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Lebeaut A, Zegel M, Steinberg L, Zvolensky MJ, Vujanovic AA. The development and initial validation of the Trauma-Related Alcohol Use Coping Measure (TRAC). PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2024; 38:616-627. [PMID: 38010782 PMCID: PMC11128532 DOI: 10.1037/adb0000974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) symptoms and alcohol use commonly co-occur and present a prevalent clinical comorbidity. The self-medication/coping model has been applied most consistently to understand the PTSD-alcohol use association. However, there is a relative paucity of self-report measures designed to assess motivations for alcohol use, specifically for coping with PTSD symptoms. The goals of the present study were to develop and validate a measure that assesses the use of alcohol to cope with specific facets of PTSD symptomatology across two independent samples. METHOD Two samples were evaluated: a university-based sample (N = 617; 77.0% women; Mage = 22.3; SD = 5.20) composed of racially diverse trauma-exposed students and a nationally representative sample (N = 510; 52.5% women; Mage = 39.5; SD = 10.9) of trauma-exposed adults who endorsed PTSD symptoms and past-year hazardous drinking. Both samples completed identical online questionnaire batteries. A Trauma-Related Alcohol Use Coping (TRAC) measure was developed and validated across both samples. RESULTS Confirmatory factor analysis was used to support the latent, hierarchical structure of the TRAC measure (total score; coping with intrusion, avoidance, negative alterations in cognitions and mood, and arousal/reactivity symptoms) and supported an 18-item version of the TRAC measure (university-based sample [N = 617]: RMSEA = 0.047, 90% CI [.04, .05]; SRMR = 0.043; CFI = 0.95; TLI = 0.95; nationally representative sample [N = 510]: RMSEA = 0.045, 90% CI [.04, .05]; SRMR = 0.021; CFI = 0.98; TLI = 0.97). The TRAC measure demonstrated excellent internal consistency, convergent, and discriminant validity with well-established measures of mental health, known-groups validity, and incremental validity relative to non-PTSD coping-motivated drinking. CONCLUSIONS Overall, the TRAC measure can be used to assess the extent to which alcohol use is related to coping with PTSD symptoms. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Antoine Lebeaut
- Department of Psychology, University of Houston, Houston, Texas
| | - Maya Zegel
- Department of Psychology, University of Houston, Houston, Texas
| | - Lynne Steinberg
- Department of Psychology, University of Houston, Houston, Texas
| | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, Texas
- Health Research Institute, University of Houston, Houston, Texas
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center
| | - Anka A. Vujanovic
- Department of Psychology, University of Houston, Houston, Texas
- Health Research Institute, University of Houston, Houston, Texas
- Department of Psychological and Brain Sciences, Texas A&M University
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Assim A, Kaminer D, Hogarth L, Magner-Parsons B, Seedat S. Coping motives as a mediator of the relationship between child maltreatment and substance use problems in south African adolescents. CHILD ABUSE & NEGLECT 2024; 154:106885. [PMID: 38850749 DOI: 10.1016/j.chiabu.2024.106885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 05/17/2024] [Accepted: 05/31/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Evidence suggests that adults with a history of child maltreatment (CM) engage in substance misuse driven by 'coping motives': maladaptive beliefs that substances help them cope with negative emotions. However, the specificity of this risk pathway is under-researched in younger and non-Western cohorts. OBJECTIVE The present study aimed to determine whether coping motives play a distinct role compared to other motives for substance use in mediating the relationship between CM and problematic alcohol and marijuana use in a sample of South African adolescents. PARTICIPANTS AND SETTING A sample of 688 high school students (M age = 15.03 years; 62.5 % female) in Cape Town, South Africa, completed a cross sectional survey. METHODS Participants completed self-report measures of CM exposure, motives for using alcohol and marijuana (coping, enhancement, social and conformity), and alcohol and marijuana related problems. Participants who endorsed using alcohol (N = 180) or marijuana (N = 136) were included in analysis. A parallel mediation model was conducted for each substance (alcohol and marijuana, respectively) to assess which motives mediated the relationship between CM exposure and substance-related problems. RESULTS CM exposure predicted both alcohol-and marijuana related problems. The relationship between CM exposure and alcohol-related problems was partially mediated by coping motives (p < .001, 95%CI 0.028, 0.115) and, to a lesser extent, conformity motives (p < .01, 95%CI 0.001, 0.041), but not by social motives or enhancement motives. The relationship between CM exposure and marijuana-related problems was partially mediated by coping motives (p < .001, 95%CI 0.004, 0.037), but not by conformity, social or enhancement motives. CONCLUSIONS The findings support the importance of coping motives as a mediator between CM and problematic substance use across different substances of abuse in South African adolescents, and the role of conformity motives in problematic alcohol use. Future research should explore whether these findings hold across other sociocultural contexts, and the utility of interventions to address coping motives for substance use in adolescence.
