Positive Affect and Alcohol Craving in Trauma-Exposed Young Adults

Background: Alcohol use disorder (AUD) and post traumatic stress disorder (PTSD) co-occur frequently. College years mark an important developmental period to examine this comorbidity, as college students are at greater risk for alcohol use problems and exposure to high-severity traumatic events. The current state of literature supports negative reinforcement of alcohol use in the etiology and maintenance of PTSD-AUD. However, individuals with PTSD symptoms drink alcohol for a variety of reasons other than coping motives, and motivation for alcohol consumption changes over the course of use. This study aimed to evaluate how positive affect and enhancement motives may help explain the relationship between alcohol cues and craving among trauma-exposed young adult drinkers. Methods: The sample was comprised of college students (N=221, 50.2% female), who endorsed lifetime exposure to interpersonal trauma (e.g., sexual/physical assault) and current weekly alcohol consumption. Utilizing a trauma and alcohol cue reactivity paradigm, participants completed self-report measures in response to four imaginal narrative (personalized trauma vs. neutral) and in-vivo beverage (personalized alcohol vs. water) cue combinations in the laboratory. Results: A series of linear mixed effect (LME) models indicated that a majority of the association between beverage cue and self-reported craving was attributed to direct effects, and enhancement motives did not moderate the association between positive affect and alcohol craving. However, enhancement motives significantly moderated the association between beverage cue and positive affect, such that the alcohol cue related to greater increases in positive affect among individuals with high compared to low levels of enhancement drinking motives. Lending support to prior research, our findings suggest that targeting enhancement motives and incorporating positive feelings could be considered as an interventional goal to decrease alcohol drinking. Furthermore, the result emphasizes the importance of targeting young adults who drink alcohol to enhance their experience of positive affect, since they might be in the early phase of developing alcohol dependence. We might be able to prevent further development of AUD and alcohol use in the young trauma survivors by aiming to increase experiences of positive feelings by means other than alcohol.