Associations between solitary drinking and increased alcohol consumption, alcohol problems, and drinking to cope motives in adolescents and young adults: a systematic review and meta-analysis

The impact of the COVID lockdown on alcohol consumption in the Netherlands. The role of living arrangements and social isolation

BACKGROUND

The COVID-19 pandemic and the subsequent lockdown have a strong impact on health and health behaviours, such as alcohol consumption. Although there is some evidence of an overall decline in alcohol consumption during the lockdown, studies also show an increase in risky drinking patterns, e.g. solitary drinking, and differences between subgroups of individuals, e.g. depending on their living arrangement. Yet most studies rely on cross-sectional designs with retrospective questions, and small samples.

METHODS

A longitudinal study was conducted using 13 waves of the COVID-Questionnaire within the Lifelines cohort from the northern Netherlands (n = 63,194). The outcome was alcohol consumption (glasses per week) between April 2020 and July 2021. Linear fixed-effects models were fitted to analyse trends in alcohol consumption, and these were compared with pre-COVID drinking levels. Moreover, the role of living arrangement and feelings of social isolation as potential moderators was tested.

RESULTS

Alcohol consumption during the pandemic was lower than in previous years, and the seasonal pattern differed from the pre-COVID one, with levels being lower when lockdown measures were stricter. Moreover, the seasonal pattern differed by living arrangement: those living alone saw a relative increase in drinking throughout tight lockdown periods, whereas those living with children showed the strongest increase during the summer. Social isolation showed a weaker moderation effect.

CONCLUSIONS

Overall alcohol levels were down in the pandemic, and in particular during strict lockdowns. Those living on their own and those who felt more isolated reacted more strongly to the lockdown, the longer it lasted.

How laboratory studies of cigarette craving can inform the experimental alcohol craving literature

Interest in alcohol and other drug craving has flourished over the past two decades, and evidence has accumulated showing that craving can be meaningfully linked to both drug use and relapse. Considerable human experimental alcohol craving research since 2000 has focused on craving as a clinical phenomenon. Self-reported craving to drink typically has served as a catch-all for the craving construct in these studies, whereas few studies have considered craving as a process (or hypothetical construct) that interacts with other phenomena to affect use. In contrast to alcohol, we believe that recently there has been more mechanistic work targeting cigarette craving-related processes. Here, we briefly present a narrative review of studies of acute alcohol craving in humans that have been conducted during the past two decades. We then specify important ways in which alcohol and tobacco differ (e.g., the role of withdrawal), and we note the unique challenges in inducing robust alcohol craving states in the laboratory. Finally, we offer recommendations for how the alcohol field might advance its conceptual understanding of craving by adopting ideas and methods drawn from the smoking research literature. Specifically, we suggest that researchers extend their studies to not only examine the link between alcohol craving and relapse but also to focus on why and, in some instances, how alcohol cravings matter clinically, and the circumstances under which craving especially matters. We propose research to investigate the shifts in alcohol-related cognitive and affective processing that occur during alcohol craving states. Furthermore, we highlight the value of research examining the level of insight that individuals with varying levels of alcohol involvement possess about their own craving-related processing shifts. We believe that laboratory studies can provide rich opportunities to examine conceptual questions about alcohol craving that are central to addiction.

Changes in drinking days among United States adults during the COVID-19 pandemic

AIMS

To examine changes in drinking behavior among United States (US) adults between March 10 and July 21, 2020, a critical period during the COVID-19 pandemic.

DESIGN

Longitudinal, internet-based panel survey.

SETTING

The Understanding America Study (UAS), a nationally representative panel of US adults age 18 or older.

PARTICIPANTS

A total of 4298 US adults who reported alcohol use.

MEASUREMENTS

Changes in number of reported drinking days from March 11, 2020 through July 21, 2020 in the overall sample and stratified by sex, age, race/ethnicity, household structure, poverty status, and census region.

FINDINGS

Compared with March 11, the number of drinking days per week was significantly higher on April 1 by an average of 0.36 days (95% CI = 0.30, 0.43), on May 1 by an average of 0.55 days (95% CI = 0.47, 0.63), on June 1 by an average of 0.41 days (95% CI = 0.33, 0.49), and on July 1 by an average of 0.39 days (95% CI = 0.31, 0.48). Males, White participants, and older adults reported sustained increases in drinking days, whereas female participants and individuals living under the federal poverty line had attenuated drinking days in the latter part of the study period.

CONCLUSIONS

Between March and mid-July 2020, adults in the United States reported increases in the number of drinking days, with sustained increases observed among males, White participants, and older adults.

Stay Home, Drink at Home? A Daily Diary Study on College Students' Alcohol and Social Media Use during the COVID-19 Pandemic

BACKGROUND

COVID-19 and measures to contain it may have impacted college students' behavior, including their drinking behavior. Students' drinking may have decreased-for example, due to the closure of bars-but problematic drinking may have increased-for example, due to (solitary) drinking at home. Another behavior that has increased due to COVID-19 and the accompanying social isolation is students' social networking site (SNS) use. This is worrisome because students' SNS use has been shown to increase their alcohol use. Nevertheless, little research has investigated these behaviors and the possible link between them during a lockdown. Therefore, this study aimed to examine (1) whether students engaged in drinking during a lockdown, (2) whether they displayed their drinking behavior on SNSs, and (3) whether exposure to and posting of alcohol-related content was linked to their daily alcohol use.

