Psychological distress, obsessive-compulsive thoughts about drinking, and alcohol consumption in young adult drinkers

Background: Psychological distress is an important predictor of heavy drinking, especially among lower-income drinkers. The mechanisms underlying this effect are not well understood. One possibility is that distressed individuals are more vulnerable to obsessive and compulsive thoughts about drinking. We hypothesized that: 1) distress would predict obsessive and compulsive thoughts about alcohol, which in turn would predict drinking and 2) effects would be particularly pronounced among lower-income drinkers. Methods: Young adults (n = 105) were recruited from an urban university and completed the Brief Symptoms Index (BSI), the Obsessive-Compulsive Drinking Scale (OCDS), and a 90-day timeline follow-back (TLFB) drinking interview. Results: Consistent with the hypotheses, drinkers with higher distress (BSI) exhibited greater obsessive and compulsive drinking-related thoughts, which in turn predicted drinking over the past 90 days (p <.0001). Path analyses revealed that the BSI had a significant indirect effect on drinking outcomes through increased OCDS. Furthermore, conditional process analyses revealed that effects were particularly pronounced among drinkers with lower household incomes. Conclusions: Findings highlight the importance of psychological distress as a predictor of obsessive and compulsive thoughts about alcohol, as well as drinking behavior, and underscore the critical need to address psychological functioning among lower-income drinkers in particular.