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Affiliation(s)
- Ayesha Assim
- Department of Psychology, University of Cape Town, Private Bag X3, Rondebosch, 7701 Cape Town, South Africa
| | - Debra Kaminer
- Department of Psychology, University of Cape Town, Private Bag X3, Rondebosch, 7701 Cape Town, South Africa.
| | - Lee Hogarth
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter EX4 4QG, United Kingdom
| | - Bella Magner-Parsons
- School of Psychology, University of Exeter, Washington Singer Building, Perry Road, Exeter EX4 4QG, United Kingdom
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, Faculty of Medicine and Health Sciences, 241, Cape Town, South Africa
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Bautista TG, Ware OD, Macias Burgos MA, Rivas VD, Cruz-Carrillo Y, Davidson A, Mezhenska M, Sanchez M, Amaro H. Mixed-methods analysis of satisfaction during a 12-session mindfulness-based intervention for women with a substance use disorder and trauma symptomatology. Front Psychol 2024; 15:1359174. [PMID: 38939226 PMCID: PMC11210173 DOI: 10.3389/fpsyg.2024.1359174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/16/2024] [Indexed: 06/29/2024] Open
Abstract
Satisfaction with an intervention influences the uptake of behavior changes and the long-term efficacy of the intervention. Therefore, it is crucial to assess satisfaction by participant profile when creating and adapting behavior interventions for minoritized populations. Qualitative and quantitative data on participant trauma symptom severity and intervention satisfaction were collected through self-report surveys from 54 women. The sample was 59.3% Hispanic, with an average age of 33.21 (SD = 10.42), who were in residential treatment for substance use disorders (SUDs) and participated in a 12-session mindfulness-based intervention. Qualitative responses were coded using thematic analysis, and an integrative mixed-methods approach was used to compare qualitative theme frequency between high-trauma (N = 28) and low-trauma (N = 26) groups at session 2 and session 11. High- and low-trauma groups were determined by interquartile ranges (bottom 25% = low; top 75% = high). In session 2, the low-trauma group reported significantly higher satisfaction (M = 4.20, SD = 0.55) than the high-trauma group (M = 3.77, SD = 0.89); t(43) = 1.90, p = 0.03. In session 11, there was no significant difference between groups. The mixed-methods analysis revealed that "trouble focusing" appeared more frequently in the high-trauma group than in the low-trauma group during session 2, but the theme was not present in either group at session 11, suggesting that this might pose an initial barrier for individuals with high trauma but subsides as the intervention progresses. This speaks to the importance of retention strategies tailored for participants with SUDs and high trauma while they adjust to the intervention. Assessing initial challenges with satisfaction may help facilitators intervene to increase participant satisfaction.
