Bidirectional Longitudinal Correlations Between Alcohol Use Frequency and Quantity, and Anxiety in Adults

Alcohol use and anxiety both contribute significantly to the global burden of disease, and understanding their longitudinal relationships may clarify whether they exacerbate each another. However, previous research on the topic has yielded mixed results, potentially due to a lack of differentiation between alcohol use patterns. This study aimed to explore the bidirectional longitudinal correlations between alcohol use frequency and quantity, and anxiety. A longitudinal random-intercept cross-lagged panel model was constructed using data from 18+ year-old individuals (<i>N</i> = 14,665), collected in the 2017 and 2019 waves of the nationally representative Household, Income, and Labor Dynamics in Australia (HILDA) survey. Anxiety was measured with the Kessler Psychological Distress Scale anxiety subscale and participants’ reported frequency and quantity of alcohol use. For individuals, anxiety was positively associated with subsequent alcohol use quantity, and alcohol use frequency and quantity were negatively and positively associated with subsequent anxiety, respectively. Cross-lagged effects were small in magnitude suggesting that alcohol use patterns and anxiety accounted for a small amount of change in each other. Results strengthen support for a reciprocal relationship between heavier alcohol use and anxiety and provide novel insight into a relationship between frequent, low quantity alcohol use, and subsequent lower anxiety. These results underscore the importance of differentiating between alcohol use patterns when evaluating mental health outcomes and emphasize that heavier drinking patterns are particularly detrimental to psychological well-being.

酒精使用与焦虑均对全球疾病负担造成显著贡献，厘清二者的纵向关联或可阐明两者是否存在相互加剧的效应。然而，过往针对该主题的研究结果莫衷一是，这可能源于未对酒精使用模式加以有效区分。本研究旨在探究酒精使用频率、使用量与焦虑之间的双向纵向相关关系。本研究采用澳大利亚全国代表性家庭、收入与劳动力动态调查（Household, Income, and Labor Dynamics in Australia, 简称HILDA）2017年与2019年追踪波次的数据，纳入18岁及以上受访者（样本量N=14,665），构建纵向随机截距交叉滞后面板模型。焦虑采用凯斯勒心理困扰量表（Kessler Psychological Distress Scale）焦虑子量表进行评估，酒精使用情况则通过受访者报告的使用频率与使用量衡量。结果显示，个体的焦虑水平与后续的酒精使用量呈正相关；而酒精使用频率与使用量分别与后续的焦虑水平呈负相关与正相关。交叉滞后效应的效应量较小，表明酒精使用模式与焦虑仅能小幅解释彼此的变化。本研究结果进一步支持了重度酒精使用与焦虑之间存在互惠关系的结论，并为高频低量酒精使用与后续更低焦虑水平之间的关联提供了全新视角。这些研究结果强调了在评估心理健康结局时区分酒精使用模式的重要性，同时指出重度饮酒模式对心理健康尤其有害。