frone--JHSB--1990

Work Stress and Alcohol Effects: A Test of Stress-Induced DrinkingAuthor(s): M. Lynne Cooper, Marcia Russell, Michael R. FroneSource: Journal of Health and Social Behavior, Vol. 31, No. 3 (Sep., 1990), pp. 260-276Published by: American Sociological AssociationStable URL: http://www.jstor.org/stable/2136891Accessed: 15/11/2010 14:28

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Work Stress and Alcohol Effects: A Test of Stress-Induced Drinking*

M. LYNNE COOPER MARCIA RUSSELL MICHAEL R. FRONE State University of New York at Buffalo and The Research Institute on Alcoholism

Journal of Health and Social Behavior 1990, Vol. 31 (September):260-276

Drawing on both tension reduction and social learning theories, we hypothesized that work stressors lead to increased distress, which in turn promotes problematic alcohol use among vulnerable individuals. Vulnerable individuals are hypothesized to possess few personal and social resources for responding adaptively to work-related stressors and distress and to hold positive expectancies for alcohol's effects. We tested our model in a random sample of 574 employed adults, using a combination of path analytic and hierarchical moderated regression techniques. Results revealed no support for a simple tension reduction model of work stress-induced drinking and only limited support for a social learning model. We conclude that a much more circumscribed view of the etiologic role of work stress in problematic alcohol use is indicated.

The belief that work stress promotes heavy or problematic alcohol use is widely accepted (e.g., Gupta and Jenkins 1984; Herold and Conlon 1981; Miller et al. 1988; Trice and Roman 1978). Indeed, efforts to reduce work stress or to provide alternative forms of coping with stress are currently advocated as measures to prevent alcohol abuse in the work force (e.g., Shain 1983; see Weiss 1986 for opposing viewpoints). Yet despite widespread acceptance of the belief that work stress promotes problematic alcohol use, few studies provide convincing empirical support for this notion. Existing research fails to provide

* This research was supported by National Institute of Alcohol Abuse and Alcoholism Grant #AA05702, awarded to the second author. Portions of these results were presented at the annual meeting of the American Psychological Association, held in New York City in August 1987. The authors wish to thank Jeremy Skinner, William George, Dean McFarlin, Gerard Connors, Jim Neff, and Jenny Crocker for their helpful comments on an earlier draft of this manuscript. Correspondence concerning this article should be addressed to the first author at 348 Park Hall, Psychology Department, State University of New York at Buffalo, Buffalo, NY 14260.

an adequate theoretically grounded test of work stress-induced drinking. Thus the pur- pose of this paper is to propose and test a comprehensive model of work stress-induced drinking.

Theoretical Perspectives on Stress-Induced Drinking

At least two major theoretical perspectives articulate a causal link between stress and alcohol-related pathology. Tension reduction theory proposes that alcohol reduces tension and, more important for our purposes, that people drink alcohol for its tension-reducing properties (Cappell and Greeley 1987). "Ten- sion" refers here to various negative emotional states that plausibly could serve as aversive sources of motivation, such as fear, anxiety, distress, or depression. Thus negative emotions play a key intervening role in a putative causal sequence linking exposure to stressful conditions and increased drinking. That is, stressful conditions are hypothesized to increase negative emotions, which in turn increase alcohol use.

The social learning perspective on alcohol use and abuse complements and extends

260

WORK STRESS AND ALCOHOL EFFECTS 261

tension reduction notions in several important ways (see Abrams and Niaura 1987 for a review). According to this perspective, individuals are more likely to drink in response to stress-producing stimuli when they lack other, more appropriate coping responses and when they believe that alcohol enhances positive mood or reduces negative mood. Hypotheti- cally, then, the distress-alcohol relationship is moderated by coping behavior and by positive expectancies for alcohol's effects.

To summarize, tension reduction theory proposes a mediated model in which negative emotions link stressors and alcohol-related outcomes, whereas social learning theory proposes a moderated model in which some individuals are more likely than others to experience negative alcohol outcomes in response to stress-producing stimuli. As noted earlier, these models are not mutually exclu- sive; there may be both direct effects of negative emotions on alcohol-related outcomes and interactive effects of negative emotions with coping and expectancies.

Empirical Studies of the Work Stress-Alcohol Relationship

A review of work stress-alcohol research reveals that few studies have incorporated key features of these theoretical perspectives. As stated above, tension reduction theory re- quires explicit testing of the mediating role of negative emotion. Indeed, failure to test in this way renders ambiguous the results of studies purporting to test work stress-induced drinking. On the one hand, null results may reflect the failure of stressors to give rise to negative emotions rather than a failure of negative emotions to lead to increased alcohol use. On the other hand, positive results linking a presumably stressful feature of the work environment to increased alcohol use may reflect instead the influence of normative prescriptions that promote drinking or of structural elements that allow individuals who drink heavily to go undetected (Herold and Conlon 1981; Trice and Roman 1978). For example, time pressures and job responsibilities have been identified as stressful features of the work environment that may lead to increased alcohol use and abuse (e.g., Parker and Farmer 1988). Yet a positive relationship between these job characteristics and alcohol use might reflect instead greater latitude

among higher-echelon workers, who hold more responsible and more demanding jobs, to hide their drinking or the negative consequences of their drinking. In the ab- sence of a demonstrated link with elevated negative emotion, one cannot distinguish unequivocally between this and other alternative explanations.

Of 17 work stress-alcohol studies that we found (Bromet et al. 1988; Conway et al. 1981; Fennell et al. 1981; Fimian et al. 1985; Harris and Fennell 1988; Hingson, Mangione, and Barrett 1981; Hingson, Scotch, et al. 1981; House et al. 1986; Markowitz 1984, 1987; Mensch and Kandel 1988; Parker and Farmer 1988; Sadava et al. 1978; Seeman and Anderson 1983; Seeman et al. 1988; Syrotuik and D'Arcy 1982; Violanti et al. 1983), only one tested the mediating role of negative emotion (Violanti et al. 1983). The results of that study, however, are compromised by use of a highly unrepresentative sample (all male police officers) and by reliance on a single- item indicator of drinking to cope with work stress as the sole dependent measure.