METHODS

337 college students (M_age = 20.63 years, SD_age = 1.55 years; 50.3% male) participated in a two-week daily diary study. Descriptive statistical analyses and generalized linear mixed modeling (GLMM) were deployed.

RESULTS

Descriptive analysis results showed that during the week, students' drinking occurred with friends in dormitories, while in the weekend, this behavior shifted to drinking with friends and parents at home. Moreover, students mostly saw visual and posted textual posts of this drinking on SNSs. Furthermore, GLMM revealed associations between exposure to alcohol postings, sharing of alcohol postings, and students' probability of drinking on the same day.

CONCLUSION

This study provides important insights into students' alcohol use and its underlying mechanisms during health crises.

Mobile assessment of decisions to drink in young adults: Examining the role of incentives and disincentives

BACKGROUND

Research on decision-making (DM) biases in persons with alcohol use disorder have largely relied on behavioral economic DM tasks, which do not assess the dynamic multitude of factors associated with real-world decisions about drinking. The current study extends the literature on DM and alcohol use by using a mobile daily diary approach to investigate whether, and how, real-world incentives and disincentives are associated with actual drinking decisions in college students.

METHODS

We assessed current drinking and lifetime alcohol problems in 104 young adults (61.5% female, 84.5% White) who, for 14 days, used a mobile daily diary to respond to questions about drinking decisions from the day prior. Mobile prompts assessed daily data on the timing of drinking decisions, alcohol quantity initially decided to drink, quantity actually decided to drink, and the incentives that influenced drinking decisions.

RESULTS

Users of the app reported high usability, high compliance rates were observed, and incentive responses were reduced to three subtypes: alcohol, social/party, and mood. Daily mobile measures of drinking quantity were strongly correlated with self-reported drinking 2 weeks prior to the daily assessment. Lifetime alcohol problems were positively related to the average quantity decided to drink per event, drinking more than initially decided, and higher levels of self-reported drinking-decision incentives. "Alcohol" and "social/party" incentives were positively related to the quantity the participant decided to drink at drinking events. Mood incentives and disincentives showed little to no significant relationships with drinking decisions.

CONCLUSIONS

The results suggest that mobile data collection can be useful for assessing aspects of real-world drinking decisions and the influence of multiple drinking decision incentives.

'Super googs on a Zoom, are you kidding me?': The pleasures and constraints of digitally-mediated alcohol and other drug consumption

INTRODUCTION

The COVID-19 pandemic and associated social restrictions have profoundly shaped the routines, practices and space-times of alcohol and other drug (AOD) consumption. As a part of these transformations, video conferencing services (e.g. Zoom, Whereby) have emerged as popular mediums for socialising and AOD consumption. In this article, we adopt a more-than-human theoretical framework to explore how these online contexts re-shape experiences of AOD consumption.

METHODS

Data were gathered using a case-study approach, guided by principles of digital ethnography. We 'staged' the online gatherings of three established friendship clusters of adults in Melbourne, Australia, and drew on a discussion guide to elicit accounts of past online AOD encounters during the COVID-19 pandemic. Our thematic analysis was sensitised to the dynamic composition of these encounters and the kinds of relations, practices and affects they enabled and constrained.

RESULTS

Composed via video conferencing services, AOD consumption afforded distinct pleasures, including enhanced sociality, excitement and momentary reprieves from isolation. Importantly, these effects were not uniform or stable. Participants also navigated various constraints of online AOD consumption while establishing for themselves what substances and associated practices 'fit' within these novel encounters.

DISCUSSION AND CONCLUSIONS

Our study conveys the importance of digitally-mediated AOD consumption as a site of socialising and pleasure. In so doing, it demonstrates the ways in which AOD consumption was drawn on in the everyday negotiation of health and wellbeing under lockdown conditions. We call for research and policy approaches that are sensitive to the affirmative potentials of digitally=mediated AOD encounters.

Young adult simultaneous alcohol and marijuana use: Between- and within-person associations with negative alcohol-related consequences, mental health, and general health across two-years

BACKGROUND

Simultaneous alcohol and marijuana use (SAM) may be linked to both short- and longer-term problems for young adults. Across two years of longitudinal data, we examined between- and monthly within-person associations of alcohol and marijuana use patterns, including SAM, with negative alcohol-related consequences, depressive symptoms, and general health.

METHODS

773 young adults (aged 18-23 at screening; 56% women) who used alcohol in the year prior to study enrollment were surveyed monthly for 24 months. Multilevel models assessed associations of alcohol and marijuana use patterns with outcomes.

RESULTS

Individuals who reported a higher proportion of SAM months had more negative alcohol-related consequences (Rate Ratio [RR] = 1.49, 95% CI: 1.17,1.89). At the within-person level, participants experienced more alcohol-related consequences on months when SAM was reported compared to months of alcohol-only (RR = 1.17, 95% CI: 1.10,1.25) and months of concurrent alcohol and marijuana use without simultaneous use (CAM; RR = 1.20, 95% CI: 1.11,1.29). Compared to alcohol-only, SAM was associated with more depressive symptoms and poorer general health at the between-person level and with more depressive symptoms at the monthly within-person level; however, SAM did not differ substantially from using neither alcohol nor marijuana or CAM for these outcomes at either the between- or within-person level.

