Meaning and Self-control in Alcohol Use and Internalizing Symptoms: Causal Insights from (Non)clinical Populations

Background: Harmful alcohol use and internalizing symptoms are widespread problems which often cooccur in clinical populations. While both might be linked through maladaptive coping behaviors such as using alcohol to alleviate negative affective states, a lack of meaningful life experiences or low self-control might also predispose for alcohol misuse or internalizing symptoms. This notion is supported by empirical studies demonstrating negative links between meaning in life or self-control and drinking behavior or depressive and anxiety symptoms. Such findings suggest that increasing individuals’ life meaningfulness and self-control could reduce their alcohol use and internalizing symptoms. Thus far, self-control interventions are usually centered on improving cognitive control, which has not been well supported in lowering alcohol intake or internalizing symptoms to a clinically relevant extent. Here, we suggest that meaning in life instead could pose a promising target for a transdiagnostic intervention on drinking behavior and internalizing symptoms. While available evidence on the association between meaning and alcohol use or internalizing symptoms is consistent with this idea, it remains to be tested if the influence of meaning is causal. Methods: We complemented commonly seen cross-sectional network models with the use of a causal inference algorithm, which provides insights into causal relations between variables. This allows assessing the extent to which meaning indeed constitutes an expedient treatment target for reducing alcohol use and internalizing symptoms. Results: In the first study on a sample from the general Dutch population (N = 475), we showed that meaning in life has a negative causal influence on depressive symptoms, which, in turn, increased symptoms of (social) anxiety and stress. Moreover, meaning-related constructs such as purpose and competence showed positive causal relations to self-control. Alcohol use and the tendency of drinking to alleviate negative affect were particularly closely related to internalizing symptoms in participants with harmful levels of alcohol consumption. In a second study from the Netherlands Study of Depression and Anxiety (approx. N = 1700), we investigate patients diagnosed with internalizing disorders on a similar set of variables, including substance use other than alcohol. We are currently in the process of analyzing the data – outcomes will be presented during the conference. Conclusions: The findings will allow important inferences about how meaning, self-control, and substance use interact with (non)clinical levels of internalizing symptoms and alcohol use. This research informs our aims of designing and testing an effective meaning-centered intervention for individuals with alcohol use and internalizing problems.