Life stressors, drinking patterns, and depressive symptomatology: Ethnicity and stress-buffer effects of alcohol

Addictive Printed

Behaviors, in the USA.

Vol. 18, pp. 373-387, All rights reserved.

1993 Copyright

0306-4603193 $6.00 + .oo 8Z 1993 Pergamon Press Ltd.

LIFE STRESSORS, DRINKING PATTERNS, AND DEPRESSIVE SYMPTOMATOLOGY: ETHNICITY AND STRESS-BUFFER EFFECTS OF ALCOHOL JAMES Department

of Psychiatry,

The University

ALAN of Texas

NEFF Health

Science Center

at San Antonio

Abstract

- This paper seeks to extend previous research on stress buffer effects of alcohol use using data from a tri-ethnic community sample of 1.784 respondents. Differences in buffer effects between Anglos, Blacks, and Mexican Americans are examined to explore possible racial/ethnic variation in the role or function of alcohol vis-$-vis life stress and depressive symptoms. Both acute life events and chronic financial stress are examined to clarify the conditions under which buffer effects are most and least salient in these groups. The findings indicate that alcohol buffer effects are most pronounced among males with regard to life event stress and depression. Ethnic differences in buffer effects were suggested among males for life events, though statistical controls for demographic factors. fatalism. and religiosity accounted for these differences. The implications of these findings are examined, and the paper generally highlights the need lo view alcohol use and alcohol buffer effects in the context of more general coping orientations.

This paper extends previous research on possible stress-buffer effects of alcohol consumption with regard to life stress-depression relationships by examining buffer effects among Anglo, Black, and Mexican-American drinkers and nondrinkers. Relationships between life stressors (comparing recent life events and chronic financial stress), drinking patterns (comparing abstainers with drinking subgroups). and depressive symptomatology are examined to determine differences in stress-buffer effects of specific patterns of alcohol use across racial/ethnic subgroups. Because these racial/ethnic groups differ on sociodemographic and sociocultural attitude dimensions, a major focus of the study is to explore the explanatory role of fatalism/ personal mastery and religiosity dimensions with regard to possible differences in buffer effects across groups. The overall objective is to clarify the role and implications of alcohol use among Anglos, Blacks, and Mexican-Americans. Conceptually, stress-buffer effects involve relatively twnspeci’c tension reduction functions of “moderate drinking” (Neff, 1984). This implies a regular pattern of alcohol consumption independent of specific crises, that is, buffer effects do not reflect drinking to “cope” with specific problems. By analogy, social ties may provide specific support during a crisis, though, nonspecific buffer effects of social ties may be observed as well. Positive interactions with friends, family, and so forth may provide general tension reduction effects, perhaps making the individual more resilient in the face of crisis. Interest in possible stress-buffer effects of alcohol use arose from the observation of greater psychological distress among both abstainers and heavier drinkers than among light or occasional drinkers (Bell, Keeley, & Buhl, 1977). thus suggesting Presented at the Annual Meeting of the Southwestern Sociological Association. San Antonio. March. 1991. This research was supported by grants #ROI-AA06723 and ROI-AA08067 from the National Institute of Alcohol Abuse and Alcoholism. The author appreciates the helpful comments made by the anonymous journal reviewers. Requests for reprints should be sent to James Alan Neff, Department of Psychiatry. The University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX 78284-7792. 373

374

.I.

A.NEFF

drinking. Buffer properties of alcohol conbeneficent properties of .‘moderate” sumption have been explored using data from urban/rural Florida communities 1982). rural Tennessee. Ohio, and (Neff, 1984). rural Tennessee (Neff & Husaini. Oklahoma (Neff, 198s). and rural and urban Tennessee (Neff & Husaini, 1985). In these studies: (a) higher levels of psychological distress were typically found among abstainers and heavier (i.e.. high-quantity/high-frequency) drinkers. with lower distress levels among drinkers in the occasional or moderate drinking categories: and (b) life event-distress relationships were typically most pronounced among abstainers and heavier drinkers. with attenuated event-distress relationships (suggestive of buffer effects) among either occasional or moderate drinkers. These studies have also found buffer effects to be more salient with regard to anxiety than depression (Neff, 1984). catastrophic rather than chronic life events (Neff. 19X). and in rural rather than urban communities (Neff & Husaini. 1985). While stress-buffer effects of alcohol have been replicated in differing samples most of this reusing different measures of stress. distress. and drinking patterns, search has involved rural, largely Anglo populations. Racial differences in buffer effects were suggested by Neff and Husaini (1985). who found supportive evidence of buffer effects among both rural and urban Anglos. but not among urban Blacks. Interestingly. Aneshenscl (1983) did not find support for buffer effects of alcohol consumption in her tri-ethnic study in Los Angeles, though possible differences in buffer effects across racial/ethnic subgroups of her sample were not considered. Variation in the nature or magnitude of buffer effects across groups might have been obscured in the total sample analyses. The possibility of racial/ethnic (hereafter referred to as “ethnic” for the sake of brevity) variation in alcohol buffer effects is suggested by several considerations. First. research regarding ethnicity and drinking patterns dates back at least to Jessor, Graves. Hanson. and Jessor (1968). Hispanics in their data had a somewhat higher mean quantity-frequency of alcohol use and were more likely than Anglos to drink more than five drinks at a sitting. Hispanics in Cahalan’s national study (Cahalan. Cisin, & Crossley, 1969) were slightly more likely to abstain than Angles, though among drinkers, the proportion of Hispanic heavy drinkers was greater than among Anglos. Abstinence rates were similar among Black and Anglo males; among drinkers, Black and Anglo males were about equally likely to be classified as heavy drinkers. Among females. abstinence was more common among Hispanics. Heavy drinking was less common among Hispanic females, and more common among Black females than among Anglo females. More recently, Caetano (1984) found that Hispanic males in his San Francisco Bay area data drank somewhat more frequently than Angles, though racial and ethnic among regular drinkers differences were not marked in the total sample. However. (those drinking at least once a month). both Black and Hispanic males had higher rates of heavy drinking than Angles. Caetano and Herd (1988) also presented national data, finding that Anglos were more likely to drink in bars and clubs, while Blacks were most likely to drink in public settings like parks, streets, or parking lots. Although Hispanic males did not drink any more often in public than other groups, they reported heavier public consumption than Anglos or Blacks. Although research suggests differences in the nature of Hispanic drinking patterns between California and Texas (Gilbert & Cervantes, 1986) and between differing Hispanic groups in the U.S. (Caetano, 1988), a number of studies suggest that Mexican-American drinking patterns, in particular. tend to be high quantity and IOW