An adequate test of a social learning model of stress-induced drinking mandates the inclusion of relevant variables hypothesized to moderate the negative relationship between emotion and alcohol. Nevertheless, only five studies (Bromet et al. 1988; Hingson, Man- gione, et al. 1981; Seeman and Anderson 1983; Seeman et al. 1988; Syrotuik and D'Arcy 1982) incorporated potential moderator variables; of these, none examined coping or alcohol-related expectancies as potential moderators of the work stress-alcohol relationship.

Finally, even when plausible mediating and moderating effects were tested, most work stress-alcohol studies failed to control for potential confounding variables. Sociodemo- graphic characteristics, such as sex and education, may influence both the likelihood of holding a stressful job and rates of alcohol use and abuse, thereby creating a spurious relationship between work stress and alcohol outcomes. Similarly, personal and social resources (e.g., self-esteem, social support) may influence the experience and the perception of work stressors, on the one hand, and psychological distress, patterns of alcohol use, and the experience of drinking problems on the other.

Of the 17 work stress-alcohol studies reviewed, only four (Bromet et al. 1988;

262 JOURNAL OF HEALTH AND SOCIAL BEHAVIOR

Seeman and Anderson 1983; Seeman et al. 1988; Syrotuik and D'Arcy 1982) included both sociodemographic and psychosocial controls. Thus 13 of 17 work stress-alcohol studies are open to third-variable explanations of their findings.

To summarize, existing research suffers from two important limitations. First, key methodological implications of tension reduction and social learning models of stress- induced drinking have not been incorporated into the design of work stress-alcohol studies. In particular, these studies have largely ignored the mediating role of negative emotions and the moderating effects of coping and alcohol expectancies on the hypothesized negative emotion-alcohol link. Second, few studies have included adequate sociodemographic and psychosocial controls despite both theoretical and empirical evidence suggesting the potential for serious confounding of perceived work stress and alcohol-related pathology.

THE PRESENT STUDY

We propose and test a model of work stress-induced drinking that addresses each of the above limitations. According to this model (Figure 1), work stressors increase negative emotions (distress), which in turn promote heavy or problematic alcohol use, especially among vulnerable individuals. Such individuals are hypothesized to possess few resources and skills for responding adaptively to work stressors and consequent distress, and to hold strong positive expectancies for alcohol's effects. Thus the proposed model specifies the mediating role of negative

FIGURE 1. Hypothesized Model Relating Work Stressors and Distress to Alcohol Outcomes

Adaptive Personal & Social Resources

/ I \H2a-

Work Hia + Dist Hib + Alcohol Stressors

stress Use/Abuse

Alcohol + Expectancies

Note: Solid lines represent hypothesized direct or main effects; broken lines represent hypothesized moderating effects. Pluses and minuses on the paths indicate the direction of hypothesized effects; numbers correspond to specific hypotheses. For the sake of simplicity, neither sociodemographic effects nor hypothesized three-way interactions (see Hypothesis 2e) are modeled.

emotion and incorporates potential moderators of the negative emotion-alcohol relationship. Finally, to control for possible spurious associations among work stressors, distress, and alcohol-related outcomes, the proposed model, as estimated, will control for a range of potentially confounding individual difference variables.

Although the proposed model specifies moderating effects on both the work stressor- distress and the distress-alcohol links, we test moderating effects only on the latter. Moder- ating effects on the work stressor-distress relationship have been studied extensively elsewhere (for reviews see Frone and McFar- lin 1989; Greenhaus and Parasuraman 1986; Matteson and Ivancevich 1987) and are not central to either tension reduction or social learning models of alcohol use and abuse. Thus tests of potential moderating effects on the work stressor-distress link are beyond the scope of this paper. Nonetheless, insofar as work distress is found to exert significant direct effects on alcohol-related outcomes, the presence of significant moderating effects on the first link could have implications for the magnitude of the total work stressor effect on alcohol outcomes. 1

DETAILED HYPOTHESES

On the basis of tension reduction theory, we hypothesize that the relationship between work stressors, on the one hand, and drinking to cope, alcohol use, and alcohol problems, on the other, will be mediated by increases in work distress. Thus stressors and alcohol outcomes will be related only indirectly. This relationship gives rise to the following hypotheses:

After sociodemographic and personal and social resource variables are controlled, work stressors will be related significantly and positively to work distress (Hla). Similarly, work distress will be related significantly and positively to drinking to cope, alcohol use, and alcohol abuse (Hlb).

On the basis of a social learning analysis, we hypothesize that individuals low in adaptive coping should be more likely than those high in adaptive coping to drink to cope, to drink heavily, and to experience drinking problems in response to work distress. Four broad groups of adaptive coping indicators are examined in the present


study: social support (which may be con- ceived usefully as coping assistance; Thoits 1986), coping resources, coping styles, and coping responses. According to the proposed model, the nature of each moderator effect depends to a great extent on the a priori specification of the moderator variable as adaptive or maladaptive. That is, adaptive resources and skills are hypothesized to buffer the negative emotion-alcohol relationship, whereas maladaptive attributes would be expected to exacerbate or strengthen this relationship.

Social support is widely regarded as adaptive (e.g., Broadhead et al. 1983; Leavy 1983) and thus would be expected to buffer the work distress-alcohol relationship (H2a). Coping resources are generalized attitudes and skills that are considered advantageous across many situations; they include attitudes about self (esteem), attitudes about the world (belief in mastery), intellectual skills (intelli- gence), and interpersonal skill (social compe- tence) (Menaghan 1983). Thus, high levels of coping resources also would be expected to buffer the work distress-alcohol relationship (H2b).

Coping styles are typical or habitual ways of approaching (i.e., coping with) problems, whereas coping responses are specific actions (overt or covert) made in specific situations that are intended to reduce a given problem (Menaghan 1983). In the present study we contrast two broad forms of coping styles and responses-active or problem-focused coping versus avoidant or emotion-focused coping (Folkman and Lazarus 1980). Prior research suggests that individuals who rely on avoidant forms of emotion-focused coping are more likely to experience negative alcohol outcomes in response to stress-inducing life events (Billings and Moos 1983; Moos et al. 1981). Although neither stressor-by-coping nor negative emotion-by-coping interactions were tested directly in these studies, these data nonetheless imply that high-avoidance copers are more likely to rely on alcohol as a means of alleviating or managing the distress generated by stressful life events. Thus we anticipate that coping styles and responses indicative of avoidance of emotion will exacerbate the relationship between work distress and alcohol outcomes such that a significant positive relationship should be observed among high-avoidance copers, but not necessarily among low-avoidance copers

(H2c). In contrast, previous research suggests that active, problem-focused coping does not discriminate between groups with and without clinically significant evidence of alcohol pathology (Billings and Moos 1983; Moos et al. 1981). Thus we do not anticipate that problem-focused coping will moderate the relationship of work distress to alcohol outcomes.

