Adolescent and young adult drinking continues to be a widespread concern among clinicians and researchers in fields related to public health, social work, pediatrics, substance use treatment, and psychiatric medicine. Harmful use of alcohol directly causes numerous physical and mental health problems, in addition to being associated with an evolving list of short-term and long-term consequences related to almost any facet of an individual’s well-being. Many risk factors for alcohol use disorder have been identified including genetic predispositions, family histories, and cultural beliefs/norms. This review article aims to compare consequences and outcomes of alcohol use between social and solitary contexts, with emphasis being placed on emotional regulation differences.
Creswell begins by providing a general contrast of emotional profiles of social and solitary drinkers, noting relatively positive emotional and social characteristics of social drinkers and opposingly negative emotional and social characteristics in solitary drinkers. Continuing, Creswell describes alcohol related problems and consequences in social and solitary contexts. Increased consumption in either context is associated with greater problems and poorer outcomes, but differences do exist in these consequences. Social drinking is often motivated by social facilitation, with larger social groups consuming more alcohol, and is linked with elevated rates of intoxicated driving and interpersonal traumas like sexual assault, dating violence, etc. Participation in solitary drinking was found to result in overall greater alcohol consumption than that of social-only drinkers (due to an additive effect) as well as predicting increased alcohol problems over time.
Next, Creswell provides a more in-depth examination of the risk-reward mechanisms present in social and solitary drinking. Social drinkers who report greater measures of extraversion tend to experience greater social and emotional rewards resulting from alcohol consumption, despite the increasing risk for alcohol related problems as these mechanisms are endorsed and reinforced. The primary mechanism behind solitary drinking was found to be coping in negative emotional states, with little, if any, suggestion of positive enhancement motives. Creswell ends by pointing to demands of research in the field which should target middle-aged and older adults, citing the disproportionate amount of literature existing only using young-adult populations in samples. Studies examining the associations and causes of alcohol-related problems in both social and solitary drinkers are also needed to further develop the proposed framework.
Takeaway: trends in research point towards contrasts in social and solitary drinking behaviors which should be taken into context in the development of individual treatment interventions.