Drink, Don’t Think: The Role of Masculinity and Thought Suppression in Men’s Alcohol-Related Aggression

Abstract

Alcohol consumption is a well-established risk factor for aggressive behavior. However, evidence suggests that alcohol’s effect on aggression varies as a function of individual- and situational-based instigating and inhibiting factors. Endorsement of traditional masculine gender norms has been consistently identified as an instigating factor for alcohol-related aggression. Likewise, individuals who habitually engage in thought suppression (i.e., the attempt to inhibit the occurrence of unwanted thoughts) have been shown to be at increased risk for behavioral disinhibition and aggression. In the present study, we test the hypothesis that thought suppression mediates the association between masculine norms and alcohol-related aggression. Two hundred forty-five men with a history of recent heavy episodic alcohol use completed surveys assessing their endorsement of traditional masculine norms, use of thought suppression, and both trait and alcohol-related aggression. Results indicated that thought suppression fully mediated the association between the toughness masculine norm and alcohol-related aggression. In addition, thought suppression partially mediated the association between the toughness norm and trait aggression. Findings are discussed in terms of the potential utility of cognitive-emotion regulation and norm-based interventions for reducing alcohol-related aggression.

Alcohol consumption is a well-established risk factor for aggressive behavior (Brown & Leonard, 2017; Foran & O’Leary, 2008; Harford, Yi, & Grant, 2013; Parrott & Eckhardt, 2018; Schumacher et al., 2003) and has been linked to violent assaults, child abuse, domestic violence, and homicides (Rossow & Bye, 2013). As such, alcohol-related aggression constitutes a significant public health problem, not only for those who suffer violence-related injuries, but for society. When aggressive behavior occurs in the context of alcohol use, its consequences burden health services, the criminal justice system, families, and communities (Rossow & Bye, 2013). While there exists strong cross-method convergence to support the conclusion that alcohol use is a contributing cause of aggression (Leonard, 2005), it is also well-established that alcohol’s effect on aggression varies as a function of individual- and situational-based instigating and inhibiting factors (Parrott & Eckhardt, 2017; Phil & Sutton, 2009). Thus, research must move beyond whether alcohol causes aggression to identify “the critical and most potent instigating and inhibiting factors” (Leonard & Quigley, 2017, pg. 8) so that interventions can be directed at these fundamental determinants. Accordingly, the aim of the present study was to examine endorsement of masculine norms and thought suppression as two potential instigating factors of alcohol-related aggression. Specifically, the current study examines thought suppression as a putative mechanism underlying associations between masculine norms and aggression.

Masculinity and Alcohol-Related Aggression

Masculinity refers to the socially-defined set of attributes, behaviors, and roles associated with boys and men (Mosher & Tomkins, 1988; Thompson & Bennett, 2015). From a social-learning perspective, boys and men are taught what it means to “be a man” through a set of basic learning processes including reinforcement, punishment, and modeling (Addis, Mansfield, & Syzdek, 2010; Mahalik et al., 2003). Thompson and Pleck (1989) identified three fundamental and distinct norms of masculinity to which men vary in their adherence: 1) Status- men’s belief that they must gain the respect of others; 2) Toughness- men’s belief that they must appear aggressive and physically and emotionally strong; and 3) Antifemininity- men’s belief that they should avoid stereotypically feminine behaviors. Although aggression is a complex behavior whose presentation among men is most certainly multifactorial, beliefs about how men should behave, feel, or act are posited to be one potential influence on men’s behavior to the extent that the behavior provides a means to express or establish one’s masculine self-image (Leone & Parrott, 2018).

Aggression may provide one context for men to express socialized masculine beliefs. Although it is important to acknowledge that processes beyond social-learning may contribute to men’s aggressive behavior (e.g., biological factors, trait differences), a wide body of research has identified associations between masculine norms and men’s self-report of generalized aggressive behavior (for a recent review, see Leone & Parrott, 2018) as well as the perpetration of aggression toward female intimate partners (Jakupcak, Lisak, & Roemer, 2002; Locke & Mahalik, 2005; Santanta, Raj, Decker, La Marche, & Silverman, 2006; Smith, Parrott, Swartout, & Tharp 2015). In addition, studies suggest that aggressive behavior may be most strongly associated with the toughness norm. For example, research indicates that only endorsement of the toughness norm, but not the status or antifemininity norms, predicts self-reported intimate partner physical aggression (Lisco, Leone, Gallagher & Parrott, 2015).

