Anxious, alone, and thirsty for a drink: Attachment anxiety moderates the impact of social rejection on alcohol use

About This Grant

Abstract Alcohol abuse is a common and destructive behavioral pattern, accounting for roughly 178,000 deaths per year in 2020 and 2021 (Centers for Disease Control and Prevention, 2024). We know that people generally use alcohol to control physical pain (Brennan et al., 2011; Riley & King, 2009), so much so that pain is understood to be a significant risk factor for alcohol use disorder (e.g., Boissoneault et al., 2019; Jakubczyk et al., 2016; Witkiewitz & Vowles, 2018). We also know that “overdrinking” alcohol is often associated with impulsivity and self-regulatory failure (Bates & Labouvie, 1995; Grau & Ortet, 1999; Hustad et al., 2009). Thus, contextual factors that enhance pain experiences and/or diminish self-regulatory restraint may, in effect, increase one's risk of abusing alcohol. One particular type of social experience—social rejection—may be especially powerful in terms of increasing problem drinking behavior, due to its association with both pain and poorer self-control. Furthermore, people with anxious attachment—a trait distinguished by fear of rejection and a general hypersensitization towards threats (Ainsworth et al., 1978; Bretherton & Parke, 1992)—may be especially vulnerable to the influence of rejection on their alcohol use. Anxious attachment is even considered a significant risk factor for substance use disorders (SUD; e.g., Unterrainer et al., 2017). To date, no research exists on the mechanisms underlying the association between social rejection and “in- the-moment” alcohol use, nor vulnerability factors that enhance the association between rejection and alcohol use. With this application, we propose two studies to explore the link between social rejection and drinking behavior. For Study 1, we will conduct an ecologically valid, longitudinal daily diary study with 188 young adults (aged 21 – 25) to examine how fluctuations in perceptions of rejection are associated with alcohol use, whether attachment anxiety strengthens that association, and whether that association is explained by pain experience and self-regulatory failure. In Study 2, we will recruit 152 carefully screened participants (aged 21 – 25) to participate in a double-blind between-subjects experiment to address the causal nature of the associations expected in Study 1. Findings are expected to contribute to the next step in the research program: developing and testing interventions to reduce impulsive drinking following social rejection.