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. Author manuscript; available in PMC: 2020 Apr 21.
Published in final edited form as: J Dual Diagn. 2019 Apr 21;15(2):95–104. doi: 10.1080/15504263.2019.1583398

The Mediating Role of Impulsivity Between Psychological Distress and Alcohol Misuse Among College Students at a Historically Black University

Megan M Risi 1,*, Shannon R Forkus 2,*, Amanda Roy 3, Robert G Laforge 4, Joseph S Rossi 5, Nicole H Weiss 6
PMCID: PMC6541518  NIHMSID: NIHMS1012941  PMID: 31007151

Abstract

Objective:

Alcohol misuse is prevalent and clinically significant among college students. Psychological distress is one factor that has been found to predict alcohol misuse in this population. However, relatively few investigations examined the association of psychological distress to alcohol misuse or its underlying mechanisms among students attending Historically Black Colleges and Universities (HBCUs). The present study examined whether impulsivity explains the relation between psychological distress and alcohol misuse in this population using structural equation modeling.

Methods:

Participants were 287 undergraduate students attending an HBCU in the southern United States (Mage = 22.5, 66.3% female, 93.7% Black).

Results:

Impulsivity was found to significantly mediate the association of psychological distress to alcohol misuse, such that higher levels of psychological distress were associated with greater impulsivity which, in turn, was related to more alcohol misuse. Further analyses indicated that attentional impulsivity significantly mediated the association of psychological distress to alcohol misuse.

Conclusion:

These findings suggest the utility of targeting impulsivity in interventions aimed at preventing and reducing alcohol misuse among college students attending HBCUs who experience psychological distress.

Keywords: psychological distress, impulsivity, alcohol misuse, HBCU, college students

Introduction

Alcohol misuse indicates a problematic pattern of drinking characterized by excessive alcohol consumption (e.g., drinking above recommended limits), maladaptive drinking behaviors (e.g., chronic drinking that results in clinically significant impairment), and alcohol-related problems (e.g., distress or difficulties functioning in daily life; Bradley, DeBenedetti, Volk, Williams, Frank, & Kivlahan, 2007; Saunders, Aasland, Babor, De la Fuente, & Grant, 1993). Alcohol misuse presents a major public health concern. College students are more likely than their non-college peers to participate in maladaptive and high-risk alcohol-related behaviors (SAMHSA, 2014), and thus may be at a heightened risk for alcohol misuse. Indeed, compared to their same-aged peers, college students report higher rates of binge drinking (39.0% vs. 33.4%, respectively; SAMHSA, 2014) and alcohol use disorders (20.4% vs 17.0%, respectively; Blanco et al., 2008). Alcohol misuse is associated with a wide range of social, behavioral, and physical consequences among college students (e.g., illness/injury, academic problems, HIV/sexual risk; Hingson, Zha, & Weitzman, 2009; Scott-Sheldon, Carey, & Carey, 2010; Thombs et al., 2009). However, the majority of research in this area has examined students attending Predominantly White Institutions (PWI), and therefore less is known about alcohol misuse among students attending Historically Black Colleges and Universities (HBCUs; Messina, Tseng, & Correia, 2015). Attending HBCUs has been shown to be a protective factor against alcohol misuse (Lewis, Likis-Werle, & Fulton, 2012), as students who attend HBCUs, regardless of race, report lower rates of alcohol misuse (18–22%; Meilman, Presley, & Cashin, 1995; Rhodes, Singlton, McMillan, & Perrino, 2005) than students at PWIs (44%; White & Hingson, 2014). Yet, despite having generally lower rates of alcohol misuse, some students at HBCUs still go on to develop alcohol misuse. Hence, research is needed to explore the factors that contribute to alcohol misuse among these college students.

