Abstract
Early life adversity (ELA) increases the risk of problematic alcohol use and alcohol use disorder (AUD). However, it is unclear why some but not all ELA-exposed individuals develop problematic alcohol use. Research is needed to determine how this environmental risk factor interacts with underlying neurobehavioral vulnerabilities to problem alcohol use. Hypersensitivity to uncertain threats (U-threat) has been posited as an endophenotype for AUD that might aid in the refinement of mechanistic models of problematic alcohol use. Therefore, U-threat hypersensitivity requires examination as a possible individual difference factor that facilitates problematic alcohol use among ELA-exposed individuals. We examined the unique and interactive effects of ELA and U-threat reactivity on problem drinking and depressive and anxiety symptom severity. Participants (N = 131) completed a well-validated threat-of-shock task, and startle eyeblink potentiation was recorded to index aversive responding. Individuals also completed self-report measures of alcohol use, anxiety, and depressive symptoms. Results demonstrated a positive association between ELA and higher levels of problematic alcohol use at high levels of U-threat reactivity, β = .75, t = 3.93, p < .001. Conversely, at low levels of U-threat reactivity, ELA exposure was negatively associated with problematic alcohol use, β = −.49, t = −2.30, p = .023. There was no significant ELA x U-Threat reactivity interaction on anxiety or depression. U-threat response strongly interacts with ELA exposure, affecting the direction of the association between ELA and problem drinking. U-threat reactivity may be a promising target for the prevention and treatment of problematic drinking among ELA-exposed individuals.