Ethnicity and alcohol buffer effects

375

frequency compared to non-Hispanic Whites (Caetano, 1988; Golding, Burnam, & Wells, 1990; Neff, Hoppe, & Perea, 1987), Neff s (1986) examination of national data from the Health and Nutrition Examination Survey Augmentation Component indicated that Black patterns are similar to Anglo patterns (i.e., more frequent, lower quantity, even net of sociodemographic controls), a finding consistent with Neff s tri-ethnic research in Texas (Neff, 1991). A second basis for interest in ethnic differences involves differences between groups in coping or adaptive strategies. Fatalism/instrumentalism, referring to the individual’s perception of the controllability of life events, has been linked fairly consistently to symptoms of depression (Mirowsky & Ross, 1984; Wheaton, 1982). Research documents higher levels of fatalism among Hispanics than Anglos (Chandler, 1979), and Mirowski and Ross (1984) argue that fatalism may account for high levels of depression observed among Mexican-Americans, relative to Anglos. Fatalism has not been as explicitly considered with regard to Blacks, though evidence suggests that fatalistic responses in this group may be adaptive under some circumstances (Parker & Kleiner, 1966). Differences in fatalism between ethnic groups, as a reflection of differing coping styles, are of interest as fatalism may be related to drinking patterns, consistent with McClelland’s (1972) discussion of drinking to reinstate power or control, as well as more recent discussions of learned helplessness and drinking (Lisman, Keane, & Noel, 1983). Religiosity is of interest as high levels of religiosity have been observed among Blacks (Krause & Tran, 1989), and as religious ties may provide both emotional and social support, which may have beneficial psychological consequences (Peterson & Roy, 1985). This paper addresses alcohol-buffer effects (i.e., interaction effects between stress and drinking patterns) among Anglo, Black, and Mexican-American drinkers. To the extent that differences in these effects are observed, we assess the explanatory role of sociodemographic factors, fatalism, and religiosity as they influence observed differences. To clarify the specificity or generality of findings, both acute life event stressors occurring during the past 12 months and chronic financial stress are considered. This comparison tests whether buffer effects may be more pronounced with regard to acute than chronic stresses (Aneshensel, 1983). Financial stress is particularly relevant, as the “stress” of poverty is commonly offered as an explanation of alcohol problems among Blacks (Larkins, 1965) and Hispanics (Alcocer, 1982). Our focus upon depressive symptomatology stems from the interdependence of depression and fatalism posited to exist in Mexican culture (Mirowsky & Ross, 1984). Given previous research suggesting greater buffer effects for somatic than affective symptoms (Neff, 1984), our focus upon depressive symptoms poses an extremely conservative test of buffer effects. Finally, separate analyses are conducted for males and females, as previous research has not considered sex differences. METHODS

Sampling

techniques

Data were obtained via household interviews with a random sample of 1,784 male and female residents of San Antonio, Texas during 1988. The sample included 1,286 individuals reporting alcohol use at least two or more times per month (412 Anglos, 239 Blacks, and 634 Mexican-Americans), and 498 nondrinkers reporting no alcohol use during the 6 months prior to the interview. Multistage area probability sampling techniques were used, stratifying Census tracts in urban San Antonio by median

