Comorbidity of alcohol abuse and depression: exploring the self-medication hypothesis
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Abstract
Extensive evidence exists to indicate that the comorbidity of alcohol dependence disorders and major depression occurs at a rate far exceeding that which one would expect from base rates alone. Self-medication is one theory as to why this type of comorbid combination may be over-represented. Self-medication can be defined as the conscious or unconscious tendency to drink alcohol (or use other drugs) in response to the experience of depressive symptoms. The theory holds that substance use can temporarily attenuate the negative experience of depression, and for this reason can be seen as a means of escape. Unlike successful treatment with anti-depressant prescription medication, alcohol use is not an effective means of combating depression. In fact, it is predictably counter-productive. This project was undertaken with the goal of integrating many of the research findings from the last twenty years within a study of the extent to which self-medication occurs within a college student sample, a group whose drinking behavior has been notable for it's potential to become problematic.;This was the first study to examine the self-medication hypothesis throughout the range of depressive symptomology and alcohol use, and its aim was to determine the point at which the self-medicative response becomes a serious risk as depression increases. The investigation also attempted to determine the amount of variance in alcohol use that can be explained by self-medication, specifically use motives, while controlling for the amount of self-reported depression. In general, it was expected that as depressive symptoms increase, the tendency to drink for self-medicative reasons will increase.;The results indicated strong support for the existence of self-medicative drinking even at sub-diagnosable levels of depression. A clear relation between level of depression and alcohol use was not found. However, this result was thought to be related to the collegiate sample used in this investigation and the impact of drinking in a collegiate subculture. Self-esteem was not found to have an effect on self-medication. However, changes in depression over a 4-week time period were related to changes in the coping motives to drink over that same period in the predicted direction, a finding that is supportive of the self-medication hypothesis.