Running head: PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES

Role of Pregaming Motives in Accounting for Links Between Maladaptive Personality Traits and Drinking Consequences

Whitney R. Ringwald1

Elizabeth A. Edershile1

Jonathan Hale2

Trevor F. Williams3

Leonard J. Simms4

Kasey G. Creswell5

Rachel L. Bachrach1,6

Aidan G.C. Wright1

1Department of Psychology, University of Pittsburgh

2Department of Pathology & Laboratory Medicine, Lewis Katz School of Medicine at Temple University

3Department of Psychology, Northwestern University

4Department of Psychology, University at Buffalo

5Department of Psychology, Carnegie Mellon University

6 Center for Health Equity Research and Promotion; Mental Illness Research, Education, and Clinical Center, VA Pittsburgh Healthcare System

This research was supported by grants from the National Institutes of Health (R01 AA026879), the Veterans Health Administration (Health Services Research and Development CDA 20-057), the University of Pittsburgh’s Clinical and Translational Science Institute, which is funded by the National Institutes of Health Clinical and Translational Science Award program (UL1 TR001857). The opinions expressed are solely those of the authors and not those of the funders, institutions, the Department of Veterans Affairs, or the United States Government.

Declarations of interest: None.

Correspondence concerning this article should be addressed to Whitney R. Ringwald, Department of Psychology, University of Pittsburgh, 4305 Sennott Square, 210 S. Bouquet St., Pittsburgh, PA 15260. Email: [email protected] 2 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES Abstract

College students are at heightened risk of engaging in unhealthy use that leads to negative consequences (e.g., motor vehicle accidents, poor academic performance).

Understanding how individual differences, like maladaptive personality traits, contribute to that risk could improve intervention efforts. A potential pathway through which personality confers risk for consequences is by influencing students’ motivation to drink. In this study of 441 college students, we investigated whether different motivations to pregame, a particularly risky and common drinking practice on college campuses, accounts for links between maladaptive traits and alcohol-related consequences. Results of bivariate analyses showed that all pregaming motives and maladaptive traits (except Detachment) were strongly correlated with negative consequences. In path analytic models that adjusted for shared variance between pregaming motives and between maladaptive traits, results showed that traits had indirect effects on total drinking consequences via individual differences in pregaming motives as well as direct effects that were independent of motives. Specifically, Antagonism, Disinhibition, and Negative

Affectivity predicted more drinking consequences via stronger motives to pregame for instrumental reasons over and above the general motivation to pregame whereas Detachment predicted fewer consequences via weaker instrumental pregaming motives. Antagonism and

Disinhibition were also associated with more drinking consequences, and Detachment with fewer consequences, over and above pregaming motives and general personality problems. Our study indicates that one way maladaptive personality traits may shape alcohol-related consequences in college students is by associations with their motivations to pregame.

Keywords: drinking motives; alcohol use; dimensional models; personality pathology 3 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES Personality is a powerful predictor of acute alcohol-related consequences (e.g., driving drunk, unprotected sex) and longer-term problems (e.g., academic/work impairment, alcohol use disorder; Baer, 2002; Hustad et al., 2009; Samek et al., 2018; Stacy et al., 1991). Most research on associations between personality and alcohol use outcomes has examined the Big Five traits.

Meta-analyses of this literature show that Extraversion generally predicts increased alcohol consumption (but not consequences), whereas high Neuroticism, low Agreeableness, and low

Conscientiousness predicts more risky drinking behaviors (e.g., binge-drinking, solitary drinking; Adan et al., 2017; Creswell et al., 2015) and negative short and longer-term consequences, and Openness is generally unrelated to alcohol use (Lui et al., 2021; Malouff et al., 2005; Markon et al., 2005). A population that is particularly likely to engage in unhealthy alcohol use is college students due in part to various developmental and environmental factors

(e.g., changes in neurobiology and social roles, participation in Greek activities; Merrill &

Carrey, 2016), but personality also has a role in conferring risk (or resilience) during this time

(Ham & Hope, 2003). Given the heightened risk in this population, and the unique circumstances that contribute to this risk, there is a need to identify intervening factors that explain associations between personality and drinking consequences in college students.

