(PS10-65) An Exploration of the Association Between Loneliness and Alcohol Use in US Veterans

Alcohol misuse is associated with reduced social resources and social isolation (Grant et al., 2015; Peirce et al., 2000). Loneliness, in particular, appears to be implicated in problematic alcohol use (Gutkind et al., 2022). Isolation behaviors, including the experience of loneliness, dysphoria and anhedonia, and alcohol misuse all confer risk of suicidal thoughts and suicidal intent (Amiri & Behnezhad, 2020; Lee et al., 2021; Li et al., 2020; McClelland et al., 2020). These problems may be particularly prevalent among Veterans with a history of alcohol use problems (Fuehrlein et al., 2016; Kuwert et al., 2014). Yet, the association between loneliness and alcohol use in US Veterans has not been examined generally, outside of the context of the COVID-19 pandemic (Fitzke et al., 2021; Kelly et al., 2022). In this secondary analysis of a population study of the prevalence and impact of moral injury among US Veterans (N = 3002), we examined the association between reports of loneliness and overall alcohol use, as well as alcohol risk categories (high risk, medium risk, and low risk alcohol use; Babor et al., 2001). Reports of loneliness, indexed by UCLA Loneliness Scale total scores, were correlated with reports of alcohol use, indexed by Alcohol Use Disorder Identification Test total scores (r = .11, p < .001; AUDIT; Russell, 1996; Saunders et al., 1993). We then ran a one-way ANOVA that indicated that there was a significant difference in reports of loneliness for the three drinking behavior groups (F[2, 2896] = 21.76, p < .001). LSD post-hoc analyses indicated that the mean loneliness score for the high-risk alcohol use group (M = 5.52, SD = 1.76) was significantly higher than that of the medium-risk alcohol use group (M = 4.84, SD = 1.99) and the low-risk alcohol use group (M = 4.29, SD = 1.72). Given that moral injury entails social exclusion and grievance, we also ran an exploratory linear regression with reports of alcohol use as the dependent variable, and total scores on the Moral Injury Outcome Scale (MIOS; Litz et al., 2022) for those participants who endorsed a potentially morally injurious event, and UCLA Loneliness Scale as independent variables. The association between alcohol use and loneliness was substantially reduced (B = .016) when moral injury was in the model (B = .169). The results revealed a significant positive relationship between loneliness and alcohol use in US Veterans, however, reports of moral injury explained most of the variance in loneliness. In future research we will examine the centrality of moral injury to loneliness among Veterans and further examine the association between alcohol use and both variables.