Personality Disorder Symptoms, Drinking Motives, and Alcohol Use and Consequences: Cross-Sectional and Prospective Mediation

Research shows high comorbidity between Cluster B personality disorders (PDs) and alcohol use disorders (AUDs). Studies on personality traits and alcohol use have identified coping and enhancement drinking motives as mediators in the relations among impulsivity, affective instability, and alcohol use. To the extent that PDs reflect extreme expression of these traits, drinking motives should mediate the relation between PD symptoms and alcohol involvement. This was tested using path models estimating the extent to which coping and enhancement drinking motives mediated the relation between Cluster B symptom counts and alcohol use and problems both concurrently and at a 5-year follow-up. Three hundred fifty-two adults participated in a multiwave study of risk for alcoholism (average age = 29 years at Wave 1). Enhancement motives mediated (a) the cross-sectional relation between Cluster B symptoms and drinking quantity/frequency, heavy drinking, total drinking consequences, dependence features, and AUD diagnosis and (b) the prospective relation to AUDs. Although coping motives mediated the relation between Cluster B symptoms and drinking consequences and dependence features cross-sectionally, prospective effects were limited to indirect effects through Time 1.