct and are conceptualized as the most proximal factor relating to alcohol use (Cooper, 1994). The motivational models of alcohol use assume that individuals drink in order to attain certain valued outcomes and that the drinking behavior motivated by different needs is characterized by distinct patterns of antecedents and consequences (Cox and Klinger, 1988). Previous literature has suggested a role for personality in drinking motives (Cooper et al., 1995; Stewart and Devine, 2000; Trull et al., 2004; Kuntsche et al., 2006; Littlefield et al., 2010; Mezquita et al., 2010), but as a risk factor for adolescents and young adults. The present study sought to extend these results, in abstinent adult alcoholic men and women, by examining how the associations between personality traits and drinking motivation vary with gender.

Eysenck's Personality Questionnaire-Revised (EPQ-R; Eysenck and Eysenck, 1994) provides an excellent instrument for personality-based alcoholism research. Based on comprehensive psychological theory and research, Eysenck's EPQ-R Short Scale includes Extraversion (E), Neuroticism (N) and Psychoticism (P) scales (Eysenck and Eysenck, 1994). The E score provides a measure of sociability, impulsiveness and sensation-seeking. The N score reflects emotional lability and anxiousness, while the P score reflects hostile/aggressive tendencies and a lack of sensitivity toward others (i.e. empathy). An additional ‘Lie’ (L) scale (Social Conforming) is a measure used to assess degrees of a stable personality factor associated with social naivety or social conformity, as well as assessing dissimulation (McCrae and Costa, 1983; Eysenck and Eysenck, 1994). Research using the EPQ-R to measure personality disorder symptoms in alcoholic individuals has revealed negative affectivity, including the presence of N and P traits in a recently (i.e. <4 weeks) abstinent sample (King et al., 1995), and in a sample with a period of abstinence of <1 year (Trull et al., 2004). Other studies have reported similar results (Rankin et al., 1982; Ogden et al., 1989).

The Drinking Motives Questionnaire-Revised (DMQ-R) developed by Cooper (1994), and based on a conceptual model by Cox and Klinger (1988), has been employed extensively to determine why individuals drink. The revised DMQ is a 20-item test with five questions for each of four motives or reasons for drinking. The questions reflect two outcome dimensions: valence (positive or negative) and source (internal or external). The two dimensions generate four distinct classes of drinking motives: Enhancement (internally generated, positive reinforcement motives, such as drinking for excitement); Social (externally generated, positive reinforcement motives, such as drinking to have fun with others); Coping (internally generated, negative reinforcement motives, such as drinking to cope with negative emotions); and Conformity (externally generated, negative reinforcement motives, such as drinking ‘to fit in’). Previous literature has indicated that internal drinking motives—because they are entwined with affective states—mediate the relation between personality traits and alcohol use, whereas external motives for drinking are less influenced by personality factors (Kuntsche et al., 2006, 2008). Moreover, because Social motives are associated with moderate alcohol use, Enhancement with heavy drinking and Coping motives with alcohol-related problems (Kuntsche et al., 2006), it would be expected that individuals with alcohol use disorders drink most commonly for internally generated negative reinforcement reasons, i.e. to cope with negative affect.

Personality exerts its effect on alcoholism through the specific motives that drive individuals to drink (Cox and Klinger, 1988; Cooper, 1994). In the early 1990s, Cooper (1994) postulated that neuroticism should be related to coping-motivated alcohol use, whereas excitement seeking (one feature of extraversion) should be related to enhancement-motivated alcohol use. Both assumptions have been corroborated in undergraduate and adolescent samples. These studies have shown that coping motives are predicted by neuroticism (Stewart and Devine, 2000; Mezquita et al., 2010) and enhancement motives by extraversion (Cooper et al., 1995; Stewart and Devine, 2000). Cooper's hypotheses are congruent with Eysenck's motivation theory, which views personality traits as biologically based systems that respond to positive and negative affective stimuli differentially (Eysenck and Eysenck, 1985). For example, extraverted individuals appear to react strongly to positive affective stimuli, which prompt enhancement-motivated alcohol use. In contrast, neurotic individuals, prone to negative emotional states, drink to cope with distressing feelings (Stewart and Devine, 2000; Piasecki et al., 2014). Methodological differences (e.g. diverse measurements of drinking motives) and the young age of subjects, however, limit the generalization of these findings to post-dependent individuals and older adults with a history of long-term alcohol abuse.