Identifying how personality leads to negative drinking outcomes, in turn, can inform theory and improve intervention efforts.

A drinking practice that is relatively specific to college students is pregaming (sometimes referred to as “pre-partying”, “pre-drinking”, or “pre-loading”), defined as consuming alcohol in a short period of time prior to an event (Zamboanga & Olthuis, 2016). Pregaming often entails rapid consumption of high volumes of alcohol, which increases susceptibility to harmful drinking consequences such as injury, motor vehicle accidents, violence, and blackouts (Hughes 4 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES et al., 2008; Hummer et al., 2013; Labhart et al., 2013; LaBrie & Pedersen, 2008; Merrill et al.,

2013). There are multiple pathways through which personality may influence the tendency to engage in a behavior like pregaming. One of the most proximal predictors of alcohol use behavior with strong ties to personality is thought to be a person’s motivation for drinking, with different motives predicting different outcomes (Bresin & Mekawi, 2021; Cooper et al., 2015;

Cox & Klinger, 1988). The broader literature on alcohol use and personality supports this hypothesized pathway; for instance, research shows that the relationship between Extraversion and alcohol consumption is accounted for by the motivation to enhance positive emotions and social experiences, whereas the relationship between Neuroticism and alcohol problems is accounted for by the motivation to cope with negative emotions (Hussong, 2003; Mezquita et al.,

2010; Stewart et al., 2001).

There is some evidence that college students’ motivations to pregame are distinct from general drinking motives. Whereas general drinking motives consist of both positive and negative reinforcement (e.g., drinking to enhance or cope), research suggests pregaming motives are more focused on the goal of intoxication and are typically related to positive (rather than negative) reinforcement (Pedersen et al., 2009; Read et al., 2010). Scales developed specifically for pregaming motives have identified a different factor structure than general drinking motives.

Although there are slight differences across these scales, pregaming motives tend to fall into three categories: (1) to get drunk and have fun, (2) to loosen up and enjoy socializing more, and

(3) for instrumental purposes such as hooking up or insufficiency of alcohol at the event

(Bachrach et al., 2012; Labhart & Kuntsche, 2017; LaBrie et al., 2012; Read et al., 2010).

Pregaming motives are correlated with general drinking motives, but pregaming motives incrementally predict pregaming behavior above and beyond general drinking motives, and 5 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES pregaming motives influence drinking consequences both directly and indirectly via pregaming behavior (Bachrach et al., 2012; Labhart & Kuntsche, 2017; LaBrie et al., 2012). Thus, to thoroughly evaluate the potential pathways between personality and consequences via pregaming may require narrowing in on pregaming-specific motives. However, no research to date has examined whether pregaming motives may account for the links between personality and drinking consequences in college students.

Although the Big Five traits are clearly associated with alcohol use outcomes, they may not capture the full breadth of maladaptive aspects of personality needed to predict risky drinking behavior like pregaming. A substantial body of clinical research has identified five maladaptive trait domains that conceptually and empirically align with the Big Five traits (Widiger &

Simonsen, 2005), but provide more comprehensive coverage of pathological personality features

(Suzuki et al., 2015). These traits are Antagonism (maladaptively low Agreeableness),

Detachment (maladaptively low Extraversion), Disinhibition (maladaptively low

Conscientiousness), Negative Affectivity (comparable to Neuroticism), and Psychoticism (an aspect of maladaptive Openness). Most alcohol research has focused on Disinhibition and related components of impulsivity and has shown that these traits are strongly associated with alcohol use disorder and unhealthy drinking (Coskunpinar et al., 2013; Littlefield et al., 2009), including in college student samples (Adams et al., 2012; Jones et al., 2014). Few studies have examined how multiple maladaptive traits uniquely relate to drinking consequences and these found traits related to Disinhibition, Antagonism, and Negative Affectivity are significant predictors of consequences (Bryant & McNulty, 2017; Creswell et al., 2016; Few et al., 2013;

Mezquita et al., 2014). Considering the incremental information about pathological personality offered by maladaptive traits over the Big Five, and the lack of research on all five traits’ 6 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES relationship to alcohol use, there is untapped potential for predicting unhealthy drinking behaviors and outcomes. Furthermore, none of this research has explored the possible indirect effects of motives to explain how these traits may lead to consequences.