Psychological distress, defined by subjective levels of depression, anxiety, and stress (Henry & Crawford, 2005), is common among college students (Bayram & Bigel, 2008; Furr, Westefeld, McConnell, & Jenkins, 2001). For instance, in one study, college students were found to report moderate to severe levels of depression (27%), anxiety (47%), and stress symptoms (27%; Bayram & Bigel, 2008). Psychological distress among college students is associated with greater alcohol use and severity (Alati et al., 2005; O’Donnell, Wardle, Dantzer, & Steptoe, 2006; Sullivan, Fiellin, & O’Connor, 2005), as well as increased alcohol-related problems (Armeli, Conner, Cullum, & Tennen, 2010; Gonzalez, Reynolds, & Skewes, 2011). Alcohol use in college populations is often motivated by social and enhancement reasons; however, these functions are generally considered less likely to result in alcohol misuse (Kuntsche & Kuendig, 2005; Anderson, Simmons, Martens, Ferrier, & Sheehy, 2006; Beseler, Aharonovich, Keys, & Hasin, 2008; Doyle, Donovan, & Simpson, 2011). Instead, alcohol misuse is most frequently linked to the escape or avoidance of discomfort associated with psychological distress (Grant, Stewart, & Mohr, 2009). This tendency to use alcohol to cope with psychological distress may offer temporary relief but can ultimately lead to maladaptive patterns of alcohol use (i.e., alcohol misuse). Specifically, alcohol use to reduce psychological distress is negatively reinforcing, thus increasing the likelihood of using alcohol in the future to relieve stress (Steele, Southwick, & Pagano, 1986). Given evidence for a well-established relation between psychological distress and alcohol misuse, it is critical to identify mechanisms that underlie this association. Such findings will inform interventions for preventing or reducing alcohol misuse among individuals who experience psychological distress.

One important factor to consider in this regard is impulsivity. Impulsivity has been variously defined in the literature (see Smith, Fischer, Cyders, Spillane, & McCarthy, 2007), most notably as “a predisposition toward rapid, unplanned reactions to internal or external stimuli without regard to the negative consequences of these reactions to the impulsive individuals or to others” (Moeller, Barratt, Dougherty, Schmitz, & Swann, 2001, p. 1784). This may include acting without thinking (motor impulsivity), making quick cognitive decisions (cognitive impulsivity), and present orientation (non-planning impulsivity; Patton, Stanford, & Barratt, 1995). As impulsivity involves the tendency to act with little consideration of the consequences, individuals who experience heightened impulsivity may be at increased likelihood to alleviate psychological distress by engaging in high risk behaviors (e.g., alcohol misuse), which ultimately exacerbate psychological distress (Guillot, Pang, & Leventhal, 2014). In the context of alcohol use, impulsivity may impair the ability to control the amount of alcohol consumed, frequency of drinking, and behavioral decisions while under the influence. Indeed, impulsivity has a well-established association with alcohol misuse (Bayard, Raffard, & Gely-Nargeot, 2011; Dick et al., 2010; King, Karyadi, Kenny, Luk, & Patock-Peckham, 2011; Simons, Gaher, Oliver, Bush, & Palmer, 2005).

Regarding the role of impulsivity in the psychological distress and alcohol misuse association, psychological distress may, in part, lead to maladaptive patterns of drinking through deficits in impulse control (Fox, Bergquist, Peihua, & Sinha, 2010). Efforts to manage psychological distress may motivate impulsive tendencies in an attempt to receive immediate gratification (i.e., escaping psychological distress). Shifts in motivational and attentional processes may ultimately undermine self-control efforts by: (1) reducing motivation to exert control over regulating urges, and a shift towards reward-seeking tendencies; and (2) simultaneous deficits in attentional processes that divert attention away from cues that signal the need for self-control, and towards cues that signify potential rewards and gratification (i.e., process model of ego depletion; Inzlicht & Schmeichel, 2012). This may be particularly pronounced in a college context where social pressures to drink and access to alcohol are more abundant, both linked to impulsive responding (Gilman, Curran, Calderon, Stoeckel, & Evins, 2014; Park, Sher, Wood, & Krull, 2009; Stevens, Littlefield, Blanchard, Talley, & Brown, 2016). Consistent with the above findings, one study found support for the mediational effect of impulsivity on the relation between depression and alcohol use among college students (Gonzalez et al., 2011). However, this sample was comprised of students at a PWI and examined only one aspect of psychological distress: depression.

The aim of the present study is to extend the literature by investigating the mediational effect of impulsivity on psychological distress and alcohol misuse among students attending a HBCU. Consistent with the literature, we expected to find significant positive associations among psychological distress, impulsivity, and alcohol misuse. Further, we expected that impulsivity will mediate the relation between psychological distress and alcohol misuse.

Methods

Procedure and Participants

Data were collected at an HBCU in the southeastern United States. Participants were recruited from introductory psychology courses. Interested students provided written informed consent and completed study measures in small group settings (i.e., between 20 and 30 students). Participants received extra credit for their participation.

