From binge drinking to future alcohol severity: The role of emotion regulation and emerging psychopathology

OBJECTIVES: Binge drinking (BD) increases the risk for alcohol use disorders and other psychopathological disorders later in life. Emotion regulation (ER) deficits have been identified as a transdiagnostic risk factor, yet their role in risk trajectories is not well established. This is especially relevant in young BDs initially free of psychopathology, where emerging symptoms may shape risk trajectories toward severe alcohol use. Thus, this study examined whether ER difficulties mediate the link between BD and later alcohol severity, and whether emerging psychopathology moderates these associations during the critical developmental period of late adolescence. METHODS: A total of 192 university students (53% female) were followed over two years, from ages 18 to 20. Individuals with psychopathological symptoms or alcohol-related problems were excluded at baseline. Alcohol consumption patterns were assessed together with ER (Difficulties in Emotion Regulation Scale), and psychopathology (Brief Symptom Inventory). Mediation and moderated mediation analyses were conducted using PROCESS in SPSS. RESULTS: BD was associated with ER difficulties, particularly problems engaging in goal-directed behaviour. ER difficulties partially mediated the relationship between BD and later alcohol severity. Emerging psychopathological symptoms amplified both the direct effect of BD and the indirect effect through ER. Specifically, ER difficulties predicted alcohol severity only among individuals with elevated psychopathological symptoms. CONCLUSIONS: Findings suggest that ER difficulties, especially goal-directed behaviour, mediate the progression from BD to alcohol severity, and that emerging psychopathology during late adolescence heightens this risk. Preventive interventions should target both BD and ER skills in youth, particularly those developing early psychopathological symptoms.