Alcoholic men and women exhibit distinct cognitive and emotional abnormalities, and varying corresponding structural and functional brain abnormalities (Pfefferbaum et al., 2001). These gender differences, however, often are ignored in alcoholism research, which may distort findings (Ruiz and Oscar-Berman, 2013). Gender differences in personality suggest higher N and L scores among women, and higher P among men (Eysenck and Eysenck, 1994). Given the gender differences in sociocultural norms related to drinking behaviors (Ruiz and Oscar-Berman, 2015), men and women may be motivated to abuse alcohol for different reasons. Evidence from adolescent and young adult samples has suggested more social and enhancement drinking among males and coping-related drinking among females, but the results are equivocal, and gender differences in drinking motives may vary with age (Kuntsche et al., 2006). The DMQ, originally developed for use with adolescents, was validated recently as a reliable measure to elucidate drinking habits in adults (Gilson et al., 2013). However, that study was conducted using an earlier version of the DMQ that does not include Conformity. Using the DMQ-R allowed us to assess Conformity as a drinking motive in an adult population.

A meta-analysis on alcohol involvement and personality has suggested that mixed-sex samples suppress associations between personality and alcohol use (Malouff et al., 2007); thus, it is necessary to examine given findings within genders. As such, the focus of the present study was (a) to investigate how abstinent long-term adult alcoholics score differently on personality measures compared with nonalcoholic controls and how this varies with gender; (b) to investigate how abstinent long-term alcoholics display differential patterns of drinking motives and how this varies with gender; and (c) to characterize the associations between personality traits and drinking motivation among abstinent alcoholic men and women and their respective nonalcoholic controls.

MATERIALS AND METHODS

Participants

Participants included 67 abstinent long-term alcoholics (31 women) and 66 demographically similar nonalcoholic controls (31 women). All were English speakers recruited through flyers placed in public places, and advertisements in newspapers and websites. Selection procedures included a telephone interview to determine age, education, health history, and history of alcohol and drug use. Participants were right-handed as required for inclusion in previous research with the same groups (Valmas et al., 2014; Sawyer et al., 2016). The study was reviewed and approved by the Institutional Review Boards at the Boston VA Healthcare System, Massachusetts General Hospital and Boston University School of Medicine. Participants gave informed consent for participation, and were compensated for their time.

Participant characteristics are summarized in Table 1. Mean ages of the alcoholic and nonalcoholic groups were 52 years. The alcoholic group averages were lower for education and IQ, and by definition, the alcoholics drank more and for longer durations. Consistent with national trends (Dawson and Archer, 1992), alcoholic men drank heavily for more years than alcoholic women, and alcoholic women had longer abstinence periods than alcoholic men. Three of the nonalcoholic control participants (two women) never drank; the others were occasional drinkers.

Table 1.

Participant demographics: age, education, neuropsychological performance and drinking history by group and gender

All alcoholics All nonalcoholics Alcoholic women Alcoholic men Nonalcoholic women Nonalcoholic men
n = 67 n = 66 n = 31 n = 36 n = 31 n = 35
Education (years)a
 Mean (SD) 14.3 (1.8) 15.3 (2.5) 14.7 (1.8) 13.9 (1.8) 15.3 (2.6) 15.3 (2.4)
 95% Confidence interval 13.8–14.7 14.7–15.9 14.0–15.3 13.3–14.6 14.3–16.2 14.5–16.2
Age (years)
 Mean (SD) 52.4 (11) 52 (13.9) 54.5 (12) 50.6 (9.9) 53.8 (15.4) 50.3 (12.5)
 95% Confidence interval 49.7–55.1 48.5–55.4 50.1–58.9 47.2–53.9 48.2–59.5 46.0–54.6
WAIS-IV Full Scale IQa
 Mean (SD) 103.2 (15.1) 111.1 (15.1) 103.1 (14.5) 103.3 (15.7) 110.3 (15.3) 111.8 (15.1)
 95% Confidence interval 99.5–106.9 107.4–114.8 97.8–108.4 98.0–108.6 104.7–115.9 106.7–117.0
Duration of heavy drinking (years)a,b,c
 Mean (SD) 15.7 (7.8) 0 (0) 13.7 (5.6) 17.4 (8.9) 0 (0) 0 (0)
 95% Confidence interval 13.8–17.5 0 11.6–15.7 14.4–20.4 0 0
Quantity Frequency Index (drinks per day)a
 Mean (SD) 11.2 (8.2) 0.2 (0.3) 9.2 (7.3) 12.9 (8.6) 0.2 (0.3) 0.2 (0.2)
 95% Confidence interval 9.2–13.2 0.1–0.3 6.5–11.9 10.0–15.8 0.1–0.4 0.1–0.2
Length of sobriety (years)a,b,c
 Mean (SD) 7.2 (9.8) 2.1 (7.4) 10.9 (11.9) 4 (6.1) 2.2 (7.4) 2 (7.6)
 95% Confidence interval 4.8–9.6 0.2–4.0 6.5–15.3 1.9–6.0 −0.6–5.0 −0.6–4.7
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Significant differences (P ≤ 0.05): aGroup; bGroup; cGroup-by-Gender.

