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

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. The current study is the first to combine laboratory alcohol-administration, ambulatory methods, and longitudinal follow-ups to assess whether alcohol's ability to enhance positive mood and reduce negative mood predicts later drinking problems. Sixty young heavy social drinkers (50% female) participated in laboratory-based alcohol-administration, attending both alcohol (target blood alcohol concentration [BAC].08%) and no-alcohol laboratory sessions. Forty-eight of these participants also wore transdermal alcohol monitors 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 reduction 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 =-.24, p =.02, as well as via ambulatory methods, b =-3.14, p =.01. Greater positive mood enhancement from alcohol, captured via laboratory methods, also predicted drinking problems, b =.16, p =.03, and binge drinking, b = 3.22, p =.02, at follow-up. Models examining drinking frequency/quantity were nonsignificant. Results provide support for emotional reward as a potential factor in the development of problematic drinking.