Drinking Motives, Alcohol Misuse, and Internalizing and Externalizing Psychopathology across College: A Cross-Lagged Panel Study

<i>Background:</i> Drinking motives are strong proximal predictors of alcohol use behaviors and may represent a mediational mechanism by which different individual predispositions toward internalizing or externalizing psychopathology lead to the development of alcohol misuse. However, whether the association is due to a causal relationship or a shared etiology (i.e., confounding) is difficult to determine and may change across developmental periods. <i>Methods:</i> This study leveraged a cross-lagged panel design to disentangle the nature of the relationships between self-report measures of drinking motives, alcohol misuse, and internalizing and externalizing psychopathology in a 4-year longitudinal sample of college students (<i>N</i> = 9,889). <i>Results:</i> Results pointed to a putative causal effect of drinking motives on early binge drinking frequency, but the direction of effect later reversed, reflecting a possible developmental shift during college. On the other hand, the relationships between drinking motives and internalizing/externalizing psychopathology appeared to be driven by shared etiology rather than direct causal mechanisms. <i>Conclusions:</i> These findings highlight the distinct and important role of drinking motives in the etiology of alcohol misuse and have implications for the application of tailored prevention and treatment strategies.

<i>背景：</i>饮酒动机（drinking motives）是酒精使用行为的强近端预测因子，同时可作为中介机制，介导个体针对内化精神病理（internalizing psychopathology）或外化精神病理（externalizing psychopathology）的不同易感性倾向，进而引发酒精滥用。然而，上述关联究竟源于因果关系还是共同病因（即混杂偏倚），目前难以判定，且可能随个体发育阶段发生动态变化。<i>方法：</i>本研究采用交叉滞后面板设计（cross-lagged panel design），针对9889名大学生组成的4年纵向队列样本，对饮酒动机的自我报告测评结果、酒精滥用与内化、外化精神病理之间的关联本质进行拆解分析。<i>结果：</i>研究结果显示，饮酒动机对早期狂饮（binge drinking）频率存在推测性的因果效应，但该效应的作用方向后续发生反转，反映出大学阶段可能存在的发育转变。另一方面，饮酒动机与内化/外化精神病理之间的关联，似乎由共同病因驱动，而非直接的因果机制。<i>结论：</i>本研究结果凸显了饮酒动机在酒精滥用病因学中独特且重要的作用，并为定制化预防与干预策略的应用提供了理论参考依据。