Assessments

Participants underwent a medical history interview, responded to a series of questionnaires and were given a computer-assisted, shortened version of the Computerized Diagnostic Interview Schedule (DIS; Robins et al., 2000), which provides lifetime psychiatric diagnoses according to criteria established by the American Psychiatric Association. Participants were excluded if they had one of the following: Korsakoff's syndrome; HIV; hepatic disease; head injury with loss of consciousness greater than 15 min; stroke; seizures unrelated to alcoholism; schizophrenia; Hamilton Rating Scale for Depression (HRSD; Hamilton, 1960) score over 16; corrected visual acuity worse than 20/50 in both eyes; or illicit drug use (except marijuana) more frequently than once per week within the prior 5 years.

Participants received a structured interview to assess their drinking history, including duration of heavy drinking (DHD, i.e. years of consumption of 21 drinks or more per week) and abstinence duration (length of sobriety; LOS). A Quantity Frequency Index (QFI; Cahalan et al., 1969), which factors the amount, type and frequency of alcohol usage (ounces of ethanol per day, roughly corresponding to number of drinks per day) over either the last 6 months (for the nonalcoholic participants) or over the 6 months preceding cessation of drinking (for the abstinent alcoholic participants), was calculated for each participant. The alcoholics met criteria for alcohol abuse or dependence for a period of at least 5 years in their lives, and had abstained from alcohol for at least 4 weeks prior to testing.

Evaluations typically required 6–9 h over 3 or more days. Psychological measures included the Wechsler Adult Intelligence Scale-IV (WAIS-IV), the Wechsler Memory Scale-IV (WMS-IV) and the Wechsler Advanced Clinical Solutions (ACS) module (Holdnack et al., 2013). Personality characteristics were assessed with the 57-item EPQ-R Short Scale (with E, N, P and L scales; Eysenck and Eysenck, 1994). The participants responded to the EPQ-R based on their present preferences and self-ratings (which are reported to be stable across the lifetime; Sanderman and Ranchor, 1994; Wilson and Gullone, 1999). To evaluate drinking motivation, participants completed the 20-item self-report DMQ-R (Cooper, 1994). When rating their responses on the DMQ-R alcoholic participants were instructed to think back to the period of time during which they had been drinking.

Statistical analyses

Statistical analyses were performed using JMP Pro Version 11.0.0 (SAS Institute, 2013) and SPSS Version 20 (IBM Corp., 2011). Demographic variables were examined using separate univariate analysis of variance (ANOVA) models for Group, Gender and Group-by-Gender effects (Table 1). A primary goal of this study was to examine Group and Gender differences in Personality (EPQ-R) and Drinking Motives (DMQ-R). Table 2 shows Group means, standard deviations (SDs) and confidence intervals for Personality and Drinking Motives scores. Full factorial repeated-measures ANOVA models were run with between-subject factors of Group and Gender and within-subject factors of either Personality (Supplementary Fig. 1) or Drinking Motive (Supplementary Fig. 2). Since QFI and DHD are redundant with the main effects of Group (i.e. there is high multicollinearity), we did not include them as covariates in the ANOVA models.

Table 2.

