Coping via substance use, internal attribution bias, and their depressive interplay: Findings from a three-week daily diary study using a clinical sample

Abstract

BackgroundThe relationship between depression and coping-oriented substance use is extensively documented; however, the cognitive processes moderating this bidirectional relationship are not well-understood. The present study investigated whether internal attribution bias coupled with a tendency to use drugs and/or alcohol to cope predicts increases in depression and daily-levels of general negative affectivity, sadness, and hostility. MethodSixty-seven adults diagnosed with depression were recruited from out-patient treatment settings (66% female, 81% White, Mage = 31, SDage = 13.2). Participants completed measures on substance-related coping, depression, attributional style, and daily affect over a three-week period. ResultsSubstance use to cope predicted increases in depression among individuals with high-level internal attribution bias. Further, coping via substance use moderated the relationship between internal attribution bias and daily-level sadness, such that sadness was highest among individuals with a high internal attribution bias coupled with greater levels of coping via substance use. A modest, yet, non-significant upward trend in daily-level hostility was also observed. ConclusionsResults suggested that depressed individuals who habitually perceive themselves as being responsible or blameworthy for negative life events are at an increased risk of worsening depressive symptoms and experiencing greater daily levels of sadness over a relatively brief period of time, particularly, when tending to engage in substance use as a mechanism to cope. This interaction effect can elicit greater daily-level sadness as well. Findings may aid in the identification and treatment of individuals at risk of maintaining or worsening their depressive symptoms.