Heavy Episodic Drinking (HED) is a prevalent issue on college campuses, and it is considered a serious public health concern, particularly as students with high social anxiety tend to consume greater quantities of alcohol. Previous research indicates that alcohol weakens regulatory functions and conscious control processes, thereby allowing implicit cognitive processes to exert greater influence on behavior, while also impairing initial appraisal by weakening connections between new and existing information. In this context, existing studies have primarily investigated the relationship between social anxiety and alcohol consumption through explicit measurements; however, research examining the impact of appraisal disruption on implicit drinking identity and implicit self-esteem among individuals with varying levels of social anxiety remains notably insufficient. Therefore, this study aims to investigate how the timing of alcohol consumption affects implicit drinking identity and self-esteem according to levels of social anxiety.
The study was conducted with 51 undergraduate heavy episodic drinkers who were first stratified into high social anxiety (n = 17) and low social anxiety (n = 34) groups and then randomly assigned to one of two sequence conditions—alcohol before vs. after a social anxiety induction. After baseline assessments of drinking patterns, social anxiety, and alcohol-related problems, Implicit Association Tasks measured implicit drinking identity and self-esteem. Alcohol dosing targeted a 0.08% BAC. Repeated-measures ANOVAs analyzed condition × time interactions, with additional analyses examining how trait social anxiety moderated the relationship between drinking sequence and changes in implicit cognition.
Results revealed that mean BAC at the 20-minute absorption check was 0.05% across both conditions, and baseline state craving was included as a covariate in all analyses. Although 2 (Time) × 2 (Condition) repeated-measures ANOVAs revealed no significant Time × Condition interactions for either implicit self-esteem or implicit drinking identity, a significant Trait Social Anxiety × Condition interaction emerged for changes in implicit drinking identity. Specifically, only in the Alcohol → Stress condition did participants high in trait social anxiety exhibit greater increases in implicit drinking identity, whereas implicit self-esteem remained unchanged across conditions and anxiety levels. These findings underscore that the role of appraisal disruption on implicit drinking identity among college students with high social anxiety who endorse heavy episodic drinking, such that appraisal disruption is associated with greater increases in implicit drinking identity among students with high social anxiety.
Takeaway: For socially anxious college students with heavy episodic drinking patterns, consuming alcohol before encountering social stressors significantly increases implicit drinking identity—suggesting that the timing of alcohol consumption plays a critical role in reinforcing alcohol-related self-concepts that may perpetuate problematic drinking behaviors.