Negative emotions and alcohol use disorder treatment

We review the association of negative emotions and alcohol use disorder (AUD) through the lens of three discrete disciplines: psychology, psychiatry, and neuroscience. Taking an integrative view of these models and related findings we conclude that: (1) drinking to cope (DTC) serves as the primary final common pathway linking negative emotions to AUD; (2) the quantity rather than the quality of negative emotions modulate their association to drinking and AUD; (3) chronic alcohol use is a neurobiological insult that can dysregulate mood/stress systems leading to a cycle of escalating negative emotions and DTC; (4) preaddiction chronic/traumatic stress or psychiatric disorder constitutes a neurobiological vulnerability to develop a cycle of escalating negative emotions and DTC; (5) increased risk for relapse among those with preaddiction chronic/traumatic stress or psychiatric disorder likely marks a retarded neurobiological re-regulation of stress-mood systems during abstinence; (6) standard psychiatric treatments for anxiety and depression with comorbid AUD improves the former, but only minimally affects the latter; and (7) cognitive-behavioral treatment explicitly focused on reducing DTC and pharmacological treatment targeting neurobiological stress systems show promise in improving AUD associated with strong negative emotions.