Drinking motives among patients with alcohol use disorder: a longitudinal study

This current two-year clinical study among adult patients with alcohol use disorder (AUD) examined drinking motives and their cross-sectional and longitudinal associations with alcohol consumption, severity of AUD, and other alcohol-related problems. Enhancement, coping, conformity, and social motives have been found to impact alcohol use, yet longitudinal studies on drinking motives in clinical populations are sparse. This observational study used data from a randomized controlled trial (RCT) conducted in Stockholm, Sweden, from 2017 to 2022, including 250 participants with AUD. Data from both treatment groups were included. Assessments of study outcomes were conducted at five time points: at baseline, and after 12, 26, 52, and 104 weeks. Self-report questionnaires and diagnostic interviews were used to assess drinking motives, alcohol consumption, alcohol-related problems, and mental health. Instruments used for self-reports included: The Drinking Motives Questionnaire-Revised Short Form (DMQ-R SF) and the Alcohol Use Disorders Identification Test (AUDIT). The DMQ-R SF assessed enhancement, coping, conformity, and social motives. The AUDIT assessed self-perceived alcohol problems. Interviews were conducted to assess alcohol consumption using the Timeline Follow-Back method (TLFB) and AUD using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Generalized linear models were used to examine associations between drinking motives (DMQ R-SF) and alcohol-related outcomes (TLFB/AUDIT/AUD by the DSM-5). Reductions in both drinking motives (enhancement 15.6%, coping 23.6%, conformity 15.4%, and social 17.9%) and alcohol-related outcomes (drinks per week 40.5%, number of DSM-5 criteria 50.9%, and AUDIT total score 36.3%) were observed during the study period. Across outcomes, the most prevalent drinking motives was enhancement, followed by social, coping, and conformity motives. Elevated enhancement, coping and social motives were cross-sectionally associated with worse alcohol-related outcomes at different time points, whereas higher conformity motives had links to less alcohol consumption. Higher enhancement motives at baseline predicted a larger reduction in the severity of alcohol problems from baseline to the 104-week follow-up. Enhancement motives were most prevalent among people with AUD, and higher enhancement motives were associated with reductions in AUD severity over time. Motive domains likely play a role in understanding changes in the severity of AUD over time. The original RCT study was registered retrospectively at isrctn.com (14539251), registration date 04/09/2018.