376

J. A. NEFF

family income and ethnic heterogeneity to assure sample representativity. Randomly selected blocks and households within sample tracts were screened for potential respondents aged 18-60 meeting drinker/nondrinker eligibility criteria, and one eligible respondent per household was selected using Kish (1965) techniques. Refusal rates for the study were approximately 30% for drinkers and 40% for nondrinkers. While no data were available on characteristics of refusals, Black and MexicanAmerican drinkers and nondrinkers were socioeconomically disadvantaged relative to Anglos, and Blacks were significantly less likely to be currently married. The consistency of these demographic profiles with Census data for San Antonio argues against systematic biases due to refusals. Measurement considerutions Data on the individual’s typical quantity (number of drinks per typical drinking occasion) and frequency (number of drinking occasions per typical week) of beer. wine, and liquor consumption were assessed separately for each beverage. Drinking questions referred to recent typical patterns - no particular time period was specified (e.g., the last week or month). Total quantity and total frequency measures were computed by summing across beverage types. In constructing a typology of drinking patterns, current nondrinkers with a history of heavy or problem drinking which might confound present comparisons were excluded (Eward, Wolfe, Mall, & Harbry, 1986). A total of 59 current nondrinkers were eliminated due to reports of a history of one or more of the following: prior heavy drinking (49), prior drinking problems (31). or prior treatment for alcohol problems (10). Among drinkers, total quantity and total frequency measures were combined to form a typology as shown in Table 1. Quuntity cut-offs were chosen to be consistent with previous research indicating: (a) significant buffer effects using cut-off points of an average of 2 drinks/occasion (Neff & Husaini, 1985), (b) possibly beneficent effects of alcohol use with regard to coronary heart disease mortality at roughly 2 drinks/day (Klatsky, Friedman, & Siegelaub, 1979), and (c) self-reported four drinks on an average of three days per week as a cut-off indicating the beginning of a phase of “problem drinking” (Sanchez-Craig & Israel, 1985). Frequency cut-offs contrasted those drinking l-2 days/week (largely weekend drinking in these data) and those drinking more frequently. As our sample of drinkers was selected to include only fegltlar drinkers, consumption levels appear higher than observed in previous general population samples and, as a result, frequent-light drinking is rather rare in our data, that is, frequent drinkers tend to drink more heavily than l-3 drinks/occasion. As this frequent-light category is conceptually critical in representing “frequent-though moderate” drinking in contrast to occasional-heavy (possibly “binge”) drinking, it is

Table Drinking

pattern

I Definition

of a quantity-frequency-based

category

Abstainers Occasional-light Occasional-heavy Frequent-light Frequent-heavy

drinking Quantity

Frequency no no ~2 52 3+ 3+

current drinking/ previous problems occiwk occiwk occiwk occlwk

pattern

53 4-t 53 4+

drinks/episode drinks/episode drinks/episode drinks/episode

typology Males

Females

16% 13% 26% 10% 35%

34% 20% 24% 7% 15%

377

Ethnicity and alcohol buffer effects

important to keep these categories distinct. pattern groups will be discussed below.

Other distinctions

between

drinking

Stress. Two stress measures were developed. Acute life events were measured in terms of the number of nine possible events (marriage, divorce/separation, widowhood, moving, being fired, being laid off, retiring, hospitalization, or development of new health problems) reported in the past 12 months. The total number of events was dichotomized roughly at the median into 0 (41%) and I+ (59%) events. Chronic stress was assessed using an 8-item measure of financial stress developed from factor analyses of a larger pool of financial stress items presented in Pearlin and Schooler (1978). This measure focused upon the individual’s degree of worry, tension, concern, etc., regarding his/her financial situation and had an internal consistency reliability (Cronbach’s alpha) of .84, .80, and .82 for Anglo, Black, and Mexican-American drinkers, respectively, and .84, .83, .83 for nondrinkers. Scores on this measure were split at the median into “low” and “high” stress categories. Depressive symptomutology. This was measured with the Center for Epidemiologic Studies Depression measure (CES-D: Radloff, 1977), a 20-item measure of the presence and frequency of depressive symptoms during the past week. Reliability estimates for Angles, Blacks, and Mexican-Americans were .90. .90, and .89 for drinkers, and .91, .92, and .93 for nondrinkers. Control variables. These included measures of fatalism, rehgiosity, and social desirability. Futalism was assessed with a 7-item measure derived from factor analyses of 11 fatalism/mastery items used by Pearlin and Schooler (1978) and additional items from Chandler (1979). This measure tapped personal ,futulism (items were phrased in the first person and assessed the individual’s perceived control of his/her own life, e.g., “I have little control over things that happen to me”). Reliability estimates for Anglo, Black, and Mexican-American subgroups were .74. .71, and .73 for drinkers, and .66, .78, and .77 for nondrinkers. Religiosity. This was assessed using five items tapping self-rated degree of religiosity, frequency of church attendance, perceived influence of religion upon one’s life, frequency of prayer, and frequency of talks with religious officials. The items had reliability estimates of .80, .71, and .73 for drinkers, and .86, .67, and .71 for nondrinkers. Sociul desirability. Finally, because Ross and Mirowsky (1984) found that Mexican-Americans were more prone than Angles to report socially desirable responses, a 29-item social desirability measure was used to control for possible confounding by response bias. These items were drawn from the original MarloweCrowne (1964) scale and had an internal consistency reliability (Cronbach’s alpha) of .77, .74, and .76 for drinkers, and .82, .87, and .88 for nondrinkers.

