(1) Overall, do women and men differ in their exposure to social influences, stressors, and emotional distress? Specifically, do men experience greater exposure to these social influences or stressors, which might help explain men’s higher problem-drinking prevalence? (2) Consistent with their higher problem-drinking prevalence, do men overall experience greater drinking reactivity to social influences or stressors? (3) Among problem drinkers, are there gender differences in exposure to social influences, stressors, or emotional distress or (4) in drinking reactivity to these experiences? If present, such differences might help guide prevention and treatment planning for problem-drinking women and men and clarify differences between them in terms of response to treatment and patterns of recovery.
Stress Drinking Has a Gender Divide
Drinking motives have been linked to heavier alcohol use among adolescents (Cooper, 1994; Cox & Klinger, 1988). It is important to note that although drinking motives impact undergraduate alcohol behavior (Kuntsche et al., 2005) the relationship between motives and drinking appears to be less robust in college compared to adolescent samples. Research suggests that over time, associations between drinking motives and alcohol use diminish (Sher et al., 1996) or disappear (Read et al., 2003). This might indicate a more complex relationship between drinking motives and alcohol consumption among undergraduates than the direct linkage evidenced during adolescence.
Subjective Emotion Experience
However, the specific pathways through which stress affects long-term health may differ between men and women. The Differential Emotions Scale (DES) -Revised short form (Izard, 1972) was used as a measure of subjective emotional experience. Participants rate on a 5-point scale the extent to which each word describes the way they feel at the present moment.
Therefore, these results imply that longer persistence of high stress drinking has a gender divide ethanol blood level exists in women compared to men after alcohol intake, and thus, women tend to be exposed to higher degrees of alcohol in organs such as the brain that can affect mood and suicidal ideation. Regarding neurotransmitter system and the influence of gonadal hormones, males and females show differential patterns of neurotransmitter release and receptor availability in response to alcohol consumption 12. Alcohol is known to alter γ-aminobutyric acid (GABA) system through the GABAA receptor 41,42 and other neurotransmitter systems such as the serotonergic system 11, and sex is an important factor for neurotransmitters’ receptor subunit expression 43-45. In addition, female gonadal hormones affect many neurobiological responses 11, and specifically, changes in estrogen levels have been shown to influence concentrations of serotonin and serotonin-receptor subtype 46. This interaction may contribute to an increased vulnerability to depression or suicidal ideation in women. Studies of adults have shown that men and women cope differently with stress (Wang et al., 2009) and that women may be more sensitive to a range of stressors than men (Hammen, 2005; Meadows, Brown, & Elder, 2006).
In summarizing the existing research, we therefore first focus on gender differences in general population samples or samples that include both problem and nonproblem drinkers. Within each of these categories, we also distinguish between exposure and reactivity to social influences to drink and to stressors. Gender differences in exposure to social influences and stressors generally do not help explain men’s higher problem-drinking prevalence, but men’s overall greater drinking reactivity corresponds with their propensity to develop problem drinking. Problem-drinking women and men tend to be exposed to somewhat different social influences and stressors but share a tendency to respond to these experiences with increased drinking.
Understanding Stress and Its Gendered Impact
Furthermore, more frequent adolescent drunkenness was indirectly related to more young adult binge drinking through more occupational stress, which was then related to greater endorsement of coping motives. The model accounted for 34% and 29% of the variance in negative consequences of drinking and 40% and 15% of the variance in binge drinking for men and women, respectively. For men, greater occupational stress was significantly related to stronger endorsement of coping and social motives, partially supporting Hypothesis 1 (see Figure 1). Furthermore, endorsement of each drinking motive was positively related to binge drinking, and endorsement of social motives (but not coping motives) was related to negative consequences of drinking.
Longitudinal Effects of Adolescent Drunkenness
- The current study evaluates gender differences overall—that is, in a sample that includes both nonproblem and problem drinkers—and among problem drinkers alone.
- The chi-square analyses comparing nonproblem and problem drinkers separately for men and for women indicated that, for both men and women, problem drinkers reported significantly greater reactivity to each of the social influence and stressor situations.
- Longitudinal research across early adulthood is needed to test systematically for bidirectional effects and to determine the predictive value of life stress and drinking motives for subsequent alcohol misuse.
- The finding that both social and coping motives are implicated in alcohol misuse indicates that it may be useful to steer young adults away from using alcohol for either reason.
- Women’s stress responses are largely modulated by estrogen and progesterone, while men’s are primarily influenced by testosterone.
- Presumably, competence in these domains is a desirable outcome for young adults, whereas difficulties and lack of progress are stressful.
Thus, in addition to examining the association between stress and alcohol misuse in early adulthood, the present study also tested the longitudinal association between alcohol misuse in adolescence and young adult occupational and relationship stress. The current study also evaluated depressive symptoms as a moderator of the effect of CDM on drinking. We hypothesized that individuals who reported higher levels of depressive symptoms would drink more relative to those who report lower depressive symptoms, especially if they are also high in CDM, because these individuals might be more likely to drink to cope with their negative affect. However, contrary to expectations, the positive relationship between CDM and peak drinking was more true for those lower in depressive symptoms.