In this study, we evaluated whether maladaptive traits confer risk for hazardous drinking outcomes in college students via individual differences in motives to pregame. By narrowing in on hypothesized pathways with specific relevance to this at-risk population, and using trait predictors with better coverage of pathological features than the Big Five, we aimed to add new insights to our understanding of how personality influences alcohol use in college students.

Methods

Participants and Procedures

Participants for this study were college students recruited from the University at Buffalo and University of Pittsburgh. Students completed online questionnaires through Survey Monkey for course credit. For this study, we excluded participants that did not report drinking alcohol in the past 30 days (n = 163). Participants were not selected for pregaming frequency/quantity which allowed for greater variability in pregaming behavior. An additional 11 participants were missing data on covariates so were also excluded from the analyses. The final sample size was

441. Participants were mostly white (82%; 9% Asian; 7% Black/African American)1 and roughly balanced on gender (54% male) with an average age of 19.3 (SD = 2.1).

Measures

Maladaptive traits were measured using the Comprehensive Assessment of Traits

Relevant to Personality Disorder-Static Form (CAT-PD-SF; Simms et al., 2011). The CAT-PD-

SF is a 216-item self-report inventory, which asks participants to describe themselves how they

1 The total percentage exceeds 100% because participants could self-identify as belonging to more than one racial group. 7 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES behave in general compared to others (e.g., “I get angry easily”). Items were rated on a scale from (0) “Very Untrue of Me” to (5) “Very True of Me.” We calculated five higher-order maladaptive trait domains from the CAT-PD-SF by averaging the corresponding lower-order facet scales identified by previous factor analytic work (Wright & Simms, 2014): Antagonism

(Hostile Aggression, Grandiosity, Manipulativeness), Detachment (Romantic Disinterest,

Emotional Detachment, Social Withdraw), Disinhibition (Non-Planfulness, Non-Perseverance,

Irresponsibility), Negative Affectivity (Affect Liability, Anxiousness, Relationship Insecurity), and Psychoticism (Peculiarity, Fantasy Proneness, Unusual Beliefs).

Pregaming motives were assessed with the Pregaming Motives Measure (PGMM;

Bachrach et al., 2012). The PGMM is a 15-item self-report instrument in which participants indicate how often they pregame for various reasons. Each item describes a reason for pregaming and is rated on a Likert scale from (0) “Almost never/Never to (4) “All of the Time.”

We calculated three subscale scores using the PGMM reflecting individual differences in motives: Inebriation/Fun (e.g., “To socialize with friends), Social Ease (e.g., “To make an awkward situation at the event easier to deal with”), and Instrumental (e.g., “Because there will not be enough alcohol at the event”).

Drinking consequences were self-reported using the Brief Young Adult Alcohol

Consequences Questionnaire (B-YAACQ; Kahler et al., 2005), a 24-item version of the YAACQ

(Read et al., 2006). The B-YAACQ includes items from the YAACQ that were empirically selected to capture an optimal range of alcohol problem severity, show high discrimination between levels of severity, and to be invariant across gender (Kahler et al., 2008). For each item, participants indicated whether or not they have experienced a given alcohol-related consequence in the past year (e.g., “I have passed out from drinking”). Items represent a range of negative 8 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES consequences that fall into eight facets, including social/interpersonal problems, impaired control, negative self-perception, self-care, risky behaviors, academic/occupational problems, physiological dependence, and blackout drinking. We calculated a single summed score to represent total drinking consequences in the past year.

