A longitudinal examination of the impact of self-esteem on alcohol use in untreated heavy drinkers

Approximately one third of men and 16% of women regularly drink over the weekly UK alcohol guidelines (Stats Team, NHS Digital, 2017). There is a public health requirement to identify factors that reduce heavy drinking, due to the harm this level of drinking can cause. Most of the previous research has excluded heavy drinkers who are not alcohol dependent. The processes by which heavy drinking is maintained or reduced are thus unclear in this population (Sobell, Ellingstad, & Sobell, 2000). Clinical research has suggested that individuals with lower self-esteem may drink alcohol to moderate stress levels or cope with different situations. A literature review of the research in this area suggested that the relationship between self-esteem and alcohol use was unclear, partially due to the limited controlling for potential confounders in previous research. This study therefore sought to address this gap by examining the relationship between self-esteem and heavy alcohol use, from both a cross sectional and longitudinal perspective. Data was utilised from the Birmingham Untreated Heavy Drinkers cohort. This dataset had repeated measures of multiple measures of alcohol use, self-esteem and other sociodemographic and clinical variables of interest. The results of the multiple linear regression models suggested that over time heavy drinkers with higher self-esteem drank more alcohol on a weekly basis and had lower number of abstinent days. However, individuals with lower self-esteem reported more disadvantages of drinking alcohol and had higher levels of alcohol dependency. The variables which affect the relationship between self-esteem and alcohol use appeared to vary based on the different alcohol outcomes. The results of this study have important implications for individualised formulations in clinical psychology. Further research is required in this area, particularly more longitudinal research from other cohort studies of high quality design.