EPQ and DMQ scores

All alcoholics All nonalcoholics Alcoholic women Alcoholic men Nonalcoholic women Nonalcoholic men
n = 67 n = 66 n = 31 n = 36 n = 31 n = 35
EPQ-R Extraversion
 Mean (SD) 6.4 (3.6) 7.7 (3.7) 6.7 (3.8) 6.1 (3.5) 7.6 (3.8) 7.7 (3.6)
 95% Confidence interval 5.5–7.3 7.0–8.6 5.4–8.1 4.9–7.3 6.3–9.0 6.5–9.0
EPQ-R Neuroticism
 Mean (SD) 6.4 (3.6) 3.1 (3) 7.2 (3.9) 5.6 (3.3) 3.7 (2.9) 2.6 (2.9)
 95% Confidence interval 5.5–7.2 2.4–3.8 5.8–8.6 4.5–6.8 2.6–4.8 1.6–3.6
EPQ-R Psychoticism
 Mean (SD) 2.9 (1.7) 2 (1.7) 2.6 (1.7) 3.2 (1.7) 1.5 (1.4) 2.4 (1.9)
 95% Confidence interval 2.5–3.3 1.5–2.4 2.0–3.2 2.6–3.8 1.0–2.0 1.7–3.0
EPQ-R Lie
 Mean (SD) 5.4 (3.4) 7.9 (3.3) 5.7 (3.2) 5.1 (3.6) 8.6 (3.4) 7.3 (3.3)
 95% Confidence interval 4.6–6.2 7.1–8.7 4.5–6.9 3.9–6.3 7.4–9.8 6.2–8.4
Drinking Motives Enhancement
 Mean (SD) 23.6 (5) 10.5 (5.4) 22.9 (6) 24.2 (4) 10.4 (6) 10.5 (5)
 95% Confidence interval 22.4–24.8 9.1–11.8 20.7–25.1 22.8–25.6 8.2–12.5 8.8–12.3
Drinking Motives Coping
 Mean (SD) 22.6 (6.1) 6.8 (3.5) 23.3 (5.5) 22 (6.5) 7.4 (3.2) 6.3 (3.7)
 95% Confidence interval 21.1–24.1 6.0–7.7 21.3–25.3 19.8–24.2 6.2–8.5 5.1–7.6
Drinking Motives Conformity
 Mean (SD) 11.4 (6) 6.2 (2.2) 11.4 (6.1) 11.5 (6) 6.3 (2.5) 6.1 (2)
 95% Confidence interval 10.0–12.9 5.7–6.8 9.1–13.6 9.5–13.5 5.4–7.2 5.5–6.8
Drinking Motives Social
 Mean (SD) 20.9 (6.6) 11.6 (5.8) 21.5 (6.8) 20.5 (6.4) 11.3 (6.1) 11.9 (5.7)
 95% Confidence interval 19.3–22.5 10.2–13.0 18.9–24.0 18.3–22.7 9.1–13.5 9.9–13.8
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Mean and SD raw scores from EPQ-R Short Scale and DMQ-R by group and gender.

With one exception, we used raw scores as independent measures on the DMQ-R and EPQ-R throughout the analyses so that the group differences in gender would not be masked by normative scales. The exception was converting raw scores to z-scores to allow clear interpretation of within-subject repeated-measures ANOVA, which require that the outcome variables have the same ranges, i.e. for EPQ-R scores, where the numbers of items per trait are unequal. When we converted raw scores to z-scores, we used EPQ-R gender-specific norms (having the same ranges) prior to running the repeated-measures ANOVA.

Outliers of greater than three standard deviations from the overall group of participants for any Drinking Motive (two outliers for Conformity) or Personality score (none) were removed from the repeated-measures ANOVA for that outcome. Sphericity tests were not significant for the Drinking Motives analysis. As sphericity was violated for the Personality scores repeated-measures ANOVA, Greenhouse–Geiser-adjusted P-values are reported. Post hoc tests for all interactions were conducted using Bonferroni correction.

To examine the relationships between Personality and Drinking Motives, and how these relationships are affected by a history of long-term alcoholism and gender, we used linear regression in four separate groups: alcoholic women, alcoholic men, control women and control men. Raw scores were used for both Personality and Drinking Motives variables, with Personality entered as the predictor variable. All regression analyses included an examination of influential points; any point with Cook's D ≥1 was removed prior to final analyses. When a significant relationship between a Personality factor and Drinking Motive for a given subgroup was identified (Figs 1 and 2), Group-by-Gender interaction effects were tested.

