Associations of Sensitivity to Reward and Punishment with Alcohol Use Severity in a Trauma-Exposed Community Sample: The Role of Drinking Motives

Background: Sensitivity to reward (SR), or the likelihood of engagement in positively reinforcing experiences, and sensitivity to punishment (SP), or the tendency to avoid behaviors associated with negative outcomes, are risk and maintenance factors for problematic alcohol use, particularly when proximal motivations for drinking are present. Trauma-exposed adults are at increased risk of engaging in problematic alcohol use, particularly if they are using alcohol to cope with negative emotions. Present Study: Thus, the present study examined, among trauma-exposed community adults, the indirect effects of SP and SR on alcohol use severity through drinking motives. Using two parallel mediation models, we hypothesized that coping motives and enhancement motives, would statistically mediate the associations between: a) SR and alcohol use severity and b) SP and alcohol use severity. We predicted that higher SP and SR would be associated with higher coping motives and enhancement motives, and in turn higher alcohol use severity. Method: Participants with histories of experiencing at least one DSM-5 PTSD Criterion A traumatic event (N = 284, M_age = 38.15, SD_age = 12.67, 63.0% men, 72.5% White) were recruited through Prolific and completed an online questionnaire battery. Results: Results revealed significant indirect effects of: a) SR on alcohol use severity through coping motives (b = 0.11, 95% CI [0.04, 0.18]) and b) SP on alcohol use severity through coping motives (b = 0.11, 95% CI [0.05, 0.17]). Conclusions: Findings suggest that drinking to cope may better explain the associations between SP and SR on alcohol use severity, compared to drinking for enhancement, in trauma-exposed samples.