The effect of resilience on alcohol use and alcohol-related outcomes: A systematic review and meta-analysis.

Résumé

BACKGROUND: Resilience, defined as the capacity to recover from difficulties or to adapt well to stressors, challenges, and adversities in life, is increasingly studied, yet its role in a range of alcohol-related outcomes remains unclear, including alcohol consumption, risky drinking, and alcohol use disorder. This review synthesises available evidence while considering variability across populations, contexts, and measurement approaches.METHODS: We systematically searched MEDLINE, PsycINFO, CINAHL, and Web of Science for observational studies examining the relationship between individual-level resilience and alcohol-related outcomes. Two independent reviewers screened records and extracted data, with disagreements resolved by consensus. We included studies published on or after 1 January 2014 that reported an association or provided sufficient data to determine its direction. Random-effects meta-analysis was used to estimate pooled associations for studies reporting comparable effect sizes (odds ratios or correlation coefficients), and narrative synthesis was used for studies not amenable to meta-analysis.RESULTS: A total of 66 studies met the inclusion criteria and were included in the review. Approximately two-fifths (42.6%) were conducted in high school or college student populations, and 65.3% were conducted in high-income countries, primarily the United States. Meta-analysis of 24 studies showed that higher resilience was associated with lower odds of alcohol-related outcomes (pooled OR = 0.91, 95% CI = 0.87-0.95), although the observed heterogeneity was substantial (I = 99.9%, p