Mediational Role of Drinking to Cope in the Associations of Depression and Suicidal Ideation with Solitary Drinking in Adults Seeking Alcohol Treatment

Abstract

Background: Little research on solitary drinking has focused on clinical samples. Previous research in college students has found that depression, suicidal ideation, and drinking to cope with negative affect are associated with drinking in solitary, but not social, contexts. These associations have not been examined among individuals with alcohol use disorder, despite their high rates of depression and suicidal behavior. Method: To fill this gap in knowledge, the associations of depression and suicidal ideation with solitary and social drinking were examined among 96 individuals seeking alcohol treatment, the majority of whom had alcohol use disorder (97.9%). Multiple mediation models were conducted to examine the mediating effects of two drinking to cope variables (drinking excessively to cope and coping motives) on the associations of depression and suicidal ideation with drinks per month and heavy episodic drinking in social and solitary contexts. Results: Significant indirect effects were found for depression and suicidal ideation with solitary drinking variables through greater drinking excessively to cope. No significant indirect effects were found for social drinking variables. However, a positive direct association was found between suicidal ideation and greater social drinks per month that was not mediated by drinking to cope. Conclusions: These findings suggest that greater depression or suicidal ideation, through their effect on greater drinking to cope, are associated with greater solitary drinking in a treatment seeking sample. Drinking context should perhaps be considered in alcohol interventions, particularly when treating individuals suffering from depression or suicidal ideation.

Keywords:

• Solitary drinking
• depression
• suicidal ideation
• alcohol use disorder
• drinking to cope

Acknowledgment

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Declaration of interest

The authors report no conflict of interest.

Notes

1 One participant who completed the baseline interview was 47 years old and should have been excluded during the phone screening; however, this participant was included in the current study as there was no age-related rationale for their exclusion from this study.

2 Supplemental models with arrows reversed were examined. Indirect effects were not found to be significant for depression or suicidal ideation predicting social drinking variables through drinking to cope variables. Significant indirect effects for solitary drinks per month and heavy episodic drinking predicting depression through drinking excessively to cope (but not coping motives) were found. In contrast, no significant indirect effects were found for solitary drinking variables predicting suicidal ideation through drinking to cope variables. While these findings could be taken to suggest that directionality of the effects found for suicidal ideation to solitary drinking through drinking excessively to cope should be preferred, while either model for depression are valid, authors such as Thoemmes (2015) argue that reversing arrows in mediational models does not help to elucidate the true nature of associations or provide evidence that one model should be preferred.

Additional information

Funding

This research was supported by National Institute on Alcohol Abuse and Alcoholism Grant RC2AA019422.