Survey measures of subjective response to alcohol are improved by incorporating questions about the intensity of alcohol effects

Objective: Extant survey measures of subjective response to alcohol, an important risk factor for alcohol problems, query the number of drinks to experience alcohol effects but do not consider how intensely individuals experience them. We tested whether new measures of the intensity of alcohol effects, alongside the “number of drinks,” contributed uniquely or interactively in predicting alcohol problems. We examined associations among these subjective response variables with race and sex assigned at birth. Method: Participants (N=246; 18-50 years; 44.3% Black; 55.7% White; 58.4% assigned female; 41.6% assigned male) were oversampled for alcohol-related risk and completed an online survey. Participants reported the number of drinks to experience alcohol effects (ASQ; Fleming et al., 2016), the intensity of these alcohol effects, alcohol-related problems, and covariates (heavy drinking frequency, tolerance, demographics). Results: According to confirmatory factor analyses, two factors underlay the ‘number of drinks items (“stimulation-number of drinks,” “sedation-number of drinks”), and the same for the alcohol effect intensity items (“stimulation intensity,” “sedation intensity”). Stimulation intensity and sedation-number of drinks were significantly associated with, and interacted to predict, alcohol problems; individuals reporting both greater stimulation intensity and needing more drinks to experience sedation showed greatest risk. Black relative to White individuals reported greater intensity of, and needing more drinks to feel, stimulation. Male relative to female individuals reported needing more drinks to feel sedation. Conclusions: Participants’ self-reports of the intensity of alcohol effects may capture an important aspect of subjective response that could improve existing survey-based measures of this important alcohol-related risk factor.