Analytic Plan

We first established the bivariate associations between maladaptive traits and drinking consequences. Then, to evaluate the extent to which pregaming motives account for the association between maladaptive traits and consequences, we used path analysis. In this model, we examined the indirect effects of traits on consequences through pregaming motives and the direct effects of traits on consequences not accounted for by motives. The path analytic model included a series of multivariable regression paths. First, all traits were entered as simultaneous predictors of pregaming motives. These paths reflect the specific associations between each trait and pregaming motives adjusted for their shared variance. Additionally, all traits and pregaming motives were entered as simultaneous predictors of drinking consequences. The paths between pregaming motives and consequences indicate the indirect effects of maladaptive traits through motives, and the paths between traits and consequences indicate their direct effects (i.e., associations not accounted for by motives). Because multivariable regression was used to estimate these direct and indirect effects, the shared variance among motives and among traits was partialled out; thus, the paths reflect specific associations. Maladaptive traits and pregaming motives were adjusted for participant gender, age, and race to account for differences in alcohol use patterns across these demographic characteristics (Delker et al., 2016). All correlations between pregaming motives and between traits were freely estimated. Because this model was fully saturated (i.e., zero degrees of freedom), model fit was perfect, so we did not evaluate 9 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES global fit indices. We considered path coefficients with p < .05 to be statistically significant.

Path analytic models were estimated in Mplus Version 8.4 (Muthén & Muthén, 2020) and additional analyses were conducted in R (R core Team, 2018).

Results

Code, model output, and supplementary materials are available on the Open Science

Framework: https://osf.io/nqyfb/?view_only=fce7072d50c64aaeb77145b364a51f0d

Descriptive statistics and scale reliabilities for study variables are presented in Table 1.

Bivariate correlations among study variables are presented in Table 2. As shown in Table 2, pregaming motives were strongly correlated with one another suggesting there are individual differences in the motivation to pregame in general, regardless of the reason. Stronger pregaming motives and higher levels of maladaptive traits, except for Detachment, were correlated with more drinking consequences. We then examined the role of pregaming motives in accounting for the relationships between traits and consequences, adjusted for shared variance among pregaming motives and among maladaptive traits, with the path analytic model depicted in Figure 1. Results from this model showed that traits had specific, direct effects on consequences and indirect effects via pregaming motives.

Antagonism and Disinhibition were uniquely associated with stronger Inebriation/Fun and Instrumental motives, but only Instrumental motives were associated with more consequences. Antagonism was additionally associated with stronger Social Ease motives. Both

Antagonism and Disinhibition traits were also associated with more drinking consequences over and above drinking motives.

Detachment had the opposite pattern of associations as Antagonism and Disinhibition.

Detachment was associated with lower Inebriation/Fun and Instrumental motives. Although 10 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES Detachment was not associated with consequences in the bivariate models, we found that after adjusting for shared variance with other traits and motives in the full structural model, it had a negative, direct effect on consequences in addition to its indirect buffering effect via decreased

Instrumental motives. This pattern of results indicates a suppression effect.

Negative Affectivity was associated with more consequences via stronger Instrumental motives, and had an especially strong association with Social Ease motives; however, Social

Ease motives did not predict drinking consequences. Negative Affectivity did not have a direct effect on consequences after accounting for motives. Finally, after adjusting for shared variance with the other traits, Psychoticism was no longer associated with consequences directly or indirectly through motives.

We focused on the five, broad maladaptive trait domains due to their representation across prominent models of personality and psychopathology, but the CAT-PD also assesses 33 lower-order scales that capture more specific aspects personality pathology within these domains. In exploratory analyses, we examined bivariate correlations between the lower order trait scales, pregaming motives, and drinking consequences. Overall, the lower order traits had similar patterns of associations with pregaming motives and consequences as their corresponding higher-order trait domains. Full results are reported in the supplement.

