People who drink to improve their mood are three times more likely to become dependent on alcohol, compared with those who don’t use alcohol to feel better or stay calm, new research suggests.

Among people with an increased risk of alcohol dependence, those who drink to improve their mood are less likely to become sober several years later, compared with people who don’t drink to ease painful emotions, the Los Angeles Times reports.

One new study, published in JAMA Psychiatry, included people who were at increased risk of alcoholism, who were asked whether they drank to improve their mood or reduce tension. They were interviewed again several years later, to determine whether they had become, or stayed, alcohol-dependent. “Drinking to self-medicate mood symptoms may be a potential target for prevention and early intervention efforts aimed at reducing the occurrence of alcohol dependence,” the researchers wrote.

A second study, published in the same journal, used brain scanners in 45 people with alcoholism at an inpatient treatment program, while they were in the first four to eight weeks of a 12-step program. They were asked to think about situations when they were relaxed, and then to imagine highly stressful situations or those associated with heavy drinking.

Patients who would later relapse were more likely than those who did not return to drinking to show low activity in regions of the brain associated with regulation of mood, emotional arousal and cognitive control when they thought about stressful situations or drinking-related scenarios. When they were relaxed, they showed increased activity in these brain regions.

In an editorial accompanying the studies, Nora D. Volkow, Director of the National Institute on Drug Abuse, wrote, “A better understanding of a patient’s response to stress and/or alcohol cues is bound to contribute to the design of more personalized and, therefore, effective treatment strategies.”