Implicit Social Attunement & Alcohol Use: The Effect of Peer Feedback on Willingness to Drink in Social Settings

Background. Social alcohol use is common and associated with heavier alcohol consumption, but most studies have focused on explicit measures of social drinking norms and peer pressure. This study aimed to 1) develop an implicit social attunement (ISA) task to experimentally assess how willingness to drink alcohol is affected by social settings and peer feedback in the absence of explicit norms or peer pressure, and 2) assess how ISA is associated with explicit social attunement, age, and alcohol use. Methods. An online assessment was completed by an international sample (N = 506, 60.1% female) of 16–60-year-olds recruited from the Netherlands. All participants completed the ISA task in which they were shown images of different social settings and asked to report their willingness to drink alcohol in these setting, including social alcohol drinking (SAD), social non-alcohol drinking (SNAD), and social non-drinking (SND) settings. Next, they were shown average peer willingness (cover story) to drink alcohol in this situation, indicating the same, lower, or higher willingness to drink. After a break, participants repeated the task without receiving peer feedback. Implicit social attunement was calculated as an increase in response to higher peer willingness or a decrease in response to lower peer willingness, controlled for the change in response following trials where peers reported the same willingness. Furthermore, participants reported on their alcohol use, age, and explicit social attunement. Results. On average, participants were recreational consumers using alcohol about 1 in 3 days and reporting low-risk consumption based on the alcohol use disorder identification test. The novel ISA task showed good internal consistency within social setting (all a > .91). Willingness to drink was highest in social settings where others consumed alcohol (SAD), but willingness was also higher in the SNAD setting than in the SND setting. Regardless of social setting, peer feedback indicating lower willingness to drink induced larger ISA than peer feedback indicating higher willingness to drink. Higher ISA to higher peer willingness to drink in SAD or SNAD settings was associated with higher alcohol use. Higher ISA to lower peer willingness to drink in SND settings was associated with lower alcohol use. Furthermore, higher ISA to higher peer willingness to drink in SAD settings was positively associated with explicit social attunement, but no associations between ISA and explicit social attunement were observed for the other conditions. Also, explicit social attunement, but not ISA, mediated the association between lower age and higher alcohol use. Conclusions. Results from the novel ISA task indicate that peer feedback might act as protective or risk factor for alcohol use depending on the social setting and highlight the potential differences between implicit and explicit social attunement in their associations with age and alcohol use.