Background and aims Emerging evidence suggests that solitary drinking may be an important early risk marker for alcohol use disorder. The current paper is the first meta-analysis and systematic review on adolescent and young adult solitary drinking to examine associations between solitary drinking and increased alcohol consumption, alcohol problems, and drinking to cope motives. Methods PsychINFO, PubMed, and Google Scholar were searched using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology and a pre-registered International Prospective Register of Systematic Reviews (PROSPERO) protocol (no. CRD42020143449). Data from self-report questionnaires regarding negative correlates of solitary drinking (e.g. alcohol problems) and solitary drinking motives (e.g. drinking to cope) were pooled across studies using random-effects models. Studies included adolescents (aged 12-18 years) and young adults (mean age between 18 and 30 years or samples with the majority of participants aged 30 years or younger). Results Meta-analytical results from 21 unique samples including 28,372 participants showed significant effects for the associations between solitary drinking and the following factors:

Underage drinkers with lower, rather than higher, social discomfort appear to be at greater risk for drinking alone. These findings may inform our understanding of individuals at greatest risk for drinking alone and promote new avenues for intervention.

These results partially replicate and extend recent meta-analytic findings reported by Sharma et al. (2014) to further clarify the predictive validity of impulsivity-related trait scales and laboratory behavioral tasks on externalizing behaviors.

Aims: To (1) measure the aggregated effect size of empathy deficits in individuals with alcohol use disorder (AUD) compared with healthy controls, (2) measure the aggregated effect sizes for associations between lower empathy and heavier alcohol consumption and more alcohol problems in non-clinical samples and (3) identify potential moderators on the variability of effect sizes across studies in these meta-analyses.Method: PsycINFO, PubMed and Google Scholar were searched following a preregistered International Prospective Register of Systematic Reviews (PROSPERO) protocol (CRD42021225392) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology. We meta-analyzed (using random-effects models) mean differences in empathy between individuals with AUD compared with healthy controls and associations between empathy and alcohol consumption and alcohol problems in non-clinical samples. A total of 714 participants were included in the meta-analysis on clinical samples; 3955 were included in the meta-analyses on non-clinical samples.Results: Individuals with AUD reported significantly lower empathy than healthy controls [Hedges' g = −0.53, 95% confidence interval (CI) = −0.91, -0.16, k = 9, P < 0.01, Q = 40.09, I 2 = 80.04]. Study quality [Q = 1.88, degrees of freedom (d.f.) = 1, P = 0.17] and gender (β = −0.006, Z = −0.60, P = 0.55) were not moderators. Increases in age corresponded to an increase in effect size (β = 0.095, Z = 3.34, P < 0.001). Individuals with AUD (versus healthy controls) had significantly lower cognitive (Hedges' g = −0.44, CI = −0.79, -0.10, P < 0.05), but not affective empathy (Hedges' g = −0.19, CI = −0.51, 0.14, P = 0.27), and the difference between these was significant (Z = 2.34, k = 6, P < 0.01). In non-clinical samples, individuals with lower (versus higher) empathy reported heavier alcohol consumption (r = −0.12, CI = −0.15, -0.09, k = 11, P < 0.001, Q = 9.68, I 2 = 0.00) and more alcohol problems (r = −0.08, CI = −0.14, -0.01, k = 7, P = 0.021, Q = 6.55, I 2 = 8.34). There was no significant heterogeneity across studies. Conclusion:Individuals with alcohol use disorder appear to show deficits in empathy compared with healthy controls. Deficits are particularly pronounced for older individuals and for cognitive (versus affective) empathy. In non-clinical samples, lower empathy appears to be associated with heavier alcohol consumption and more alcohol problems.

Background and aimsNearly all the research conducted on high‐intensity drinking has focused on college and school‐based samples, with recent calls for research to understand this risky drinking pattern in non‐school‐based samples and across time. This study aimed to characterize predictors and consequences of non‐binge drinking, age‐ and gender‐adjusted binge drinking (level I) and drinking at levels representing two or more times (level II) and three or more times the level I binge threshold (level III) in a clinical sample of adolescents followed into young adulthood.DesignCross‐sectional associations between non‐binge drinking, binge levels, and negative alcohol‐related consequences were examined during adolescence; prospective analyses tested whether adolescent non‐binge drinking and binge levels predicted alcohol use disorder (AUD) symptoms in young adulthood and whether changes in drinking motives over time were associated with binge levels in young adulthood.SettingUS clinical settings.ParticipantsA total of 432 adolescents (aged 12–18 years) with alcohol‐related problems followed into young adulthood (aged 19–25 years).MeasurementsLife‐time drinking history, Structured Clinical Interview for DSM AUDs, and Inventory of Drinking Situations.FindingsResults were generally consistent with a distinction between binge level I versus levels II–III on various negative alcohol‐related consequences in adolescence (Ps < 0.05) that were maintained in young adulthood (Ps < 0.01). The maintenance of relatively high endorsement of enhancement and social motives over time was associated with binge levels II–III in young adulthood (Ps < 0.001); decreases in coping motives were associated with less risky drinking in adulthood (P = 0.003).ConclusionsAmong US adolescents with alcohol‐related problems who were followed‐up in young adulthood (aged 19–25 years), standard threshold binge drinking (five or more drinks per occasion; level I) was generally associated with fewer alcohol‐related consequences and problem behaviors than binge drinking at two or more times (level II) or three or more times (level III) the standard binge threshold.