Specific details regarding item content for all scales are available from the author upon request. ANALYSIS

AND

RESULTS

Analyses were conducted using analysis of variance and chi-square techniques, as appropriate. To further clarify the nature and magnitude of differences, specific a

37X

J. A. NEFF

Table

2. Demographic

and model variables

by race/ethniclty

Male\

Demographic\ Age (X) Education (X) Income (U) Unemployed ((4) Married t %I Drinking pattern\ Ab\t,iinel-s ‘ (%) OccaGonal-light (‘2) Occasional-heavv (‘2) Frequent-light (4) Frequent-heavy (<&I Stressors I + 1,ife Events (9) Financial Stress (9 Psychological distress CES-D (2;) Psychosocial variable\ Fatalism (X) Religiosity t:U) Social de5irdbility (3 *Denotes i-Denote5

Anglo C!V = 241)

BlXk OX’ = 1581

30.19 14.56 30.381

36.YX ’ 11.62* IX.815’

5

‘2

61

3x-’

I7 I3

22 I7 I7 II 33

16 I5 3Y

and sex Females

MexicanAmerican (IV = 366)

Anglo (N = 300)

BlXk (N = 220)

36.49’ I I .7s22.819” II’ 691

40.76 13.77 173~0 5 hl

37.5912.67. 16.344’: 17‘. ix-.

I3 I’ 36” 7‘ 74

29 20 73 IO I7

4’) I6 12 Y I4

?Y 2.7 31’ 3’ I4

54 18.46”

57 17.77”

64 16.51

48” IX. lo*

59 17.26

54 16.7’)

3.06

1.22

4.64*

4.21

5.49%

13.53 12.59 16.27

14.91 r 14.46’ 18.55’

14.56 13.01 1x.49*

14.17 13.87 16.04

14.c)3* 15.99* ls.Yl*

significant mean difference from Angles at p % .O.S. mean difference from An&s. approaching significance

at p <

Mexican.4merican (1%’= 476)

36.33‘ I I .50” lY,524’ #-I 56

4.YY 14.73x 14.16 1x.x1*

IO.

priori contrasts were conducted to compare subgroup means. Thus, to clarify ethnic differences. mean scores for Anglos were contrasted against means for Blacks and Mexican-Americans. respectively. Drinking pattern subgroup differences were contrasted by comparing means for abstainers with means for each other drinking pattern subgroup. Stress effects involved contrasts between low and high stress conditions.

Characteristics of ethnic subgroups are presented in Table 2. Blacks and Mexican Americans were significantly younger, and lower in both education and income, relative to Anglos (p < .OS) for both males and females. Unemployment was significantly higher among Blacks than Anglo males and females: unemployment was greater among Mexican-Americans than Anglos. though differences were significant only among males, respectively ([I < .Ol). Anglos and Mexican-Americans were significantly more likely currently married than Blacks (/, < .OS). Table 2 also indicates that Mexican American males clnd females were roughly twice as likely to be classified as occasional-heavy drinkers than were Anglos or Blacks, while frequent-light drinking was more commonly reported by Anglos and Blacks than Mexican-Americans. Overall, males were also significantly more likely to fall into the frequent drinking categories than were females. Interestingly. frequent-heavy drinking was more common among Anglo than either Black or Mexican-American males. although differences were small among females. Black males reported significantly lower likelihood of life-event stress during the past 12 months than Anglos or Mexican-Americans: differences were not significant

Ethnicity

and alcohol

buffer

effects

379

among females. Black males and females reported significantly higher mean scores on the unrecoded financial stress measure than did Anglos; Mexican-American females also reported significantly greater financial stress than did Angles. While Mexican-American males had significantly higher depression scores than did Anglos or Blacks, Black females were more depressed than their Anglo or Black counterparts. For both males and females, both Blacks and Mexican-Americans were significantly more fatalistic than Anglos. Both Blacks and Mexican-Americans - both males and females - had higher levels of religiosity than Anglos, though these differences were significant only between Anglos and Blacks. Anglo males and females reported significantly lower levels of social desirability than did Blacks or Mexican Americans (p < .05). Relationships

between

key model

vuriahles

Table 3 presents the results of further analyses examining relationships between drinking patterns, life events, financial stress, and depressive symptomatology. In contrast to previous studies indicating distress levels higher among abstainers and heavy drinkers than moderate drinkers (Bell et al., 1977; Neff & Husaini. 1982), levels of depression were generally lower among abstainers than almost all drinking groups for both males and females. However, among male drinkers, distress levels were lowest among frequent-light (and occasional-light) drinkers. Life-event prevalence varied only among males, with abstainers significantly more likely to report I + events than all but frequent-light drinkers. There were no financial stress differences among males; however, among females, abstainers reported lower mean levels of financial stress than occasional-heavy and frequent-heavy drinkers. Both life events and financial stress were significantly related to higher levels of depression for males and females. Finally, males and females reporting higher levels of financial stress were significantly more likely to report life events, while those reporting life events reported significantly higher levels of financial stress. Table