CONCLUSIONS

SAM use may indicate risk for negative alcohol-related consequences, both within months of SAM use and across more extended time periods. Individuals who engage in SAM may experience worse mental and physical health than individuals who use alcohol exclusively.

Correlates of solitary alcohol and cannabis use among American Indian adolescents

BACKGROUND

Solitary substance use, or using substances while alone, is common among adolescents but understudied. This is the first study to examine solitary substance use among American Indian (AI) adolescents. The objective was to examine correlates of solitary alcohol use and solitary cannabis use that occur within the individual, family, school, peer, and cultural domains of the social ecology.

METHOD

Data were from the 2009-2013 Drug Use Among Young American Indians Study, a cross-sectional cohort study. Two sets of hierarchical logistic regressions were conducted to examine solitary alcohol use (getting drunk) among lifetime alcohol users (n = 2082; Mage = 15.12 years; SD = 1.68; 54.2% female) and solitary cannabis use among lifetime cannabis users (n = 2085; Mage = 14.99 years; SD = 1.69; 50.5% female), including adjustment for level of substance involvement.

RESULTS

Prevalence of solitary alcohol use among lifetime drinkers was 24.9%. Among lifetime cannabis users, 53.6% reported solitary cannabis use. Regression analyses for solitary alcohol use showed statistically significant positive associations with coping motive, descriptive norms, violent behavior, depression, peer models for use, and (unexpectedly) peer sanctions against use and a negative association with family sanctions against use. Regression analyses for solitary cannabis use showed statistically significant positive associations with coping motive, violent behavior, and peer models for use and a negative association with family sanctions against use.

CONCLUSIONS

Solitary alcohol and cannabis use are prevalent among AI adolescents and might, in particular, reflect attempts to cope with adversity. Findings could help guide the development of screening and prevention efforts.

Adolescents' Alcohol Use: Does the Type of Leisure Activity Matter? A Cross-National Study

The main objective of this study was to analyze the relationship between structured, unstructured, and family leisure activities on the frequency of adolescent alcohol intake across three different countries (Spain, Peru, and The Netherlands). The self-control of adolescents was also investigated as a moderator in the relationship between leisure activities and alcohol consumption.

METHODOLOGY

This research involved 4608 adolescents aged between 12 and 17 from three countries (Spain, Peru, and The Netherlands). In Spain and Peru, data was collected through a self-report questionnaire which was part of the Your Life project. In The Netherlands, a self-questionnaire was used, collected by the University of Utrecht. A multiple logistic regression was performed for each country.

RESULTS

The results showed that participation in unstructured leisure activities increased the likelihood of drinking more frequently and more heavily in all three countries. Structured leisure activities, in general, did not have a significant predictive effect on alcohol consumption in any of the countries. Family leisure activities reduced the risk of engaging in yearly alcohol use and yearly binge drinking among adolescents, especially in The Netherlands and Spain. The protective effect of family leisure and unstructured leisure risk on yearly alcohol use applied especially to Dutch adolescents with a low level of self-control.

DISCUSSION

The article emphasizes the need for parents to engage in leisure activities with their child; participation in unstructured activities is not to be encouraged.

Associations between Mental Health, Alcohol Consumption and Drinking Motives during COVID-19 Second Lockdown in Ireland

Aims

The novel coronavirus pandemic (COVID-19) has impacted the lives of people worldwide since March 2020. Social restrictions aimed at flattening the curve may be associated with an increase in mental health problems and have raised concerns regarding their effect on alcohol consumption. The objective of this study was to characterize changes in alcohol use during lockdown in Ireland and associations with drinking motives and psychopathological symptoms.

Methods

We collected data from 713 adults (aged 18–60) during the second lockdown period (October/December 2020). By means of an online survey, participants self-reported their alcohol use before COVID and during lockdown. Motives to drink and psychopathological symptoms were also recorded.

Results

Our findings showed that 66% decreased their alcohol consumption, while 15% increased their alcohol consumption. An older age and coping motives were the strongest predictors of increased alcohol use during lockdown. Depression and hostility were the specific psychopathological dimensions associated with drinking to cope.

Conclusions

Older adults who drink to cope—mainly with depression symptomatology—are an important at-risk population, in line with predictions from alcohol self-medication frameworks. Future research is needed to incorporate strategies into the public mental health ecosystem.

A systematic review and meta-analysis on the association between solitary drinking and alcohol problems in adults

BACKGROUND AND AIMS

Solitary drinking in adolescents and young adults is associated with greater risk for alcohol problems, but it is unclear whether this association exists in older demographics. The current paper is the first meta-analysis and systematic review, to our knowledge, to determine whether adult solitary drinking is associated with greater risk for alcohol problems.