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Affiliation(s)
- Tara G. Bautista
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, AZ, United States
| | - Orrin D. Ware
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | - Veronica D. Rivas
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, AZ, United States
| | | | - Alec Davidson
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, AZ, United States
| | - Mariia Mezhenska
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, AZ, United States
| | - Mariana Sanchez
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
| | - Hortensia Amaro
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, United States
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Farrelly KN, Keough MT, Wardell JD. Indirect Associations Between PTSD Symptoms and Cannabis Problems in Young Adults: The Unique Roles of Cannabis Coping Motives and Medicinal Use Orientation. Subst Use Misuse 2024; 59:1431-1439. [PMID: 38750663 DOI: 10.1080/10826084.2024.2352621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2024]
Abstract
Background: Cannabis use in young adulthood has been associated with exposure to traumatic events and posttraumatic stress disorder (PTSD). Coping motives for cannabis use represent one mechanism linking PTSD with cannabis problems, yet some individuals with PTSD consider their cannabis use to be medicinal in nature. While a medicinal orientation to cannabis overlaps conceptually with coping motives, it could be associated with unique cannabis outcomes. Objectives: This study examined trauma-related coping motives and medicinal cannabis orientation as mediators of the association between PTSD symptoms and cannabis outcomes in young adults. Method: Data came from an online survey of 212 university students (M age = 19.41; 70.3% Women; 43.4% White) who used cannabis in the past month and endorsed a traumatic life event. Path analyses examined associations of PTSD symptoms with past month cannabis frequency and problems through medicinal cannabis orientation (i.e., number of mental health symptoms that cannabis is used to manage) and trauma-related coping motives. Results: PTSD symptoms were associated with trauma-related coping motives but not with medicinal cannabis orientation. Both trauma-related coping motives and medicinal cannabis orientation were uniquely associated with greater cannabis use frequency, but only trauma-related coping motives were associated with greater cannabis problems. There were significant indirect relationships from PTSD symptoms to cannabis use frequency and problems through trauma-related coping motives but not through medicinal cannabis orientation. Conclusions: Results support unique contributions of trauma-related coping motives and medicinal cannabis orientation to cannabis outcomes and suggest that trauma-related coping motives are specifically implicated in the link between PTSD and cannabis problems.
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Affiliation(s)
- Kyra N Farrelly
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Matthew T Keough
- Department of Psychology, York University, Toronto, Ontario, Canada
| | - Jeffrey D Wardell
- Department of Psychology, York University, Toronto, Ontario, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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Lutz-Zois CJ, Selvey AM, Anderson KL, Smidt AM. The Role of Mistrust in Sexual Revictimization: An Analysis of Serial Indirect Effects. Violence Against Women 2024; 30:1477-1497. [PMID: 36540934 DOI: 10.1177/10778012221145294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
A sample of 819 female college students completed measures of childhood sexual abuse (CSA), adult sexual victimization (ASV), mistrust, trauma-related symptoms, and drinking problems. Using a serial indirect effects model, we hypothesized that CSA would be associated with ASV through the indirect effects of mistrust → trauma-related symptoms → drinking problems. The results indicated that this serial indirect effects model was significant. When the order of the first two indirect effects was reversed, the model was not significant. These results highlight the importance of examining potential factors involved in sexual revictimization in tandem rather than in isolation.
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Affiliation(s)
| | - Alicia M Selvey
- Department of Psychology, University of Minnesota, Minnesota, USA
| | - Kirsten L Anderson
- Department of Human Development & Family Studies, Purdue University, West Lafayette, Indiana, USA
| | - Alec M Smidt
- Department of Psychiatry, Yale University, New Haven, Connecticut, USA
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Woloshchuk CJ, Portillo C, Rodriguez-Crespo A, De Alba J, Amador NC, Cooper TV. Protective and risk factors for increased alcohol use in Latinx college students on the U.S./Mexico border. J Ethn Subst Abuse 2024; 23:287-304. [PMID: 35758062 DOI: 10.1080/15332640.2022.2089939] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Alcohol use is prevalent among undergraduates, however, limited research on drinking among Latinx college students exists. This study examined potential risk and protective factors of alcohol use and consequences. Participants (n = 382) completed multiple measures including alcohol use frequency and the Rutgers Alcohol Problem Index (RAPI). Linear regression models identified predictors of monthly and yearly drinking days and RAPI. Findings indicated that alcohol use frequency was associated with increasing age, parental alcohol use disorder, greater anger, and lower self-efficacy. Alcohol-related consequences were positively associated with anxiety and adverse childhood experiences. Early alcohol prevention and intervention efforts appear warranted.
