A theory-informed examination of biopsychosocial influences on transdermal alcohol concentration and next-day reports of alcohol-induced blackouts in young adults.

Alcohol-induced blackouts (AIBs) are a common and serious consequence of drinking often associated with increased alcohol-related harms. Understanding factors that place individuals at increased odds of experiencing an AIB is critical to inform interventions aimed at reducing alcohol-related harms. The present study seeks to examine a theory-informed model of biopsychosocial factors that may increase a person's risk for experiencing AIBs over and above drinking. Young adults (n = 175, 52.6% female, 86.9% White, Mage = 20.8) with recent history of heavy drinking and AIBs wore transdermal alcohol concentration sensors and completed twice-daily surveys about previous-day alcohol use and AIBs over six weekends. Multilevel structural equation models were conducted to test for direct and indirect effects (through transdermal alcohol concentration) of social norms (descriptive and injunctive AIB norms, separately), psychological factors (impulsivity and sensation seeking), and family history of alcohol problems on AIB risk. One in three drinking days (n = 535, 33.8%) resulted in an AIB. Descriptive AIB norms (OR = 1.42, 95% CrI [1.06, 1.97]) and family history (OR = 1.41, 95% CrI [1.04, 1.92]) were uniquely associated with increased odds of experiencing AIBs. Psychological influences were not significantly associated with AIBs. No indirect effects were observed. In a theory-informed examination of biopsychosocial factors, higher descriptive norms and family history increased the odds of experiencing AIBs. Our findings highlight the potential value of future research examining interventions targeting misperceptions of peer AIB frequency. (PsycInfo Database Record (c) 2026 APA, all rights reserved).