Running head: PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES Role of Pregaming Motives in Accounting for Links Between Maladaptive Personality Traits and Drinking Consequences Whitney R. Ringwald1 Elizabeth A. Edershile1 Jonathan Hale2 Trevor F. Williams3 Leonard J. Simms4 Kasey G. Creswell5 Rachel L. Bachrach1,6 Aidan G.C. Wright1 1Department of Psychology, University of Pittsburgh 2Department of Pathology & Laboratory Medicine, Lewis Katz School of Medicine at Temple University 3Department of Psychology, Northwestern University 4Department of Psychology, University at Buffalo 5Department of Psychology, Carnegie Mellon University 6 Center for Health Equity Research and Promotion; Mental Illness Research, Education, and Clinical Center, VA Pittsburgh Healthcare System This research was supported by grants from the National Institutes of Health (R01 AA026879), the Veterans Health Administration (Health Services Research and Development CDA 20-057), the University of Pittsburgh’s Clinical and Translational Science Institute, which is funded by the National Institutes of Health Clinical and Translational Science Award program (UL1 TR001857). The opinions expressed are solely those of the authors and not those of the funders, institutions, the Department of Veterans Affairs, or the United States Government. Declarations of interest: None. Correspondence concerning this article should be addressed to Whitney R. Ringwald, Department of Psychology, University of Pittsburgh, 4305 Sennott Square, 210 S. Bouquet St., Pittsburgh, PA 15260. Email: [email protected] 2 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES Abstract College students are at heightened risk of engaging in unhealthy alcohol use that leads to negative consequences (e.g., motor vehicle accidents, poor academic performance). Understanding how individual differences, like maladaptive personality traits, contribute to that risk could improve intervention efforts. A potential pathway through which personality confers risk for consequences is by influencing students’ motivation to drink. In this study of 441 college students, we investigated whether different motivations to pregame, a particularly risky and common drinking practice on college campuses, accounts for links between maladaptive traits and alcohol-related consequences. Results of bivariate analyses showed that all pregaming motives and maladaptive traits (except Detachment) were strongly correlated with negative consequences. In path analytic models that adjusted for shared variance between pregaming motives and between maladaptive traits, results showed that traits had indirect effects on total drinking consequences via individual differences in pregaming motives as well as direct effects that were independent of motives. Specifically, Antagonism, Disinhibition, and Negative Affectivity predicted more drinking consequences via stronger motives to pregame for instrumental reasons over and above the general motivation to pregame whereas Detachment predicted fewer consequences via weaker instrumental pregaming motives. Antagonism and Disinhibition were also associated with more drinking consequences, and Detachment with fewer consequences, over and above pregaming motives and general personality problems. Our study indicates that one way maladaptive personality traits may shape alcohol-related consequences in college students is by associations with their motivations to pregame. Keywords: drinking motives; alcohol use; dimensional models; personality pathology 3 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES Personality is a powerful predictor of acute alcohol-related consequences (e.g., driving drunk, unprotected sex) and longer-term problems (e.g., academic/work impairment, alcohol use disorder; Baer, 2002; Hustad et al., 2009; Samek et al., 2018; Stacy et al., 1991). Most research on associations between personality and alcohol use outcomes has examined the Big Five traits. Meta-analyses of this literature show that Extraversion generally predicts increased alcohol consumption (but not consequences), whereas high Neuroticism, low Agreeableness, and low Conscientiousness predicts more risky drinking behaviors (e.g., binge-drinking, solitary drinking; Adan et al., 2017; Creswell et al., 2015) and negative short and longer-term consequences, and Openness is generally unrelated to alcohol use (Lui et al., 2021; Malouff et al., 2005; Markon et al., 2005). A population that is particularly likely to engage in unhealthy alcohol use is college students due in part to various developmental and environmental factors (e.g., changes in neurobiology and social roles, participation in Greek activities; Merrill & Carrey, 2016), but personality also has a role in conferring risk (or resilience) during