Most alcohol consumption takes place in social contexts. Humans are fundamentally social beings; regardless of their nationality, age, and problem drinking status, people mainly consume alcohol in the company of other people. Yet, in seeking to understand alcohol’s basic reinforcing properties, scientists have overwhelmingly studied the solitary rather than the social drinker. Thus, research exploring the acute rewarding effects of consuming alcohol—rewards that can so often drive the decision to take the next drink—provides little insight on social elements of alcohol reinforcement. To fill this gap, here in the Alcohol Research Laboratory, we have developed a program of research aimed at deepening our basic understanding of alcohol’s social rewards. Our experimental research introduces ecologically valid experimental drinking paradigms, sophisticated non-verbal measures of affect, and statistical methods capable of tracking complex patterns of affect over time. Our more recent work extends beyond the laboratory, leveraging technological advances in ambulatory methods, multi-modal designs combining laboratory and longitudinal assessments, and methods in multilevel research synthesis aggregating effects across studies. Using these new tools we have revisited questions of enduring interest to alcohol researchers, including the question of why alcohol leads to reward (what are the mechanisms underlying alcohol’s reinforcing effects?), who is particularly vulnerable to alcohol-related reward (are there individual differences in alcohol reward sensitivity?), and finally where alcohol’s rewards are most potent (are there social-contextual moderators of alcohol reward?).
Research indicates that alcohol’s emotionally reinforcing properties are especially potent in social context. Alcohol produces dramatically larger positive mood enhancing and negative mood relieving effects when consumed in social settings vs. when it is consumed alone. This leaves open the question of why—what is it about the combination of alcohol and social interaction that can together evoke such a powerful emotional response? Researchers have long held that if we can identify the fundamental mechanisms underlying alcohol reward, then we can ultimately understand a lot about alcohol and what makes it addictive. In pursuit of this understanding, Dr. Fairbairn proposed the social-attributional model of alcohol response (Fairbairn & Sayette, 2014, Psychological Bulletin), positing that alcohol’s effects within social context are explained by its ability to free individuals from preoccupation with social rejection and thereby access social rewards. To explore these theorized underpinnings, our research has employed laboratory procedures that incorporate group-based alcohol-administration paradigms (Fairbairn et al., 2018, Journal of Abnormal Psychology). Similar to alcohol-administration paradigms employed in prior research, these paradigms involve the random assignment of participants to alcohol vs. no-alcohol conditions, thus informing the understanding of causality. Unlike much prior laboratory alcohol research, however, these paradigms involve the coordination of simultaneous laboratory visits among multiple participants, thus permitting the direct examination of alcohol’s effects on group interaction. In early work with these paradigms, we produced evidence that alcohol’s social rewards are explained by its tendency to help drinkers “bounce back” following intervals of low social pleasure, permitting them to enjoy the present moment and leave the troubles of the immediate past behind (Fairbairn & Sayette, 2013, Journal of Abnormal Psychology). In more recent work we leverage these laboratory group drinking paradigms in combination with continuous objective measures of nonverbal display and dynamic statistical procedures capable of tracking the interplay of emotional states over time. Using these methods, we found evidence that alcohol specifically boosts participants’ mood during less intrinsically pleasurable social moments, whereas its effects are comparatively weak during the more naturally pleasant moments of social exchange (Fairbairn et al., in press, Journal of Experimental Social Psychology). Taken together, this body of work suggests that alcohol can enhance social interactions by increasing enjoyment during, and increasing resilience following, the less positive moments of everyday social exchange.
Individuals can differ dramatically in how they respond to alcohol. Two people with nearly identical drinking histories often display very different reactions to drinking—in one individual alcohol might conjure up intense feelings of elation and relaxation while, in the other, it might simply promote a mild sense of lightheadedness or drowsiness. Etiological models of alcohol use disorder (AUD) suggest that individual differences in alcohol response are a key mechanism underlying vulnerability for alcohol problems, with those who display heightened sensitivity to alcohol reward being at increased risk for developing AUD. But prior laboratory studies employing solitary drinking paradigms have often failed to produce evidence of alcohol reward sensitivity among those at risk, even when these same individuals consistently report being sensitive to alcohol reward when they drink in everyday contexts. Thus, extant laboratory paradigms struggle to capture individual-differences that emerge as robust outside the lab. Employing group-based paradigms our research provided the first experimental evidence of alcohol-reward sensitivity among key groups of individuals at risk for heavy drinking, including among men (Fairbairn et al., 2015a, Clinical Psychological Science; Fairbairn et al., 2015b), individuals with specific “risky” personality traits (Fairbairn et al., 2015c, Journal of Abnormal Psychology), and individuals with low quality close social relationships (Fairbairn & Testa, 2017, Clinical Psychological Science). With the aim of capturing uniquely social elements of alcohol reward, our research has emphasized measures capable of modelling the complex interplay of behaviors across individuals over time, an endeavor that ultimately led to the development of a novel statistical approach for examining emotional contagion (nested frailty survival modelling for multilevel behavioral data; Fairbairn et al., 2015a; Fairbairn, 2016). Thus, using group paradigms that more closely mirror drinking contexts outside the lab paired with measures uniquely suited to capturing social elements of experience, this body of work has moved towards reconciling a previously inconsistent literature.