As social drinking may be modeled to men as a cultural symbol of masculinity by peers and media (Towns, Parker, & Chase, 2012), alcohol consumption may provide another context for men to express socialized masculine beliefs and norms (Fugitt & Ham, 2018; Leone & Parrott, 2015; Mullen, Watson, Swift, & Black, 2007; Wells et al., 2013). Indeed, in one study of college students, the majority of participants interpreted alcohol consumption and heavy drinking as a form of “macho” or masculine behavior (Peralta, 2007). Further, some men described heavy drinking as evidence of perceived power and strength, while abstinence from alcohol use or drinking “too little” symbolized weakness or femininity (Peralta, 2007). Being perceived as weak and feminine directly contradicts the expectations set forth by the toughness and antifemininity norms of masculinity. Thus, it is possible that some men may engage in excessive alcohol consumption to conform to these masculine norms. Consistent with this supposition, research consistently shows that masculine norm adherence is associated with heavier alcohol use and more alcohol-related problems (Iwamoto et al., 2011; Iwamoto, Corbin, Lejuez, & Macpherson, 2014; Liu & Iwamoto, 2007; Uy, Massoth, & Gottdiner, 2014; Wells et al., 2013) as well as participation in drinking games (i.e., risky social drinking activities involving heavy alcohol consumption; Zamboanga, Audley, Iwamoto, Martin, & Tomaso, 2017; Zamboagna, Iwamoto, Pesigan, & Tomaso, 2015).

Given these data, it is not surprising that a number of recent empirical studies have explored relationships between masculinity and alcohol-related aggression (Leone & Parrott, 2015; Lisco et al., 2015; O’Brian et al., 2017; Wells, Graham, & Tremblay, 2009). For example, in a recent study of college athletes in the United Kingdom, O’Brian and colleagues (2017) found that higher levels of masculinity and alcohol consumption were related to greater likelihood of having perpetrated an aggressive act while intoxicated in the past 12 months. Moreover, young men’s reports of male-to-male aggression in barrooms have been associated with the need to display physical toughness for others and to maintain a personal image of masculinity (Wells et al., 2009). Lisco and colleagues (2015) accounted for the multidimensional structure of masculinity and found that the effect of men’s endorsement of the toughness and antifemininity norms, but not the status norm, on perpetration of intimate partner physical aggression was significantly stronger among men who were heavy episodic drinkers. Consistent with these cross-sectional data, Leone and Parrott (2015) used an experimental design and a well-validated laboratory analogue of physical aggression to show that heterosexual men’s endorsement of the toughness and antifemininity norms, but not the status norm, was a stronger predictor of intoxicated, relative to sober, aggression toward a gay man. These findings suggest that aggression may be one way for men to enact specific dimensions of masculinity, particularly in the context of heavy episodic drinking.

Despite this literature, research on the putative dimensions of masculinity facilitating men’s alcohol-related aggression remains limited. Moreover, mechanisms driving associations between masculine norms and aggression in heavy episodic drinkers have yet to be fully explicated. As such, the current study aims to build on these preliminary findings to identify modifiable mechanisms over and above alcohol consumption that may link distinct masculine norms to alcohol-related aggression.

Thought Suppression: A Potential Mechanism

A wealth of experimental research has shown that thought suppression, or the attempt to control unwanted thoughts for the chief purpose of inhibiting their occurrence (Wegner & Zanakos, 1994), produces a range of consequences that increase the likelihood for aggressive behavior. Consistent with the ironic process theory of mental control (e.g., Wegner 1994; Wegner & Wenzlaff, 1996), research demonstrates that attempts to suppress unwanted thoughts actually make these thoughts hyperaccessible (Abramowitz, Tolin, & Street, 2001; Harsányi et al., 2014; Wenzlaff & Wegner, 2000). Thought suppression has also been shown to increase physiological activation (Gross, 2002; Gross & Levenson, 1993) and negative urgency (Gay, Schmidt, & Linden, 2011), activate negative affect (Amstadter & Vernon, 2008; Campbell-Sills, Barlow, Brown, & Hofmann, 2006; McDermott, Tull, Soenke, Jakupcak, & Gratz, 2010; Wegner 1994; Wegner & Wenzlaff, 1996), and impair inhibitory control (Richards & Gross, 2000; Schmeichel, Vohs, & Baumeister, 2003). These same cognitive, physiological, and affective consequences have been shown to increase the likelihood for aggressive behavior (Clements & Schumacher, 2010; Eckhardt, Samoer, Suhr, & Holtzworth-Munroe, 2012). Research also supports a direct positive association between thought suppression and risk for aggressive behavior (e.g., Denzler, Förster, Liberman, & Rozenman, 2010; Gallagher, Lisco, Parrott, & Giancola, 2014; Maldonado, DiLillo, & Hoffman, 2015; Panno, Lauriola, & Figner, 2013).

