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 l evels of drinking to cope with negative affect among problem drinkers relat ive 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 ep iphenomena. A cross-sectional design was used to compare levels of self-rep orted drinking to cope with negative affect between individuals who had cur rent DSM-IV alcohol use disorders-and those who did not. Method: Participan ts consisted of a sample of community residents (N = 777, 55% men). All par ticipants completed an in-person structured psychiatric interview and a sel f-report questionnaire assessing alcohol use, drinking motives. depressive affect, and negative alcohol consequences. Results: Linear regression model s yielded significant differences in mean drinking to cope with negative af fect scores between participants with a DSM-IV alcohol dependence diagnosis and participants with Ilo diagnosis. These differences remained after cont rolling for depressive affect and frequency of negative alcohol consequence s in three of the four adjusted comparisons. No significant differences in adjusted mean drinking to cope with negative affect scores were demonstrate d between subjects with a DSM-IV alcohol abuse diagnosis and those with no diagnosis. Conclusions: The DSM-IV alcohol dependence and no-diagnosis comp arisons were most consistent with the predictions of a risk-factor model. T hese results provide further evidence that drinking to cope with negative a ffect may haven etiological role in development of alcohol dependence.