Our model suggests that individuals who hold strong positive expectancies for alcohol's effects should be more likely to drink to cope with work distress, to drink heavily, and ultimately to experience alcohol problems. Thus we hypothesize that positive alcohol expectancies will exacerbate the relationship between work distress and alcohol outcomes such that a significant positive relationship should be obtained among high-expectancy individuals but not among low-expectancy individuals (H2d).

Finally, we propose that individuals who are deficient in adaptive resources and skills (or high in maladaptive attributes) and who are also high in positive expectancies should be most likely to experience adverse alcohol outcomes as a result of elevations in work distress. Thus, positive expectancies, adaptive resources, and work distress will interact to predict drinking to cope, alcohol use, and alcohol problems such that high-distress, low-resource, high-expectancy individuals, will exhibit the greatest involvement with alcohol (H2e).

METHOD

Sample

Respondents in the present study were drawn from a random sample survey of 1,933 household residents in Erie County, New York. Designated respondents 19 years of age and older were identified in a three-stage probability sample designed to yield equal representation of two racial groups (blacks and nonblacks) and three educational levels (less than high school, high school, at least some college). The overall sample completion rate in the present study was 78.3 percent; most (84.5%) of the noncompletions were refusals.

Of the 1,933 respondents, 916 were employed at least 20 hours per week. Of these, 175 respondents who abstained and


167 who drank less than once a month were eliminated, yielding a final sample of 574 adult respondents who had drunk at least once a month over the past year. To avoid biasing our test of the proposed hypotheses, we limited the sample to respondents who drank regularly. Abstainers and infrequent drinkers, though unlikely to use alcohol to cope, almost certainly would experience varying degrees of job stress. Thus their inclusion would tend to attenuate the predicted effects.

Respondents in the present study were sociodemographically heterogeneous. Ap- proximately half were white (51.6%); 47 percent were married or living in stable relationship; 51 percent were female. They ranged in age from 19 to 69 (mean = 36.5, sd = 10.8). Nearly 73 percent of the sample had completed high school; an additional 22 percent had completed four or more years of college. White-collar occupations (profes- sional, technical, managerial) were followed by 53 percent of the sample.

Procedures

Data were collected by a corps of 27 interviewers in the summer and fall of 1986. Interviewers received five days of intensive training on general interviewing techniques, administration of the survey, and study- specific procedures. Interviews were conducted in respondents' homes according to a highly structured interview schedule that contained both interviewer- and self-adminis- tered portions. The complete interview re- quired approximately 90 minutes to adminis- ter. Respondents were paid $25 for their time.

Measures

We employed a total of 24 indices in the present study to assess six broad categories of variables: 1) sociodemographic covariates (five indicators), 2) work stressors (two measures), 3) alcohol-related outcomes (three measures), 4) work distress (one measure), 5) personal and social resources (12 measures), and 6) alcohol expectancies (one measure). These measures are described below; estimates of internal consistency reliability (coefficient alpha), zero-order correlations, and descriptive statistics are provided in Table 1. Except where noted otherwise, all scales were

formed by computing the arithmetic mean of their respective items.

Sociodemographic covariates. Sex (1 = male, 2 = female), age (in years), race (1 = nonblack, 2 = black), education (in years), and occupational status (1 = white-collar, 2 = blue-collar) were used as covariates in the present study. Race and education were controlled because of the highly stratified sampling design used in the present study; sex, age, and occupation were controlled because of documented differences in patterns of alcohol use and abuse as a function of these sociodemographic characteristics (e.g., Hil- ton 1987; Olkinuora 1984).

Work stressors. We assessed two stressors: work pressure and lack of job control. Work pressure (WP; 11 items) assessed the frequency with which individuals perceived high job-related demands resulting from heavy workload and responsibilities. Lack of job control (LJC; six items) assessed the frequency with which individuals perceived constraints on their ability to function auton- omously and to influence important job parameters. Both scales were derived empirically from a pool of 17 items taken from several previously published measures of work stressors (viz., House et al. 1979; Insel and Moos 1974; Pearlin and Schooler 1978). We used a four-point response format (almost never to almost always).

Although items originally were intended to measure three stressor dimensions (workload, responsibility, and lack of job control), both principal components and factor analyses revealed two robust factors in which items constituting the workload and the responsibility dimensions loaded together on the first factor. Because the obtained two-factor structure proved to be largely invariant across both sexes and races and because it yielded the most reliable indices, we employed the empirically derived scales in all subsequent analyses (see appendix for individual items).

Alcohol outcome measures. We examined three alcohol-related outcomes in the present study: 1) the self-reported frequency with which respondents used alcohol to cope, 2) average daily consumption over the past 12 months, and 3) the number of drinking problems experienced over the past 12 months.

Drinking to cope (Polich and Orvis 1979) was assessed by six items. On a four-point scale, respondents reported the frequency of

TABLE 1. Descriptive Statistics and Correlations among Major Study Variables 0

Stan- dard devia- C

1 2 3 4a 4b 4c 5a Sb 6a 6b 6c 6d 7a 7b 7c 8 9 10 I1 12 13 14 15 16 Mean tiona-

Stressors 1. Work pressure (81) 2.44 0.60 > 2. Lack of job control 17 (68) 1.70 0.52 Z

Mediating Variable 3. Work distress 37 51 (86) 1.90 0.65 >

Moderating Variables 4. Social support 0

a. Appraisal 02 -10 -14 (71) 3.42 0.53 O b. Belonging -02 -18 -19 52 (68) 3.52 0.44 t c. Tangible 03 -07 -11 49 53 (72) 3.72 0.42 tl

5. Coping resources a. Mastery -04 - 25 - 26 26 25 22 (76) 3.15 0.48 I b. Self-esteem 02 -23 -21 27 32 22 61 (85) 3.33 0.44

