Childhood Adversity and the Association Between Stress Sensitivity and Problematic Alcohol Use in Adults

Early life adversity (ELA) increases the risk of problematic alcohol use and alcohol use disorder (AUD). However, it is unclear why some but not all ELA-exposed individuals develop problematic alcohol use. Research is needed to determine how this environmental risk factor interacts with underlying neurobehavioral vulnerabilities to problem alcohol use. Hypersensitivity to uncertain threats (U-threat) has been posited as an endophenotype for AUD that might aid in the refinement of mechanistic models of problematic alcohol use. Therefore, U-threat hypersensitivity requires examination as a possible individual difference factor that facilitates problematic alcohol use among ELA-exposed individuals. We examined the unique and interactive effects of ELA and U-threat reactivity on problem drinking and depressive and anxiety symptom severity. Participants (N = 131) completed a well-validated threat-of-shock task, and startle eyeblink potentiation was recorded to index aversive responding. Individuals also completed self-report measures of alcohol use, anxiety, and depressive symptoms. Results demonstrated a positive association between ELA and higher levels of problematic alcohol use at high levels of U-threat reactivity, β = .75, t = 3.93, p < .001. Conversely, at low levels of U-threat reactivity, ELA exposure was negatively associated with problematic alcohol use, β = -.49, t = -2.30, p = .023. There was no significant ELA x U-Threat reactivity interaction on anxiety or depression. U-threat response strongly interacts with ELA exposure, affecting the direction of the association between ELA and problem drinking. U-threat reactivity may be a promising target for the prevention and treatment of problematic drinking among ELA-exposed individuals.