METHODS

PsychINFO, PubMed and Google Scholar were searched following a pre-registered International Prospective Register of Systematic Reviews (PROSPERO) protocol (CRD42019147075) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. Following the methodology used in our recent systematic review and meta-analysis on adolescent/young adult solitary drinking, we systematically reviewed solitary drinking measures/definitions, prevalence rates and associated demographic variables in adults. We then meta-analyzed (using random-effects models) associations between adult solitary drinking and alcohol use/problems, negative affect and negative/positive reinforcement-related variables (e.g. drinking to cope or for enhancement).

RESULTS

Solitary drinking was defined as drinking while physically alone in nearly all studies, but measures varied. Prevalence rates were generally in the 30-40% range, with some exceptions. In general, males were more likely than females to report drinking alone, and married individuals were less likely than unmarried individuals to report drinking alone; racial/ethnic differences were mixed. Meta-analytical results showed significant effects for the associations between solitary drinking and the following factors: alcohol consumption, r = 0.25, 95% confidence interval (CI) = 0.18, 0.33, k = 15, I²  = 97.41; drinking problems, r = 0.15, 95% CI = 0.10, 0.21, k = 14, I²  = 92.70; and negative reinforcement, r = 0.24, 95% CI = 0.14, 0.32, k = 11, I²  = 89.77; but not positive reinforcement, r = 0.02, 95% CI = 0.06, 0.09, k = 8, I²  = 76.18; or negative affect, r = 0.03, 95% CI = -0.02, 0.08, k = 8, I²  = 52.06. Study quality moderated the association between solitary drinking and negative affect (β = -0.07, P < 0.01) such that lower-quality studies were significantly associated with larger effect sizes. Study quality was generally low; the majority of studies were cross-sectional.

CONCLUSIONS

Solitary drinking appears to have a small positive association with alcohol problems.

Longitudinal associations with alcohol consumption during the first COVID-19 lockdown: Associations with mood, drinking motives, context of drinking, and mental health

BACKGROUND

Coronavirus (COVID-19) resulted in lockdown measures in the UK, which has impacted alcohol use. Alcohol is often used as a coping mechanism and there are public health concerns regarding excessive consumption due to the pandemic. We aimed to longitudinally assess drinking behaviors, and associated factors, during the first UK government-mandated lockdown.

METHODS

An online survey was distributed through social media (8^th April 2020, onwards). Fortnightly follow up surveys were emailed to participants. The primary outcome measure was 'weekly unit consumption' and data was collected on a range of potentially related factors: demographics, factors relating to COVID-19 (e.g., health, work status), drinking motives, context of drinking, drinking intentions, mood, depression and anxiety.

FINDINGS

A total of 539 self-selected participants completed the baseline survey, with 186 completing at least 3 follow up surveys for multilevel modelling analysis. Personal coping motives, anxiety, drinking at home alone, and drinking at home with others were positively associated with alcohol consumption during lockdown. The following baseline measures also predicted increased consumption: male gender, lower education, and higher AUDIT scores (based on behavior prior to lockdown). Findings were consistent when utilizing an inverse probability weight to account for predictors of attrition (female, younger age, higher baseline AUDIT scores).

CONCLUSIONS

Those already drinking at hazardous levels were more likely to increase their consumption, as were those who were drinking to cope. As we recover from the pandemic, there is a need for widespread alcohol support, and certain groups may need targeted support.

Drink (socially) and be merry: Predicting enjoyment and self-perceptions from alcohol consumption among college students

Although many college students view drinking as a means of gaining a community and being social, research has not established whether alcohol consumption influences students' enjoyment and perceptions of how others view them or how this may differ based on the social or solitary nature of that consumption. The current study used online daily diary methods to examine the association between alcohol consumption and enjoyment and self-perceptions at the within- and between-person levels of analysis. Results indicated that undergraduate students (N=877; 52% female) enjoyed their evenings more when they consumed more than their typical number of drinks with others, but enjoyed evenings less when they consumed more than their typical number of drinks alone. In addition, consuming greater than their average number of drinks with others (but not alone) was related to feeling more social and attractive but less competent. These findings further highlight the distinct nature of social and solitary drinking and demonstrate positive outcomes of social alcohol consumption that may contribute to college alcohol consumption.

Reciprocal longitudinal associations between anxiety sensitivity and alcohol consumption/problems across adolescence: Examining anxiety as a mediator and race/ethnicity as a moderator

The conditions and populations for which anxiety sensitivity (AS; i.e., the tendency to interpret unpleasant physiological sensations as dangerous) relates to adolescent alcohol use is unclear. This study tested latent-variable cross-lagged panel modeling of AS-alcohol relations in a racially/ethnically heterogenous longitudinal youth cohort (N = 3396; 53.4% female, 45.8% Latinx) assessed annually across high school. Anxiety and race/ethnicity were tested as mediators and moderators, respectively, of AS-alcohol associations. AS prospectively predicted alcohol problems (β's = 0.05-0.07) but not alcohol consumption (β's = 0.02-0.04) across high school. Alcohol problems predicted AS at the end (β = 0.09) but not beginning (β's = 0.01-0.03) of high school and alcohol consumption predicted lower AS at the beginning (β = -0.06) but not end (β's = -0.02-0.01) of high school. Anxiety mediated AS's predictive effects on alcohol problems (βindirect's = 0.01, 95% CI [0.003, 0.03]) across high school. Race/ethnicity did not moderate interrelations of AS, anxiety, and alcohol outcomes. These findings lend support to the risk factor model of AS on alcohol problems (but not consumption) through anxiety and the scar/complication model whereby alcohol problems may exacerbate AS later in adolescence. Addressing reciprocal risk processes between AS, anxiety, and alcohol problems warrant consideration in adolescent behavioral health promotion for various racial/ethnic populations.

