There is a high level of co-morbidity among those who have alcohol use disorders, involving other types of mental disorders. Many who struggle with alcohol are also diagnosed with disorders like depression and anxiety.
Scientists believe due to previous research that different types of disorders affect drinking in distinct ways. Those with "internalizing" disorders drink in order to deal with overwhelming negative emotions. Those with "externalizing" disorders tend to drink more in response to positive feelings.
A recent study look at how externalizing and internalizing disorders affected the behaviors of first-time DUI offenders, specifically looking at high-risk drinking and their perception of their ability to maintain control over alcohol consumption (Schlauch, O’Malley, Rounsaville & Ball, 2012).
The researchers evaluated 292 first-time DUI offenders, using a questionnaire to assess internalizing and externalizing disorders, in addition to measuring coping self-efficacy. Self-efficacy refers to an individual’s perception of their control over drinking behaviors when placed in different types of high-risk settings.
The internalizing disorders evaluated by the research team included anxiety, depression and other diagnoses centered on negative emotionality. The externalizing disorders evaluated were, for example, antisocial personality and conduct disorder.
The self-efficacy was focused on the participants’ ability to choose not to drink in both negative and positive situations. A negative situation might be when the individual is feeling a sense of failure in the professional realm. A positive situation could be when an individual is having fun at a party but wants to drink to increase the fun.
Problematic alcohol behaviors were measured using the Time Line Follow-Back tool, in addition to the Addiction Severity Index. To analyze the data, the researchers used the ASI score in addition to the number of days the participant drank heavily over the past month. The researchers also incorporation a structural equation model to measure the direct and indirect relationships observed between the variables.
The results showed that there was a strong connection between internalizing behaviors and a persons ability to handle not drinking in negative situations. There was not a connection observed between internalizing disorders and coping efficacy in a positive setting. The researchers also found that there was a connection between externalizing disorders and coping self-efficacy in both negative and positive situations.
The study also showed that those with a high score on internalizing were more challenged when it came to avoiding alcohol consumption in negative settings. The reverse was true for those with high scores on externalizing disorders.
The authors note several limitations on the results of the study. For instance, the study was designed to be correlational, and does not provide evidence for causality between the variables involved. In addition, the use of self-report in the Time Line Follow-Back may result in different measurements than what actually occurred.