Sensitivity Analyses with All Cases

To evaluate whether removing participants that did not report drinking in the past 30 days influenced our results, we re-ran analyses with the full sample (N = 601). Complete results from this model are in the supplement. Overall, the pattern of results was similar to our main analyses but there were notable differences: (1) All traits were associated with Social Ease motives (not just Antagonism and Negative Affectivity); namely, they predicted stronger Social Ease motives 11 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES except Detachment and Psychoticism which predicted significantly lower Social Ease motives

(2) Negative Affectivity was associated with all three pregaming motives (not just Social Ease and Instrumental), and (3) Inebriation/Fun motives (not just Instrumental motives) were associated with more consequences.

We considered whether limiting the sample to students that drank regularly indirectly resulted in a sample selected for higher levels of maladaptive traits, and whether this was essentially selecting on a collider that is often observed in substance use research (Tattan‐ Birch et al., 2021). In this case, how much a person drinks could be a collider variable that is related to both the predictors (maladaptive traits) and the outcome (consequences). Inadvertently restricting the range of the predictors by selecting on the collider (how much a person drinks) could result in a Berkson’s bias that led to some significant effects becoming null and null effects becoming significant in the full sample compared to the selected sample. To further explore this potential effect, we compared the mean differences in maladaptive traits between students who drank in the past 30 days and those who did not. We found that the students who drank (i.e., the selected sample) scored significantly higher on Disinhibition and Antagonism and lower on

Detachment compared to those who did not drink (i.e., excluded participants). These results are consistent with Berkson’s bias, but do not provide conclusive evidence; thus, we primarily interpret results from the selected sample used in the main analyses per conventional practices in the alcohol use and personality literature and report these sensitivity analyses for comprehensiveness.

Discussion

Clarifying the pathways through which personality contributes to risky drinking in college students could help prevent and reduce harmful consequences. In this study, we found 12 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES that maladaptive traits predict consequences, in part, through individual differences in pregaming motives. Our results suggest that the reasons students pregame may be an important intervening factor that accounts for the link between personality and problematic alcohol use in this at-risk population. We found that all five maladaptive traits predicted consequences (in either bivariate or multivariable models), which underscores the potential value in expanding beyond the Big

Five and impulsigenic traits in predicting problematic drinking. We also found that maladaptive traits were associated with all three pregaming motives, but only the tendency to pregame for instrumental purposes predicted drinking consequences.

Links Between Personality, Pregaming Motives, and Consequences

Our results align with previous work on Big Five personality and general drinking motives, suggesting that similar personality processes, unsurprisingly, unfold in the context of college student’s pregaming alcohol use. We found that pregaming motives were strongly correlated with one another—as tends to be the case for general drinking motives (Bresin &

Mekawi, 2021)—and all motives were correlated with more consequences in bivariate models.

After partialling out the shared variance in motives, all the associations with consequences were attenuated, indicating that individual differences in the general tendency to pregame accounts for considerable variance in risk. In our main analyses, we focused on the unique, indirect effects of motives to describe trait-specific associations over and above this general individual difference risk factor.

Specifically, Antagonism and Disinhibition were both associated with Inebriation/Fun and Instrumental pregaming motives which relate to drinking to enhance social, emotional, and physiological experiences. These findings are similar to studies showing low Conscientiousness/ impulsivity (i.e., Disinhibition), and to some extent low Agreeableness (i.e., Antagonism), 13 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES predict enhancement motives (Stewart et al., 2001; Stewart & Devine, 2000; Theakston et al.,

2004). That Antagonism and Disinhibition showed common pathways to pregaming motives and drinking consequences is also consistent with these traits being subsumed within a broader externalizing dimension (Krueger et al., 2021; Ringwald et al., 2021).

At the same time, Antagonism can be distinguished from Disinhibition by its unique association with Social Ease motives, which involves pregaming to manage emotions in social situations. Because Antagonism comprises tendencies that outwardly disregard people’s thoughts and feelings, this result may seem unexpected. Our findings raise the possibility that despite hostile or callous behavior suggesting disregard for others, more antagonistic college students struggle to feel comfortable in social situations and pregame to cope with that discomfort. The idea that insecurity underlies (at least some) overt antagonistic behaviors is well-established in clinical theories (e.g., vulnerable narcissism; Cain et al., 2008), so it may be that similar self- regulating processes can explain how this trait influences college students’ motivation to pregame.