6. Coping styles a. Anger-in 13 22 35 -19 -24 -14 -25 -31 (69) 1.81 0.49 b. Anger-out 14 17 29 -06 -08 -10 -14 -23 55 (70) 1.70 0.45 c. Anger-reflect -04 -16 -21 09 11 08 28 32 -31 -48 (78) 2.83 0.68 d. Active coping 09 -25 -19 20 29 21 20 29 -17 -18 22 (80) 3.34 0.37

7. Coping responses a. Active behavioral 13 -01 -01 15 11 10 06 07 -02 -01 10 25 (68) 1.98 0.31 b. Active cognitive 09 -02 -07 02 01 01 -02 -02 -04 -09 16 32 57 (65) 2.10 0.34 c. Avoidance 03 12 22 -21 -27 -18 -24 -29 32 20 -13 -03 10 25 (52) 1.31 0.25

8. Positive alcohol expectancies 11 06 14 -15 -16 -13 -19 -27 29 20 -13 -05 04 08 21 (82) 1.36 0.21

Outcome Variables 9. Alcohol consumption -02 00 -08 -14 01 -05 -03 -08 04 03 -02 00 -05 00 07 16 - 0.94 1.44 10. Drinking problems -04 12 08 -08 -08 -09 -11 -13 13 13 -10 -08 01 -01 16 26 41 (72) 0.38 1.05 11. Drinking to cope 06 15 19 -22 -26 -26 -24 -31 24 18 -07 -07 04 08 23 46 33 38 (80) 1.42 0.46

Demographic Variables 12. Sex (1 = male,

2=female) 06 07 21 10 04 -05 -11 -04 10 08 -16 00 06 04 08 03 -28 -16 -03 - 1.51 0.50 13. Race (I = nonblack,

2=black) -18 03 -03 -10 -11 -15 -13 -04 -06 -10 07 14 02 17 11 -09 -04 01 05 06 - 1.48 0.50 14. Age (years) -06 -15 -15 01 09 -04 -08 03 -24 -31 20 11 07 13 -07 -07 07 -03 02 -06 -04 - 36.53 10.83 15. Education (years) 15 -09 -02 17 03 00 23 18 -01 01 09 -06 17 01 -12 -02 -06 -08 -09 04 -18 -13 - 13.59 2.17 16. Occupation

(I = white collar, 2=bluecollar) -20 07 -04 -18 -10 -05 -14 -19 05 06 01 00 -08 04 11 04 15 16 11 -32 18 -08 -46 - 1.47 0.50

Note: N = 574. Except for sociodemographic variables, all measures are scored so that higher numbers indicate more of the measured construct. Reliability coefficients (coefficient o alpha) are on the diagonal. Decimals are omitted. All correlations ' .08 are significant at p


drinking to manage or cope with negative emotions (e.g., to forget your worries, to cheer up when you're in a bad mood).

Average alcohol consumption during the past 12 months was estimated from standard quantity-frequency questions employed in the National Health and Leisure Time Survey (Wilsnack et al. 1984). We converted responses into average number of drinks per day: one drink was defined as 12 ounces of beer, four ounces of wine, or one ounce of hard liquor (i.e., approximately .5 ounces of absolute alcohol). (See Stacy et al. 1985 for evidence supporting the reliability and validity of self-report measures of alcohol use.)

We assessed drinking problems with 17 items designed to yield a DSM-III diagnosis of alcohol abuse and dependence, taken from the National Institute of Mental Health Diagnostic Interview Schedule (Robins, Helzer, Croughan, Williams, and Spitzer 1981; also see Robins, Helzer, Croughan, and Ratcliff 1981 for validity and reliability data). Representative problems include going on "binges or benders," losing a job because of drinking, and having "blackouts" or the "shakes." In the present study we computed an index of drinking problems by counting the total number of problems that had occurred one time or more in the past 12 months.

Work distress. Work distress was assessed with a six-item scale developed by Kandel et al. (1985). On a four-point intensity scale, respondents stated how bothered or upset, frustrated, pleased (reverse scored), etc. they felt when thinking of their day-to-day job experiences.

Personal and social resources. We included four broad categories of resource variables as covariates and examined them as potential moderators of the work distress- alcohol relationship: 1) social support, 2) coping resources, 3) coping styles, and 4) coping responses. All psychosocial resource measures employed a four-point Likert-type response format except for the coping response indices, which used a three-point format.

Social support was measured by three abbreviated subscales (five items each) of the Interpersonal Support Evaluation List (Cohen and Hoberman 1983): the perceived availability of 1) tangible assistance or material aid, 2) appraisal support (i.e., the availability of a confidant and trusted advisor), and 3) belonging support (i.e., the availability of someone

with whom the respondent could socialize or relax).

Coping resources examined in the present study included mastery and self-esteem. Mastery (Pearlin et al. 1981; seven items) assessed the extent to which individuals see themselves as controlling the forces that strongly affect their lives. Self-esteem refers to one's general perception of self-worth; we assessed this resource with Rosenberg's (1965) 10-item self-esteem scale.

In this study we used two measures of active coping style ("John Henryism" [JH] active coping, anger-reflect) and two measures of avoidant coping style (anger-in, anger-out). JH active coping style (James et al. 1983; 12 items) is a stress-coping style characterized by the belief that one can control one's environment, coupled with direct and active efforts to do so. Anger coping styles assess how individuals charac- teristically react or behave when they feel angry or upset. Anger-reflect (Harburg and Gleiberman 1986; four items) assesses the extent to which respondents typically control their anger in an effort to address the underlying problem or the cause of their anger. Anger-in (Spielberger et al. 1985; six items) assesses the extent to which respondents typically suppress or avoid dealing with their angry feelings. Conversely, anger-out (Spielberger et al. 1985; six items) measures the degree to which individuals engage in aggressive behaviors when motivated by angry feelings.