Prevailing masculinity norms prescribe mental toughness and hold that men should control, restrict, or suppress their emotions, with the exception of anger (Chaplin et al., 2005; Eisler & Skidmore, 1987; Kilmartin, 2009). As thoughts may function as a causal antecedent to emotion (Beck, 1991), men who adhere to masculine norms prescribing restrictive emotionality and mental toughness may suppress thoughts incongruent with this norm to bring emotional experience and expression in-line with gender-emotion norms (Berke et al., 2017). Thoughts that evoke feelings of sadness, vulnerability, fear, weakness, or shame violate the normative expectation that men should be tough. Arguably, men who endorse this norm may be motivated to suppress such thoughts.

Take for example, a man who has recently been fired from his job and thinks, “I am failing in my duty as a father and husband.” Not only is this thought likely to generate significant anxiety, guilt, or sadness, these emotions may be associated with physiological responses (e.g., the urge to flee, hide, or cry) that further signal a failure to live up to the expectations of masculinity. Why not push these thoughts away and have a drink? Unfortunately, thought suppression can paradoxically generate greater emotional and physiological distress and dyscontrol. Aggressive behavior may result, in turn, as a consequence of this dysregulation and/or as strategy for bringing affect and behavior back in line with masculine norms. Thus, when the man in the above example is shoved aside by another man while ordering a drink at the bar, he may respond aggressively both as a direct expression of toughness norms and as an indirect consequence of the impaired inhibitory control conferred by his use of thought suppression.

Theoretical Integration

Taken in synthesis, existing data point to thought suppression as a potential mechanism by which endorsement of masculine norms may confer risk for alcohol-related aggression. This theory is consistent with the dynamic model of masculinity and men’s psychopathology (Berke, Reidy, & Zeichner, 2018), which posits that men’s disproportionate rates of engagement in externalizing behaviors (including binge drinking and aggression) relative to women may reflect socialized constructions of masculinity that pressure individual men to constrict internal experiences (e.g., thoughts, emotions) via overreliance on avoidant and/or inhibitory emotion regulation strategies. This theory is supported by relevant evidence.

First, research has consistently demonstrated that endorsement of masculine norms is positively associated with aggressive behavior (for a review, see Leone & Parrott, 2018).

Second, research demonstrates that men who endorse traditional masculine norms (which dictate mental toughness and the restriction of emotional expression) report greater fear of emotion (Jakupcak, Salters, Gratz, & Roemer; 2003) and may therefore be more likely to suppress or otherwise inhibit thoughts with the potential to generate proscribed vulnerable emotions (e.g., sadness, fear). Specifically, theory points to the toughness norm, which holds that men should be physically and emotionally strong, as the masculine norm most strongly linked to thought suppression (Thompson & Pleck, 1989). Third, suppression has been shown to heighten emotional arousal and distress (e.g., Amstadter & Vernon, 2008; Campbell-Sills et al., 2006; McDermott et al., 2010), thereby increasing risk for behavioral disinhibition and aggression (e.g., Clements & Schumacher, 2010; Eckhardt et al., 2012). These risks are likely exacerbated among men who engage in heavy episodic alcohol use, as alcohol disrupts higher-order cognitive functioning involved in the perception of cues and the regulation of behavior (Giancola, 2004). Finally, aggressive behavior may itself function as an expression of socialized masculine norms prescribing mental and physical dominance, providing both an escape from the direct expression or acknowledgment of negative affect and a means of reaffirming masculinity. Despite this evidence, this theory has yet to be tested empirically as it applies to hypothesized associations among endorsement of traditional masculine norms, thought suppression, and general or alcohol- related aggression.

