Co-Occurring Posttraumatic Stress Disorder Symptoms and Alcohol Use Behaviors: The Mediating Role of Drinking to Cope with PTSD Symptoms

Abstract

Objective

Posttraumatic stress disorder (PTSD) symptoms and hazardous drinking often co-occur. One widely acknowledged explanation for this co-occurrence is the self-medication hypothesis. However, only one study to date has explicitly examined the extent to which drinking to cope with trauma-related symptoms, rather than drinking to cope with negative affect more broadly, accounts for this association.

Method

Survey data were collected from a nationally representative sample of adults (n = 360; 48.9% female, Mage = 38.50 years, SD = 10.23).

Results

Results revealed a significant indirect effect of PTSD symptom severity on alcohol use frequency and alcohol use-related problems via drinking to cope with PTSD symptoms but not alcohol use quantity or binge drinking frequency. Drinking to cope with negative affect did not indirectly mediate the relations between PTSD symptom severity and any of the alcohol use-related outcomes.

Conclusions

Findings will be discussed with regard to previous and future research.

Keywords:

• Alcohol
• drinking
• trauma
• PTSD
• coping
• use motives

Acknowledgements

This material is the result of work supported with resources and the use of facilities at the Southeast Louisiana Veterans Health Care System in New Orleans, LA. Dr. Amanda M. Raines is supported by the United States Department of Veterans Affairs (Clinical Science Research and Development Service) under Career Development Award-2 IK2CX001978-02. The contents of this article do not represent the views of the Department of Veterans Affairs or the United States Government.

Ethics approval

All research was conducted in an ethical and responsible manner, aligned with the standards delineated in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. After a complete discussion of the study with potential participants, informed consent was obtained. The study’s protocol was approved by the respective university’s Institutional Review Board prior to data collection. Lastly, this work does not contain identifying information, therefore, consent to publish is not applicable and was not obtained.

Disclosure statement

The authors report no financial relationships with commercial interests and do not have any competing interests to declare.

Data availability statement

All data, analysis code, and research materials can be made available upon reasonable request from Mara Ferrie.

Notes

1 We assessed the alcohol use-related problems model including alcohol use frequency and quantity as covariates to determine whether the associations were consistent when accounting for consumption. A similar pattern emerged. Further, we re-ran all models using a correlated mediation approach in which drinking to cope with PTSD symptoms and drinking to cope with negative affect were allowed to covary. Findings remained the same.

Additional information

Funding

Research reported in this publication was supported by the National Institute on Minority Health and Health Disparities (NIMHD) of the National Institutes of Health (NIH) to the University of Houston under [Award Number U54MD015946]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funding also was supported through an endowment to Dr. Michael Zvolensky.