Coping responses were assessed by the Health and Daily Living Coping Response Index (Moos et al. 1986). Respondents rated the extent to which they used each of 32 coping responses to deal with a recently experienced stressful event or situation. We derived three method-of-coping indices: active behavioral, active cognitive, and avoidance coping. Active behavioral coping (13 items) assesses the extent to which respondents engaged in direct action and problem solving. Active cognitive coping (11 items) assesses the use of cognitive strategies aimed at minimizing or redefining the situation in a more positive light. Avoidance coping (seven items) assesses reliance on avoidance, denial, or tension reduction as strategies for coping with the stressful event.2

Positive alcohol expectancies. We assessed expectancies with a composite of six subscales taken from the abbreviated version of


the Alcohol Effects Questionnaire (Rohsenow 1983). Subscales assessed expectancies for global positive effects, social and physical pleasure, sexual enhancement, aggression and power, social expressiveness, and relaxation and tension reduction. Each item used a two-point scale (true, false). We obtained a summary score for positive expectancies by computing the mean of the means for the six positive expectancy subscales.

RESULTS

Tension Reduction Model of the Work Stress-Alcohol Relationship

The direct and indirect effects of work stressors and distress on three alcohol outcome measures (as depicted in Figure 1) were estimated in two steps, using standard path analytic techniques (see Kenny 1979).3 First, we estimated the direct effect of work stressors on distress by regressing work distress on work pressure (WP) and on lack of job control (LJC) simultaneously. Second, we estimated the direct effects of work stressors and distress on drinking to cope, alcohol consumption, and drinking problems by regressing each alcohol outcome in turn on WP, LJC, and work distress simultaneously. We estimated each equation controlling for all sociodemographic, personal resource, and social resource variables described previously. Relevant results of these analyses are summarized in Figure 2.

As shown in Figure 2, both WP and LJC exerted significant direct effects on work distress, even after sociodemographic and psychosocial resource variables were controlled. Collectively these stressors accounted for a nontrivial increment in explained variance (R2 = .214, p < .001) of work distress. Thus Hypothesis la was supported. As shown in Figure 2, however, Hypothesis lb was not supported. After all sociodemographic and psychosocial resource variables were controlled, work distress did not significantly predict any of the alcohol outcomes.4 The indirect effects of work stressors on each of these outcomes are summarized in Figure 2. Because of the lack of significant direct effects of work distress on the alcohol outcome measures, none of the indirect effects would be considered statistically reliable (Cohen and Cohen 1983).

FIGURE 2. Estimated Model Relating Work Stressors and Distress to Three Indicators of Alcohol Pathology

Drinking to Cp

Work 07 Presure .276

Work -.096 Alcohol Distress Consumption

Lack of 023 Job Control

Dnnking Problems

Indirect Effects of Work Stressors on Alcohol Outcomes

Alcohol Outcomes Work Drinking Alcohol Dnnking Stressors to Cope Consumption Problems

Work .020 -.026 .006 Pressure Lack of .027 -.035 .008 Job Control

Note: The path coefficients for each of the alcohol outcomes were estimated in separate equations, but, results are presented in a single path diagram to avoid redundant presentation of the stressor-distress coefficients. We estimated the model controlling for all sociodemographic, psychosocial resource, and expectancy variables. All indirect effects are nonsignificant.

* p


action) terms and their constituent variables, we centered all variables (or deviated them from their means) before computing and testing the hypothesized interactions (see Finney et al. 1984 for a discussion of this and other issues related to the estimation and interpretation of modifier effects).

We estimated separate equations for each of the five categories of hypothesized moderators and for each of the three alcohol outcome measures. Thus a total of 15 regression equations was estimated. Analyses are summarized in Table 2.

We conducted follow-up analyses only when the block of interactions attained significance at the conventional p < .05 level. We probed significant interactions following procedures described by Cohen and Cohen (1983). Specifically, we generated separate regression lines from the overall regression equation to represent the distress- alcohol relationship at relatively high (+ 1 sd

above the mean) and at relatively low (- 1 sd below the mean) levels of the relevant moderator variable.

We believe that the present data analytic strategy is conservative with respect to Type I error without unduly sacrificing statistical power. We use an inherently conservative hierarchical procedure in which the variables of theoretical interest must make significant independent contributions after a large number of potentially confounding sociodemographic and psychosocial resource variables are controlled, and we probe interactions only when the entire block of product terms is statistically significant at the conventional p < .05 level.

Work distress-drinking to cope relationship. As shown in the first two columns of Table 2, coping resources, coping styles, and alcohol expectancies interacted significantly with work distress in the prediction of drinking to cope. The magnitude of all effects

TABLE 2. Summary of Hierarchical Moderated Regression Analyses Predicting Alcohol Outcomes from Work Distress, Personal and Social Resources, and the Distress- by-Resource Interactions

Drinking to Cope Alcohol Consumption Drinking Problems

Moderator Variables AR2 AR2 AR2 DF

Step 1: All main effects .318** .147** 143** 21,552 Eq. 1, Step 2: WD x social support .007 .004 .002 3,549

Appraisal support -.056 .042 -.044 1,549 Belonging support - .056 - .051 - .020 1,549 Tangible support .016 .048 .056 1,549

Eq. 2, Step 2: WD x coping resources .008* .002 .000 2,550

Self-esteem .009 .039 -.009 1,550 Mastery - .100* - .050 - .008 1,550

Eq. 3, Step 2: WD x coping styles .014* .009 .009 4,548

Anger-in .016 .062 -.023 1,548 Anger-out .098* -.018 .016 1,548 Anger-reflect .100* .088* -.010 1,548 JH active coping .038 .012 .095* 1,548

Eq. 4, Step 2: WD x coping responses .008 .005 .012* 3,549

Behavioral coping - .027 .030 - .018 1,549 Cognitive coping .091* .050 - .024 1,549 Avoidance coping .031 -.008 .123** 1,549

Eq. 5, Step 2: WD x expectancies .011** .001 .004 1,551

Positive expectancies .108** - .037 .064 1,551 * p


was small, however, accounting for less than 1?/2 percent of the variance in drinking to cope.

Within the block of work distress-by- coping resource interactions, only mastery interacted significantly with work distress. Examination of the form of the interaction revealed that work distress was related positively to drinking to cope among low- mastery individuals, but was essentially unrelated among high-mastery individuals. This pattern is consistent with the hypothesized buffering effect of coping resources (H2b), except for a slight crossover at lower levels of work distress (below 1.9 on a 1-to-4 scale).

