Alcohol use disorders (AUDs) affect nearly 3 in 10 Americans in their lifetimes, and impact individuals in a variety of arenas, including work, personal relationships, and via heightened risk for other health issues. Much research and theory on the development of AUDs from adolescence into adulthood has focused on broad environmental and psychological risk factors; less research has focused on developmental pathways of risk. Enhanced understanding of the processes by which risky alcohol use develops and of the individuals most at- risk for later AUDs will be critical to honing interventions to target the psychological factors most likely to reduce risk. Research has shown that an emotional and impulsive temperament may predispose a person to later risky drinking, and further that much of this risk is due to an increased likelihood of learning that alcohol is an effective means of reducing negative emotions. The Acquired Preparedness (AP) model formalizes this idea into a testable mediational model. However, just how temperament may bias this learning of drinking to cope (DTC) as an emotion regulation strategy is not well-understood. We propose that temperament may make learning DTC more likely by predisposing individuals to more general avoidant coping, which in turn generalizes to drinking behavior. Avoidant coping is related to emotionality and impulsivity, and to broad internalizing and externalizing problems. Moreover, avoidant coping behavior has intuitive appeal in explaining the behavior of drinking alcohol for the purpose of avoiding negative emotions, and precedes regular alcohol use. Still, avoidant coping has not yet been tested as a mechanism by which teens with an emotional, impulsive temperament develop maladaptive beliefs about alcohol use. The present study integrates coping research into a current model of AUD etiology, with the goal of better articulating the development of AUDs. By analyzing longitudinal data following adolescents into their 30s, the proposed project will provide an important test of the longitudinal mechanisms by which early-appearing temperament characteristics convey risk for outcomes in adulthood. A second goal of the proposed project is to understand who is most likely to develop DTC; we hypothesize that individuals who have the most opportunities to learn the affect regulation function of alcohol ? through their own drinking and through seeing peers drink ? will have the strongest link between avoidant coping and DTC. The current project has the potential to clarify mechanisms of risk and identify targets for treatment and primary prevention efforts.
The current project aims to integrate research on coping into developmental models of risky alcohol use by testing a model of how general coping styles that emerge early in development predict drinking-specific coping behaviors. In doing so, we hope to improve current models of alcohol use and link risk factors to potential behavioral mechanisms. Greater understanding of risk and etiology for alcohol use disorders may inform prevention and treatment efforts.
