Adolescent Neural Reactivity to Alcohol Cues: The Role of Violence Exposure and Coping Motives

Exposure to violence (physical, domestic, or sexual assault) increases risk for alcohol problems and alcohol use disorder (AUD), consistent with self-medication and drinking-to-cope theories of alcohol use, which posit that some individuals may misuse alcohol to alleviate distress associated with trauma. Yet how violence exposure and coping motives interact to influence objective AUD risk markers remains unclear. Emerging evidence suggests that trauma type affects psychiatric outcomes, but its role in moderating AUD risk via coping motives remains unknown. We examined these gaps in the literature in a cohort of youth (ages 16-19; n = 157) over-sampled for violence exposure. Participants completed a structured trauma interview and an assessment of drinking motives. A total of 60 participants reported experiencing sexual assault (SA), 54 physical assault (PA), and 32 domestic violence (DV). AUD risk was captured using the alcohol cue reactivity paradigm. Participants were exposed to images of alcoholic beverages, high-calorie foods (reward-related control), and neutral objects. The late positive potential (LPP), an event-related potential captured via electroencephalogram, was used to index cue reactivity. We ran two linear regression analyses to assess the relationship between trauma type and coping motives to drink on LPP to alcohol and food cues (>neutral). For alcohol cues, there was a significant SA and coping interaction. At high levels of coping motivations, SA was associated with enhanced LPP to alcohol cues. At low levels of coping motivations there was no association. No effects were observed for food cues. Our results demonstrate that heightened coping motives to drink are associated with enhanced alcohol cue reactivity among SA victims, indicating increased vulnerability for AUD risk.