Self-Esteem Mediates the Effects of Loneliness on Problematic Alcohol Use.

Loneliness has been associated with problematic alcohol use, but it is not known whether self-perceptions mediate this relationship. In this study, the general population in China (N = 1123) and Germany (N = 1018) was surveyed to assess whether self-esteem and self-efficacy mediate the effect of loneliness on problematic alcohol use in two culturally distinct environments. Multiple regression analysis demonstrated that higher AUDIT scores were negatively associated with self-esteem ( = -0.08,  < .001). Self-esteem mediated the effect of loneliness on AUDIT score (indirect effect: 0.06, CI: 0.03 - 0.10,  < .001), while self-efficacy did not (indirect effect: 0.02, CI: -0.003 - 0.05,  = .10). These findings suggest that self-esteem explains the relationship between loneliness and problematic alcohol use. As self-esteem may be more modifiable than external social factors, these results have positive practical implications for alcohol use disorder treatment strategies.