this time (Ham & Hope, 2003). Given the heightened risk in this population, and the unique circumstances that contribute to this risk, there is a need to identify intervening factors that explain associations between personality and drinking consequences in college students. Identifying how personality leads to negative drinking outcomes, in turn, can inform theory and improve intervention efforts. A drinking practice that is relatively specific to college students is pregaming (sometimes referred to as “pre-partying”, “pre-drinking”, or “pre-loading”), defined as consuming alcohol in a short period of time prior to an event (Zamboanga & Olthuis, 2016). Pregaming often entails rapid consumption of high volumes of alcohol, which increases susceptibility to harmful drinking consequences such as injury, motor vehicle accidents, violence, and blackouts (Hughes 4 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES et al., 2008; Hummer et al., 2013; Labhart et al., 2013; LaBrie & Pedersen, 2008; Merrill et al., 2013). There are multiple pathways through which personality may influence the tendency to engage in a behavior like pregaming. One of the most proximal predictors of alcohol use behavior with strong ties to personality is thought to be a person’s motivation for drinking, with different motives predicting different outcomes (Bresin & Mekawi, 2021; Cooper et al., 2015; Cox & Klinger, 1988). The broader literature on alcohol use and personality supports this hypothesized pathway; for instance, research shows that the relationship between Extraversion and alcohol consumption is accounted for by the motivation to enhance positive emotions and social experiences, whereas the relationship between Neuroticism and alcohol problems is accounted for by the motivation to cope with negative emotions (Hussong, 2003; Mezquita et al., 2010; Stewart et al., 2001). There is some evidence that college students’ motivations to pregame are distinct from general drinking motives. Whereas general drinking motives consist of both positive and negative reinforcement (e.g., drinking to enhance or cope), research suggests pregaming motives are more focused on the goal of intoxication and are typically related to positive (rather than negative) reinforcement (Pedersen et al., 2009; Read et al., 2010). Scales developed specifically for pregaming motives have identified a different factor structure than general drinking motives. Although there are slight differences across these scales, pregaming motives tend to fall into three categories: (1) to get drunk and have fun, (2) to loosen up and enjoy socializing more, and (3) for instrumental purposes such as hooking up or insufficiency of alcohol at the event (Bachrach et al., 2012; Labhart & Kuntsche, 2017; LaBrie et al., 2012; Read et al., 2010). Pregaming motives are correlated with general drinking motives, but pregaming motives incrementally predict pregaming behavior above and beyond general drinking motives, and 5 PREGAMING MOTIVES, MALADAPTIVE TRAITS, CONSEQUENCES pregaming motives influence drinking consequences both directly and indirectly via pregaming behavior (Bachrach et al., 2012; Labhart & Kuntsche, 2017; LaBrie et al., 2012). Thus, to thoroughly evaluate the potential pathways between personality and consequences via pregaming may require narrowing in on pregaming-specific motives. However, no research to date has examined whether pregaming motives may account for the links between personality and drinking consequences in college students. Although the Big Five traits are clearly associated with alcohol use outcomes, they may not capture the full breadth of maladaptive aspects of personality needed to predict risky drinking behavior like pregaming. A substantial body of clinical research has identified five maladaptive trait domains that conceptually and empirically align with the Big Five traits (Widiger & Simonsen, 2005), but provide more comprehensive coverage of pathological personality features (Suzuki et al., 2015). These traits are Antagonism (maladaptively low Agreeableness), Detachment (maladaptively low Extraversion), Disinhibition (maladaptively low Conscientiousness), Negative Affectivity (comparable to Neuroticism), and Psychoticism (an aspect of maladaptive Openness). Most alcohol research has focused on Disinhibition and related components of impulsivity and has shown that these traits are strongly associated with alcohol use disorder and unhealthy drinking (Coskunpinar et al., 2013; Littlefield et al., 2009), including in college student samples (Adams et al., 2012; Jones et al., 2014). Few studies have examined how multiple maladaptive traits uniquely relate to drinking consequences and these found traits related to Disinhibition, Antagonism, and Negative