Background: Loneliness is a predisposing and maintaining factor of alcohol use behavior. Several studies have linked loneliness to daily drinking and elevated alcohol use disorder (AUD) risk; however, operationalizations of both loneliness and drinking have varied greatly.
Methods: The current study adopted a multidimensional framework of loneliness (i.e., emotional and social subtypes) to examine daily prospective relations between loneliness and drinking among non-treatment seeking individuals with AUD. Participants (N= 60) reported on current loneliness and drinking twice daily for 14-days. Scores on emotional and social loneliness were disaggregated into within- and between-person predictors, and a multilevel hurdle model proxy was fitted with drinking likelihood (logistic) and quantity (zero truncated negative binomial) specified as separate outcomes.
Results: Emotional loneliness (within-person) was associated with increased drinking likelihood (OR=1.05, 95 % BCI [1.01, 1.10]) and quantity (IRR=1.05, 95 % BCI [1.02, 1.09]), while social loneliness (within-person) was associated with decreases in both drinking likelihood (OR=.94, 95 % BCI [.89,.99]) and quantity (IRR=.96, 95 % BCI [.93,.99]). Between-person loneliness scores were unrelated to both outcomes.
Conclusions: These discrepant findings by loneliness subtype may be ascribed to differences in subjective manifestations, in that emotional loneliness is a more severe form of loneliness that overlaps significantly with other negative affective states and promotes a coping response, while social loneliness may be readily alleviated by adaptive behavioral strategies for some, and social withdrawal for others. These findings offer insight into the nuances of loneliness-drinking relations and their clinical implications.
Keywords: Alcohol use disorder; Drinking; Ecological momentary assessment; Emotional loneliness; Multilevel modeling; Social loneliness.
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