When young adults are asked to recall their drinking habits, their recollections may not always match what actually happened in their day-to-day lives, a new study suggests. Though people tend to remember major events, like an accident or a fight, they may lose track of more subjective experiences, such as cravings or changes in alcohol tolerance.
This disconnect between recollection and reality can make it difficult for clinicians and researchers to fully understand the range of alcohol use disorder (AUD) symptoms a person is experiencing. The findings, published in Clinical Psychological Science , suggest that relying on memory alone may leave important gaps and that new assessment strategies are needed to gain a clearer picture of what's really happening.
In the study, researchers found that real-time measurements of AUD symptoms provide more detailed insights into daily experiences than traditional retrospective self-reports, which have long been the standard in both research and clinical settings.
"Some of the retrospective measures were highly associated with the daily measures, but some were less associated," said Dani Kang, an assistant professor of psychiatry at the University of Washington and lead author of the paper.
That means "we're missing half the picture," added APS Fellow Kevin King, a professor of psychology at the University of Washington and coauthor of the study.
Retrospective self-reports, often asking people to reflect on their experiences over the past 6 months or year, are important tools for screening and treatment. But they fall short when it comes to capturing how AUD symptoms unfold and fluctuate in everyday life.
"We're doing all this research to understand the etiology of AUD, but we're doing it with entirely retrospective assessments," King said. "We can't use those reports to understand how AUD progresses and develops in daily lives."
His goal, he added, is to better understand both the objective events and the subjective experiences that shape alcohol use in real time, and how those compare with what people later report.
To explore this question, the researchers studied 496 young adults in Washington state, ages 18 to 22, all of whom reported using alcohol or cannabis at least once a week. Participants completed retrospective self-reports at the start of the study and again six months later. They also completed real-time assessments over an eight-week period, receiving brief surveys on their cell phones five times a day.
The surveys focused on a subset of AUD symptoms, including hazardous use, social/occupational problems, failure to fulfill obligations, craving, tolerance, larger/longer consumption, and time spent obtaining/using alcohol. Participants were tracked over eight long weekends, Thursday to Sunday, when substance use tends to be highest among young adults.
The results revealed a clear divide in what people remember accurately. Participants were generally good at recalling concrete, memorable events, such as getting into a fight, being injured, or missing work or school. However, compared to more objective events, what they said in the moment or on the day mapped less well to their retrospective recall.
"It's fair to say that people are better at remembering what happened to them than how they felt about it," King said.
Daily reports of symptoms also predicted how participants described their alcohol use 6 months later, suggesting that real-time data may capture patterns linked to longer-term risk.
In clinical settings, Kang said, patients often struggle to recall or recognize patterns in their drinking. Real-time tracking could help people see those patterns more clearly and recognize when they may need help. The researchers also noted that AUD can look very different from person to person, making more detailed, real-time data especially valuable.
One limitation, the researchers cautioned, is that many participants used both alcohol and cannabis, making it difficult to determine whether certain symptoms were driven by alcohol alone or by combined use. Future analyses will aim to account for this, Kang noted.
Although real-time monitoring is unlikely to replace retrospective assessments, the researchers said the two approaches could complement each other.
"Real-time and retrospective assessments are not interchangeable because they have different strengths," King said. "Real-time assessments tell us how someone experiences the world in the moment. Retrospective assessments are a blend of aggregated moments and how people evaluate or make sense of them."
Using both approaches together, he said, could allow clinicians and researchers to move beyond a one-size-fits-all method of assessment.
"When you have a hammer, everything looks like a nail," he says, "We need to build and refine these tools so we can use them in a less blunt way."
The researchers are continuing to expand on their work by incorporating new technologies, including transdermal alcohol biosensors and GPS tracking, to better understand individuals' behaviors and environments in real time.
Reference
Kang, D., Watts, A. L., Boness, C. L., Schultz, M. E., Dora, J., Lee, C. M., & King, K. M. (2026). Daily life assessment of seven alcohol-use-disorder symptoms . Clinical Psychological Science.