The Present Study

The purpose of the current study was to build on theoretical and empirical literature regarding endorsement of masculine norms, its impact on cognitive emotion regulation processes (i.e., thought suppression), and attendant risk for alcohol-related aggression. Given that alcohol- consumption is a well-established predictor of aggression and that the effect of alcohol- consumption on aggression is theorized to vary as a function of individual- and situational-based instigating and inhibiting factors, a primary goal of the current study was to assess the potential instigating effects of adherence to masculine norms and thought suppression on aggression beyond the effect of alcohol-consumption. Several hypotheses were investigated to test associations among masculine norms, thought suppression, and both trait and alcohol-related aggression in a large community sample of men with a history of heavy episodic alcohol use:

Hypothesis 1:

There will be a positive association between endorsement of the toughness norm and thought suppression such that men who more strongly endorse the toughness norm will report a greater tendency to attempt to control unwanted thoughts. No such associations are expected for the status and antifemininity norms.

Hypothesis 2:

There will be a positive association between thought suppression and both trait and alcohol-related aggression.

Hypothesis 3:

Thought suppression will mediate the association between endorsement of the toughness norm and both trait and alcohol-related aggression.

Method

Participants

The distinct set of hypotheses tested herein utilized data that were drawn from a larger investigation on the effects of self-awareness on heavy drinking men’s alcohol-related aggression towards women ([reference omitted for blind review]). To this end, all participants who presented to the laboratory reported heavy drinking during the past year (see below). The present hypotheses are novel, and the analytic plan was developed specifically to address these aims.

Men were recruited from the metro-[city name omitted for blind review] community through Internet advertisements and local newspapers for a study on “alcohol’s effect on behavior.” Respondents were initially screened by telephone to confirm a pattern of heavy episodic drinking, defined as consumption of at least five drinks per occasion a minimum of two times per month. Respondents were also excluded if they reported past or present attempts to seek treatment for an alcohol or substance use disorder or abstinence from alcohol use. Eligible participants were contacted by phone and scheduled for a laboratory session. Notably, participants self-reported drinking patterns were re-assessed upon arrival to the laboratory; however, participants were not excluded based on changes to their alcohol use.

One participant requested his data be deleted following completion of the study and five participants did not complete pertinent questionnaires. This left a final sample of 245 men (age M = 34.68, SD = 10.83). Three-quarters of participants identified as Black or African American, 18% identified as Caucasian, 4% identified with more than one race, and 3% identified as another racial description. Most men identified as heterosexual (92%) and had never been married (75%). The sample had an average of 13.81 years of education and on average earned $18,836 a year in individual income. Men reported consuming an average of 6.47 (SD = 3.52) alcoholic drinks per drinking day approximately 3.05 (SD = 2.03) days per week. This study was approved by the university’s Institutional Review Board.

Questionnaire Battery

Demographic form.

This self-report form obtained information such as age, self- identified sexual orientation, race, relationship status, years of education, and yearly individual income.

Drinking Patterns Questionnaire.

This 6-item self-report form measures participants’ alcohol use during the past year using the National Institute on Alcohol Abuse and Alcoholism’s (NIAAA, 2003) recommended set of alcohol consumption questions. Two aspects of participants’ alcohol use were of particular interest in the present study: participants’ frequency of alcohol consumption and average quantity of drinks per drinking day during the past year. Frequency of alcohol consumption was assessed with the question, “During the last 12 months, how often did you usually have any kind of drink containing alcohol?” A categorical response ranging from “everyday” to “I never drank alcohol in my whole life” was provided. In addition, average quantity of alcohol consumption during the past year was assessed with the question, “During the last 12 months, how many alcoholic drinks did you have on a typical day when you drank alcohol?” A categorical range of responses from “1 drink” to “25 or more drinks” was provided (e.g., 3-4 drinks, 5-6 drinks etc.). Total scores were obtained by computing the average number of drinks in each range. For example, if a participant indicated a response of “9-11” drinks per drinking occasion, his average quantity of alcohol consumption would be “10.” This strategy reliably assesses an individual’s average quantity of alcohol consumption per drinking day over a specific period of time (for a review, see Sobell and Sobell, 1995).

Male Role Norms Scale (MRNS).

The MRNS (Thompson & Pleck, 1986) is a 26-item Likert-type scale that measures men’s endorsement of three dimensions of traditional masculine ideology: Status (e.g., “A man always deserves the respect of his wife and children”), Toughness (e.g., “A man should never back down in the face of trouble”), and Antifemininity (e.g., “It bothers me when a man does something that I consider ‘feminine’”). Participants rate items on a 1 (strongly disagree) to 7 (strongly agree) scale, with higher scores reflecting greater endorsement of these dimensions of masculinity. Exploratory and confirmatory factor analyses have supported this tri-dimensional factor structure (Sinn, 1997; Thompson & Pleck, 1986). These subscales have good reliability, with alpha coefficients ranging from .74 and .81 in standardization samples (Thompson & Pleck, 1986), which was consistent with the present sample (Status: α = .81, Toughness: α = .70, Antifemininity: α = .72).

