Drinking to cope with negative affect and DSM-IV alcohol use disorders: A test of three alternative explanations

Objective: previous studies of drinking motives have demonstrated greater levels of drinking to cope with negative affect among problem drinkers relative to nonproblem drinkers. These findings suggest that the use of alcohol to cope with negative affect may place individuals at greater risk for the development of alcohol problems. However, several alternative explanations exist, each with different intervention implications. This study evaluated three alternative explanations or models: risk-factor, generalizing, and epiphenomena. A cross-sectional design was used to compare levels of self-reported drinking to cope with negative affect between individuals who had current DSM-IV alcohol use disorders-and those who did not. Method: Participants consisted of a sample of community residents (N = 777, 55% men). All participants completed an in-person structured psychiatric interview and a self-report questionnaire assessing alcohol use, drinking motives. depressive affect, and negative alcohol consequences. Results: Linear regression models yielded significant differences in mean drinking to cope with negative affect scores between participants with a DSM-IV alcohol dependence diagnosis and participants with Ilo diagnosis. These differences remained after controlling for depressive affect and frequency of negative alcohol consequences in three of the four adjusted comparisons. No significant differences in adjusted mean drinking to cope with negative affect scores were demonstrated between subjects with a DSM-IV alcohol abuse diagnosis and those with no diagnosis. Conclusions: The DSM-IV alcohol dependence and no-diagnosis comparisons were most consistent with the predictions of a risk-factor model. These results provide further evidence that drinking to cope with negative affect may haven etiological role in development of alcohol dependence.