Contextual Moderators of the Relationship Between Alcohol-Induced Blackouts and Alcohol-Related Consequences Among...

Alcohol-induced blackouts (AIBs) are a common and serious consequence of drinking in young adults. AIBs are associated with experiencing increased alcohol-related consequences. To inform efforts to reduce alcohol-related harms on especially risky drinking days that result in AIBs, we sought to identify contextual factors that contribute to excess AIB-associated harms. This study aims to (1) examine relationships between AIBs and four consequence domains; and (2) explore how these relationships differ by social context and location.

Young adults (N = 175, 52.6% female, 86.9% White, M_age = 20.8) with recent heavy drinking and AIBs wore alcohol sensors and completed surveys about their consequences (including AIBs) and the social context and locations in which drinking occurred over six weekends. Four consequence domains included positive (reflective of desired alcohol expectancies), common (relatively acute, low potential for personal harm), uncommon (relatively serious, i.e., sexual, legal, great potential for personal harm), and alcohol-related problems (related to impaired control and physical dependence). Multilevel structural equation models were conducted to test for main effects of AIBs and moderating effects of contextual factors.

AIBs were significantly associated with experiencing 15% more positive consequences, 205% more common consequences, 367% more uncommon consequences, and 166% more alcohol-related problems. AIBs were more strongly associated with common consequences and alcohol-related problems when drinking occurred exclusively with family, friend(s), and/or a romantic partner (vs. with a large group). AIBs were also more strongly associated with common consequences when drinking took place exclusively at a residential location (vs. non-residential). No other significant moderating effects were observed.

Days with an AIB were associated with experiencing significantly more positive and negative alcohol-related consequences compared to days without an AIB. Our findings support the notion that the context in which drinking occurs is an important consideration for reducing alcohol-related harms.