Examining social attention as a predictor of problem drinking behavior: A longitudinal study using eye-tracking

Background: Researchers have long been interested in identifying objective markers for problem drinking susceptibility informed by the environments in which individuals drink. However, little is known of objective cognitive-behavioral indices relevant to the social contexts in which alcohol is typically consumed. Combining group-based alcohol administration, eye-tracking technology, and longitudinal follow-up over a 2-year span, the current study examined the role of social attention in predicting patterns of problem drinking over time. Methods: Young heavy drinkers (N = 246) were randomly assigned to consume either an alcoholic (target BAC 0.08%) or a control beverage in dyads comprising friends or strangers. Dyads completed a virtual video call in which half of the screen comprised a view of themselves (“self-view”) and half a view of their interaction partner (“other-view”). Participants' gaze behaviors, operationalized as the proportion of time spent looking at “self-view” and “other-view,” were tracked throughout the call. Problem drinking was assessed at the time of the laboratory visit and then every year subsequent for 2 years. Results: Significant interactions emerged between beverage condition and social attention in predicting binge drinking days. In cross-sectional analyses, among participants assigned to the control (but not alcohol) group, heightened self-focused attention was linked with increased binge days at baseline, B = 0.013, Exp(B) = 1.013, 95% CI = [0.004, 0.022], p = 0.005. In contrast, longitudinal models indicated that heightened self-focused attention among control participants while interacting with friends was linked with a more pronounced decline in binge drinking over time. Conclusions: The relationship between social attention and problem drinking is complex and evolves over time. While dispositional self-consciousness may act as a risk factor at the cross-sectional level, it appears to serve a potentially protective function as participants mature into young adulthood. More broadly, results highlight potential utility for objective markers of self-consciousness in the understanding of problem drinking etiology.