Effects of alcohol sensitivity on alcohol‐induced blackouts and passing out: An examination of the alcohol sensitivity questionnaire among underage drinkers

Background The role of alcohol sensitivity in the experience of blacking out and passing out has not been well established. Here, we examined the relation between individual differences in alcohol sensitivity (i.e., numbers of drinks required to experience various effects of alcohol) and reports of blacking out and passing out in the past year. Methods Participants (925 healthy, underage college student drinkers) completed the Alcohol Sensitivity Questionnaire (ASQ) and reported on their past year blacking out and passing out experiences. Results The fit of the ASQ’s 2‐factor structure was fair (CFI = 0.90, RMSEA = 0.09) in this sample of underage drinkers. In unadjusted models, higher ASQ scores (i.e., requiring more drinks to experience effects, indicating lower alcohol sensitivity) were associated with experiencing more blackouts (IRR = 1.68 [1.31–2.15]) and passing out (IRR = 2.25 [1.59–3.18]) in the past year. After controlling for typical consumption, however, higher ASQ scores were associated with fewer past‐year blackouts (IRR = 0.76 [0.60–0.98]). Total ASQ scores moderated the relationship between typical alcohol consumption and blackout occurrence (interaction IRR = 0.96 [0.93–0.98]), but not passing out occurrence (interaction IRR = 0.95 [0.89–1.01]), with the quantity of alcohol consumed more strongly associated with blackout occurrence among higher‐sensitivity than lower‐sensitivity drinkers. Conclusions These findings are consistent with prior work suggesting that low sensitivity may act as a paradoxical risk factor for certain heavy drinking effects, contributing to higher levels of alcohol consumption and more frequent negative consequences while also conferring protection (relative to high‐sensitivity peers) at a given level of alcohol exposure. Low sensitivity to alcohol appears to act as a paradoxical risk factor for experiencing alcohol‐induced blackouts, consistent with previous work on alcohol‐related regretted sex and hangovers. While low sensitivity to alcohol contributes to higher levels of alcohol consumption and more frequent negative consequences compared to higher sensitivity peers, at a given level of alcohol exposure, low sensitivity may confer protection from certain heavy drinking consequences.