Examination of the block of work distress- by-coping style interactions revealed that anger-reflect and anger-out interacted significantly with work distress to predict drinking to cope. Examining the form of the interactions revealed that both high anger-out and high anger-reflect individuals were more likely to drink in order to cope with increasing work distress, although slight crossovers were evident at or below 1.5 for both anger-coping moderators. The distress- by-anger-out interaction is consistent with Hypothesis 2c, suggesting that individuals high in avoidant styles of coping with emotion are more likely to drink to cope with work distress. In contrast, the results obtained for anger-reflect were unexpected. Prior research generally has failed to find moderating effects for measures of active or problem- focused coping (e.g., Billings and Moos 1983); in addition, if such an effect were to occur, one would expect a buffering effect because anger-reflect is widely regarded as an adaptive coping style (Harburg et al. 1979).

Finally, positive alcohol expectancies significantly moderated the work distress- drinking to cope relationship. The form of this interaction was consistent with prediction (H2d). The relationship between distress and drinking to cope was significant and positive among individuals holding strong positive expectancies for alcohol's effects; it was essentially zero among individuals holding weak expectancies.

Work distress-alcohol consumption relationship. As shown in Columns 3 and 4 of Table 2, we found no evidence for moderating effects on the work distress-consumption relationship. Not one of the five blocks of

interaction terms accounted for significant variance in alcohol consumption.

Work distress-drinking problems relationship. As shown in the last two columns of Table 2, only one of five moderator sets accounted for a small (about 11/2%) but significant increment in explained variance. Avoidance coping interacted with work distress in the prediction of drinking problems. Although we observed a slight crossover under low-distress conditions (1.5 on a 1-to-4 scale), high-avoidance copers appeared to be more vulnerable to drinking problems under high-distress conditions, as predicted (H2c).

Work distress-by-resource-by-expectancy interactions. We hypothesized that individuals who are deficient in adaptive resources and who also hold strong expectancies for alcohol's positive effects would be most likely to drink to cope, to drink heavily, and to experience drinking problems in response to high levels of work distress. Empirical support for this hypothesis would be sug- gested by a significant distress-by-resource- by-expectancy interaction. To test this hypothesis, we regressed each of three alcohol outcomes independently on a block of three- way interactions after entering all main effects and all relevant two-way interactions on prior steps. We evaluated moderating effects in independent equations for each of the four categories of personal and social resources; thus a total of 12 equations was estimated. Across these analyses (data not shown), not a single block of three-way interactions was statistically significant at p < .05. Hence we obtained no support for the predicted three-way interactions (H2e).

Summary

Results of these analyses provide limited support for the hypothesized moderating effects of mastery (H2b), avoidant or maladaptive forms of coping with emotion (H2c), and positive expectancies for alcohol's effects (H2d) on the work distress-alcohol relationship. Significant effects generally were small in magnitude, however; they accounted for no more than 2 percent of the variance in alcohol outcomes. In addition, we obtained no support for the hypothesized buffering effects of social support on the distress-alcohol outcome relationship (H2a) or for the hypothesized three-way interactions of adaptive


resources, expectancies, and distress (H2e). Finally, we obtained counterintuitive effects for several indicators of active coping, including anger reflect, JH active coping, and active cognitive coping.6

DISCUSSION AND CONCLUSIONS

This research tested a model of stress- induced drinking in relation to the experience of work stressors and negative emotional sequelae. Overall we found no support for a simple tension reduction model of work stress-induced drinking. Of three separate alcohol outcomes examined, not one was predicted significantly by exposure to work stressors and the experience of work-related negative emotion after both sociodemographic and psychosocial resource variables were controlled.7 Furthermore, we obtained only qualified support for a social learning model of work stress-induced drinking. On the one hand, data showing enhanced vulnerability among individuals with limited coping abilities and strong positive alcohol expectancies support the fundamental logic of the social learning perspective. On the other hand, these effects were neither robust nor consistent across multiple indicators of a given moderator or across multiple outcome measures.

Indeed, the only consistent pattern of significant interaction effects was obtained for drinking to cope. This pattern of findings suggests that individual differences may be more likely to govern motivations for drinking than to influence alcohol consumption or the experience of drinking problems per se. Such an interpretation is consistent with both social learning theory (Abrams and Niaura 1987) and empirical research (Cooper et al. 1988), which show that drinking motivations at least partially may mediate the influence of predisposing individual differences on alcohol use and abuse.

Despite limited support for theoretical predictions made by the social learning model, our findings suggest that the real- world impact of work stressors on alcohol- related outcomes is likely to be small. Indeed, even among individuals identified as most vulnerable (e.g., those high in avoidance coping), the estimated effect of work stressors on the experience of drinking problems was small: for each sd increase in work distress,

we obtained an estimated direct effect of .17 sd increase in drinking problems.8 Moreover, although the presence of multiple vulnerability factors may predispose an individual to experience negative alcohol-related outcomes in response to high levels of work stress (cf. Bry et al. 1982), few individuals in this representative sample of employed persons were actually high on more than one vulnerability factor. For example, only 33 people (about 6% of the sample) were even one-half of one standard deviation above the mean on both avoidance coping and expectancies; only six (less than 1 %) were a full standard deviation above the mean on both. Other combinations proved equally rare. Thus it seems plausible that the most vulnerable individuals in fact are underrepresented in the work force, perhaps because they lack many of the skills requisite to successful employment. Hence the impact of work stressors and work distress on alcohol outcomes may necessarily be limited by the relative compe- tence of those who are able to secure and maintain employment.

Because of the small number of people who appear likely to experience negative alcohol outcomes in response to work stress and because of the generally small magnitude of the obtained effects, our findings suggest that prevention programs aimed at reducing and managing work stress may not be a cost- effective way to address alcohol problems in the work force. Although such an approach may prove useful in reducing other stress- related problems (e.g., depression, absentee- ism, low productivity), it seems unlikely to have significant impact on alcohol pathology. Instead, interventions targeted to individuals known or suspected to have alcohol-related problems may be more appropriate (e.g., constructive confrontation, Archer 1977; Trice and Roman 1978). In addition, strategies aimed at altering norms that promote heavy drinking or at structural features of the work environment that allow heavy drinking may be useful (Trice and Roman 1978).