3. Summary

of relationships between drinking patterns, and CES-D depression measures by sex

financial

Male

Drinking pattern Abstainers Occasional-light Occasional-heavy Frequent-light Frequent-heavy Financial stress Low High Life events Low High

stress,

Female

N

CES-D (mean)

Life events (%‘c) I+

FinancialS stress (mean)

119 102 198 76 220

2.32 3.06’ 4.31* 3.57* 4.47*

68 55* 56* 62 56*

16.53 16.70 17.12 16.57 18.09

436 361

2.28 6.54t

35 501-

N

CES-D (mean)

Life events (%,) I+

326 198 231 64 146

3.76 4.76 5.55* 5.17 6.46*

57 59 54 52 51

16.89 17.28 1x.66* 16.47 18.26*

514 472

2.78 8.39

41 48t

_ _

4.21 5.69t

_

17.09 l8.24+

463

3.35

-

16.37

545

334

4.47t

-

18.36t

442

*Denotes a significant mean difference from abstainers at p 5 .05. I-Denotes a significant mean difference between high vs. low stress conditions *Mean score on continuous financial stress score.

_

at p 5 .05.

FinancialS stress (mean)

380

J. A. NEFF

The analysis strategy involved analysis of variance and covariance procedures to identify significant main and interaction effects. Of particular interest are interactions of drinking patterns and stress measures (as these may involve buffer effects), and interactions between drinking patterns, stress, and ethnicity (as these may indicate differing patterns of buffer effects across ethnic subgroups). Because we are interested not only in testing for the existence of buffer effects (01 whether such effects differ across groups), but also in explaining such differences, three sequential sets of covariance analyses were conducted. First. a simple analysis of variance was conducted without covariates. Second, as demographic factors are typically related to model variables of interest, age, income. education, occupational status. sex, marital status (broken vs. married; never-married vs. married). and employment status (unemployed vs. employed) were included as covariates. Finally, personal fatalism, religiosity, and social desirability were added to the model including demographic covariates. These sequential analyses assessed the effect of adding each set of covariates upon the significance of interactions between drinking patterns, stressors. and ethnicity. Analyses were conducted separately for males and females to assess whether buffer effects differ by sex. Also. because the CES-D measure typically has a skewed distribution (with most people scoring at the “not depressed” end of the distribution). analyses were conducted using log transformed CES-D scores (i.e., log,,,[CES-D + I]) to normalize distributions (cf. Aneshensel. Frerichs, & Clark. 1981). After computation of adjusted means, transformed scores were resealed back to their original metrics (by taking their anti-logs). for ease of interpretation. Finally. while b. tests for drinking pattern by stress-interaction effects (and higher order interactions with ethnicity) provide omnibus tests of buffer effects. these tests do not pinpoint conditions (i.e., specific drinking-pattern categories) in which buffeteffects are present or absent. To clarify the nature and magnitude of stress effects in the data. the interaction analyses were supplemented with specific a priori contrasts between mean scores for low- and high-stress conditions within drinking pattern. ethnic. and sex subgroups. These tests of simple main effects (conducted using SAS Proc GLM software; SAS Institute, Inc., 1988) serve to pinpoint conditions under which buffer effects are found (i.e., where stress effects are nonsignificant). It should be noted that these specific contrasts provide a somewhat different approach to testing for buffer effects (i.e., are stress effects significant in particular subgroups‘?) than the omnibus interaction tests (i.e., do stress profiles differ across subgroups?) and may suggest buffer effects where no significant interaction effects were found. Given this fact and the number of contrasts conducted, it will be important to consider not only the significance of contrasts. but also the consistency and interpretability of differences. Results of the global tests for main effects and interactions are as follows. For males and females, main effects of both life events and financial stress measures were highly significant before controls for covariates (II < ,002 for life events; 12 < .OOOl for financial stress) and remained significant at or beyond the .04 level after statistical controls. Drinking pattern main effects, as well. were significant at the p < .02 level for males and females and remained significant after statistical controls. A significant interaction between /if;> cwtlts and drinking patterns was observed for males before statistical controls (E-A,73 (,, = 2.78, p < .03) and this interaction remained significant after all covariates were included (Fd. 71q(,, = 3.20. p < .02).

Ethnicity

Table 4. Adjusted

depression

and alcohol

buffer

effects

381

mean scores for stress x drinking by race/ethnicity and sex

pattern

Female

Male

Life events Abstainers Occasionallight Occasionalheavy Frequentlight Frequentheavy Financial

stress

Abstainers Occasionallight Occasionalheavy Frequentlight Frequentheavy *Denotes

significant

MexicanAmerican

Black

Anglo

interaction

MexicanAmerican

Black

Anglo

0

1+

0

I-t

0

I+

0

I+

0

t+

0

t+

2.74 (32) 3.18 (20) I .97 (23) 2.07 (19) 3.95 (5)

2.56 (9) 3.95 (10) 8.21* (15) 2.16 (15) 4.00 (36)

I.05 (17) 4.53 (13) 2.74 (14) 2.71 (6) 3.76 (24)