In contrast to the externalizing traits, Detachment was associated with lower motivation for Inebriation/Fun or Instrumental pregaming. Detachment encompasses features related to low reward sensitivity and anhedonia, and our results suggest this lack of motivation extends to pregaming tendencies in college students. This finding that maladaptively low Extraversion (i.e.,

Detachment) associates with weaker motivation to pregame for fun or to feel drunk converges with prior work on the Big Five showing Extraversion predicts stronger enhancement drinking motives (Hussong, 2003; Kuntsche et al., 2006; Mezquita et al., 2010, 2018). We found that the lack of motivation to pregame for instrumental purposes associated with Detachment in particular reduced alcohol-related consequences. Thus, although Detachment is considered a 14 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES maladaptive trait, it may serve as a protective factor against risky drinking in college students.

People who are more detached tend to be socially withdrawn, and because pregaming by definition takes place before a social event, it could also be that more detached people are less motivated to pregame because they are less inclined to attend social events. Decreased likelihood to pregame overall due to low motivation, in turn, may help explain why Detachment has a buffering effect. However, we could not explore this possibility in our study since we did not measure frequency of pregaming or other social drinking events attended, but future research should test this hypothesis.

The strongest relationship between traits and motivation was the association between

Negative Affectivity and Social Ease pregaming motives. Social Ease motives share features with drinking to cope identified in the general motives literature, and this finding parallels previous research showing Neuroticism (the Big Five trait corresponding to Negative

Affectivity) is robustly associated with coping motives (Littlefield & Sher, 2010; Mezquita et al.,

2014, 2018; Stewart & Devine, 2000; Theakston et al., 2004). Although Negative Affectivity was most clearly characterized by Social Ease motives, only the trait’s association with

Instrumental motives accounted for its link to alcohol-related consequences. This result is somewhat in contrast to prior findings on Neuroticism that suggest coping motives lead to greater consequences (e.g., Mezquita et al., 2010; Stewart et al., 2001). However, as shown in prior work, Social Ease motives are not isomorphic with coping motives and there may be unique processes to consider in the context of college students’ pregaming that explain the lack of association with consequences. For instance, pregaming for social ease in this population may be more normative (and thus result in fewer negative consequences) than generally drinking to cope. Another consideration is that the measure of consequences we used may not capture the 15 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES types of harmful outcomes that result from a tendency to pregame for social ease, and is a point we expand on further in the next section.

Finally, we found a significant bivariate association between Psychoticism and consequences, but this effect became non-significant after accounting for shared variance with other maladaptive traits. The shared variance that was partialled out likely reflects general distress or dysfunction (Smith et al., 2020), suggesting Psychoticism is not a unique risk factor for risky drinking. This finding is in line with the literature on the Big Five model of personality that shows Openness to Experience, the adaptive variant of Psychoticism, rarely relates to alcohol use (cf. Hakulinen et al., 2015; Theakston et al., 2004).

Why Pregaming Motives May be a Risk Factor

A logical question that flows from our results is why do pregaming motives account for the links between maladaptive personality traits and consequences in college students? One possibility is that students who tend to pregame more, regardless of the reason, typically drink more often and drink higher volumes of alcohol, which then results in more consequences.

Supporting this explanation, we found that all pregaming motives were correlated with more consequences, and previous work has shown all pregaming motives predict increased drinking

(LaBrie et al., 2012). Instrumental motives were uniquely associated with consequences suggesting processes that are independent of the general tendency to pregame. However, drinking frequency and quantity may nonetheless be the intervening factor—in a study of college students that pregamed at least once in the past year, Bachrach and colleagues (2012) found that how much students drank mediated the unique association between Instrumental motives and consequences. Taken together with our study, two pathways by which maladaptive traits lead to 16 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES downstream consequences is by influencing the general motivation to pregame, and to pregame for a purpose, both of which may lead to drinking more and more often.

