Alcohol Expectancies, Posttraumatic Stress Disorder, and Alcohol Use in College Students With a History of Childhood Trauma

abstract

Objective: Prior research has emphasized that the key mediator in the posttraumatic stress disorder (PTSD) symptom–alcohol use relationship is the expectancy of alcohol's tension-reducing properties. This study extends the literature by examining various alcohol outcome expectancies. Methods: Cross-sectional data were obtained from 198 college students who reported experiencing at least one traumatic event in childhood. Participants answered surveys measuring PTSD symptoms, alcohol outcome expectancies, and three measures of alcohol consumption and related problems. Results: Participants included 131 males (mean age = 19.65 years, SD = 1.06, range = 18 to 24) and 67 females (mean age = 19.43 years, SD = 0.82, range = 18 to 23), who were predominantly European-American (82%). For males and females, results of the multivariate analyses suggested that self-perception expectancies mediated the effects of PTSD symptoms on alcohol use severity, whereas sociability expectancies mediated the effects of PTSD symptoms on monthly alcohol use. For women, risk and aggression and sexuality expectancies mediated the relationship between PTSD symptoms and alcohol use severity, while risk and aggression expectancies mediated the relationship between PTSD symptoms and alcohol use consequences. For men, sociability expectancies mediated the effects of PTSD symptoms on alcohol use severity. Across genders, tension-reduction expectancies did not mediate the relationship between PTSD symptom and the three alcohol measures. Conclusions: This study was unable to find support for the self-medication hypothesis via the tension-reduction outcome expectancy pathway. However, other significant findings can be interpreted in light of the self-medication hypothesis. For example, alcohol may aid in coping with social impairments related to PTSD symptoms, particularly in a college sample. This study also highlighted gender differences in the association between PTSD symptoms and alcohol consumption and related problems.

Keywords:

• Alcohol abuse
• alcohol outcome expectancy
• posttraumatic stress
• gender differences
• self-medication hypothesis

Acknowledgments

We acknowledge the anonymous reviewers for their valuable comments. A related poster was presented at the 36th Annual Research Society on Alcoholism Scientific Meeting, Orlando, Florida, June 22 to 26, 2013.

Disclosures

The authors report no financial relationships with commercial interests with regard to this study, nor do they have additional income to declare.

Notes

¹ Of the 213 college students mandated to an alcohol intervention who volunteered to complete assessments, 198 (93.0%) endorsed at least one childhood trauma on the ETISR-SF. The high prevalence of childhood trauma in the current sample (for a comparison, see Felitti et al., 1998) may be related to the inclusive nature of items assessed on the ETISR-SF, as well as the presence of alcohol problems in all participants.