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Johnson VE, Courtney K, Chng K. Race-based Traumatic Stress Predicts Risky Drinking, Over and Above Negative Affect, and Non-race-related Trauma Symptoms in Racial/Ethnic Minority Female College Students. J Racial Ethn Health Disparities 2024; 11:371-381. [PMID: 36859740 DOI: 10.1007/s40615-023-01525-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/06/2023] [Accepted: 01/16/2023] [Indexed: 03/03/2023]
Abstract
OBJECTIVES Alcohol misuse remains a major concern in college student populations and rates of risky and problematic drinking are specifically on the rise for women. One important factor that has been shown to be positively associated with substance use/misuse for women from historically marginalized or minoritized racial/ethnic backgrounds is exposure to racial discrimination and possible resulting traumatic stress reactions. Questions remain about the relationship between race-based traumatic stress and risky drinking particularly among diverse female college students who are at greater risk due to their marginalized status in their racial/ethnic and gender groups. DESIGN The current study examined race-based traumatic stress as a unique predictor of risky drinking when controlling for negative affectivity and general trauma symptoms, additional risk factors for risky drinking in women. RESULTS Hierarchical linear regressions revealed that race-based traumatic stress made a significant and unique contribution to the amount of variance in risky drinking, above negative affectivity, and general trauma symptoms. CONCLUSION These findings highlight the importance of considering experiences of racism as risk factors in substance use prevention and intervention, specifically for female college students from marginalized or minoritized racial/ethnic backgrounds.
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Affiliation(s)
- Veronica E Johnson
- John Jay College of Criminal Justice, City University of New York, 524 West 59th Street, 10.65.19 New Building, NY, 10019, New York, USA.
| | - Kellie Courtney
- John Jay College of Criminal Justice, City University of New York, 524 West 59th Street, 10.65.19 New Building, NY, 10019, New York, USA
| | - Kobi Chng
- John Jay College of Criminal Justice, City University of New York, 524 West 59th Street, 10.65.19 New Building, NY, 10019, New York, USA
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Moskal D, Bennett ME, Marks RM, Roche DJO. Associations among Trauma Exposure, Post-Traumatic Stress Symptoms and Alcohol Use in Black/African American Treatment-Seeking Adults. J Dual Diagn 2024; 20:5-15. [PMID: 38113919 PMCID: PMC10842739 DOI: 10.1080/15504263.2023.2286025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
OBJECTIVE Black/African American (AA) individuals are a group at risk for co-occurring posttraumatic stress disorder (PTSD) symptoms and alcohol use due to unique cultural and system-level barriers. Although associations between trauma exposure, PTSD symptoms, and alcohol use are well established across various populations, Black/AA individuals are underrepresented in this literature, and related findings in this population are inconclusive. Thus, the goal of this study was to examine the associations among trauma exposure, PTSD symptoms, and alcohol use in a sample of treatment-seeking, Black/AA adults. We hypothesized that trauma exposure and alcohol use would be positively associated and that this relationship would be mediated by PTSD symptoms. METHODS This study conducted secondary analysis of screening data from a PTSD and alcohol use disorder clinical trial. Participants were 96 Black/AA adults (57.3% male; 2.0% Hispanic; M age = 44.73, SD = 11.83) who were seeking treatment for alcohol use and endorsed trauma exposure. Associations between trauma exposure, PTSD symptom severity, and quantity and frequency of alcohol use were tested using bivariate correlations and linear regressions. Hypothesized indirect effects were tested using IBM SPSS Statistics Version 27 PROCESS model 4 with bootstrapping. RESULTS Findings illustrated a significant positive association between trauma exposure and PTSD symptoms and between PTSD symptoms and drinks per typical drinking day. PTSD symptoms were not significantly associated with number of drinking days. Tests of indirect effects were significant for trauma exposure on drinks per typical drinking day through PTSD symptoms. CONCLUSIONS Results from the test of indirect effects suggest that among Black/AA adults with heavy alcohol use and trauma exposure, trauma exposure is associated with PTSD symptoms, which in turn is associated with quantity of alcohol use. These findings are consistent with research conducted with White/mixed groups and align with tenets of the self-medication model of PTSD-AUD comorbidity. These findings support current practices that highlight the importance of screening for and addressing PTSD and alcohol use in individuals exposed to trauma. Findings from this paper provide initial data on understudied relationships in an underserved sample and several suggestions are made to generate future research and improve clinical care for Black/AA adults. CLINICAL TRIALS REGISTRY NAME Pharmacogenetic Treatment With Anti-Glutaminergic Agents for Comorbid PTSD & AUD; ClinicalTrials.gov Identifier: NCT02884908.