Fig. 1.

Fig. 1.

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The relationship between Drinking Motives and Personality Traits was analyzed using linear regression for each group separately by gender. Conformity scores were negatively associated with Extraversion scores in alcoholic women, whereas no significant relationship between Conformity and Extraversion was found in control women (A). No significant association was found between Conformity and Extraversion scores in either alcoholic or control men (B). Coping scores were positively associated with Psychoticism scores in alcoholic women, but not in control women (C). No association was found between Coping and Psychoticism scores in either alcoholic or control men (D). Coping scores were positively associated with Neuroticism scores in alcoholic women, and a similar though non-significant effect was present among control women (E). No significant association was found between Coping and Neuroticism scores in either alcoholic or control men (F).

*P < 0.05; +Group interaction, P < 0.05.

Fig. 2.

Fig. 2.

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The relationship between Drinking Motivation and Personality Traits was analyzed using linear regression for each group separately by gender. The Coping motive scores were inversely associated with Lie Scale scores in both alcoholic women (A) and alcoholic men (B). The Enhancement drinking motive scores were inversely associated with the Lie Scale scores in both control women (C) and alcoholic men (D). The Conformity drinking motive scores were inversely associated with Lie Scale scores in alcoholic men (F), and a similar though non-significant effect was present among alcoholic women (E).

*P < 0.05; +Group interaction, P < 0.05.

RESULTS

Personality, group and gender effects

We examined relationships of education and IQ to DMQ-R and EPQ-R scores for each group separately. For the nonalcoholic control group, neither education nor IQ was significantly correlated with any of the EPQ-R or DMQ-R scores. Likewise, for alcoholics, neither education nor IQ was significantly related to DMQ-R scores, but on the EPQ-R, P scale scores had a small negative relationship with education (r = −0.25), as did L scale scores with IQ (r = −0.25).

The full factorial repeated-measures ANOVA model using gender-normed z-scores revealed a main effect of Personality and a significant interaction of Personality-by-Group (Table 3). Bonferroni-corrected post hoc analyses of the between-subject effects showed that alcoholics differed from nonalcoholic controls on all four personality scales. Relative to controls, alcoholics scored lower on the E and L scales, and higher on the N and P scales (Table 3). The three-way interaction of Personality, Group and Gender was not significant, nor was the interaction of Personality-by-Gender.

Table 3.

Repeated-measures ANOVA results for Eysenck Personality Scale z-scores

Full model
Group Gender Personality Personality-by-Gender Personality-by-Group Group-by-Gender Personality-by-Group-by-Gender
F 0.68 0.54 20.70*** 0.37 19.60*** 0.42 0.27
Between-subject effects
Mean difference (alcoholics vs. controls) Standard error of mean difference 95% CI of mean difference
Extraversion −0.38* 0.19 [−0.76, 0.001]
Neuroticism 0.97*** 0.17 [0.64, 1.30]
Psychoticism 0.47*** 0.14 [0.18, 0.75]
Lie −0.81*** 0.19 [−1.19, −0.44]
Within-subject effects
Alcoholics Controls
Mean difference Standard error of mean difference 95% CI of mean difference Mean difference Standard error of mean difference 95% CI of mean difference
Extraversion
 vs. Neuroticism −0.69** 0.20 [−1.23, −0.14] 0.66** 0.20 [0.12, 1.21]
 vs. Psychoticism −0.68** 0.18 [−1.17, −0.18] 0.17 0.19 [−0.32, 0.67]
 vs. Lie −0.67** 0.19 [−1.18, −0.16] −1.10*** 0.19 [−1.61, −0.59]
Neuroticism
 vs. Psychoticism 0.01 0.14 [−0.36, 0.38] −0.49** 0.14 [−0.86, −0.12]
 vs. Lie 0.02 0.20 [−0.51, 0.54] −1.76*** 0.20 [−2.29, −1.23]
Psychoticism
 vs. Lie 0.01 0.17 [−0.45, 0.47] −1.27*** 0.17 [−1.73, −0.81]
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Post hoc between- and within-subject effects are reported with Bonferroni adjustment applied. *P < 0.05; **P < 0.01; ***P < 0.001.

