Women's Social Roles and Alcohol Use Among Military-Connected Spouses

Increases in women's alcohol use are an intensifying public health problem in the United States, contributing to a hidden epidemic of alcohol-related mortality. Women's alcohol consumption is often not openly discussed or recognized due to social stigma, the perception that women drink less than men, and the fact that women can experience negative health consequences from lower levels of alcohol consumption (relative to men), making the issue less visible than it actually is. A range of factors potentially influence women's drinking, including social roles (i.e., mother); yet, the literature is varied as to whether the combination of multiple-role demands/expectations fosters reduced consumption or maladaptive coping with alcohol. Considering the past three decades have involved shifts in women's social and cultural landscapes (i.e., workforce participation; delaying or abstaining from motherhood), contextual data on women's alcohol use is needed to understand better how societal influences through role demands and expectations work to shape health behaviors. This dissertation explored women's drinking behavior with a specific focus on multiple role strain (MRS) among women military-connected spouses, who are an under-researched population vulnerable to heightened experiences of role strain and embedded in a culture of high and problematic alcohol use. Study 1 examined synchronous role strain from occupational, parental, and household roles (i.e., MRS) associated with alcohol use behavior as a function of distress and drinking to cope (DTC) motivation among National Guard service member spouses who are mothers. Results demonstrated that MRS predicted increased drinking frequency, quantity, and heavy episodic drinking through a serial pathway: increased distress followed by heightened DTC motives. A suppression analysis revealed that distress alone predicted decreased consumption, but DTC motivation emerged as the critical catalyst driving increased alcohol use despite role constraints, helping explain conflicting literature on whether role strain increases or decreases women's drinking. Study 2 provides a descriptive analysis of drinking patterns across social roles among women military-connected spouses using daily diary data. Three distinct role-based risk profiles emerged: employed childless women exhibited a high-risk profile with the greatest consumption and heavy episodic drinking rates with concentrated risk in social contexts; unemployed parents showed a moderate-to-high risk pattern where drinking is infrequent but intense when it occurs suggesting opportunistic or circumstance-driven risk; and employed parents demonstrated the most frequent participation in moderate drinking, highest solitary consumption and all solitary HED, yet (relative to other role categories) exhibits the lowest per-occasion consumption and HED rates in social contexts, suggesting a risk pattern hidden by social self-regulation and maintained role performance. Findings also revealed that daily monitoring captured more frequent and heavier consumption than retrospective reports, highlighting systematic underreporting in general surveys. Study 3 tested whether daily role strain is associated with negative affect and motivates alcohol consumption using consecutive daily assessments. Contrary to the negative reinforcement model, women military-connected spouses consumed significantly less alcohol on high-stress days with elevated role strain and negative affect. Instead, women demonstrated strategic recreational drinking: concentrating consumption during low-stress weekend periods, timing drinking to precede days with minimal demands, and avoiding alcohol when circumstances required full functioning. However, average consumption per drinking occasion exceeds recommended limits for women, revealing a critical functionality-risk disconnect wherein maintained role performance may mask accumulating health risks. Comprehensively, this research challenges dominant self-medication frameworks and reveals that drinking to cope motivation, rather than stress or distress alone, drives increased consumption among mothers experiencing role strain, while more generally, women managing multiple roles demonstrate sophisticated self-regulation by strategically timing consumption rather than drinking reactively to stress. These findings necessitate fundamental shifts in prevention and intervention approaches: moving beyond traditional stress-management programs to interventions that address the functionality-risk disconnect, challenge "wine mom culture" narratives, provide competence-affirming health risk education, and offer harm reduction strategies. This work provides empirical groundwork for building nuanced conceptual frameworks that illuminate promising pathways for developing targeted theoretical models of women's alcohol use more generally. The distinctive patterns observed among military-connected spouses offer critical insights for gender-informed treatment models while highlighting broader implications for civilian women managing comparable high-stress multiple role demands.