The final sample of 287 participants was primarily Black (93.7%, n = 269) and ranged in age from 17 to 46, with an average age of 22.5 (SD = 5.38). Participants were majority female (66.3% n = 189). See Table 1 for further descriptive data. All procedures were reviewed and approved by the university’s Institutional Review Board.

Table 1.

Descriptive Data

Variables M (SD) n (%)
Age 22.45 (5.38)
Gender
 Female 189 (66.3%)
 Male 96 (33.7%)
Employment Status
 Unemployed 155 (54.2%)
 Employed Part-time 98 (34.3%)
 Employed Full-time 33 (11.5%)
Family Annual Income
 ≤ $9,999 42 (14.9%)
 $10,000-$19,999 39 (13.6%)
 $20,000-$29,999 48 (17.0%)
 $30,000-$39,999 (median) 26 (9.2%)
 $40,000-$49,999 29 (10.3%)
 $50,000-$59,999 21 (7.4%)
 $60,000-$69,999 25 (8.9%)
 $70,000-$79,999 13 (4.6%)
 $80,000-$89,999 11 (3.9%)
 $90,000-$99,999 7 (2.5%)
 ≥ $100,000 21 (7.3%)
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Note. M = mean; SD = standard deviation.

Measures

The Depression Anxiety Stress Scale – 21 (DASS-21; Lovibond & Lovibond, 1995) is a 21-item self-report measure assessing past-month psychological distress across three domains: depression, anxiety, and stress. Participants rate their level of agreement to each statement on a 4-point Likert-type scale ranging from 0 (did not apply to me) to 3 (applied to me very much, or most of the time), with total scores ranging from 0 to 63. Scores for the DASS-21 depression, anxiety, and stress scales are calculated by summing respective items for each subscale, with scores ranging from 0 to 21. Higher scores indicate greater psychological distress. The DASS-21 has good internal consistency and good convergent and discriminant validity (Osman, Wong, Bagge, Freedenthal, Gutierrez, & Lozano, 2012). Reliability in the current study was good for the depression (α = .86), anxiety (α = .85), and stress (α = .82) scales.

The Barratt Impulsiveness Scale-11 (BIS; Patton et al., 1995) is a 30-item questionnaire designed to assess attention (e.g., “I am restless at the theater or lectures”), motor (e.g., “I do things without thinking”), and non-planning (e.g., “I am more interested in the present than the future”) impulsivity. Participants are asked to respond to each item on a 4-point Likert-type scale ranging from 0 (never) to 4 (daily or almost daily), with total scores ranging from 30 to 120. Scores for the attention, motor, and non-planning scales are calculated by summing respective items, with total score ranges of 8 to 32, 11 to 44, and 11 to 44, respectively. Higher scores indicate greater impulsivity. The BIS-11 has been shown to have adequate internal consistency ranging from.62 to .83 (see Vasconcelos, Malloy-Diniz, & Correa, 2012). Reliability in this study was adequate: attention (α = .61), motor (α = .68), and non-planning (α = .71).

The Alcohol Use Disorder Identification Test (AUDIT; Saunders, Aasland, Babor, De la Fuente, & Grant, 1993) is a 10-item self-report measure of alcohol misuse that assesses consumption, dependence, and harm. Participants rate each item using a 5-point Likert-type scale ranging from 0 (never) to 4 (daily or almost daily), with total scores ranging from 0 to 40. Scores for the AUDIT consumption, dependence, and harm scales are calculated by summing respective items, with higher scores indicating greater alcohol misuse. Total scores for the AUDIT subscales range from 0 to 12 for consumption, 0 to 12 for dependence, and 0 to 16 for harm. A total score of 8 or more indicates hazardous or harmful alcohol use. The AUDIT has been found to have good psychometric properties. Reliability in the current study was good for the consumption (α = .77), dependence (α = .83), and harm (α = .74) scales.

Demographic information.

All participants completed a demographics form assessing age, gender, employment status, and annual household income.

Data Analysis

Preliminary analyses were conducted to assess whether assumptions of normality and multicollinearity were met, according to standards set by Tabachnick and Fidell (2007). Descriptive information and intercorrelations were obtained to examine associations among the primary study variables. Structural equation modeling was used to evaluate the factor structure of our three primary latent variables (psychological distress, impulsivity, alcohol misuse). This preliminary analysis was conducted to examine the measurement model and whether the factor structure held in our current sample. This was evaluated by assessing the correlated three latent variables without imposing any directional paths. This model was evaluated based on fit indices.