2.71 (18) 4.75 (14) 5.62 (12) 3.35 (91 2.25 (26)

1.97 (32) 3.81 (22) 4.47 (68) 6.09 (20) 5.62 (69)

4.99s (11) 3.95 (18) 4.64 (59) 5.89 (4) 5.30 (53)

3.10 (47) 3.71 (32) 3.86 (36) 5.36 (15) 5.50 (26)

3.31 (40) 3.62 (28) 5.82 (30) 6.69 (16) 5.69 (24)

4.05 (61) 6.69 (23) 4.76 (13) 5.42 (11) 5.75 (14)

3.62 (49) Il.81 (12) 8.49 (14) 5.42 (8) 9.91 (18)

4.31 (73) 4.00 (59) 4.37 (71) 4.64 (6) 5.49 (33)

4.76 (48) 6.93* (39) 6.32 (61) 4.42 (7) 5.55 (27)

Low

Hi

Low

Hi

Low

Hi

Low

Hi

Low

Hi

Low

Hi

2.07

3.62

.51

3.86*

1.48

6.10*

2.63

4.16

2.56

5.55*

2.67

8.03*

2.29

4.52

2.94

7.67*

3.06

5.69

2.29

6.32*

3.67

13.30*

2.63

9.59*

1.83

6.32*

2.49

6.93*

3.22

6.93”

3.53

6.24

I .46

12.07*

3.86

6.85”

1.36

3._53*

4.10

3.35

4.70

9.49

4.81

8.58

8.39

4.21

2.74

7.50

2.98

5.36*

2.82

3.22

3.39

7.76*

3.48

7.82*

4.70

13.59*

3.86

9.07*

mean difference

between

low versus

high stress

groups

at p 5 .05.

There was no suggestion of interaction between life events and drinking patterns among females (p > .10). No significant interactions between financial stress and drinking patterns were found for males or females (p > .lO). While the three-factor interaction between ethnicity, stressors, and drinking patterns did not reach significance, there was at least suggestive evidence of such an interaction with regard to life events among males (FK. ~~5J,’ = 1.73, p = .09). This borderline effect was attenuated in magnitude by demographic and psycho-social controls, most notably by fatalism, which was associated with higher levels of depression (b = .08, p < .OOOl) and social desirability, associated with lower levels of depression (b = -.04, p < .OOOl). To facilitate interpretation of observed differences, mean scores (after all covariante adjustments) are presented for the interactions between drinking patterns and both life-event and financial-stress measures for ethnic and sex subgroups in Table 4. Considering first the findings for life events among males, simple main effects of life events were nonsignificant in most subgroups of drinkers. Events were significantly related to depression among Black and Mexican-American male abstainers. For Black abstainers, life events were associated with significantly higher depression levels. Significant event effects were found among Anglo occasional-heavy drinkers. The only other significant event effect was found among Black male occasionalheavy drinkers. Among females, the only significant event effects were found among Mexican-American occasional-light and occasional-heavy drinkers. It is interesting that, in the frequent-light and frequent-heavy subgroups, not only were none of the

387

J. A. NEFF

event effects significant, but depression scores in the high events categories were as likely to be equal to or lower than depression means in the no events category. Overall, the conditions under which events were most consistently and significantly related to higher depression levels involved abstinence (for males) and occasionalheavy drinking (for Anglo males and Mexican-American females). Table 4 also presents adjusted mean depression scores for the interaction between drinking patterns and financial stress for ethnic and sex subgroups. Overall. as the interaction analyses suggested. little evidence of buffer effects was observed with regard to financial stress - higher levels of financial stress were fairly consistently associated with higher levels of depression. For males, financial stress effects were nonsignificant among Anglo occasional drinkers. Black frequent drinkers (both frequent-light and frequent-heavy), and Mexican-American light drinkers (both occasional-light and frequent-light). Among females, the findings were more consistent, with financial stress effects nonsignificant among frequent-light drinkers.

II 1 S C L S S 1 0 N

A N D

C 0 N C 1. U S I 0

N S

This paper has sought to extend previous research on stress buffer effects of alcohol use in at least three ways. First. differences in buffer effects between Anglos, Blacks. and Mexican-Americans have been examined to explore possible ethnic variation in the role or function of alcohol vis-a-vis life stress and depressive symptoms. Second, by considering alternative types of stressors (acute life events and chronic financial stress), the paper has sought to clarify the conditions under which buffer effects are most (or least) salient in these groups. Finally. by introducing statistical controls for socioculturally relevant attitude dimensions such as fatalism and religiosity, the paper has sought to put alcohol use and alcohol buffer effects in the context of more general coping orientations. This paper documents ethnic differences in drinking patterns, stress levels, fatalism, and religiosity. Generally, Anglos and Blacks were more frequent. low quantity drinkers, while Mexican-Americans tended to be less frequent, higher quantity drinkers. Minority individuals - Blacks in particular - were more socioeconomitally disadvantaged than Anglos and tended to experience more chronic financial stressors than did majority respondents in our data, and both Mexican-Americans and Blacks tended to be more fatalistic than Anglos. Blacks were also significantly more religious than Anglos. Our analyses did not confirm previous evidence of higher levels of depression among both abstainers and heavier drinkers than “moderate” drinkers (Bell et al.. 1977; Neff & Husaini, 1982). It is possible that the failure to replicate high distress levels among abstainers may reflect the careful exclusion of abstainers with previous alcohol problems. Comparisons (not presented here) of the present sample of abstainers with those excluded from the analyses due to prior drinking problems indicated somewhat higher levels of depression among previous problem drinkers than among abstainers with no history of problem drinking. Stress measures were strongly related to depression in this sample and buffer effects were more marked with regard to life event stress than financial stress. Interestingly. more frequent, heavier drinking patterns (frequent-light and frequentheavy drinking) generally appeared to buffer acute life events. while occasional-light or frequent-light patterns appeared more relevant to buffer effects of financial stress.