There are other reasons besides amount of drinking that may explain why personality- related pregaming motives differentially predict consequences. There are aspects of social drinking situations that may provoke more or less risky behavior, and so the mediators between pregaming motives and consequences may be features of the context rather than (or in addition to) how much a person drank. Further complicating the picture is the likelihood that personality influences both a person’s pregaming motives and the types of contexts they tend to drink in (or prior to). Indeed, situation-selection is another key pathway by which personality is thought to relate to alcohol use (Kahler et al., 2003; Sher et al., 2018). To illustrate, people who tend to drink for instrumental reasons may also tend to go to fraternity parties where they engage in more reckless behavior due to cultural norms or peer pressure (Sher et al., 2001). Or people who pregame to facilitate “hooking-up” may also tend to have unprotected sex. People who tend to pregame to ensure intoxication could be more likely to co-use cannabis which amplifies the substances’ physiological effects and leads to a greater number of consequences than using just one substance or the other (Egan et al., 2019; Lee et al., 2017).

The relationships between traits, pregaming motives, situations, and consequences are likely bi-directional and feedback into one another, so a challenge moving forward for understanding the role of personality in alcohol use will be delineating these complex pathways.

One way to accomplish this could be using intensive longitudinal designs (e.g., ecological momentary assessment) that can disentangle between and within-person associations among these factors. Such a study design would allow researchers to test between-person hypotheses such as do the people who tend to be motivated to pregame for instrumental reasons also tend to 17 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES be those that go to fraternity parties? and within-person hypotheses such as when people are motivated to pregame for instrumental reasons is it typically before going to a fraternity party

(regardless of their trait levels)? It could also be that traits moderate associations between motives and contexts, and intensive longitudinal designs would enable testing of cross-level hypotheses such as are more antagonistic people more likely than less antagonistic people to pregame for instrumental reasons before going to a fraternity party? Investigating these types of questions will begin to uncover the mechanisms underlying personality and alcohol relations and can provide targets for prevention and intervention efforts.

Limitations and Future Directions

Our study adds to our knowledge of personality’s role in risky drinking behavior in college students, but there are several notable limitations. Drinking motives are considered the most proximal determinant of alcohol use according to prominent motivational theories (Cooper et al., 2015; Cox & Klinger, 1988), but our cross-sectional study design did not allow us to establish temporal ordering of motives and consequences; thus, we cannot say that motives precede consequences. As indicated in the above discussion, intensive longitudinal designs are a more appropriate approach to study temporal relationships.

We found that only Instrumental motives predicted consequences over and above the general tendency to pregame, but previous work has found Inebriation/Fun and Social Ease motives to have unique associations as well (Bachrach et al., 2012). These discrepancies may be due to sampling variability or inclusion of different covariates. Another reason may be that we used the brief instead of the full version of the YAACQ used in this previous study. Although the brief and full versions are comparable (Kahler et al., 2005), it is possible that the brief version omits consequences that are especially relevant to Inebriation/Fun or Social Ease motives 18 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES that we did not detect. More generally, the YAACQ assesses acute and direct alcohol-related consequences, but there are many distal and indirect outcomes that we did not measure.

Additionally, because our study was cross-sectional, we could not examine the role of developmental factors and how pregaming motives may contribute to longer-term functioning outcomes. For example, pregaming to reduce stress in social situations may be somewhat normative and have few acute consequences in college, but relying on drinking instead of developing other coping skills may, over time, lead to poor psychosocial functioning or the development of alcohol use disorder. Examination of the developmental trajectory of a person’s motivation to pregame and its relationship to a broad range of acute and long-term consequences within and beyond college is a fruitful direction for future research.

Our sensitivity analyses raise questions about the impact of sample selection on inferences that can be made. It is conventional in alcohol research to select samples of people that drink above a certain threshold (e.g., report at least once in the past 30 days) to draw inferences about the target population of “drinkers” as opposed to the general population of, for example, college students. Results of our sensitivity analyses comparing results using all participants to the sample of drinkers suggest that this methodological decision may lead to divergent inferences. We probed one possible reason for these differences in our study, namely that this practice indirectly selects participants along the predictor variable which can result in a

Berkson’s bias. There is no way to confirm the presence of such a bias empirically, and its effects on model estimates are not straight-forward. For these reasons, determining what sample is most appropriate, and thus which results are more valid, is also not straight-forward. We presented results from the selected sample to maintain consistency with the broader literature, 19 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES but encourage researchers to give careful thought to decisions about restricting the range of participant characteristics.

