A multimodal, longitudinal investigation of alcohol’s emotional rewards and alcohol consumption over time in young adults

Abstract

Theories of Alcohol Use Disorder (AUD) have long suggested that alcohol's emotional rewards play a key role in reinforcing problematic drinking. Studies employing survey methods, in which participants recall and aggregate their experiences with alcohol in a single questionnaire, indicate that self-reported expectancies and motivations surrounding alcohol’s emotional rewards predict problematic drinking trajectories over time. But, to date, no longitudinal research has directly assessed participants’ emotional responses to alcohol as a predictor of drinking outcomes. The current study combines laboratory alcohol-administration, ambulatory methods, and longitudinal follow-ups to assess whether alcohol’s ability to enhance positive mood and relieve negative mood predicts later drinking problems. Sixty heavy social drinkers (50% female) participated in laboratory-based alcohol-administration, attending both alcohol (target BAC .08%) and no-alcohol laboratory sessions. Forty-eight of these participants also wore transdermal alcohol monitors—calibrated for each participant via laboratory alcohol-administration—and completed mood surveys outside the laboratory for 7-days. Participants reported on their drinking at 18-month follow-up (90% compliance). Controlling for baseline drinking, greater negative mood relief from alcohol at baseline predicted more drinking problems at follow-up, an effect that emerged as consistent across methods capturing alcohol’s emotional rewards in the laboratory, b=-.23, p=.03, as well as via ambulatory methods, b=-1.81, p=.02. Greater positive mood enhancement from alcohol, captured via laboratory methods, also predicted drinking problems, b=.17, p=.01, and binge drinking, b= 2.04, p=.01, at follow-up. Models examining drinking frequency/quantity were non-significant. Results provide initial support for emotional reward as a potential factor in the development of problematic drinking.