Self-management with alcohol over lifespan: psychological mechanisms, neurobiological underpinnings, and risk assessment

Abstract

Self-management includes all behavioural measures and cognitive activities aimed at coping with challenges arising throughout the lifespan. While virtually all of these challenges can be met without pharmacological means, alcohol consumption has long been instrumentalized as a supporting tool to help coping with problems arising selectively at adolescence, adulthood, and ageing. Here, we present, to our knowledge, the first systematic review of alcohol instrumentalization throughout lifespan. We searched MEDLINE, Google Scholar, PsycINFO and CINAHL (from Jan, 1990, to Dec, 2022) and analysed consumption patterns, goals and potential neurobiological mechanisms. Evidence shows a regular non-addictive use of alcohol to self-manage developmental issues during adolescence, adulthood, and ageing. Alcohol is selectively used to overcome problems arising from dysfunctional personality traits, which manifest in adolescence. A large range of psychiatric disorders gives rise to alcohol use for the self-management of distinct symptoms starting mainly in adulthood. We identify those neuropharmacological effects of alcohol that selectively serve self-management under specific conditions. Finally, we discuss the adverse effects and associated risks that arise from the use of alcohol for self-management. Even well-controlled alcohol use adversely impacts health. Based on these findings, we suggest the implementation of an entirely new view. Health policy action may actively embrace both sides of the phenomenon through a personalized informed use that allows for harm-controlled self-management with alcohol.

Alcohol does not influence trust in others or oxytocin, but increases positive affect and risk-taking: a randomized, controlled, within-subject trial

“…Therefore, we also explored the effects of alcohol on testosterone and DHT concentrations as well as a potential mediation effect regarding perceived trustworthiness. Finally, we aimed to confirm previous findings on how alcohol influences positive affect and risk-taking, since multiple studies demonstrated that alcohol administration increases positive affect and risk-taking [ 2 , 38 – 41 ], both of which exert prosocial effects [ 42 – 48 ] and may, thus, be involved in alcohol-induced facilitation of social interaction. We did not examine negative affect since we did not sample depressed participants and hence, potential floor effects would have prevented the detection of an alcohol-related decrease.…”

“…Alcohol is among the most culturally meaningful substances that people use throughout history to induce specific bodily states [ 1 , 2 ]. However, since consuming alcohol is a major health risk, it is necessary to consider relevant drinking motives [ 3 ].…”