Exploring Associations Between Drinking Contexts and Alcohol Consumption: An Analysis of Photographs

Drinking contexts are theorized to represent a core factor driving hazardous consumption and ultimately susceptibility to alcohol use disorder.Yet capturing and characterizing contextual influences on alcohol consumption has posed a significant challenge. In this study, we employ objective ambulatory assessment methods to test a multiaxial framework for understanding contextual influences on drinking. Specifically, we propose a novel SPAIS framework, comprising five exogenous, objectively measurable domains of drinking context (schedule/time, physical, activity, interpersonal, and substance/drink type), corresponding loosely to the when, where, what, how, and (with) whom of alcohol consumption. Contextual effects are examined through a database comprising 6,259 photographs of everyday life (1,422 drinking contexts), with participants including individuals with normative consumption patterns (N = 48) as well as those meeting criteria for alcohol use disorder (N = 60). Participants wore transdermal alcohol biosensors during an ambulatory assessment period, while also taking photographs of their surroundings in response to random prompts. Computer vision methods were employed to extract contextual features from photographs. Results indicated numerous and often potent links between contextual features and patterns of consumption across SPAIS dimensions. Specifically, evening and weekend drinking, drinking during celebrations, drinking in bars, the presence of alcohol-related cues, distracting activity, and crowded, mixed-gender spaces were all associated with elevated levels of consumption. Results represent a step toward the identification of behavioral and structural change targets for alcohol use intervention programs, while at the same time providing new methods for capturing context in the field of addiction science.