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Affiliation(s)
- Dezarie Moskal
- VA Center for Integrated Healthcare, VA Western New York Healthcare System, Buffalo, New York, USA
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Melanie E Bennett
- VA VISN 5 Mental Illness Research, Education and Clinical Center, Baltimore VA Medical Center, Baltimore, Maryland, USA
- Department of Psychiatry, University of Maryland, Baltimore, Baltimore, Maryland, USA
| | - Russell M Marks
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Daniel J O Roche
- Department of Psychiatry, University of Maryland, Baltimore, Baltimore, Maryland, USA
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Puddephatt JA, Makin H, Gage SH, Jones A, Goodwin L. Understanding alcohol use and changes in drinking habits among people with a severe mental illness: a qualitative framework analysis study. Front Psychol 2023; 14:1282086. [PMID: 38155700 PMCID: PMC10752932 DOI: 10.3389/fpsyg.2023.1282086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
Introduction Individuals with a severe mental illness (SMI) are more likely to drink at harmful levels or abstain. While it is known that drinking patterns change over time, the reasons for this among those with a SMI are unclear. This study aimed to (i) explore the experiences with alcohol, particularly in relation to mental health symptoms, and (ii) how drinking patterns have changed over time, among individuals who have a SMI diagnosis, who either currently drink alcohol or no longer drink. Methods One-to-one semi-structured telephone interviews were conducted to address the study aims. Current drinkers' alcohol use was assessed using the Alcohol Use Disorder Identification Test. A framework analysis was used to address the study aims with a specific focus on the differences in the experiences with alcohol use between current and former drinkers. Results 16 participants were interviewed, and five themes were developed. The analysis highlighted how alcohol was increasingly used to cope with (i) trauma, (ii) SMI-related symptoms, or (iii) stress. Among those with a SMI, non-drinking was facilitated through declines in SMI-related symptoms, previous negative consequences due to alcohol and changing the social environment. Current drinking habits were facilitated through changes in the reasons for drinking and adopting different alcohol moderation techniques. Discussion Among those with a SMI diagnosis and who either currently drink alcohol or no longer drink, our findings support the self-medication hypothesis and drinking motives model. However, our findings indicate the need for further development of drinking to cope with a focus on symptoms of a SMI and trauma. Our findings also have implications on specialist alcohol and mental health services, the need to improve individuals' understanding of SMI, and the need to identify reasons for drinking among those with a recent diagnosis of a SMI.
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Affiliation(s)
- Jo-Anne Puddephatt
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, United Kingdom
- Department of Psychology, Edge Hill University, Ormskirk, United Kingdom
| | - Harriet Makin
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Suzanne H. Gage
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Andrew Jones
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
| | - Laura Goodwin
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, United Kingdom
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Saraiya TC, Back SE, Jarnecke AM, Blakey SM, Bauer AG, Brown DG, Ruglass LM, Killeen T, Hien DA. Sex and Gender Differences in Co-Occurring Alcohol Use Disorder and PTSD. CURRENT ADDICTION REPORTS 2023; 10:617-627. [PMID: 39026610 PMCID: PMC11257080 DOI: 10.1007/s40429-023-00511-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2023] [Indexed: 07/20/2024]
Abstract
Purpose of Review Research demonstrates a strong association between alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD). However, less is known about sex- and gender-based differences among individuals with AUD + PTSD. This narrative review examines recent literature in this area and aims to be a reference for future research endeavors. Recent Findings Extant literature shows that intertwining biological systems increase females' risk of developing PTSD and experiencing more adverse effects from AUD compared to males. Sex-based physiological differences further interact with gendered sociocultural environments to influence the risk of AUD + PTSD. Emerging research suggests potential gender-specific pathways between PTSD, coping, and AUD which may inform prevention and treatment. However, barriers to care are often gender-specific and tailored approaches are needed to improve reach and uptake. Summary Additional research is needed to examine intersectional and contextual factors that synergistically influence sex/gender differences in AUD + PTSD, particularly beyond cisgender identities, and mechanisms of action.
