Reward and Cognition: Integrating Reinforcement Sensitivity Theory and Social Cognitive Theory to Predict Drinking Behavior

Background: Both Reinforcement Sensitivity Theory and Social Cognitive Theory have been applied to understanding drinking behavior. We propose that theoretical relationships between these models support an integrated approach to understanding alcohol use and misuse. Objectives: We aimed to test an integrated model in which the relationships between reward sensitivity and drinking behavior (alcohol consumption, alcohol-related problems, and symptoms of dependence) were mediated by alcohol expectancies and drinking refusal self-efficacy. Methods: Online questionnaires assessing the constructs of interest were completed by 443 Australian adults (M age = 26.40, sd = 1.83) in 2013 and 2014. Results: Path analysis revealed both direct and indirect effects and implicated two pathways to drinking behavior with differential outcomes. Drinking refusal self-efficacy both in social situations and for emotional relief was related to alcohol consumption. Sensitivity to reward was associated with alcohol-related problems, but operated through expectations of increased confidence and personal belief in the ability to limit drinking in social situations. Conversely, sensitivity to punishment operated through negative expectancies and drinking refusal self-efficacy for emotional relief to predict symptoms of dependence. Conclusions: Two pathways relating reward sensitivity, alcohol expectancies, and drinking refusal self-efficacy may underlie social and dependent drinking, which has implications for development of intervention to limit harmful drinking.