Buss-Perry Aggression Questionnaire (BAQ).

The BAQ (Buss & Perry, 1992) is a 29- item Likert-type scale that measures dispositional tendencies towards physical aggression, verbal aggression, anger, and hostility. For the purpose of the present study, the 9-item physical aggression subscale was used to assess trait aggression. The selection of this subscale as a dependent variable of interest aligns with the primary goals of the current study – to examine the putative role of masculine norms and thought suppression on aggressive behavior. Participants rate items (e.g., If somebody hits me, I hit back.) on a 1 (extremely uncharacteristic of me) to 5 (extremely characteristic of me) scale, with higher scores reflecting higher levels of trait aggression. Buss and Perry (1992) reported an alpha coefficient of .85 for the physical aggression subscale, which is consistent with the present sample (α = .77).

White Bear Suppression Inventory (WBSI).

The WBSI (Wegner & Zanakos, 1994) is a 15-item Likert-type scale that measures the tendency to engage in thought suppression. Participants rate each item on a scale from 1 (strongly disagree) to 5 (strongly agree), with higher scores indicating a greater tendency to suppress thoughts. Sample items include “I have thoughts that I try to avoid” and “My thoughts frequently return to one idea.” The WBSI demonstrates strong convergent validity with measures of intrusive thinking (e.g., Wegner & Sanakos, 1994) and has strong internal consistency with alphas ranging from .87 to .89, consistent with the present sample (α = .92).

Alcohol-Related Aggression Questionnaire (ARAQ).

The ARAQ (McMurran et al., 2006) is a 28-item Likert-type scale that measures proneness to alcohol-related aggression. Four subscales assess: Alcohol-Related Aggression (outcome expectancies), Trait Aggression, Drinking Contexts, and Sensitivity to Pain and Anxiety. These four subscales are highly intercorrelated and the total score has been shown to be psychometrically better than individual subscales (McMurran et al., 2006); thus, the total score was used. Participants rate each item on a scale from 0 (always false for me) to 3 (always true for me), with higher scores indicating a greater proneness of alcohol-related aggression. Sample items include “I get aggressive if I drink too much” and “The more I drink, the less able I am to reason with people” The ARAQ has strong internal consistency (α = .96), consistent with the present sample (α = .96).

Results

Preliminary Analyses

Descriptive statistics and bivariate correlations for pertinent study variables were computed and are displayed in Table 1. A significant association was detected between all three male role norms and trait aggression. Endorsement of the toughness and antifemininity norms was positively associated with alcohol-related aggression. Thought suppression was positively associated with frequency of drinking, all three male role norms, and both alcohol-related aggression and trait aggression.

Table 1.

Descriptive Statistics and Intercorrelations.

	M	SD	2	3	4	5	6	7	8
1. Drinking Frequency	3.05	2.03	.19*	.08	.10	.01	.14*	.09	.15*
2. Drinking Quantity	6.47	3.53		−.10	−.10	.01	.00	−.04	.03
3. Status	53.42	11.69			.44**	.24**	.23**	.23**	.09
4. Toughness	33.28	8.14				.53**	.36**	.41**	. 23**
5. Antifemininity	22.77	8.07					.17*	.24**	.31**
6. Thought Suppression	42.36	12.90						.42**	.40**
7. Trait Aggression	20.38	6.83							.37**
8. Alcohol-Related Aggression	15.20	14.52

Note. Drinking Frequency = Frequency of alcohol consumption in the past year in days per week; Drinking Quantity = average drinks per drinking day;

*p < .05

**p < .01.

Analytic Strategy

To test study hypotheses, we used the PROCESS macro (www.processmacro.org) for SPSS (IBM Corporation, New York, NY; Hayes, 2017). A simple mediation model (corresponding to Model 4 in Hayes, 2017) was computed to examine the indirect effect of each male role norm (i.e., status, toughness, antifemininity) on trait aggression and alcohol-related aggression through thought suppression, controlling for the effects of drinking frequency and quantity. This model simultaneously estimated paths from each male role norm to thought suppression, trait aggression, and alcohol-related aggression while accounting for relations between the predictors and covariates. Participants’ frequency of alcohol consumption and average drinks per drinking day were included in the analysis as covariates to statistically remove these potential confounding influences on the paths in the model. The inclusion of these covariates allowed for a direct test of thought suppression as a hypothesized mediator of the association between endorsement of male role norms and both trait and alcohol-related aggression, over and above the effects of participants’ typical patterns of alcohol use. As the products of regression coefficients are non-normally distributed, each analysis utilized 5,000 bootstrap resamples. See Figure 1 for the conceptual model.

