Autistic Traits, Emotion Regulation, Social Anxiety, Drinking to Cope, and Problematic Alcohol Use: A Cross-Cultural Examination Among Young Adults from Seven Countries

Background: Prior research suggests that individuals reporting autistic traits are at heightened risk for alcohol dependence once they begin drinking; thus, examining factors that may lead to problematic drinking in this population is imperative. Neurotypical college students higher in autistic traits tend to have more social anxiety, more challenges with social skills and communication, and weaker social adjustment than those lower in autistic traits, which are risk factors for problematic alcohol use. Objectives: The present study sought to assess whether university students with more autistic traits would report greater alcohol-related negative consequences, and whether this association would be indirectly influenced by social anxiety, emotion regulation, and drinking to cope. Students (<i>n</i>=3,756; 71.4% female) from 12 universities spanning seven countries completed questionnaires assessing autistic traits, social anxiety, emotion regulation, drinking to cope, and negative alcohol-related consequences. Results: Results from our comprehensive path model indicated that exhibiting more autistic traits was associated with higher social anxiety and distinct emotion regulation strategies (i.e., higher endorsement of expressive suppression and lower endorsement of cognitive reappraisal), which in turn were associated with more drinking to cope motives, which in turn was associated with more alcohol-related problems. These findings were consistent across gender and country groupings (i.e., test of model invariance). Conclusions: These results inform our understanding of how university students with higher autistic traits may develop problems with alcohol and our results may inform interventions or preventative efforts. Future research should examine longitudinal designs to further refine this model and establish temporal evidence of its trajectory.