Path analysis with latent variables was used to examine whether impulsivity mediates the relation between psychological distress and alcohol misuse. First, a total effects model was tested to evaluate the path between the predictor variable (i.e., psychological distress) and the outcome variable (i.e., alcohol misuse). This model represents the unmediated relationship, and the path between the predictor and outcome variable is represented by the “c” path, also known as the total effect.

Next, a proposed mediation model was tested. In this model, the “a” path represents the associations between the predictor and the mediator (i.e., impulsivity). The “b” path represents the associations between the mediator variable and the outcome variable. The estimate of the mediational effect of impulsivity on the relation between psychological distress and alcohol misuse is approximately the product of the two paths, a*b (MacKinnon, Fairchild, & Fritz, 2007). The “c’” path represent the direct path from the predictor to the outcome, while controlling for the indirect effects of the mediator. Mediation occurs when the indirect relations are significant, and full mediation occurs when the direct path from the predictor to the outcome loses significance when controlling for the indirect effects of the mediator, as this suggests that the mediator is fully explaining the relationship.

Supplemental analyses were then conducted to model each component of impulsivity separately to examine whether they independently mediated the relation between psychological distress and alcohol misuse. Specifically, three separate analyses were conducted with psychological distress as the predictor, each component of impulsivity entered independently as the mediator (i.e., motor, attention, and non-planning), and alcohol misuse as the outcome.

Analyses were conducted using R version 3.4.1 (R Core Team, 2017) and Path Analyses were completed using the lavaan package (Rosseel, 2012), which uses the maximum likelihood (ML) method of estimation to obtain maximum likelihood parameter estimates and provide goodness-of-fit indices. The adequacy of the hypothesized model was evaluated by examining several fit indices: the Tucker Lewis index (TLI; Tucker & Lewis, 1973), the root mean square error of approximation (RMSEA; Steiger, 1990), the standardized root mean square residual (SRMR; Hu & Bentler, 1999), and the comparative fit index (CFI; Bentler, 1990). The TLI is an incremental fit index that penalizes additional parameters by accounting for degrees of freedom in a model where values closer to 1.0 indicate a better fitting model. The RMSEA assesses closeness of fit with preferred values < .05, and values between .05 - .08 considered a moderate fit, and values between .08 - .10 an adequate fit (Browne & Cudeck, 1993). The SRMR is the standardized difference between the observed correlation and the predicted correlation with a value < .08 generally considered good fit (Hu & Bentler, 1999). The CFI, an incremental fit index, assesses fit relative to a null model, by comparing the χ2 value of the hypothesized model to an appropriately specified null model; a suggested rule of thumb for determining goodness of fit is a CFI value > .95 (Hu & Bentler, 1999). These parameters were used to evaluate the goodness of fit of each hypothesized model. To be considered a well-fitting model, each fit index needs to be in the preferred range, TLI ≥ 0.95, RMSEA < .05, SRMR < .08, and CFI > .95. To be considered a decent fitting model, majority of the fit indices need to be in the preferred range. If none (or majority) of the indices are outside of these ranges then the model is considered to be a poor fit.

Results

Descriptive information of the study variables are presented in Table 2. Our measurement model demonstrated good fit, χ2 (24, N = 227) = 48.745, TLI = .96, CFI = .97, RMSEA = .067, 90% CI [.04, .09], SRMR = .05. All latent variables were significantly correlated, and all indicators significantly loaded onto their factors.

Table 2.

Study Variables Means and Standard Deviations

Variables M (SD) Range
BIS - Total Score 59.76 (11.62) 22 – 93
BIS - Attention 14.99 (3.83) 4 – 25
BIS - Motor 21.52 (5.09) 4 – 38
BIS – Non-planning 23.29 (5.53) 11 – 36
DASS - Total Score 14.40 (13.06) 0 – 53
DASS - Depression 3.93 (4.57) 0 – 18
DASS - Anxiety 4.43 (4.80) 0 – 20
DASS - Stress 6.04 (4.93) 0 – 18
AUDIT - Total Score 3.6 (5.36) 0 – 34
AUDIT - Consume 2.06 (2.31) 0 – 12
AUDIT - Depend 0.65(1.81) 0 – 12
AUDIT - Harm 0.89(2.20) 0 – 16
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Note. M = mean; SD = standard deviation; BIS = Barratt Impulsiveness Scale; DASS = Depression Anxiety Stress Scale; AUDIT = Alcohol Use Disorders Identification Test.

