Binge drinking (BD) during emerging adulthood increases the risk of developing alcohol use disorders, yet not all individuals follow this trajectory. Deficits in emotion regulation has been identified as a risk factor for psychopathology, but its specific role in shaping long-term alcohol severity among young binge drinkers remains insufficiently understood. This study investigates the role of emotion regulation difficulties as a mediator in the relationship between binge BD and future alcohol severity in young people and the moderator role of emerging psychopathological symptoms. We followed a cohort of 192 university students (53% female) over two years, from ages 18 to 20 We measured alcohol consumption and emotion regulation (Difficulties in Emotion Regulation Scale), as well as psychopathological symptoms (Brief Symptom Inventory). Mediation and moderated mediation models were conducted with PROCESS. Results show that BD predicts future alcohol severity, with emotion regulation difficulties, specifically challenges in goal-directed behaviour, partially mediating this relationship. Psychopathological symptoms moderated the effects, with difficulties in emotion regulation being a significant predictor of future alcohol severity only in individuals with emerging psychopathological symptoms. Additionally, the association between BD and future alcohol severity was amplified in those with emerging psychopathological symptoms. These findings offer new insights into the risk factors underlying the escalation of problematic alcohol use and the interplay between BD, emotion regulation, and psychopathology. They also stress the importance of early interventions focused on enhancing emotion regulation abilities in young binge drinkers, especially those displaying early psychopathological symptoms.

The authors have declared no competing interest.

This work was supported by Grant PID2020-113487RB-I00 funded by MCIU/AEI/ 10.13039/501100011033; Grant PNSD 2015/034 funded by PNSD; Grant PSI2015-70525-P co-funded by MEIC and ERDF. Carina Carbia received funding from the Fonds de la Recherche Scientifique (FNRS) as a Charge de Recherches (CR).

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The study was approved by the University of Santiago de Compostela (Spain) USC's Bioethics Committee on July 28, 2016.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

All data produced in the present study are available upon reasonable request to the authors