Results of the present study suggest several directions for future research. First, our results underscore the need to control for individual differences in models purporting to examine the impact of work stressors and distress on alcohol-related outcomes. Zero- order correlations, as reported in Table 1, reveal significant relationships between work stressors and distress and several alcohol


outcomes. After controlling for sociodemographic and psychosocial resource variables, however, we observed no significant relationships between work stress and alcohol variables. This outcome suggests that significant zero-order relationships may reflect confounding due to sociodemographic characteristics or to underlying deficits in personal and social resources.

Second, future research using domain- specific measures of personal and social resources would provide a more compelling test of our model. Indeed, the assumption of cross-situational consistency implied by the use of general measures of personal and social resources may not be warranted (see Swindle et al. 1988 for a recent discussion of this issue). Consequently the failure to use domain-specific moderator measures may systematically underestimate moderator effects.

Third, future research using prospective designs would enable more confident causal inference. Yet insofar as work stress-related effects are etiologically important, we specu- late that their influence is likely to be played out over the course of hours or days rather than years. That is, a stressful day at work may be followed by increased alcohol use that evening; a stressful week at work may be followed by heavier use that weekend. Hence a design sensitive to such short-term, within- person fluctuations (e.g., a daily diary study) may be needed to test work stress-related effects on alcohol use more definitively.

Finally, in keeping with the generally weak results reported in this and several other recent studies (e.g., Mensch and Kandel 1988), we believe that increased research attention should be focused on other possible sources of work-related influence on drinking behavior. Potentially useful areas for future research include structural features of the work environment that promote drinking or allow it to go undetected, as well as workplace norms, cultures, or networks that overtly or covertly encourage drinking.

Despite the limitations of this study, we find little support for the widely held belief that work stress promotes problematic alcohol use. Although a small number of individuals who are deficient in adaptive resources or who hold strong positive expectancies for alcohol' s effects may be vulnerable, our findings suggest the adoption of a consider-

ably more circumscribed view of the etiologic role of work stress in alcohol pathology.

NOTES

1. In the interests of parsimony we have made several simplifying assumptions in the proposed model. First, drinking to cope, alcohol use, and drinking problems are treated as separate indicators of alcohol pathology, with the assumption of similar consequent status in our model. Although a causal order may exist among these dependent measures (cf. Cooper et al. 1988), we have chosen not to model relationships among them in order to maintain comparability with other published research in the work stress-alcohol literature where these outcomes have been treated universally as discrete indicators of alcohol-related pathology. The net effect of any bias introduced by this treatment of our outcome measures should be to overestimate the magnitude of the work stress effects on alcohol use and drinking problems. Therefore, in view of the essentially null results reported in this paper, modeling a causal order among these outcomes would not alter our basic conclusions.

Second, sociodemographic characteristics are not modeled as potential moderators of the work stress-distress or distress-alcohol relationships. Although it is possible that some subgroups defined, for example, by racial/ ethnic or socioeconomic characteristics are more vulnerable than others to work stress effects on alcohol-related outcomes, such effects are not specifically relevant to an adequate test of either tension reduction or social learning models. Such analyses are therefore beyond the scope of the present paper. In omitting these tests, however, we do not mean to imply that these effects may not be important. In particular, gender has been identified as a potentially important moderator effect. According to Horwitz and White (1987), males and females may have different styles of pathology; female deviance hypothetically is characterized by internalization of distress, whereas male deviance is more outwardly directed and antisocial (see Robbins 1989 for related data). Hence females may be prone to internalize stress-related effects, whereas males may be more likely to use alcohol and to exhibit alcohol-related problems as a result of work- related stressors and distress. The available data, however, lend little support to this hypothesis. Data reported by both Parker and Farmer (1988) and House et al. (1986) suggest little difference between males and females in the magnitude of effects for work-related stressors on alcohol use.

2. According to Lazarus and Folkman (1984), low


internal-consistency reliability may reflect an inherent property of the coping construct rather than inadequate measurement per se. In particular, these authors argue that the successful use of one strategy within a given coping domain may obviate the need to use others. Thus the generally low reliability obtained for several of the coping indices in the present study may reflect accurately the underlying nature of coping processes. Nonetheless, we must ac- knowledge that lower-than-optimal reliability among some of our moderator variables may attenuate estimates of their interactive effects (Baron and Kenny 1986).

3. The use of structural equation modeling that takes into account the effects of measurement error has several clear advantages over standard path analytic techniques (Bollen 1989; James et al. 1982). Even so, structural equation modeling also has a number of drawbacks, several of which militate against its use in the present context. First, a large number of interaction effects are specified in the present model; techniques for testing such effects among latent variables are complex and carry a number of stringent assumptions that in practice are difficult to meet (Bollen 1989). Moreover, the consequences of violating these assumptions are not generally well understood (Kenny and Judd 1984). In addition, as Schmitt (1989) pointed out recently, path analytic models may be preferable to structural equation models insofar as they are more readily accessible to a wider audience. Hence in at least some situations, the methodological gains associated with the use of structural equation modeling may be more than offset by the accompanying loss in comprehensibility.

4. Both alcohol consumption and drinking problems were highly skewed (skewness = 4.64 and 4.08 respectively). To reduce skewness, we log-transformed both variables (skewness = .01 and 1.77 respectively for consumption and for problems); using the log-transformed ver- sions, we reran all analyses involving either dependent variable. Results obtained by using the transformed variables did not differ substan- tively from those based on the nontransformed variables. Thus only results using the untrans- formed variables are reported in this study.

5. To assess the effect of deleting infrequent drinkers, we reestimated the path model, including respondents who drank less than once a month. Results were essentially identical to those summarized in Figure 2, except that the path from work distress to drinking to cope became significant (p = .035). This change, however, appeared to reflect an increase in power due to the larger sample size (N = 711 vs. 574) rather than an appreciable increase in the magnitude of the path coefficient (B = .088

vs. .074). We also reestimated the model, including both infrequent drinkers and abstainers (N = 787), and found no appreciable changes in the magnitude or the significance of effects on alcohol use or alcohol problems. We could not reestimate the model in this larger sample using drinking to cope as the ultimate outcome because abstainers did not complete drinking to cope items. Overall, the results of these analyses suggest that our findings are relatively robust and were not biased unduly by our exclusionary criteria.

6. Three of these interactions were not discussed previously because the blocks did not reach conventional levels of significance. Yet the consistency (as indicated by the sign of the interaction term) observed across these several active coping indicators is noteworthy.