Changes in Young Adults' Alcohol and Marijuana Use, Norms, and Motives From Before to During the COVID-19 Pandemic

PURPOSE

Alongside the SARS-CoV-2 virus, the COVID-19 pandemic is associated with several secondary health effects. There is concern for increased substance use motivated by coping with stress, anxiety, depression, and boredom-all of which may be elevated during the pandemic. The current study examined intraindividual changes (from pre-COVID to during COVID) in young adults' alcohol and marijuana use, perceptions of peers' use (i.e., norms), and motives for use.

METHODS

A community sample of young adults (N = 572; Mage= 25.14; 60.8% women) was recruited in Washington State. By using a repeated-measures design, data were collected prior to the COVID-19 pandemic (January 2020) and again during the initial acute phase of the pandemic (April/May of 2020).

RESULTS

Young adults, on average, increased alcohol use frequency but decreased the amount consumed per drinking occasion. No changes in marijuana use were identified. Young adults (on average) perceived that peers had increased the frequency and total amount of alcohol use and perceived that peers were engaging in heavier marijuana use than prior to COVID-19. For alcohol use motives, there was a significant increase in depression coping motives and significant decreases in social, enhancement, and conformity motives. Boredom motives for marijuana use significantly increased, while celebration motives decreased.

CONCLUSIONS

Using a prospective design with a sample initially recruited in Washington State, these data indicate that (a) young adults' patterns of alcohol use may have changed, (b) young adults tend to think that peers are engaging in heavier alcohol/marijuana use than before the pandemic, and (c) motives for using alcohol/marijuana may have changed during the pandemic.

Changes in Alcohol Use and Drinking Context due to the COVID-19 Pandemic: A Multimethod Study of College Student Drinkers

Background

In spring 2020, U.S. universities closed campuses to limit the transmission of COVID‐19, resulting in an abrupt change in residence, reductions in social interaction, and in many cases, movement away from a heavy drinking culture. The present mixed‐methods study explores COVID‐19‐related changes in college student drinking. We characterize concomitant changes in social and location drinking contexts and describe reasons attributed to changes in drinking.

Methods

We conducted two studies of the impact of the COVID‐19 pandemic on drinking behavior, drinking context, and reasons for both increases and decreases in consumption among college students. Study 1 (qualitative) included 18 heavy‐drinking college students (M_age = 20.2; 56% female) who completed semi‐structured interviews. Study 2 (quantitative) included 312 current and former college students who reported use of alcohol and cannabis (M_age = 21.3; 62% female) and who completed an online survey.

Results

In both studies, COVID‐19‐related increases in drinking frequency were accompanied by decreases in quantity, heavy drinking, and drunkenness. Yet, in Study 2, although heavier drinkers reduced their drinking, among non‐heavy drinkers several indices of consumption increased or remained stable . Both studies also provided evidence of reductions in social drinking with friends and roommates and at parties and increased drinking with family. Participants confirmed that their drinking decreased due to reduced social opportunities and/or settings, limited access to alcohol, and reasons related to health and self‐discipline. Increases were attributed to greater opportunity (more time) and boredom and to a lesser extent, lower perceived risk of harm and to cope with distress.

Conclusion

This study documents COVID‐19‐related changes in drinking among college student drinkers that were attributable to changes in context, particularly a shift away from heavy drinking with peers to lighter drinking with family. Given the continued threat of COVID‐19, it is imperative for researchers, administrators, and parents to understand these trends as they may have lasting effects on college student drinking behaviors.

Social facilitation of alcohol subjective effects in adolescents: Associations with subsequent alcohol use

RATIONALE

Laboratory research in adults indicates that alcohol-related subjective effects are enhanced under some social conditions. However, it is unknown whether this "social facilitation" of alcohol effects occurs in adolescents and is associated with alcohol use in the natural ecology.

OBJECTIVES

We examined associations of social facilitation of alcohol-related subjective effects with subsequent alcohol use among a relatively high-risk group of adolescents who reported drinking alcohol both with friends and alone.

METHODS

Los Angeles high school students from a prospective study (N = 142; 51% female; 10th graders) completed a baseline survey that assessed alcohol-related "positive" and "negative" subjective effects in two contexts: social (alcohol with friends) and solitary (alcohol alone); social facilitation was calculated as the difference between social and solitary. Students then completed five semi-annual surveys spanning 30 months (2014-2017) assessing 30-day alcohol use (days used, number of drinks, binge drinking).

