Daily loneliness and alcohol use in Alcohol Use Disorder: an 8-week EMA study of within-person associations
Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Background and Aims: Loneliness has been suggested as a risk factor for alcohol consumption (AC), potentially contributing to a cycle whereby loneliness increases drinking, which in turn exacerbates loneliness through alcohol-related consequences. However, longitudinal evidence is inconsistent, and little is known about short-term, within-person associations in individuals with alcohol use disorder (AUD). We examined concurrent and lagged bidirectional associations between loneliness and AC in daily life and whether these associations varied according to social contact, mood, age, and gender.Design: Ecological momentary assessment (EMA) study with daily assessments over 8 weeks. Within-person associations were examined using fixed-effects panel regression models; multilevel models examined moderation by age and gender.Setting: A real-life context with data collection between December 2025 and June 2026 in Germany.Participants: The final analytic sample comprised 58 adults meeting at least two DSM-5 criteria for AUD (74% men; mean age = 48.8 years, SD = 8.3).Intervention: Observational study without interventions.Measurements: Daily alcohol use (yes/no) and quantity (grams), loneliness, social contact, perceived social support, and mood valence and calmness were assessed using smartphone-based EMA. Concurrent and prospective associations across consecutive days were examined, accounting for autoregressive stability.Findings: EMA compliance was high (96.7%). Greater-than-usual loneliness was associated with lower probability of alcohol use during the same retrospective assessment interval (b = −0.092, 95% CI [−0.151, −0.033], pFDR = .006) and lower alcohol quantity (b = −15.89 g, 95% CI [−24.16, −7.61], pFDR = .003). Prospective associations in either direction were small, with confidence intervals constraining their plausible magnitude. The concurrent association between loneliness and alcohol quantity was stronger on days with social contact, higher positive mood valence and calmness, and among men. Mood also moderated the prospective association between loneliness and subsequent alcohol use, although simple slopes were not significant.Conclusions: In adults with AUD, loneliness was associated with lower AC concurrently whereas prospective associations in either direction were small. The concurrent association varied by social and mood context and gender, suggesting that loneliness alone may provide limited information about imminent drinking risk.
Source: PsyArXiv (OSF Preprints)
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7214711977