The two distinct neural risk profiles we identify may at least partially map onto previously identified psychological pathways to problem drinking. Specifically, the high VS-low amygdala profile may be associated with a pathway characterized by positive emotion enhancement and behavioral disinhibition. The opposite risk phenotype of low VS-high amygdala reactivity may conversely map onto a pathway associated with negative emotion relief and stress coping. Notably, however, we found that unlike shared anxious/depressive symptomatology and delay discounting, self-reported positive emotion and hedonic processing did not significantly mediate the relationship between stress and problem drinking. While some studies have pointed out similarities and potential overlap between the positive emotion and disinhibition pathways to problem drinking,28, 29 others have suggested that positive emotion enhancement and lack of behavioral control may be distinct determinants of excessive alcohol consumption.27, 47, 48 Furthermore, drinking to enhance positive emotion, even when excessive and problematic, is less likely to increase as a function of recent life stress, whereas convergent data from animal models49, 50 and humans51, 52 suggests that stress can increase behavioral disinhibition and impulsive responding. Thus,