RESULTS

Greater social facilitation of positive effects was significantly associated with greater number of alcohol use days (RR [95% CI] = 1.48 [1.19, 1.82]; p < .001), greater number of drinks (RR [95% CI] = 1.38 [1.14, 1.66]; p = .001), and greater odds of binge drinking (OR [95% CI] = 1.75 [1.20, 2.57]; p = .004). Similar associations were found with social positive effects. There were no significant associations between solitary positive effects-or any negative effects-and alcohol use outcomes.

CONCLUSIONS

Social facilitation can be measured outside of the laboratory. Relatively high-risk drinking adolescents who are more susceptible to the social facilitation of subjective alcohol effects are more likely to use more alcohol and binge drink.

The influence of negative mood on solitary drinking preference: An experiment with young adult solitary drinkers

Solitary drinking is a risk marker for alcohol use disorder; thus, it is important to identify why individuals drink alone and for whom this association is particularly relevant. Evidence suggests the desire to ameliorate negative affect (NA) motivates solitary drinking, with some individuals particularly likely to drink alone to cope, but all past studies are cross-sectional. The present study therefore aimed to determine whether 1) experimentally induced NA increased preferences to drink alcohol alone, and 2) whether the relationship between NA and choosing to drink alcohol alone was moderated by neuroticism, drinking to cope motives, and social anxiety. Current drinkers (ages 21-29) with a solitary drinking history (N=126) were randomly assigned to either NA, positive affect [PA], or no affect change (control) conditions via differing cognitive task feedback. After the mood manipulation, participants chose between drinking alcoholic or nonalcoholic beverages in one of two contexts: alone or socially. Evidence regarding effectiveness of the mood manipulation was mixed, and few chose non-alcoholic beverages in either context. Condition did not influence outcome choice. Across conditions, increases in NA and the importance placed on receiving one's context choice were associated with solitary (versus social) alcohol preference. Neuroticism and its interaction with NA change also influenced choice; individuals high in neuroticism chose more solitary (versus social) drinking contexts while the opposite was true for those low in neuroticism, and among the latter, the preference difference was more pronounced with relatively smaller NA increases. Findings are discussed based on the existing solitary drinking literature.

Drinking Together and Drinking Alone: A Social-Contextual Framework for Examining Risk for Alcohol Use Disorder

The context in which drinking occurs is a critical but relatively understudied factor in alcohol use disorder (AUD) etiology. In this article, I offer a social-contextual framework for examining AUD risk by reviewing studies on the unique antecedents and deleterious consequences of social versus solitary alcohol use in adolescents and young adults. Specifically, I provide evidence of distinct emotion regulatory functions across settings, with social drinking linked to enhancing positive emotions and social experiences and solitary drinking linked to coping with negative emotions. I end by considering the conceptual, methodological, and clinical implications of this social-contextual account of AUD risk.

Antecedents, concurrent correlates, and potential consequences of young adult solitary alcohol use

OBJECTIVE

Research on young adults has found solitary alcohol use to be positively associated with negative emotions, coping motives for drinking, and negative alcohol-related consequences, but most research has been cross-sectional and based on samples of college students. We examined associations across multiple time points within a sample that was diverse with respect to educational status and age.

METHODS

A community sample (N = 754, ages 18-26; 56% female) completed surveys at baseline, monthly for 2 years, and at 30-month postbaseline. Multilevel and single-level regression models assessed longitudinal and concurrent associations between solitary drinking and potential correlates, adjusting for frequency of alcohol use.

RESULTS

Moderate depressive symptoms at baseline were associated with a greater likelihood of solitary drinking in drinking months in the subsequent 2 years (Adjusted Odds Ratio [AOR] = 2.22, 95% CI [1.54-3.20]). During those 2 years, both depressive symptoms and coping motives were positively concurrently associated with solitary drinking at the between- and within-person level. Although solitary drinking in a particular month had a small and nonsignificant association with negative alcohol-related consequences, the proportion of drinking months that involved solitary drinking was positively associated with negative alcohol-related consequences across months. More solitary drinking during monthly data collection was associated with greater likelihoods of hazardous drinking and moderate depressive symptoms at 30-month follow-up, but these associations were not statistically significant after adjusting for earlier measures of drinking and depressive symptoms.

CONCLUSIONS

The findings point to the importance of considering the drinking context when screening and providing treatment for alcohol misuse. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Solitary and Social Drinking in South Korea: An Exploratory Study

Objectives

This study aimed to identify differences in drinking norms, heavy drinking, and motives between types of drinkers (abstainers, solitary, and social drinkers) in a representative sample of Korean adults.

Methods

An online survey of people registered on the electoral roll were randomly invited to be part of the “National Korean Drinking Culture Study” conducted in 2018 (n = 3,015). Participants included 1,532 men and 1,469 women aged 19–60 years. Questions included the number of times they drank in the last month, what they drank, and the volume drank. The amount of pure alcohol consumed was calculated. Drinking norms, motives, and types were determined in the survey questions.

Results

Solitary drinkers were more likely to be divorced or separated, less educated, and marginally employed. Solitary drinking peaked in those in their 30s (18.5%) and social drinkers in their 50s (68.1%). Solitary drinkers drank more frequently compared with social drinkers (6.1 vs. 3.6 times per month, p < 0.001), and consumed a significantly larger quantity of alcohol (69.5 g vs. 46.8 g per week). Solitary drinkers were more accepting of drinking-related behaviors in diverse situations compared with social drinkers. The regression analysis revealed that personal drinking motives were the most important factor influencing the frequency and quantity of alcohol consumption in both solitary and social drinking.