Our total effects model tested the unmediated relationship between psychological distress and alcohol misuse. This model demonstrated good fit, χ2 (25, N = 227) = 32.54, TLI = .93, CFI = .97, RMSEA = .12, 90% CI [.08, .16], SRMR = .06. In this model, psychological distress was significantly associated with alcohol misuse, β = 0.27, SE = 0.03; z = 3.24, p = .001. This finding suggests that the unmediated total effects model (c path) is significant.

Our mediation model tested whether impulsivity mediated the relation between psychological distress and alcohol misuse. This hypothesized model showed adequate model fit, χ2 (24, N = 227) = 48.75, p =.002, TLI = .96, CFI = .97, RMSEA = .07, 90% CI [.04, .10], SRMR = .05. In this model, psychological distress was significantly associated with impulsivity, β = 0.65, SE = 0.06, z = 9.33, p < .001, demonstrating a significant direct effect between psychological distress and impulsivity (a path). The path between impulsivity and alcohol misuse (b path) was also significant, β = 0.24; SE = 0.04, z = 2.14, p = .03. The indirect effect of psychological distress on alcohol misuse through impulsivity (a*b) was significant, β = 0.16; SE = 0.03, z = 2.11, p = .04. The direct effect between psychological distress and alcohol misuse (c’ path) was not significant after controlling for the indirect effects of impulsivity, β = 0.08, SE = 0.04; z = 0.82, p = .42, demonstrating evidence for mediation. See Figure 1 for a diagram of the mediational model with standardized values.

Figure 1.

Figure 1.

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Final mediational model of psychological distress on alcohol misuse through impulsivity

Note. a = path between predictor and mediator; b = path between mediator variable and outcome variable; c’ = path between the predictor and the outcome while controlling for the mediator.

*p < .05. **p < .01. ***p < .001.

Supplemental analyses were then conducted to examine each of the three dimensions of impulsivity. First, a mediation model was tested to examine whether attentional impulsivity mediated the relation between psychological distress and alcohol misuse; this showed adequate fit, χ2(12, N = 228) = 42.09, TLI = 0.93, CFI = 0.96, RMSEA = 0.11, 90% CI [.072, .140], SRMR = 0.06. In this model, total effects (c path) of psychological distress was significantly associated with alcohol misuse, β = 0.26, SE = 0.3, z = 3.36, p = .001. Psychological distress was significantly associated with attention, β = 0.58, SE = 0.06; z = 9.248, p < .001, demonstrating a significant direct effect between psychological distress and attention (a path). The direct path between attention and alcohol misuse (b path) was also significant, β = 0.21; SE = 0.03, z = 2.40, p = .02. The indirect effect of psychological distress on alcohol misuse through attention (a*b) was significant, β = 0.12; SE = 0.02, z = 2.33, p = .02. The direct effect between psychological distress and alcohol misuse was not significant after controlling for the indirect effects of attention, β = 0.14, SE = 0.03, z = 1.56, p = .12.

A mediation model was tested to examine whether motor impulsivity mediated the relation between psychological distress and alcohol misuse and showed adequate fit, χ2(12, N = 228) = 34.90, TLI = 0.95, CFI = 0.97, RMSEA = 0.09, CI 90% [.057, .128], SRMR = 0.06. In this model, the total unmediated effect (c path) of psychological distress on alcohol misuse was significant, β = 0.26; SE = 0.03, z = 3.40, p = .001. Psychological distress was significantly associated with motor, β = 0.44, SE = 0.09; z = 6.73, p < .001, demonstrating a significant direct effect between psychological distress and BIS-Motor (a path). The direct path between motor and alcohol misuse (b path) was not significant, β = 0.11; SE = 0.02, z = 1.42, p = .16. The indirect effect of psychological distress on alcohol misuse through motor (a*b) was also not significant, β = 0.05; SE = 0.01, z = 1.39, p = .16. The direct effect between psychological distress and alcohol misuse was significant but reduced after controlling for the indirect effects of motor, β = 0.22, SE = 0.03; z = 2.58, p = .01.