Bonferroni-corrected within-group post hoc analyses showed that alcoholics scored lower on E than on N, P and L scales (Supplementary Fig. 1). By contrast, nonalcoholic controls scored higher on the L scale relative to E, N and P. Nonalcoholic controls also scored higher on both E and P relative to N. This pattern was consistent across genders. It should be noted that even though the L scale z-scores for our nonalcoholic controls were higher than all other scores, the means and standard deviations (for the men and women alike) were not significantly different when compared with standardization data from the EPQ-R Manual. This supports the validity of our measures, and the L scale's reliability as a stable personality characteristic of social naivety or conformity (McCrae and Costa, 1983; Eysenck and Eysenck, 1994). In addition to the repeated-measures ANOVA on personality scale z-scores, we performed confirmatory repeated-measures ANOVA on the EPQ-R raw scores to examine Gender without the gender-based normalization of scores; these analyses confirmed the expected gender differences (Eysenck and Eysenck, 1994). A Personality-by-Gender trend was identified (F3,387 = 32.64, P = 0.07) wherein women scored significantly higher than men on the N scale (mean diff. = 1.33, standard error (SE) = 0.57, P = 0.02; 95% confidence interval [CI] [0.20, 2.46]), while men scored higher than women on the P scale (mean diff. = −0.72, SE = 0.29, P = 0.02; 95% CI [−1.30, −0.14]). These gender effects were consistent for the alcoholic and control groups.

Drinking motivation, group and gender effects

As was expected, the full factorial repeated-measures ANOVA model confirmed a significant interaction of Drinking Motive-by-Group (Table 4). Bonferroni-corrected post hoc analyses of the between-subject effects showed that alcoholics scored higher than nonalcoholics on all four drinking motives scales. This pattern was consistent across genders. The three-way interaction of Drinking Motive, Group and Gender was not significant, nor was the interaction of Drinking Motive-by-Gender.

Table 4.

Repeated-measures ANOVA results for Drinking Motives Questionnaire raw scores

Full model
Group Gender Drinking motive Drinking motive-by-gender Drinking Motive-by-Group Group-by-Gender Drinking Motive-by-Group-by-Gender
F 248.53*** 0.05 111.06*** 1.20 42.51*** 0.005 0.59
Between-subject effects
Mean difference (alcoholics vs. controls) Standard error of mean difference 95% CI of mean difference
Enhancement 13.11*** 0.92 [11.31, 14.93]
Coping 15.79*** 0.86 [14.09, 17.50]
Conformity 5.23*** 0.80 [3.65, 6.81]
Social 9.40*** 1.09 [7.25, 11.55]
Within-subject effects
Alcoholics Controls
Mean difference Standard error of mean difference 95% CI of mean difference Mean difference Standard error of mean difference 95% CI of mean difference
Enhancement
 vs. Coping 0.91 0.64 [−0.82, 2.63] 3.58*** 0.65 [1.85, 5.32]
 vs. Conformity 12.12*** 0.73 [10.17, 14.08] 4.23*** 0.73 [2.27, 6.20]
 vs. Social 2.59*** 0.67 [0.81, 4.38] −1.13 0.67 [−2.92, 0.67]
Coping
 vs. Conformity 11.22*** 0.69 [9.36, 13.07] 0.65 0.70 [−1.22, 2.52]
 vs. Social 1.68 0.75 [−0.33, 3.70] −4.71*** 0.76 [−6.74, −2.68]
Conformity
 vs. Social −9.53*** 0.72 [−11.47, −7.60] −5.36*** 0.72 [−7.31, −3.41]
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Post hoc between- and within-subject effects are reported with Bonferroni adjustment applied. ***P < 0.001.

Examination of within-group effects using a Bonferroni correction for multiple comparisons showed that alcoholics scored lower on Conformity than on all three other drinking motives (Supplementary Fig. 2). Alcoholics also scored higher for Enhancement than for Social drinking. A different pattern emerged for nonalcoholic controls, who scored higher for Enhancement drinking relative to both Coping and Conformity, and also higher on Social drinking relative to both Coping and Conformity. These within-group differences on drinking motives were consistent across genders.

Relationships between personality and drinking motives

Associations between personality and drinking motivation measures were assessed for all four groups separately. Significant associations between each of the four personality measures with each of the four drinking motives are reported below. Significant group differences in these relationships are also reported (i.e. interaction tests); significant gender differences in these relationships were not detected.

