Binge Drinking in Adolescence and Early Adulthood: The Salience of PTSD and PTSD-Linked Strain Sensitivity from a Developmental Perspective

Abstract

Background: Post-traumatic stress disorder (PTSD) has been identified by past research as a risk factor for substance use. Further, past research has indicated that individuals with PTSD may demonstrate an increased sensitivity to strain. Despite this, no study has examined the relevance of these processes for understanding binge drinking behaviors from a developmental perspective. Purpose/Objectives: Understand the relevance of PTSD-linked strain sensitivity for predicting binge drinking in adolescence and adulthood. Methods: This study utilizes data from the Pathways to Desistance study, comprising the responses of 1354 juvenile offenders across seven years following an adjudication. A series of ordinal logistic regression models estimated these effects in adolescence and early adulthood. Results: Results indicate that adolescent PTSD interacted with witnessed violence to produce lower frequency binge drinking. This effect was non-significant in early adulthood. Conclusions/Importance: These findings indicate that adolescent PTSD-sufferers demonstrate diminished sensitivity to witnessed violence. This may have to do with adolescence social processes.

Keywords:

• Binge drinking
• PTSD
• juvenile offenders
• exposure to violence
• development

Notes

1 Five represents the number of drinks for males, this number is four drinks in a single sitting for females.

2 The direct victimization items assessed were: have you been chased where you thought you might be seriously hurt?; have you been beaten up, mugged, or seriously threatened by another person?; have you been raped, had someone attempt to rape you or been sexually attacked in some other way?; have you been attacked with a weapon, like a knife, box cutter, or bat?; have you been shot at?; have you been shot?. The witnessed violence items assessed are analogous to the direct victimization items except participants are asked whether they witnessed the event, rather than experiencing it directly; with the addition of one additional item: have you seen someone else get killed as a result of violence, like being shot, stabbed, or beaten to death?

3 The domains in which social support could be provided were: Are there any adults who you admire and would want to be like?; If you needed some information or advice about something, is there someone you could talk to?;; If you were having trouble at home, is there someone you could talk to?; If you got an award or did something well, is there someone you would tell?; Is there an adult with whom you can talk about important decisions in your life?; Is there an adult you can depend on for help if you really need it?; Is there an adult you feel comfortable talking about problems with?; Is there a special adult person in your life who cares about your feelings?

4 It should be noted that there was some disagreement between reviewers and the author regarding inclusion of covariates. A reviewer suggested exclusion of deviant peer association, age, depression, and self-control as covariates because of concerns over mediation. Ultimately, the author relented and agreed to exclude these variables, but contrary to expectations, mediation was not observed. Rather, a suppression effect was observed, as in the full model with all potential covariates included, the interaction between PTSD and direct victimization was significant in the expected manner. This suppression and the disagreement between the reviewer and author should be considered when conducting further research on PTSD and PTSD-linked strain sensitivity, as there may be an observed relationship between PTSD and direct victimization that is relevant for understanding binge drinking. This is especially relevant because little difference was observed in actual magnitude of effects, as results mainly differed simply on p-values that were suppressed when covariates were excluded.