Drinking Motives as Moderators of In‐the‐Moment Drinking Risks in Response to Trauma‐Related Distress

Background Trauma exposure and posttraumatic stress disorder (PTSD) symptomatology are linked to increased risk for problematic drinking, yet the factors that increase such risk remain largely unknown. Theoretical models suggest that affectively oriented drinking motives may be central to trauma‐related drinking. Specifically, individual‐level motivations to drink to regulate affect may be important for moderating drinking urges that occur acutely in response to trauma cues. Further, elevated distress associated with PTSD symptomatology may increase any affectively motivated, momentary drinking risks. However, research has yet to examine these dynamic affective processes. In a large experimental sample, the current study tested whether affective (i.e., coping and enhancement) drinking motives and PTSD symptomatology moderated individuals’ drinking urge in response to a trauma cue in a laboratory cue reactivity paradigm. Methods College drinkers (n = 611, 53% female) were recruited and selected across levels of trauma exposure and PTSD symptomatology by a structured clinical interview. Participants were randomized to a personalized trauma or neutral cue, reporting on their urge to drink alcohol before and after cue exposure. Drinking motives were assessed at the end of the experimental session. Results Trauma cue associations with drinking urge were moderated by coping, but not enhancement, motives. Specifically, stronger coping motives were associated with increases in urge to drink alcohol following exposure to a trauma but not neutral cue. PTSD classification did not significantly moderate these associations. Conclusions Coping motives may increase drinking urge immediately following exposure to trauma cues and may differentiate individuals most at risk for problematic drinking during trauma‐associated distress. Findings support momentary negative affect processes driving dynamic, immediate trauma‐related drinking risks. The motivational processes at play in momentary shifts in drinking risk following trauma cue exposure are not well delineated. This study tested whether affective drinking motives moderated effects of a trauma cue paradigm on acute urge to drink alcohol. Coping, but not enhancement, motives moderated cue exposure effects on drinking urge. Stronger coping motives were associated with escalations in cue‐elicited drinking urge following a trauma but not neutral cue. Findings underscore the importance of drinking motivation in trauma‐related