Results from our study underscore the equifinality of the relationship between traits and drinking consequences and the need for continued investigation into other pathways.

Detachment, Antagonism, and Disinhibition had direct effects on consequences that were not accounted for by pregaming motives. We discussed how situation-selection may explain additional variance, but other hypotheses have been proposed such as individual differences in sensitivity to the physiological effects of alcohol (Sher et al., 1999), general deviant proneness

(e.g., externalizing tendencies), peer behavior/social norms (Borsari & Carey, 2006), the social context of alcohol use (Creswell, 2021), and genetic factors (Aliev et al., 2015; Harden et al.,

2012) are likely at play alongside motives.

Conclusion

Personality is an important predictor of alcohol use behavior and outcomes. In this study, we found evidence that maladaptive traits may shape college student’s alcohol use via associations with their motivation to pregame. Individual differences in the motivation to pregame for instrumental purposes may be particularly risky and accounted for associations between personality and alcohol-related consequences over and above the general tendency to pregame. These results lay the groundwork for further investigation into the processes underlying these associations, and can help to better understand and prevent drinking-related harm in college students. 20 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES References

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Use & Misuse, 51(8), 953–960. https://doi.org/10.1080/10826084.2016.1187524 31 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES Table 1. Descriptive statistics for study variables

Standard Reliability Mean Skew Kurtosis Deviation (ω) PGMM Inebriation/Fun 2.97 1.11 -.19 -.78 .93 Instrumental 2.08 .93 .76 .04 .85 Social Ease 2.49 1.03 .11 -.83 .90

B-YAACQ 5.24 5.44 1.46 1.95 .93

CAT-PD-SF Antagonism .62 .51 1.23 1.77 .89 Detachment 1.29 .61 .33 -.46 .85 Disinhibition 1.17 .64 .60 .18 .89 Negative Affectivity 1.24 .74 .62 -.27 .91 Psychoticism 1.04 .60 .52 -.24 .85

Note. Reliability (ω) = McDonald’s omega, PGMM = Pregaming Motives Measure, B-YAACQ = Brief Young Adult Alcohol Consequences Questionnaire, CAT-PD-SF = Comprehensive Assessment of Traits Relevant to Personality Disorder Static Form. 32 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES Table 2. Correlations among study variables

Alcohol Pre-gaming Motives Maladaptive Traits Consequences

Inebriation/ Negative Instrumental Social Ease Total Antagonism Detachment Disinhibition Psychoticism Fun Affectivity Inebriation/Fun Instrumental .61 Social Ease .71 .64 Alc. Conseq. .33 .37 .33 Antagonism .28 .22 .32 .34 Detachment -.05 .03 .19 .04 .31 Disinhibition .23 .22 .29 .32 .49 .42 Negative Aff. .16 .20 .40 .22 .43 .54 .51 Psychoticism .16 .14 .20 .21 .53 .35 .52 .48

Note. Bolded coefficients are statistically significant (p < .05). 33 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES

Figure 1. Structural equation model of paths between maladaptive traits, pregaming motives, and consequences

Inebriation/ -.23 Fun Detachment .18 .24

Disinhibition -.15 .21 .24 Consequences Antagonism .18 -.12 .14 .26 Negative .14 Instrumental Affectivity .14 .40 Psychoticism Social Ease

Note. All effects are standardized regression coefficients. All paths are regression paths. Dotted lines are direct effects of personality. All predictors were allowed to freely correlate. Every motive was regressed on every maladaptive trait, and consequences were regressed on all motives and traits; however, only significant (p < .05) regression paths are depicted for ease of interpretation.