A final mediation model was tested to examine whether non-planning impulsivity mediated the relation between psychological distress and alcohol misuse and showed adequate fit, χ2(12, N = 228) = 34.44, TLI = 0.95, CFI = 0.97, RMSEA = 0.09, CI 90% [.056, .127], SRMR = 0.03. In this model, the total unmediated effect of psychological distress on alcohol misuse was significant, β = 0.25; SE = 0.03, z = 3.23, p = .001. Psychological distress was significantly associated with non-planning, β = 0.36, SE = 0.10; z = 5.24, p < .001, demonstrating a significant direct effect between psychological distress and non-planning (a path). The direct path between non-planning and alcohol misuse (b path) was not significant, β = 0.30; SE = 0.02, z = 0.42, p = .674. The indirect effect of psychological distress on alcohol misuse through non-planning (a*b) was also not significant, β = 0.01; SE = 0.01, z = 0.42, p = .674. The direct effect between psychological distress and alcohol misuse was still significant after controlling for the indirect effects of non-planning, β = 0.24, SE = 0.03, z = 2.91, p < .001.

Discussion

The goal of this study was to examine the associations among psychological distress, impulsivity, and alcohol misuse in a sample of students attending a HBCU, and to assess whether impulsivity mediated the relation between psychological distress and alcohol misuse. Findings indicated that latent constructs of psychological distress, impulsivity, and alcohol misuse were all significantly positively associated. Additionally, our results showed that impulsivity mediated the relation between psychological distress and alcohol misuse. Supplemental analyses revealed that when each component of impulsivity was modeled separately, only attention explained the relation between psychological distress and alcohol misuse. These findings suggest that impulsivity (and attention in particular) may be an important consideration in understanding and treating alcohol misuse among HBCU college students who experience psychological distress.

Consistent with past literature among college students attending a PWI (Alati et al., 2005; O’Donnell et al., 2006; Sullivan et al., 2005), greater psychological distress was found to be associated with higher levels of alcohol misuse. Extending this research, our findings provided support for the mediating role of impulsivity in this relation among students attending a HBCU. Specifically, once impulsivity was added to the model, the relation between psychological distress and alcohol misuse was no longer significant. This suggests that alcohol misuse in the context of psychological distress may be explained – at least in part – by a tendency toward impulsive responding. In addition to psychological distress leading to impulsivity, previous research has indicated that impulsive responding increases the propensity to engage in high-risk behaviors (Guillot et al., 2014), which can have negative consequence that can elicit, maintain, and/or exacerbate psychological distress. This suggests that patterns of psychological distress and impulsivity are reinforcing, and as they both relate to alcohol misuse together, and separately, this further emphasizes the importance of examining these constructs in the context of alcohol misuse.

Our findings revealed that attentional impulsivity was significantly related to alcohol misuse, but motor and non-planning were not. This is inconsistent with previous literature that has additionally found non-planning and motor impulsivity to be associated with alcohol consumption (Caswell et al., 2015; Sanchez-Roige et al., 2014). Caswell and colleagues (2015) found that among heavy drinking 18–25 year olds, non-planning was related to number of weekly alcohol units. Similarly, Sanchez-Roige and colleagues (2014) found binge drinking to be associated with both motor and non-planning. In another study, attention and non-planning were associated with alcohol misuse, but notably motor was not (O’Halloran et al., 2018). Importantly, these studies were conducted at a PWIs. In our sample of college students attending a HBCU, attentional impulsivity, but not motor or non-planning, was found to related to alcohol misuse as well as mediate the relation between psychological distress and alcohol misuse. Consistent with the process model of ego depletion (Inzlicht & Schmeichel, 2012), psychological distress may divert attentional resources away from down-regulating psychological distress and towards more rewarding and immediately gratifying behaviors (i.e., alcohol consumption); however, these processes may undermine self-control and lead to more disinhibited behavior, such as overconsumption and maladaptive use. To build upon these findings, future work should examine whether the above proposed attentional processes explain the associations among psychological distress, impulsivity, and alcohol misuse.