A considerable body of evidence has accumulated to indicate a link between regular alcohol consumption in unfamiliar drinking contexts and AUD risk. Specifically, habitual drinking in unfamiliar contexts (e.g., with strangers) has been linked to risk for subsequent AUD, whereas drinking among highly familiar individuals has been identified as a protective factor (Fairbairn & Sayette, 2014). A better understanding of such associations might have key clinical implications, refining prevention and intervention measures by informing our understanding of high-risk contexts for heavy drinking. To date, however, little research has explored the role of social familiarity in alcohol reward and AUD risk. Within the social-attributional model of alcohol’s effects, we proposed that links between drinking in unfamiliar context and AUD might be explained by enhanced alcohol-related reinforcement in unfamiliar contexts—in other words, that people would gain more alcohol-related stress relief and positive mood enhancement when interacting with strangers vs. with familiar individuals. We have conducted a series of studies that provide support for this premise, including survey-based research indicating that people believe that alcohol will be more reinforcing when consumed among strangers vs. friends (Fairbairn & Bresin, 2017), alcohol-administration research indicating alcohol-related stress reduction is larger in an outgroup (vs. ingroup) context (Fairbairn et al., 2013), and meta-analytic research indicating that reinforcement from alcohol in a laboratory context is larger within stranger vs. familiar interactions (Fairbairn, 2017). More recently, we have combined laboratory methods with procedures that harness technological advances in ambulatory assessment, including transdermal measures of drinking episodes and photographic indexes of social context, bringing some of the precision of the laboratory into the real world. Using these new tools, our ambulatory research produced preliminary evidence that alcohol’s tendency to enhance mood was strongest in the presence of strangers vs. familiar individuals (Fairbairn et al., 2018, Journal of Abnormal Psychology). With the aim of further refining measures for assessing drinking in everyday settings we initiated a related line of work examining the validity of wearable BAC biosensors, leveraging new-generation sensors and novel analytic approaches to model the complex association between transdermal sensor output and blood alcohol concentration (Fairbairn & Kang, 2019; Fairbairn et al., 2019; Sirlanci et al., 2018; 2019). Our ongoing funded R01 further builds this body of work by examining the impact of social familiarity using both laboratory and ambulatory methods and offering further opportunities for alcohol biosensor development in a large participant sample (R01AA025969).
Social Processes and AUD
A core aim of basic alcohol science is to identify factors that predict the development of problem drinking. Thus, the question arises: do social relationships and social drinking contexts truly matter for AUD etiology? Prior cross-sectional studies point to correlations between social drinking contexts and significant alcohol-related problems (e.g., binge drinking, driving while intoxicated), and longitudinal questionnaire-based studies further indicate associations between beliefs about alcohol’s social effects and AUD vulnerability. Our research has sought to further build this body of work, leveraging objective behavioral measures of social processes, longitudinal methods that facilitate the parsing of temporal precedence, and randomized study designs. In a recent series of studies that combined direct laboratory assessment of behavior at baseline with longitudinal assessment of drinking over time, we found evidence that behavioral-observation measures of social relationship quality among individuals with AUD predict longitudinal drinking trajectories above and beyond individual-level behaviors (Fairbairn & Cranford, 2016, Journal of Abnormal Psychology) and further that alcohol-related mood enhancement assessed in a laboratory group drinking context predicts increases in drinking problems 18 months later (Venerable & Fairbairn, in press, Psychology of Addictive Behaviors). In a research synthesis that incorporated 34 longitudinal samples (total N=56,721), we used SEM-based meta-regression analysis of within-study cross-lagged effects, producing evidence that social relationship distress temporally precedes substance use (Fairbairn et al., 2018, Psychological Bulletin). Finally, in a meta-analysis of addiction treatment studies employing randomized designs, we found that addiction treatments that focus on the enhancement of social relationships and “sober” social rewards outperform individually-focused addiction treatments by a significant margin, hinting at a potential causal role for social factors in AUD maintenance (Ariss & Fairbairn, in press, Journal of Consulting and Clinical Psychology). Taken together, this research suggests that social and relationship factors may have core relevance for understanding the development of alcohol-related problems.
People drink alcohol in social settings, and many of the more potent rewards people experience from drinking are social in nature. In a program of work incorporating multiple methods and measures, we have sought to build a fundamental understanding of the social value people gain from consuming alcohol. Taken as a whole, this work indicates social reward processes as an area worthy of attention within addiction science.