Predictors of persistent alcohol use disorder and co-occurring depressive symptoms: Insights from the longitudinal college experiences study.

Abstract

Problematic alcohol use and depression are prevalent in the college student population. The purpose of this study was to identify how personality and social-contextual factors in the first year of college work together to predict stable and potentially co-occurring alcohol use disorder (AUD) and depressive symptoms over a period of approximately 4 years. Participants were first-year college students from the Southeastern United States (N = 209, 90% white, 62% female). Baseline data were collected in the first year of college and follow-up assessments were completed ~1 and ~4 years later (retention rates: 80%+, average ages ~19, 20, and 23 years, respectively). At each assessment, participants completed a comprehensive online survey assessing mental health and substance use, as well as personality, social support, stress, sleep, and other features of peer and romantic partner affiliations. Results from our random-intercept cross-lagged panel model indicated AUD and depressive symptoms were more likely to co-occur in the transition out of rather than into college. Significant predictors of stable AUD symptoms across the ~4-year period included greater alcohol quantity, marijuana frequency, affiliation with antisocial/substance-using peers, and frequency of drinking with romantic partner in the first year of college. Significant predictors of stable depressive symptoms included greater constraint, greater negative emotionality, lower positive emotionality, greater stress, and less weekday sleep. Findings suggest that personality factors, stress, and sleep in the first year of college may be useful targets to screen for in efforts to reduce long-term depressive symptoms in the college context. Disrupting affiliation with antisocial/substance-using peers and romantic partners and reducing the high quantity of alcohol and frequency of marijuana may be more relevant to reducing long-term problematic alcohol use. Implications for incorporating individually-tailored approaches to prevention/intervention are addressed.