Development and Validation of the Motives for Using Substances for Trauma Coping (MUST-Cope) Questionnaire: A Novel Multidimensional Scale to Assess Trauma-Specific Substance Use Coping Motives

The present study sought to develop and validate a novel multidimensional assessment of substance use (SU) coping motives to manage trauma symptoms. In Study 1 (<i>N</i> = 326 trauma-exposed adults recruited from several online platforms), a set of questionnaire items was created and administered, and exploratory factor analysis was performed. A correlated four-factor structure represented by cognitive-affective motives, physiological motives, sleep motives, and social motives emerged. In Study 2 (<i>N</i> = 261 trauma-exposed adults recruited from ResearchMatch), confirmatory factor analysis cross-validated the correlated four-factor structure and additionally tested a five-factor higher-order structure. In tests of convergent, discriminant, and criterion validities, the subscales demonstrated differential correlations with previously validated measures of SU motives and positively correlated with higher PTSD symptom severity, functional impairment, and alcohol and drug use severity. The final 31-item Motives for Using Substances for Trauma Coping (MUST-Cope) Questionnaire offers a novel multifactorial measurement instrument to help researchers and clinicians assess and identify functional coping motives for SU that can be targeted in psychosocial treatment.