Biological Factors Influencing the Gender Divide in Stress Drinking
There were significant indirect effects from occupational stress to binge drinking and negative consequences through stronger endorsement of both social and coping motives, partially supporting Hypothesis 2 (see Table 2). The model accounted for 33% of the variance in negative consequences of drinking and 40% of the variance in binge drinking for men. Furthermore, research indicates that gender moderated the relationship between depressive symptoms and daily alcohol use such that depressive symptoms were positively linked with daily drinking and risk for compulsive drinking for male undergraduates (Pedrelli et al., 2011). Examinations of this relationship among female undergraduates revealed that depressive symptoms increased the risk for compulsive drinking but not for daily drinking (Pedrelli et al., 2011). Research demonstrates that gender is an important factor to consider in drinking, and males have consistently been shown to be at greater risk for increased drinking and problems relative to females (e.g., Caetano, 1994; Greenfield et al., 2000; Korcuska et al., 2003; Randolph et al., 2009).
It may guide future prospective research designed to clarify causal pathways to problem drinking. For example, the findings suggest that differential reactivity to stressors may help explain the development and stabilization of drinking problems in adulthood. In sum, exposure to social influences to drink and to stressors provides an opportunity for elicitation of drinking reactivity.
We predict, however, that women will show lower physiological arousal in response to stress than men, as indicated by lower cardiovascular response, especially for BP. We will also explore gender differences in the alcohol-cue and neutral-relaxing conditions, in which alcohol craving and positive emotion were likely. Lastly, we will examine correlations among subjective, behavioral, cardiovascular, and alcohol-craving systems during stress and alcohol-cue conditions for men and women. Women and men are at risk for different types of stress-related disorders, with women at greater risk for depression and anxiety and men at greater risk for alcohol- use disorders (Kajantie and Phillips, 2005; Kessler et al., 1993).
While we may be aware of the biological differences between men and women, it’s the subtle impacts of these differences that create a notable disparity in how alcohol affects men and women differently. This study was based on data obtained from the fifth and sixth KNHANES conducted by the Korea Centers for Disease Control and Prevention in 2010–2012 (5th KNHANES) and 2013–2015 (6th KNHANES), respectively. We used the data from 2013 and 2015 except 2014 from the 6th KNHANES because some of the items in the alcohol use disorders identification test (AUDIT) were not investigated in 2014. “I drank to relieve anxiety, and then to relieve the anxiety caused by my drinking,” says Claire, a former management consultant withholding her real name for privacy reasons. “Men’s drinking is more forgivable – you don’t see many tabloid headlines about fathers who drink too much. There’s still this attitude that women, especially mothers, should behave in a certain way, even though women’s drinking has become normalised.
Previous studies have indicated that men show greater stress-related brain response in the fronto-limbic area 52 and higher cortisol response 53-55, whereas women show blunted adrenal responsivity 56 and greater tendencies to negative cognitions such as rumination under stress 57. On the other hand, some studies have reported that alcohol consumption predicted decreased stress the day following alcohol intake in both sexes 51. In addition, several factors such as individual differences in stress appraisal, coping strategies to stress, and response to alcohol intoxication play a role in modulating alcohol–stress interaction 58-60. As such, the alcohol, stress, and gender interaction is complex and dynamic, and future studies with valid animal models are needed to understand mechanisms that underlie the complexity of alcohol and stress in males and females. This previous work underlined the importance of considering exposure and reactivity separately. Furthermore, as we have noted, gender differences in drinking may vary depending on whether they are based on comparisons across individuals who vary in their alcohol use and levels of problem drinking or on comparisons among problem drinkers.
Support systems play a crucial role in stress management, and there are notable gender differences in how these systems are utilized. Women tend to have more extensive and diverse social support networks, which they actively engage during times of stress. Men, however, often have smaller support networks and may be less likely to seek emotional support from friends or family, relying more on their partners for emotional needs.
Theorists have argued that we must consider the intersection between gender and other social categories (e.g., ethnicity, socioeconomic status) in order to fully understand when and in what setting gender differences occur (e.g., Crenshaw, 1997). Thus, future research on the intersection of gender and ethnicity in terms of emotional response to stress is warranted. Some gender differences in exposure to social influences and stressors found in the general population nevertheless also are apparent when problem-drinking men and women are compared.
By embracing a more nuanced understanding of how stress manifests differently in women and men, we can develop more effective strategies to combat its negative impacts and promote overall well-being for all individuals. The biological underpinnings of stress responses in men and women are significantly influenced by hormonal differences. Women’s stress responses are largely modulated by estrogen and progesterone, while men’s are primarily influenced by testosterone.
More specifically, women are at greater risk of developing cardiovascular disease, liver inflammation, certain cancers, and alcohol dependence. Women are also found to have a faster progression of alcoholic liver disease and alcohol use disorder. Alcohol drinking and AUDIT levels were assessed for evaluating the participants’ amount of alcohol intake and alcohol-related problems. The Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977) was used to evaluate depressive symptoms.
Project staff administered the survey without school staff being present, and girls and boys were surveyed separately. Students’ names were removed from survey forms when the surveys were administered, and numeric codes were used to link students’ questionnaires between survey years. For the young adult follow-up survey, data were collected via mailed survey and participants received a monetary incentive. Parents consented to their adolescents’ participation (passive consent); young adults provided informed consent for their own participation. Participants reported demographic information such as year in school, racial background, ethnicity, age, and gender. The researchers were surprised that there was such a stark gender divide among the participants who didn’t receive alcohol for their first drink.