The E scores were negatively associated with Conformity scores in alcoholic women (R2 = 0.14, P < 0.05; Fig. 1A). This effect was significantly different from the relationship between the E scores and Conformity in nonalcoholic control women, for whom there was no significant relationship (Group interaction, P < 0.05). The E scores were not associated with Conformity scores in either alcoholic or control men (Fig. 1B).

The P scores were positively associated with Coping scores in alcoholic women (R2 = 0.13, P < 0.05), a relationship that was not present in control women (Fig. 1C), nor in alcoholic or control men (Fig. 1D). The N scores were positively associated with Coping scores in alcoholic women (R2 = 0.17, P < 0.05), and a similar though non-significant effect was present among nonalcoholic control women (Fig. 1E). The N scores were not associated with the Coping scores in either alcoholic or control men (Fig. 1F).

The L scores were negatively associated with Coping in alcoholic women (R2 = 0.20, P < 0.05, Fig. 2A) and in alcoholic men (R2 = 0.19, P < 0.01; Fig. 2B). This relationship was not present in the controls for either gender (Group interactions: women, P < 0.05; men, P < 0.01). The L scores also were inversely associated with the Enhancement drinking motive in control women (R2 = 0.20, P < 0.05; Fig. 2C) as well as in alcoholic men (R2 = 0.15, P < 0.05; Fig. 2D). Finally, higher L scores were associated with lower Conformity scores in alcoholic men (R2 = 0.12, P < 0.05; Fig. 2F), an effect that differed significantly from control men (Group interaction, P < 0.05).

DISCUSSION

In the present study, analyses of personality characteristics using the EPQ-R indicated that alcoholics scored higher on N and P scales and lower on E and L scales than controls. This expands upon prior findings showing alcohol involvement to be significantly associated with low agreeableness, low conscientiousness and high neuroticism (Malouff et al., 2007). Further, our finding that women showed higher N and L scores, while men scored higher on the P scale, supports other gender-based personality differences typically observed in abstinent long-term alcoholics (King et al., 2003).

Drinking motives research has suggested that positive reinforcement motives (Enhancement and Social) are associated with non-problematic alcohol use, whereas the negative reinforcement motives (Coping and Conformity) are related to problem drinking both in adolescents (Cooper, 1994; Kuntsche et al., 2006) and in adults (Willinger et al. 2002; Boschloo et al., 2012). We confirmed that nonalcoholic controls were more likely to drink for Enhancement and Social reasons relative to Coping and Conformity, and further showed that this pattern was consistent within genders. Our sample of alcoholic adults drank less for Conformity reasons relative to Enhancement, Social and Coping reasons. Within positive reinforcement motives, the alcoholics were more likely to drink for internally generated reasons (Enhancement) relative to externally-motivated reasons (Social), consistent with the suggestion that enhancement motives are correlated with drinking problems indirectly through heavy drinking (Cooper, 1994). In contrast, conformity motives are negatively related to heavy drinking but positively related to drinking problems (Cooper, 1994). The fact that our Conformity drinking motives results with alcoholic adults is less consistent with those for adolescents makes sense, as internally generated motives (Enhancement and Coping) have a more robust association to heavy drinking than externally generated motives (Social and Conformity), which depend more on context and are less stable over time (Cooper, 1994; Stewart and Devine, 2000).

Our study included alcoholics who were abstinent for extended lengths, on average for 7.2 years, after prolonged heavy drinking (21 or more drinks per week for 15.7 years on average). When rating their responses on the DMQ-R, the alcoholics were instructed to think back to the period of time when they had been drinking, and to respond to the EPQ-R based on their present preferences and self-ratings (which are stable over time; Sanderman and Ranchor, 1994; Wilson and Gullone, 1999). Prior research examining responses on EPQ traits in non-abstinent alcoholics, or in alcoholics with shorter lengths of sobriety, have consistently shown negative affectivity. For example, in a sample of current drinkers (Rankin et al., 1982) and in individuals with at least 2 weeks of abstinence (Ogden et al., 1989), participants scored higher on E, N and P scales. Additionally, the scores of King et al.’s (1995) participants, who were abstinent fewer than 4 weeks, as well as Trull et al.’s (2004) participants, abstinent for less than a year, revealed elevated N and P traits. In the present study, we also observed higher N and P traits in our alcoholic sample, but lower E and L traits. It is possible that our sample of alcoholics, with longer durations of abstinence than in the aforementioned studies, had developed strategies to help reduce their impulses to drink and their need for social conformity as a motive to drink. Thus, although we do not have information regarding the course of treatment for our alcoholic participants, our results may reflect personality characteristics and aspects of drinking motivation for those individuals who have been more successful in responding to treatment. Clearly, these conjectures warrant additional research by directly comparing differences between non-abstinent alcoholics and short- or long-term abstinent alcoholics on personality traits, including those measured by the EPQ.

