College students are at particularly high risk for alcohol use and its adverse consequences compared to other age groups, and this risk is further elevated when comorbid conditions such as ADHD present. ADHD symptoms manifest differently between childhood and adulthood; in adults, overt hyperactivity may diminish, yet may be replaced by internal restlessness. Prior studies have indicated that such higher level of internal restlessness increase the risk not only of substance use but also mental health problems. Furthermore, there is evidence that drinking motives may mediate the relationship between ADHD symptoms and alcohol use. However, research systematically examining the associations among internal restlessness, drinking motives, and alcohol use remains scarce. Therefore, the current study aims to investigate whether heightened internal restlessness is associated increased alcohol use and negative consequences, and whether these associations are mediated by specific drinking motives (i.e., social, enhancement, coping, conformity) and overall alcohol consumption.
The study utilized an online survey administered to 291 undergraduate students at a university in Rhode Island, U.S., who met the following inclusion criteria: having consumed alcohol within the past 30 days, demonstrating English proficiency, and residing U.S. The survey assessed internal restlessness (Internal Restlessness Scale), drinking motives (Drinking Motives Questionnaire-Revised), alcohol consumption (Daily Drinking Questionnaire), negative alcohol-related consequences (Brief Young Adult Alcohol Consequences Questionnaire), and ADHD symptoms (Current Symptoms Scale). Following an examination of bivariate correlations among these key variables, a path analysis was conducted in Mplus to investigate the direct and indirect pathways from internal restlessness to negative alcohol-related outcomes via drinking motives and alcohol consumption. Self-reported ADHD diagnosis was included as a covariate in the analyses.
According to the findings, students with higher internal restlessness exhibited significantly greater alcohol consumption (p = .049) and negative alcohol-related outcomes (p < .001). Internal restlessness was positively correlated with coping (p = .003), enhancement (p < .001), social (p = .002), and conformity (p < .001) motives. In addition, alcohol consumption showed significant positive associations with coping, enhancement, social, and conformity motives, and higher levels of alcohol use were linked to increased negative outcomes. ADHD diagnosis also exhibited a significant relationship with internal restlessness (p < .001). Subsequent path analyses indicated that internal restlessness significantly elevated all four drinking motives. Among these, coping (B = 0.55, p = .032) and enhancement (B = 0.32, p = .048) motives were significantly associated with increased alcohol consumption, whereas social motives (B = 0.29, p = .001) directly predicted negative alcohol-related outcomes. Furthermore, an indirect effect emerged, suggesting that higher internal restlessness led to greater negative alcohol-related consequences via increased enhancement and coping motives, which in turn elevated alcohol consumption (Internal restlessness → enhancement and coping motives → alcohol consumption → negative alcohol-related outcomes).
Takeaway: College students with high internal restlessness may exhibit increased alcohol consumption through coping and enhancement motives as mediators, leading to intensified negative alcohol-related outcomes.