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The apparently more pronounced buffer effects of alcohol with regard to acute life stressors than for chronic financial stressors may reflect the fact that acute stressors involve discrete, often time-limited events. It may be easier to “adapt” to such an acute life event via heavier drinking than adapting to a continuing life situation such as financial stress. For a chronic stressor, regular frequent-light drinking may serve general tension-reduction functions, though frequent-heavy drinking may ultimately lead to higher depression levels over time. To pursue this point further, the apparent presence of buffer effects among frequent drinkers in these data is interesting, as previous research (Neff & Husaini, 1985) observed the strongest buffer effects among “occasional drinkers” (those drinking up to a few drinking occasions per week, with any quantity) and “moderate drinkers” (those drinking at least “several” times/week, but 2 or less drinks/occasion). The absence of stress-distress associations under conditions of frequent-light drinking in our data with regard to financial stress are consistent with buffer effects of “moderate” drinking, and, indeed, frequent-light male drinkers in these data consumed an average of 1.5 drinks per occasion, roughly 4-5 times per week on average (an average of 10.1, 9.4, and 10.4 drinks/week for Anglo, Black, and Mexican-American males, respectively). “Moderation” would seem a plausible hypothesis within these groups. However, for frequent-heavy drinkers, total drinks per week averaged approximately 30 in all ethnic groups. It is difficult to argue that consuming an average of 5 six-packs per week (or almost a six-pack/day) constitutes moderation. Though one might think that drinkers in this group may be sufficiently numbed that acute events may not impact them, apparent buffer effects of frequentheavy drinking were suggested only for Black males with regard to chronic financial stress. These findings for frequent-heavy drinking raise the question of whether buffer effects or some other process (i.e., “escape drinking”) may be operative. It is further important to note that controls for demographic and psychosocial covariates - particularly fatalism - attenuated ethnic differences in buffer effects somewhat. However, it is important to note that these controls did not entirely eliminate buffer effects. Observed buffer effects are not simply artifacts of demographic or psychosocial differences, though the suggested ethnic differences in buffer effects were attributable to differences between groups on these dimensions. Our findings are also of interest in suggesting sex differences in buffer properties of alcohol use. Buffer effects were generally specific to males with regard to life event stress and these effects remained significant after statistical controls. While overall tests for the significance of buffer effects among females were not significant, the analyses suggest that frequent-light drinking may provide the most consistent buffer effects among females with regard to financial stressors. In contrast, among males with regard to life event stress, buffer effects were suggested for virtually all drinking groups, except for occasional-heavy drinking Anglos. For financial stress, the data suggest that occasional-light drinking may serve stress-buffer functions for Anglos and Mexican-Americans. Occasional-heavy (perhaps binge drinking) patterns appear consistently deleterious with regard to depression among males in all subgroups. The greater salience of buffer effects among males might well be anticipated, as drinking is more normative for males than females, buffer effects might be more common among males. Other dimensions (e.g., social support) may be more salient among females. Thus, Husaini, Neff, Newbrough, and Moore (1982) found greater evidence of buffer effects of social support with regard to life event stress among married females than among married males. Alternatively, females may be more