Alcoholic men and women tend to have different patterns of associated comorbid psychiatric disorders, distinct cognitive and emotional abnormalities, and varying corresponding structural and functional brain abnormalities (Ruiz and Oscar-Berman, 2013). Previous research has shown that abstinent alcoholic men and women differ in personality characteristics (King et al., 2003; Oscar-Berman et al., 2009), and that among abstinent alcoholic men, N and P scores were significantly higher than other EPQ scales (King et al., 1995). Moreover, in women, P scores were related to increased quantity and frequency of alcohol consumption (Grau and Ortet, 1999). Additionally, recovering alcoholic men and women may be motivated to relapse for different reasons (Boschloo et al., 2012). Further, although converging, there remain gender differences in sociocultural norms related to alcohol use behaviors (Brady et al., 2009; Ruiz and Oscar-Berman, 2015). As such, we expected to find different drinking motivation for men and women. Previous research with young adults and adolescents had suggested that enhancement-motivated drinkers tend to be male, while coping-motivated drinkers are likely to be female (Kuntsche et al., 2006). However, our results with older adults did not indicate gender differences of this nature.

Although significant gender differences in drinking motivation were not observed for either alcoholics or controls, there were differences in the relationships between personality and drinking motivation. In alcoholic women, E scores were negatively associated with Conformity scores, suggesting that introverted women felt a greater need to drink ‘to fit in’. Also in alcoholic women, both the N and P scores were positively associated with Coping scores, suggesting that greater psychopathology in alcoholic women motivated more drinking to deal with negative mood states. The L scores were negatively associated with Coping in alcoholic men and women alike, which may suggest that alcoholics who see themselves as less socially conforming have higher need to build self-confidence and quell worries than those who are more socially conforming. The L scores also were inversely associated with the Enhancement drinking motive in both control women and alcoholic men. In the control women, this could be interpreted as conforming to a social norm that women should not drink ‘just for fun’. The L scores also were associated with lower Conformity scores in alcoholic men, suggesting that the men who see themselves as socially inadequate feel the need to drink for Conformity reasons.

Limitations

We used the EPQ-R to assess personality characteristics, and the DMQ-R to assess drinking motives in abstinent alcoholics. However, other personality and motivation scales measure different sets of constructs (Kuntsche et al., 2006; Littlefield and Sher, 2010). Additionally, norms for any given personality or motivation scale may vary with variables such as cultural and developmental changes over time, whereby different traits are emphasized. Likewise, personality characteristics and drinking motives are influenced by variables such as age, education, socioeconomic standing, active drinking patterns and treatment status (Eysenck and Eysenck, 1994; Trull et al., 2004). Thus, caution is advised in using different scales, and generalizing findings or comparing studies undertaken with different populations and cultures. Finally, consistent with previous literature (Dawson and Archer, 1992), alcoholic men demonstrated heavier drinking behaviors compared with alcoholic women. Notwithstanding a source of variability by gender, this discrepancy gives credence to the ecological soundness of our findings.

Acknowledgements

The authors thank Diane Merritt, Pooja Parikh, Riya B. Luhar and Zoe Gravitz for recruitment assistance and neuropsychological testing, and Gordon J. Harris and Eve M. Valera for their comments on this project.

Supplementary material

Supplementary material is available at Alcohol And Alcoholism online.

Conflict of Interest Statement

None declared.

Funding

This work was supported by funds from the National Institute on Alcohol Abuse and Alcoholism (NIAAA) grants R01AA07112 and K05AA00219, and the US Department of Veterans Affairs Clinical Science Research and Development grant I01CX000326 to Dr Marlene Oscar Berman.

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