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.