Importantly, such coping motives for drinking predict a more problematic course of substance use in general (Carpenter & Hasin, 1999; Cooper et al., 1995). With progression of the addictive process, affect-related cues for drinking and coping motives may become classically conditioned and part of a sub-conscious process (Baker, Piper, McCarthy, Majeskie, & Fiore, 2004). This, in turn, further entrenches the relation between affective and substance use disorders, such that the two become interdependent in a single addictive cycle. Thus, with adolescence, we posit that progression along the internalizing pathway is marked by (a) increasing coping expectancies and motives for substance use, (b) initiation of use either with the goal of self-medication by drinking alone or with the goal of peer acceptance by drinking with deviant peers, and (c) escalation in use to SUDs in adulthood to the point of addiction, particularly for COAs.
