From Daily Attitudes to Alcohol-Related Harm: A Within-Person Serial Mediation Test Informed by the Theory of Planned Behavior.
Angelo M DiBello, Jennifer E Merrill, Kate B Carey et al.
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In 30 seconds
This multilevel daily-diary study examined whether day-to-day changes in attitudes toward heavy drinking were linked to alcohol-related harm through intentions and consumption. It included 87 heavy-drinking young adults in the intervention arm of a randomized clinical trial, assessed for up to 30 consecutive days. On days when participants held more favorable attitudes than their own average, they reported stronger intentions and drank more; greater consumption predicted higher odds of alcohol-related consequences and blackout. Significant serial indirect effects supported this pathway for both outcomes, while intentions also predicted consequences directly but not blackout after accounting for consumption.
Key findings
- More favorable-than-usual daily attitudes predicted stronger drinking intentions, which predicted greater same-day alcohol consumption.
- Greater same-day consumption predicted increased odds of alcohol-related consequences and blackout.
- Significant serial indirect effects linked attitudes to both outcomes through intentions and consumption.
- Intentions directly predicted consequences independent of consumption, but did not directly predict blackout after accounting for drinking.
Why it matters
The findings suggest that alcohol-related risk may vary with daily shifts in attitudes and intentions, not only with stable differences between people. Distinct pathways for consequences and blackout also indicate that drinking quantity may not fully account for all alcohol-related harm. This day-level perspective can inform research into when risk rises and how it might be addressed.
What to keep in mind
The analysis involved 87 heavy-drinking young adults from the intervention arm of a randomized clinical trial, limiting generalisability. Daily diary associations and mediation estimates do not establish that changing attitudes or intentions would reduce harm.