Cognitive and affective empathy in binge drinking adolescents. Does empathy moderate the effect of self-efficacy in resisting peer pressure to drink?

Background: Heavy episodic drinking (HED) implies severe consequences for health, both in the short and long term. Peer conformity has shown contradictory relationships with HED, suggesting the presence of a complex interaction between social and individual factors. Objective: This study investigated the moderation role of conformity in the relationship between theory of mind (ToM) and HED. Method: Participants were 170 Italian adolescents (M age = 18.71, SD age = 0.77) recruited in public high schools. Self-report measures were administered for evaluating drunkenness and HED. The Drinking Motives Questionnaire was used to assess three drinking motives, namely coping with negative emotions, enhancement of positive feelings, and the need for peer conformity, whereas the Reading the Mind in the Eyes Test was adopted to test advanced theory of mind skills. ANOVAs, MANOVAs and regression moderation analyses were performed. Results: Drunkenness, HED and drinking motives did not vary with gender. Only social motives were higher in boys (vs. girls). HED was positively related to drunkenness and to social, coping and enhancement motives. However, only enhancement significantly predicted HED. Finally, conformity moderated the relationship between ToM and HED. In the presence of high conformity, adolescents with impaired ToM reported significantly more HED than adolescents with high ToM. Conclusions: In the presence of conformity needs, social cognition impairment appeared to be a risk factor for HED, whereas good socio-cognitive skills were protective. Implications for research, clinical assessment and prevention are discussed.