Real-time impaired control over drinking: The role of contextual influences during naturally occurring drinking...

Impaired control over drinking is a central feature of Alcohol Use Disorder (AUD), yet little within-person research on impaired control is available. As a result, there is little research regarding the dynamic impact of social drinking context on impaired control. The current study sought to fill these gaps, testing a sequential mediation model wherein social drinking context predicted episode-specific deviations in perceived impaired control, which indirectly predicted daily negative consequences via drinking more than planned. We also modeled if estimated blood alcohol concentration (eBAC) moderated associations between social context and perceived impaired control.

Emerging adults (N = 131; 51.8 % female) completed 21 days of ecological momentary assessments, including assessments of past-night drinking and planned drinking on a given day, and event-contingent reports during acute drinking episodes.

At the episode-level, social drinking context predicted higher perceived impaired control than an individual's daily average. At the daily-level, social drinking context predicted higher perceived impaired control, which indirectly predicted more negative consequences than a person's average via drinking more than planned. There was a residual effect of social context on drinking more than planned and negative consequences, and of perceived impaired control on negative consequences above and beyond drinking more than planned. Episode-level relations between social context and perceived impaired control were potentiated at higher vs. lower eBACs than an individual's daily average, but the same pattern was not observed at the daily-level.

Just-in-time interventions may benefit from increasing perceptions of control over drinking behavior, particularly during social drinking episodes.