The path from negative affect to alcohol problems: Alcohol demand as mediator transcends alcohol craving

Objective: This study examined direct and indirect relationships among negative affect, difficulties in emotion regulation (DER), mindfulness, drinking-to-cope, alcohol craving, alcohol demand intensity, alcohol consumption, and alcohol problems. Method: 417 participants (76.74% female, M_age=20.76 years) reporting past-month heavy/binge drinking completed a cross-sectional survey. Path analysis was conducted to examine the hypothesized models. Results: Direct paths between study variables were largely consistent as hypothesized (e.g., negative affect was negatively associated with mindfulness, drinking-to-cope was positively associated with craving and demand intensity). All the indirect pathways were significant except those through craving. The acting with awareness and non-judging facets of mindfulness dominated the mediating effects between negative affect and drinking-to-cope. Nonacceptance and limited ability to modulate facets of DER dominated the mediating effects between negative affect and drinking-to-cope. Conclusions: Targeting alcohol demand intensity and the dominant facets of mindfulness and DER could help break the negative affect-alcohol problems link.