Figure 1.

Conceptual mediation model.

Mediation Analyses

Endorsement of the toughness norm was positively associated with thought suppression (a = .51, p <.001) and thought suppression was positively associated with trait aggression (b = .16, p > .001) and alcohol-related aggression (b = .41, p > .001). A bootstrap confidence interval for the product of these paths that does not include zero provides evidence for an indirect effect of toughness on (1) trait aggression (ab = .10, 95% CI = .05, .16) and (2) alcohol-related aggression (ab = .21, 95% CI = .10, .34) through thought suppression. The completely standardized indirect effect indicates that this is a small effect for both trait aggression (abcs = .10, 95% CI = .05, .16) and alcohol-related aggression (abcs = .12, 95% CI = .06, .19). Endorsement of the toughness norm was associated with trait aggression independent of its effect on thought suppression (c’ = .22, p < .001). There was no evidence to suggest endorsement of the toughness norm was associated with alcohol-related aggression independent of its effect on thought suppression (c’ = −.06, p = .640). Additionally, endorsement of the antifemininity norm was associated with alcohol-related aggression independent of its effect on thought suppression (c’ = .50, p < .001). No other effects were detected. See Table 2.

Table 2.

Model Coefficients for Direct and Indirect Effects of Male Role Norms on Aggression Through Thought Suppression.

	Thought Suppression			Trait Aggression					Alcohol-Related Aggression
	Coeff.	SE	p	Coeff.	SE	p	Indirect	CI	Coeff.	SE	p	Indirect	CI
Drinking Frequency	.01	.01	.103	.001	.003	.653	---	---	.01	.01	.074	---	---
Drinking Quantity	.07	.23	.773	−.04	.11	.729	---	---	−.01	.24	.968	---	---
Status	a .09	.07	.20	c‘ .02	.04	.640	ab .02	−.01, .04	c‘ −.06	.08	.414	ab .04	−.02, .10
Toughness	a .51	.12	< .001	c‘ .22	.06	<.001	ab .08	.04, .14	c‘ −.06	.14	.64	ab .21	.10, .34
Antifemininity	a −.03	.11	.788	c‘ .03	.06	.563	ab −.005	−.04, .03	c‘ .50	.12	< .001	ab −.01	−.12, .08
Thought Suppression	---	---	---	b .16	.03	>.001	---	---	b .40	.07	< .001	---	---
Constant	iM 18.65	4.49	< .001	iY 4.56	2.31	.049			iY −9.95	4.98	.047
	R2 = .15 F (5, 239) = 8.13, p < .001			R2 = .25 F (6, 238) = 13.39, p < .001					R2 = .23 F (6, 238) = 11.96, p < .001

Discussion

In this study, we integrated masculine-socialization and cognitive-regulatory theories of alcohol-related aggression by examining thought suppression as a putative mechanism by which endorsement of traditional masculine beliefs may confer risk for alcohol-related aggression. Consistent with the dynamic model of masculinity and men’s psychopathology (Berke et al., 2018), results indicate that thought suppression mediates the relation between endorsement of the toughness norm and both trait and alcohol-related aggression in a sample of heavy episodic drinkers.

Positive bivariate correlations emerged between endorsement of each of the male role norms assessed (i.e., status, toughness, and antifemininity) and thought suppression. However, analyses indicate that only the toughness norm is significantly associated with thought suppression when controlling for the other masculinity norms in the mediation model. These results are consistent with Hypothesis 1 and suggest that attempting to suppress or otherwise control unwanted thoughts may be one way for heavy drinking men to conform with the socialized expectations of masculinity prescribing physical and emotional strength. Importantly, this finding constitutes the first empirical evidence that endorsement of traditional masculine norms, in this case the toughness norm specifically, is associated with thought suppression. We argue that this association likely reflects the suppression of thoughts that elicit emotions proscribed by the toughness norm (e.g., sadness- fear- or shame-related thoughts). Consistent with Hypothesis 2, thought suppression was associated with a predisposition towards aggression in general and aggression in the context of alcohol use in particular. This finding is in keeping with previous research (e.g., Denzler et al., 2010; Gallagher et al., 2014; Maldonado et al., 2015; Panno et al., 2013) and also adds to the body of existing data that documents effects of thought suppression on behavioral disinhibition (e.g., Richards & Gross, 2000; Schmeichel et al., 2003).

