Ashamed and Alone—Risk Factors for Alcohol Craving Among Depressed Emerging Adults
Comorbid alcohol use and depression have the highest prevalence among emerging adults and are associated with a number of consequences. Self-medication theory posits individuals with depression use alcohol to cope with their negative emotions. Preliminary work has investigated the social context of depression-related alcohol use and found that solitary alcohol use is a risky, atypical behaviour in emerging adulthood that is associated with alcohol misuse. However, it is unknown about what is unfolding in the moment that is driving depression-related alcohol use in solitary contexts. Accordingly, this study used an experimental study to examine if shame mediated the association between depression and in-lab alcohol craving.
Emerging adults (N = 80) completed a shame induction followed by an alcohol cue exposure in either a solitary or social condition. The study used moderated mediation to test hypotheses.
Consistent with hypotheses, conditional indirect effects supported the mediation of depression and alcohol craving through shame among those in the solitary condition, but not in the social condition. There was no support for guilt as a mediator.
This study demonstrates that shame is a specific emotional experience that contributes to solitary alcohol use among depressed emerging adults. It is important to use these results to inform interventions that directly target solitary contexts and shame.