Conclusion

Solitary drinkers may be more vulnerable to alcohol abuse than social drinkers.

Psychiatric Comorbidity and Stress in Medical Students Using Neuroenhancers

Background: Pharmacological neuroenhancement (PN) is a common healthcare problem at least among students. PN seems to be associated with stressful situations. There is a lack of data about personal characteristics, comorbidities, and coping strategies regarding stress and factors of resilience in students and medical staff. Methods: A web-based survey about the non-medical use of PN drugs with a focus on neuroenhancement was developed and distributed among medical students throughout Germany; the questionnaire was open in April and May of 2020. The survey contained questions about the use of well-known PN drugs, frequency, special purposes, reasons for the use, psychiatric disorders, use of psychotropic drugs apart from PN purposes, and factors of resilience using the brief resilience scale. Results: Data of 1,159 students of medicine were analyzed. The most frequently used substances for PN were coffee (78.8% lifetime prevalence rate), energy drinks (45.7%), caffeine tablets (24.3%), methylphenidate (5.2%), illicit amphetamines (2.0%), and cocaine (1.7%). 98.4% suspected that PN drug use could lead to addiction. PN drug use specifically for PN was significantly associated with the use of (a) any psychotropic drug (other than neuroenhancers), (b) any psychiatric disorder, and (c) higher values of feeling pressure to perform in professional/students' life and in private life as well as (d) the subjective feeling of pressure to perform to be burdening and (e) harmful to one's own health. PN drug use in general was significantly associated with being less resilient. The use of illicit PN drugs, over the counter drugs and prescription drugs was associated with being less resilient. Conclusion: This study indicates that PN with legal and illegal drugs is a widespread phenomenon among German medical students. Users seem to be more often burdened by psychiatric disorders, especially addictive disorders, the perception of stress, pressure to perform and low levels of resilience. These aspects should be considered in further investigation of PN drug use.

Problematic Use of Alcohol and Online Gaming as Coping Strategies During the COVID-19 Pandemic: A Mini Review

The COVID-19 (coronavirus disease 2019) pandemic has dramatically changed our daily lives and activities, including those originally intended to serve for leisure and pleasure. Drinking and online gaming became coping behaviors used to rescue ourselves from the stress and restricted lifestyle during the COVID-19 pandemic. However, frequent drinking and gaming can result in the pathological consequences of addiction. Those affected use the stimuli not to obtain pleasure, but rather to avoid the displeasure induced by stress and previous use, often unsuccessfully. This review aims to provide an overview of recent longitudinal cohort studies on alcohol and gaming use during the COVID-19 pandemic, as well as to analyze how the pandemic has affected alcohol and gaming use. There was a substantial risk of alcohol and online gaming overuse during the lockdown, which may depend on the pandemic's duration or overuse patterns. Previous studies have shown that increased alcohol consumption and online gaming are associated with heightened stress and anxiety levels caused by social isolation/quarantine. Over time, frequent or excessive alcohol consumption and gaming could lead to an increased risk of more serious mental health problems. Every effort should be made to mitigate mental health problems and ensure adequate adaptation to these exceptional circumstances. Therefore, it would be helpful to encourage physical activity, social interaction, and collaboration to facilitate psychological and physical health.

Insights Into Adolescents' Substance Use in a Low-Middle-Income Country During the COVID-19 Pandemic

Introduction: The COVID-19 pandemic and its lockdown have been a significant life event for many individuals, particularly adolescents. The immense psychological pressure could drive risky behavior, e.g., substance use, while lockdown might lead to decreased use. This study aimed to observe the change in substance use among adolescents in Indonesia and the moderating variables to consumption during the COVID-19 lockdown period. Methods: This study utilized an online survey from April 28, 2020 to June 30, 2020. The hyperlink was disseminated to school administrators and parenting groups through social media and direct messages. A total of 2,932 adolescents (17.4 ± 2.24 and 78.7% females) submitted valid responses. The survey was comprised of a sociodemographic section, substance use details, and psychometric sections, including the Alcohol Use Disorders Identification Test (AUDIT), Cigarette Dependence Scale 12 (CDS-12), Pittsburgh Sleep Quality Index (PSQI), and Strength and Difficulties Questionnaire (SDQ). Results: Overall, adolescent alcohol use during the pandemic was 5.1%, cigarette smoking was 3.1%, and drug consumption was 0.4%. Over half (53.4%) of alcohol drinkers reported increased drinking, and 33.1% had harmful or dependence-like drinking behavior; in contrast, 44.4% of adolescent smokers disclosed reduced cigarette consumption. Around 37.8% of the drug users indicated increased use. During the pandemic, adolescent alcohol use was associated with higher education [adjusted odds ratio (AOR) = 2.67, 95% confidence interval (CI) 1.02-4.86, p = 0.04], higher AUDIT scores (AOR = 1.33, 95% CI 1.25-1.42, p < 0.001), and very low prosocial behavior (AOR = 2.46, 95% CI 1.52-3.88, p < 0.001). Cigarette smoking was correlated with male sex (AOR = 9.56, 95% CI 5.64-16.62, p < 0.001), age (AOR = 1.40, 95% CI 1.14-1.75, p < 0.001), and higher CDS score (AOR = 1.17, 95% CI 1.13-1.20, p < 0.001). Conclusions: Rates of adolescent substance use were significant, with sizeable proportions reporting higher usage. This appeared to occur predominantly in specific demographics and those with a lower protective psychosocial attribute, i.e., prosocial behavior, during the lockdown. These findings should urge the strengthening of adolescent addiction care during and after the pandemic.