Consistent with Hypothesis 3, results indicate an indirect effect of thought suppression on the association between endorsement of the toughness norm and both trait and alcohol-related aggression. These findings suggest that beliefs prescribing toughness may potentiate aggression among heavy drinking men via habitual attempts to control or suppress thoughts. Arguably, thoughts that violate the toughness norm (e.g., thoughts eliciting emotions such as sadness, fear, weakness, or shame) are particularly likely to be suppressed among men who endorse this norm. Although more research is needed to test this assumption, results from this study point not only to the association between masculine socialization and habitual use of an avoidant/inhibitory cognitive emotion regulation strategy (i.e., thought suppression), but also to the potential for these factors to collectively contribute to aggression. They also align with the pertinent theory (Berke et al., 2018), which posits that aggression – and other externalizing behaviors – may provide (a) an escape from the direct expression or acknowledgment of emotions proscribed by prevailing masculine norms, and (b) a means of reaffirming masculinity (Berke et al., 2018). Thus, these findings explicate potential pathways through which socialized constructions of masculinity may give rise to a range of externalizing behaviors (including but not limited to heavy episodic drinking and aggression).

A significant direct effect of the toughness norm on trait aggression emerged independent of thought suppression; no such direct effect was found for alcohol-related aggression. That thought suppression fully mediated the relation between endorsement of the toughness masculinity norm and alcohol-related aggression, but not trait aggression, is of particular interest. These findings signal potential differences in how men’s adherence to the toughness norm may be associated with a general predisposition for aggression relative to a more specific predisposition to alcohol-related aggression. Experimental research suggests that acute alcohol intoxication and dispositional thought suppression produce similar effects that precede aggression, including increases in physiological activation, depletion of limited cognitive resources, and impairment of inhibitory control (Gallagher et al., 2014). Thus, the combination of habitual use of thought suppression as a cognitive emotion regulation strategy and alcohol consumption may strengthen the impact of these more proximal predictors of aggression relative to other masculinity-based antecedents to aggression.

We also found an effect of the antifemininity norm on alcohol-related aggression, independent of its effect on thought suppression. Although this effect was not specifically hypothesized, it does align with qualitative data suggesting that men equate femininity with abstinence from alcohol use or drinking “too little” (Peralta, 2007) and with quantitative data identifying a stronger association between the antifemininity norm and perpetration of physical aggression among intoxicated men (Leone & Parrott, 2015) and men who are heavy episodic drinkers (Lisco et al., 2015). Results from the current study suggest that some men may be motivated to engage in aggressive behavior in the context of alcohol use, not only as a way to appear tough, but also as a means of assuring that they are not perceived as feminine. Future research is needed to examine directly the potential mechanisms for this effect.

Limitations

Study findings should be evaluated in light of several limitations. First, given the cross- sectional design of this study, causal determinations cannot be made about interrelations among assessed variables. We propose that alcohol-related aggression may be immediately preceded by the suppression of emotions proscribed by traditional masculine norms (like anxiety or sadness); thus, ideal tests of this mechanism will require research designs to assess event level directly. Research employing longitudinal and experimental designs is needed to establish whether engagement in thought suppression increases subsequent risk for alcohol-related aggression and whether this process is temporally preceded by the activation of beliefs consistent with traditional masculine norms. For example, laboratory-based paradigms could allow for the direct manipulation of cognitive emotion regulation training by randomly assigning participants to manage unwanted thoughts via thought suppression versus a control strategy (e.g., cognitive reappraisal). Indeed, such methodology has been effectively used to generate evidence for causal interactive effects of anger rumination and alcohol-intoxication on intimate partner aggression as measured with an analogue aggression task (Watkins, DiLillo, & Maldonado, 2015).