7. One anonymous reviewer raised the concern that several of the psychosocial variables, which are treated as potential confounders and as moderators in the present model, instead may mediate the hypothesized stressor-distress or distress-drinking to cope links. The reviewer cites two pieces of evidence in support of this possibility: 1) Pearlin and colleagues (Pearlin et al. 1981) report that decreases in mastery and self-esteem mediate the impact of chronic stressors on depression. 2) On the basis of correlations reported in Table 1, significant direct effects can be shown for several of the psychosocial variables (e.g., self-esteem, tangible social support) on drinking to cope. The issue raised by this reviewer, of course, is a critical one that questions the fundamental accuracy of the theoretical model proposed and tested in the present study.

Although a comprehensive response to this essentially epistemological concern is beyond the scope of this paper, several points may help to place it in perspective. First, the veridicality of this or any other causal model cannot be established definitively. A network of variables can be examined to determine how closely the observed relationships correspond to the hypo- thetical relationships that should be observed if the theory is correct. Affirmative results, however, do not effectively rule out alternative interpretations of the data. Indeed, the specific case raised by this reviewer (i.e., distinguishing between a spurious and a mediated relationship) is a classic example of two alternative models that cannot be distinguished on the basis of the data (see Asher 1983 and Rogosa 1979 for a more detailed discussion of this case). Thus the fact that direct effects may be shown for several of the psychosocial variables does not help us to discriminate between these models; it is equally compatible with both models.

Ultimately one must justify the causal order specified among variables in a model on


theoretical, rational, or substantive bases. On the basis of such criteria, our model would seem to be both reasonable and well grounded. First, the model is compatible with widely accepted models of general stress processes (see, e.g., Cohen and Wills 1985 for a review), of work stress processes (see Matteson and Ivancevich 1987 for a review of work stress models), and of stress-induced drinking (see Blane and Leonard 1987 for a review of psychological theories of alcohol use). Second, more stable variables typically are modeled as causally antecedent to less stable variables (Davis 1985). In this study, our treatment of psychosocial resource variables (which are predominantly stable, traitlike characteristics such as mastery) as causally antecedent is consistent with this guideline. Third, prior work by Pearlin (Pearlin and Radabaugh 1976), which examined the relationship between a chronic stressor and drinking to cope, treated psychosocial variables not as mediating variables but as potential confounders and as moderators of the stress-drinking to cope relationship. Thus the literature would appear to contain ample precedent to support the posited causal order among these variables. Nonethe- less, the reader should bear in mind that alternative causal orders are plausible and that an alternative ordering might lead to different conclusions regarding the influence of work stress processes on drinking motives. No evidence of mediated effects was found, however, either for alcohol use or for drinking problems. Thus the substantive conclusions drawn with regard to these outcomes would appear to stand regardless of the particular theoretical model to which one subscribes.

8. We estimated the direct effect of work distress on drinking problems in a subgroup of high-avoidance copers (individuals +.5 sd above the mean on avoidance coping). We used standard multiple regression procedures in which all sociodemographic, resource, and stressor variables were controlled. Results showed a direct effect of work distress on drinking problems of .172. To the extent that stressor effects are mediated fully through elevation in work distress, this value reasonably may be regarded as an upper limit on the magnitude of the effect that would be expected on alcohol problems from increases in work stressors.

APPENDIX

Work Stressor Items

Work Pressure 1. Do you have too much work to do?

2. Do you feel that you have a lot of responsibility for the work of others?

3. Do you work very hard-either physically or mentally?

4. Do you worry about meeting the conflicting demands of different people you work with?

5. Are you under pressure to keep up with new ways of doing things?

6. Do you have to decide things where mistakes could be quite costly?

7. Do you work too many hours? 8. Do you have to deal with or satisfy too

many people? 9. Do you have too little help or equipment to

get the job done well? 10. Can you take it easy and still get your work

done? (reverse scored) 11. Do you have important responsibilities?

Lack of Job Control 1. Are you unsure about what people expect of

you? 2. Do you feel that you are unable to influence

your supervisor's decisions-even when they affect you?

3. Can you use your own initiative to do things? (reverse scored)

4. Does your supervisor keep a close watch on you?

5. Are you confused about exactly what you are supposed to do?

6. Are you given a lot of freedom to decide how to do your work? (reverse scored)

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LYNNE COOPER holds a research appointment in the Center for the Study of Behavioral and Social Aspects of Health at the State University of New York at Buffalo. Her research interests include cognitive-motivational models of alcohol use, and stress and factors that moderate effects of stress on psychological and physical well-being. Currently she is funded by the National Institute on Alcoholism and Alcohol Abuse to study alcohol use, sexual risk taking, and other health-related behaviors among adolescents.

MARCIA RUSSELL is a senior research scientist at New York State Research Institute on Alcoholism and an associate clinical professor in the Department of Social Preventive Medicine at the State University of New York at Buffalo. In addition to her work on alcohol use, stress, and blood pressure, she is interested in the epidemiology of alcohol use and abuse among women and its effects on reproduction.

MICHAEL R. FRONE is a doctoral candidate in sociallorganizational psychology at the State University of New York at Buffalo and a research scientist at the New York State Research Institute on Alcoholism. His current research is in work-family conflict, job involvement, occupational stress, and employees' alcohol use.

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Issue Table of ContentsJournal of Health and Social Behavior, Vol. 31, No. 3 (Sep., 1990), pp. i-v+217-305Front Matter [pp. ]Editorial: Moving Targets [pp. ]The Legacy of Stress Research The Course and the Impact of This Journal [pp. 217-225]The Legacy of Stress Research The Course and the Impact of This Journal: Comment [pp. 226-227]The Legacy of Stress Research The Course and the Impact of This Journal: Comment [pp. 228-230]Comment: Looking for the Right Stuff [pp. 231-239]Development and Change of Young Adults' Preventive Health Beliefs and Behavior: Influence from Parents and Peers [pp. 240-259]Work Stress and Alcohol Effects: A Test of Stress-Induced Drinking [pp. 260-276]Stability of Psychological Symptoms: Drug Use Consequences and Intervening Processes [pp. 277-291]Queues and Care: How Medical Residents Organize Their Work in a Busy Clinic [pp. 292-305]Back Matter [pp. ]

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