The following article is helpful for an evidence based alcohol treatment plan as a strategy to prevent relapse.

For most individuals, alcohol consumption is a social phenomenon, at least at the outset of their drinking. Previous research suggests that most human behavior is learned through imitation or modeling. Studies also suggest that imitation plays a role in addictive behaviors. Previous wine-tasting studies have demonstrated that participants exposed to a heavy-drinking model consume more alcohol. However, in these studies the participants knew beforehand that they would be consuming alcohol. Researchers from Canada and The Netherlands examined the effect of exposure to a heavy-drinking model on imitation of drinking behavior in a more naturalistic setting (Larsen et. al., 2009).

The study was conducted in a laboratory bar. Participants included 135 young adults (52 percent female) who were exposed to either a heavy-drinking, light-drinking, or non-drinking model of the same sex during a 30-minute session. In the current study, participants were allowed to drink alcoholic beverages but had the option of choosing to drink non-alcoholic beverages. As opposed to a wine-tasting study, this is more naturalistic.

Graduate students served as the same-sex model (confederates). Participants first answered a computer questionnaire which included questions about alcohol and drug use. Participants then met confederates in the bar lab, furnished with a bar, stools, tables, a billiards table, and a television. Pop music was played in the naturalistic bar setting. In the bar lab, participants were asked to watch the television and answer survey questions about television advertisements; this task was designed to be undemanding and neutral. Participants were then told that they could take a break and drink what they wanted. Confederates were instructed to drink either two sodas (non-alcohol control), one alcoholic beverage and two sodas (light-drinking model), or three (female) or four (male) alcoholic drinks (heavy-drinking). Participants could choose beer, wine, or soda. Sessions were videotaped from an observation room. After the drinking sessions, participants answered a questionnaire and evaluated their perceived aims of the study. Those who were suspicious of the confederates were eliminated from the study (19 individuals) to make sure that their suspicions did not affect their drinking behavior. Measures included observational data and self-reported data from participants.

Analysis of covariance (ANCOVA) was performed, and craving for alcohol was included as a covariate. Results of the analyses showed that participants exposed to heavy-drinking models consumed substantially more alcohol, as opposed to those exposed to light-drinking or non-drinking models. Further, craving levels were positively and significantly related to alcohol consumption during the experiment. These findings were true for both men and women who participated in the experimented. The results suggest that drinking behavior among males and females is influenced by imitation of same-sex peers in a naturalistic bar setting.

\”A key issue in discussing the present findings is how to explain the process of imitation,\” the authors wrote. \”What makes one drink alcohol when interacting with another drinking person? First, from a functional perspective, one explanation may be found in the prevailing social norms among youths. Specifically, youths imitate the drinking behavior of others because they may associate drinking with specific social benefits in a peer context (e.g. maintaining or increasing one\’s social status and popularity among peers). Thus, in order to acquire social approval and adapt one\’s behavior to the norms, youths might imitate peers’ alcohol use. Similarly, youths may believe that drinking alcohol best matches the prototype of popular, high-status peers. Second, imitation may be an automatic process that takes place non-consciously. When observing peers drink, one may automatically choose alcohol because of a non-conscious tendency to match or synchronize one\’s behavior to that of the interaction partner. Future research is warranted to test these hypotheses.\”

Whether the imitation is conscious or non-conscious, individuals in alcohol recovery (especially in early recovery) should be aware that exposure to heavy-drinking is likely to result in imitation of the behavior.

Larsen H, Engels RCME, Granic I, Overbeek G. An experimental study on imitation of alcohol consumption in same-sex dyads. Alcohol and Alcoholism. 2009; 40(3): 250-255.

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