Importantly, although research on alcohol misuse in college samples has been well documented, the majority of the literature has been conducted with primarily White samples (Murphy, Barnett, & Correia, 2012). Much less of the literature has examined these relations among primarily African American students, and even fewer have focused on students attending HBCUs (Messina et al., 2015). There is growing evidence to suggest that the culture of HBCUs discourage maladaptive patterns of alcohol use, instead fostering and encouraging adaptive ways of coping with psychosocial stressors (Edwards et al., 2015). Indeed, students attending HBCUs generally have stronger social support systems and employ more adaptive strategies when coping with stress (Walton & Cohen, 2007). However, despite these protective factors and generally lower rates of alcohol use, some students at HBCUs go on to develop alcohol misuse. Thus, research exploring underlying factors that may inform our understanding of alcohol misuse in this population is critical. Impulsive responding has been shown to be associated with greater alcohol misuse (Caswell et al., 2015; O’Halloran et al., 2018; Sanchez-Roige et al., 2014) and explains the psychological distress-alcohol misuse association in PWI samples (Gonzalez et al., 2011). Thus, our goal was to replicate and extend these findings in a HBCU context. Our findings support a similar role of psychological distress and impulsivity among college students attending PWIs and HBCUs, suggesting that current approaches to the conceptualization, assessment, and treatment of alcohol misuse may generalize to this population.

Several important limitations should be considered when interpreting our study findings. First, the use of cross-sectional data limits the ability to draw causal inferences, and future studies should assess these relations using prospective and longitudinal data to verify the nature and direction of this mediational relation. Second, the use of self-report measures can pose challenges, as individuals may feel pressured to respond in socially desirable ways, and their ability and willingness to respond accurately may be influenced by the use of self-report. Future work should incorporate multiple methods of assessments, including behavioral tasks to examine impulsivity (e.g., the Balloon Analogue Risk Task; Lejuez et al., 2002). Third, the current study did not assess the influence of specific cultural factors specific to HBCUs (e.g., structured/conservative setting, ethos) that may relate to alcohol use in this population. Future studies should evaluate cultural differences that may account for lower rates of alcohol misuse in these samples, and to identify other factors that may mediate psychological distress and alcohol misuse in students attending an HBCU. Additionally, the gender distribution in the study was imbalanced and sample size was not powered to analyze and compare the model in females versus males (Jackson, 2013; Kline, 2016). Future studies should examine gender differences in psychological distress, impulsivity, and alcohol use among students attending HBCUs. Lastly, a primary focus of our study was examining specific relations in a sample of students attending a HBCU. While a strength of this study, use of this sample makes it difficult to generalize to other populations, including clinical and community populations of Black individuals. Future studies should replicate our findings in larger, more diverse samples so comparisons can be made across racial/ethnic groups while retaining statistical power. Although our focus was on the mediating role of impulsivity in psychological distress and alcohol misuse in a sample of HBCU students, replication of these findings in a more diverse sample is warranted. Further examination of the various constructs of impulsivity as mediators across a more diverse sample could have implications for treatment of alcohol misuse.

Despite these limitations, results of the current study extend literature by underscoring the role of impulsivity in the association between psychological distress and alcohol misuse. This finding has important implications for identifying and reducing alcohol misuse among HBCU students. Comprehensive assessment of impulsivity may identify students experiencing psychological distress (e.g., those receiving services at university counseling centers) at risk for alcohol misuse. Further, development and refinement of interventions targeting impulsivity among individuals experiencing psychological distress may prevent or reduce alcohol misuse in this population. Indeed, among adolescents, cognitive behavioral therapies targeting impulsivity have been shown to be effective in preventing and reducing alcohol use and misuse (Castellanos & Conrod, 2006; Conrod, Stewart, Comeau, & Mclean, 2006). Future research is needed to examine the utility of these interventions among students attending HBCUs.

Funding

This work was supported by grant K23DA039327 from the National Institute on Drug Abuse awarded to the last author and by grant G20RR030883 awarded to fifth author.

Footnotes

Disclosures

The authors report no conflicts of interest.

Contributor Information

Megan M. Risi, University of Rhode Island, 142 Flagg Road, Kingston, RI 02881.

Shannon R. Forkus, University of Rhode Island, 142 Flagg Road, Kingston, RI 02881.

Amanda Roy, University of Rhode Island, 142 Flagg Road, Kingston, RI 02881

Robert G. Laforge, Department of Psychology, University of Rhode Island, 142 Flagg Road, Kingston, RI 02881

Joseph S. Rossi, Department of Psychology, University of Rhode Island, 142 Flagg Road, Kingston, RI 02881

Nicole H. Weiss, University of Rhode Island, 142 Flagg Road, Kingston, RI 02881

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