The Role of Alcohol-Induced Blackouts in Symptoms of Depression among Young Adults

Abstract Objective Blackouts are associated with other alcohol-related consequences and depression among young adults, but the mechanisms underlying these associations are unclear. Using two separate samples, we tested the hypothesis that blackouts would be linked to symptoms of depression due in part to their association with other alcohol-related consequences. Method Young adults who use alcohol completed assessments at baseline in Sample 1 (N1 = 381, 58% female) and baseline, 3 months, and 6 months in Sample 2 (N2 = 603, 53 % female). Bootstrapped confidence intervals were used to examine the direct and indirect effects of blackouts on depressive symptoms, using cross-sectional mediation analysis in Sample 1 and a counterfactual approach with longitudinal data in Sample 2. Results In both samples, alcohol-induced blackouts were associated with alcohol-related consequences, which in turn were associated with symptoms of depression. In Sample 1, blackouts had both direct and indirect (mediated) effects on depressive symptoms. In Sample 2, blackouts measured at baseline only had an indirect effect on depressive symptoms six months later through other alcohol-related consequences at three months. Conclusions Among heavy-drinking college students, the majority of whom reported minimal symptoms of depression, blackouts were associated with increases in other alcohol-related consequences, which in turn were associated with increases in symptoms of depression. These findings suggest that prevention and intervention efforts targeting blackouts may help reduce other alcohol-related consequences among young adults.