Affect and alcohol: The moderating role of episode-specific drinking motives

Findings regarding the moderating influence of drinking motives on the association between affect and alcohol consumption have been inconsistent. The current study extended previous work on this topic by examining episode-specific coping, enhancement, conformity, and social drinking motives as moderators of the association between daytime experiences of positive and negative affect and evening social and solitary alcohol consumption. Nine hundred and six participants completed daily diary surveys measuring their daily affect and evening drinking behavior each day for 30 days during college and again 5 years later, after they had left the college environment. Results of multilevel modeling analyses suggest that the associations between affect, drinking motives, and alcohol consumption are not straightforward. Specifically, whereas daytime positive affect and non-coping drinking motives predicted greater social consumption, daytime positive affect was related to lower solitary alcohol consumption among college students who were low in state social drinking motives. In addition, coping motives were related to greater social consumption during college and greater solitary alcohol consumption after college. Future research should continue to examine these episode-specific drinking motives in addition to trait-level drinking motives.

Drinking to Cope During COVID-19 Pandemic: The Role of External and Internal Factors in Coping Motive Pathways to Alcohol Use, Solitary Drinking, and Alcohol Problems

BACKGROUND

The COVID-19 pandemic has resulted in massive disruptions to society, to the economy, and to daily life. Some people may turn to alcohol to cope with stress during the pandemic, which may put them at risk for heavy drinking and alcohol-related harms. Research is needed to identify factors that are relevant for coping-motivated drinking during these extraordinary circumstances to inform interventions. This study provides an empirical examination of coping motive pathways to alcohol problems during the early stages of the COVID-19 pandemic.

METHODS

Participants (N = 320; 54.7% male; mean age of 32 years) were Canadian adult drinkers who completed an online survey assessing work- and home-related factors, psychological factors, and alcohol-related outcomes over the past 30 days, covering a time period beginning within 1 month of the initiation of the COVID-19 emergency response.

RESULTS

The results of a theory-informed path model showed that having at least 1 child under the age of 18, greater depression, and lower social connectedness each predicted unique variance in past 30-day coping motives, which in turn predicted increased past 30-day alcohol use (controlling for pre-COVID-19 alcohol use reported retrospectively). Income loss was associated with increased alcohol use, and living alone was associated with increased solitary drinking (controlling for pre-COVID-19 levels), but these associations were not mediated by coping motives. Increased alcohol use, increased solitary drinking, and greater coping motives for drinking were all independently associated with past 30-day alcohol problems, and indirect paths to alcohol problems from having children at home, depression, social connectedness, income loss, and living alone were all supported.

CONCLUSIONS

Findings provide insight into coping-motivated drinking early in the COVID-19 pandemic and highlight the need for longitudinal research to establish longer term outcomes of drinking to cope during the pandemic.

COVID-19 Related Distress Is Associated With Alcohol Problems, Social Media and Food Addiction Symptoms: Insights From the Italian Experience During the Lockdown

Background: Several scholars hypothesize that one of the most negative impacts of the coronavirus disease 2019 (COVID-19) crisis would concern the increase of prevalence and severity of both substances and behavioral addiction. Despite the general concerns about the increase of prevalence and severity of addictions related to the COVID-19 emergency, few data are still available. Thus, the main aim of this study was to investigate the association between COVID-19 related distress and: (i) alcohol problems, (ii) social media addiction (SMA) symptoms, (iii) food addiction (FA) symptoms. Methods: A national online-survey was carried out during the Italian lockdown (i.e., 9 March 2020-4 May 2020). In the current study, 1,519 participants (365 men and 1,154 women, mean age: 28.49 ± 10.89 years) were included. The survey included socio-demographic related items (e.g., age, sex, residential regions, education level, civil status, tobacco use, etc.), as well as ad-hoc developed questions aimed to investigate COVID-19 related variables (e.g., isolation/quarantine, personal diagnosis to COVID-19, friends or relatives with COVID-19 diagnosis, etc.). Participants also completed the following self-report measures in order to investigate: the psychological impact of COVID-19, alcohol problems, SMA symptoms, FA symptoms, and impulsivity. Results: The psychological impact of COVID-19 was independently associated with alcohol problems (β = 0.058, p = 0.043), SMA symptoms (β = 0.259, p < 0.001), and FA symptoms (β = 0.150, p < 0.001). Conclusion: Taken together, our results seem to confirm the general concerns about the negative impacts of the COVID-19 emergency on addictive behaviors, suggesting that this issue should be carefully monitored.