Second, utilization of self-report measures may have biased results. Social desirability motivations may have led men in the current sample to underreport their propensity for alcohol- related and trait aggression, particularly given that participants were self-referred to the study. Furthermore, individuals who habitually suppress thoughts may not be accurate or reliable in their self-assessment of this habit on a self-report scale, particularly given that doing so might evoke chronically avoided thoughts. Moreover, as a measure of general thought suppression, the WBSI does not explicitly measure the suppression of thoughts that conflict with masculine norms, nor does it measure the suppression of specific emotions hypothesized to drive aggressive behavior (e.g., sadness, anxiety, etc.) in the proposed model. Future studies should consider methods that lend more precision to the assessment of men’s tendency to suppress specific types of thoughts and emotions. In particular future research would benefit from inclusion of behavioral and or laboratory-based measures of suppression and aggression. For example, assessment of physiological correlates of suppression (e.g., heart rate elevation, skin conductance; Gross, 2002) and use of behavioral analogues for aggression (e.g., administration of electric shock or noise blasts) such as those based on the Taylor Aggression Paradigm (Bushman & Baumesiter, 1998; Taylor, 1967) could circumvent measurement error conferred by self-report bias.

Third, we could not test competing theories that may explain associations among masculine socialization, thought suppression, and aggression. For example, it is possible that results of the current study were influenced by a range of individual difference (e.g., concurrent mental illness, criminality, cognitive disabilities, self-esteem) and/or biological factors (e.g., autonomic nervous system reactivity, testosterone) that were neither assessed nor controlled in our analyses. Future research should examine whether these findings are replicated upon inclusion of additional correlates.

Implications and Conclusions

Despite these limitations, results from the current study provide promising preliminary evidence for a dynamic model of masculinity and men’s psychopathology (Berke, Reidy, & Zeichner, 2018). To our knowledge, the present study provides the first empirical support for an association between endorsement of masculine norms (i.e., particularly the toughness norm) and thought suppression. Data also indicate that men who endorse the toughness norm may be more likely to habitually rely on an avoidant or inhibitory cognitive emotion regulation strategy (i.e., thought suppression), which, in turn, may confer risk for aggression. These findings lend new support to extant literature which suggests that alcohol-related aggression may, at least in part, reflect social constructions of masculinity that pressure men to chronically suppress unwanted thoughts. These same social pressures may also reinforce heavy alcohol use and aggressive behavior as prototypical enactments of masculinity.

As such, data from the current study suggest that interventions that target gender socialization and cognitive regulatory strategies have the potential to interrupt instigating processes that facilitate alcohol-related aggression. First, men’s risk for alcohol-related aggression may be attenuated through an exploration and restructuring of social messages men receive about their gender. Indeed, findings from several rigorously designed randomized control trial program evaluation studies provide important preliminary support that interventions designed to identify and challenge prevailing masculine norms can decrease men’s use of aggressive behavior (e.g., Safe Dates: Foshee et al., 2005; Real Consent: Salazar, Vivolo-Kantor, Hardin, & Berkowitz, 2014). Second, given compelling evidence for links between thought suppression and dysregulation of affect, arousal, attention, and behavior (e.g., Amstadter & Vernon, 2008; Campbell-Sills et al., 2006; McDermott et al., 2010), it is likely that interventions designed to replace habitual use of thought-suppression with a more flexible set of strategies for coping with difficult thoughts or emotions (e.g., cognitive reappraisal, mindfulness) may be helpful in attenuating the effect of this aggression-instigating factor. Both cognitive reappraisal and mindfulness have been identified as promising evidence-based interventions for reducing aggression (Denson, 2015). As these strategies are posited to have bidirectional effects on executive functioning and emotion regulation (Denson, 2015), interventions that incorporate multiple cognitive regulatory strategies may be a particularly potent intervention for reducing aggression among those whose regulatory processes are taxed by the cumulative effects of masculine socialization, alcohol intoxication, and thought suppression.

In conclusion, the present findings are consistent with the dynamic model of masculinity and men’s psychopathology (Berke et al, 2018). Socialized expectations of masculinity prescribing physical and emotional strength may pressure some men to suppress thoughts incongruent with prevailing masculine norms. This process may potentiate engagement in aggression, particularly in the context of alcohol use.

Public Significance Statement:

Endorsement of traditional gender norms may play a role in alcohol-related aggression through its association with thought suppression. Men with histories of heavy episodic drinking who endorse the toughness norm may habitually suppress thoughts incongruent with this norm, which, in turn, may confer risk for aggression. Findings support the utility of interventions that specifically target gender socialization and cognitive regulatory strategies to interrupt processes that facilitate alcohol-related aggression.