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likely to turn to prescription and nonprescription drugs to cope, while males may be more likely to use alcohol (Parry, Cisin, Balter, Mellinger, & Manheimer, 1974). Unfortunately, we have not considered possible interrelations among drinking and other personal and social resources which may provide stress buffer functions. Finally, some comments regarding apparent ethnic differences (particularly among males) are in order. First, while both Blacks and Mexican-Americans were Wcioeconomically disadvantaged relative to Anglos and were also more fatalistic (Blacks were also more religious), Black drinking patterns were more similar to those of Anglos (more frequent, lower quantity) than to Mexican-Americans (less frequent, higher quantity). Although controls generally attenuated ethnic differences, some fundamental consistencies and differences across groups are suggested. Thus, among males. the lack of buffer effects with regard to financial stress among occasional-heavy drinkers is consistent across groups. suggesting that occasional binge drinking may generally not yield stress-buffering effects. In contrast. occasional-light drinking generally suggests consistent buffering effects in all groups - except among Black males with regard to depression, though, in this group, both frequent-light and frequent-heavy drinking suggest buffer effects. Frequent-light and frequent-heavy drinking show no buffer effects for Anglo males. Only frequent-light drinking appears efficacious among Mexican-American males (though this drinking pattern is quite rare in this group). The dramatic effect of fatalism in our analyses may suggest that interdependence of fatalism and heavy drinking among Blacks and Mexican-American males. Among less fatalistic Anglos, occasional-heavy and frequent drinking do not buffer effects of chronic stress, perhaps reflecting the inconsistency of heavy drinking (largely a passive coping strategy) with instrumental values. In contrast. frequent drinking among Blacks and Mexican-Americans is consistent with more fatalistic values. The salience of buffer effects among frequent-light and heavy Black drinkers may also reflect high levels of religiosity in this group. Neff & Hoppe (1993) suggest the particular relevance of religiosity among Blacks: high levels of religiosity combined with a fatalistic orientation may suggest giving control of one’s life to a higher power, thus reinforcing passive, fatalistic responses, such as drinking. These ideas require further examination. Several caveats should be noted. First. the use of both omnibus tests for interaction effects in addition to specific a priori contrasts for stress effects raises the question of which tests are more directly relevant to the buffer hypothesis. As buffer effects imply specific conditions under which stress is (or is not) related to distress. the a priori contrast approach may well be more sensitive. Second, as multiple comparisons among means are involved, we must be wary not only of spurious findings but must also consider whether apparent buffer effects (i.e.. nonsignificant contrasts) may be artifacts of small cell sizes in some drinking subgroups. Our approach to the multiple comparison issue has been to focus upon the consistency and interpretability of differences rather than adopting more conservative significance levels. as the latter would yield more apparent buffer effects, thus increasing the probability of spurious conclusions. Admittedly, a sample of roughly 1,800 will detect small differences between groups and the practical significance of small, but statistically significant differences can be disputed. The essential scientific question, however. is whether observed findings may be mrf$iuc.ts of unequal subgroup sizes. Subgroup sizes are variable in our data (ranging from 4 to 69 among males, for example): however. groups in which

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contrasts were significant did not necessarily have the largest cell sizes (e.g., Black male abstainers; no events [n = 171 vs. I + events [n = IS]. Conversely, groups in which contrasts were nonsignificant did not necessarily have small cell sizes (e.g.. Anglo male frequent-heavy drinkers; no events [n = 551 vs. I+ events [n = 361). Although the logical and statistical dilemma of accepting the null hypothesis is complex, the consistency of our findings with previous studies showing stronger evidence of buffer effects for acute life stress measures than chronic stressors is reassuring. These particular findings provide support of the internal validity of our findings in that: (a) chance findings should be as likely with one stress measure as the other in our data, and (b) subgroups sizes in analyses of both stress measures are identical, thus arguing against confounding by variable power of contrasts due to unequal cell sizes. A second issue deals with the distinction between “buffer effects” and “drinking to cope.” Buffer effects are posited to be nonspecific in that moderate drinking, as a routine, typical drinking patterns, rather than a specific response to stress (the latter may imply drinking-to-cope) may provide ongoing tension reduction, perhaps leaving the individual with more energy to deal with problems when they arise. There is obviously a fine line between buffer and coping effects and the individual may well alternate between the two. Further, intentionality is not necessarily implied here we do not presume that some individuals intentionally drink two drinks per day to relieve stress or that others intentionally binge drink to escape. Rather, buffer effects are empirically defined by specific patterns of associations between typical drinking patterns and symptomatology. For example, the consistent presence of stress effects among occasional-heavy drinkers in our data argues against “buffer” effects in this group and suggests that some other process, perhaps drinking-to-cope, may be operative. Part of the problem in attributing buffer effects to properties of the drinking pattern per se is to rule out alternative explanations for observed buffer effects - that is. are apparent buffer effects due to “moderate” drinking or to the fact that moderate drinkers may be “moderate” in other respects (Neff & Husaini, 1985)? In our analyses, we have controlled for effects of age, education, income, social desirability, fatalism, and religiosity. These background characteristics do not account for observed buffer effects. A final point concerns external validity. As Gilbert and Cervantes (1986) note, regional differences in drinking patterns may exist. Social-contextual differences between cities may be important as well. Thus, San Antonio is unique in that the Hispanic “minority” represents over 50% of the population and Blacks are truly a minority, representing only 7-B% of the population. It is possible that the large Mexican-American presence and the limited Black presence in San Antonio may influence the availability of alternative coping resources in these groups, thus influencing the role of alcohol use. Replication of the present findings in other multiethnic settings (e.g., Los Angeles) may help to clarify the influence of social context. In sum, the analyses presented here raise a number of questions about the role of alcohol in different ethnic groups. Fatalism appears most directly relevant to observed ethnic differences in buffer effects, thus highlighting the importance of the individual’s sense of control over his/her own life. The present analyses are admittedly limited in addressing relationships between drinking patterns, stressors and psychological distress cross-sectionally rather than longitudinally. While our crosssectional focus limits causal inferences, such analyses are viewed as an essential first

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step in assessing possible ethnic differences 12-month follow-up data are being planned

in buffer effects. Further analyses of our to address critical longitudinal issues.

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