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Affiliation(s)
- Tanya C. Saraiya
- Center of Alcohol & Substance Use Studies, Rutgers University-New Brunswick, 607 Allison Road, Piscataway, NJ 08854, USA
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, 125 Doughty Street, Suite 300, Charleston, SC 29425, USA
| | - Sudie E. Back
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, 125 Doughty Street, Suite 300, Charleston, SC 29425, USA
- Ralph H. Johnson Veterans Affairs Healthcare System, Charleston, SC, USA
| | - Amber M. Jarnecke
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, 125 Doughty Street, Suite 300, Charleston, SC 29425, USA
| | | | - Alexandria G. Bauer
- Center of Alcohol & Substance Use Studies, Rutgers University-New Brunswick, 607 Allison Road, Piscataway, NJ 08854, USA
| | - Delisa G. Brown
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, 125 Doughty Street, Suite 300, Charleston, SC 29425, USA
| | - Lesia M. Ruglass
- Center of Alcohol & Substance Use Studies, Rutgers University-New Brunswick, 607 Allison Road, Piscataway, NJ 08854, USA
- Department of Psychology, City College of New York, New York, NY, USA
| | - Therese Killeen
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Medical University of South Carolina, 125 Doughty Street, Suite 300, Charleston, SC 29425, USA
| | - Denise A. Hien
- Center of Alcohol & Substance Use Studies, Rutgers University-New Brunswick, 607 Allison Road, Piscataway, NJ 08854, USA
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Kilimnik CD, García-Ramírez G, Salamanca NK, Mazzone GM, Mullican KN, Davis KC, Orchowski LM, Leone RM, Kaysen D, Gilmore AK. Associations among sexual assault, posttraumatic stress, drinking to cope with anxiety, and alcohol use based on gender identity and sexual orientation. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:2169-2183. [PMID: 38226754 DOI: 10.1111/acer.15194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND Sexual assault (SA) is experienced by a substantial proportion of emerging adult college students and is associated with elevated rates of posttraumatic stress disorder (PTSD) and alcohol use. This study examines the mediating role of posttraumatic stress symptoms (PTSS) in the associations among SA severity, drinking to cope with anxiety, and average weekly drinks while considering the moderating roles of gender identity and sexual orientation. METHODS A total of 2160 college students who were diverse in gender (cisgender women, 64.4%; cisgender men, 30.6%, and transgender and gender diverse [TGD] individuals = 4.9%) and sexual orientation (heterosexual = 68.0%, LGBQ+ = 32.0%) completed measures of SA severity, PTSS, drinking to cope with anxiety motives, and average weekly drinks. RESULTS The mediation model for the full sample indicated significant indirect effects of SA severity on drinking to cope with anxiety through PTSS, but not on average weekly drinks. Moderation analyses revealed differential relationships between the variables based on both gender identity and sexual orientation. For instance, the association between SA severity and PTSS was stronger for cisgender women and TGD individuals than cisgender men, and for LGBQ+ individuals than heterosexual individuals. While the association between PTSS and average weekly drinks was only significant for cisgender men, the association between PTSS and drinking to cope with anxiety was significant for both cisgender men and women but not TGD individuals. Furthermore, the association between SA severity and drinking to cope with anxiety was stronger for cisgender women than cisgender men. CONCLUSIONS Findings from this study demonstrate sexual orientation and gender identity differences and similarities in the associations of SA severity, PTSS, drinking to cope with anxiety, and alcohol use. Results are discussed in relation to the self-medication hypothesis and tailoring interventions for diverse groups.
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Affiliation(s)
- Chelsea D Kilimnik
- Department of Psychology & Neuroscience and the Renée Crown Wellness Institute, University of Colorado Boulder, Colorado, Boulder, USA
| | - Grisel García-Ramírez
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Georgia, Atlanta, USA
- The National Center for Sexual Violence Prevention, Mark Chaffin Center for Healthy Development, Georgia State University, Georgia, Atlanta, USA
| | - Nashalys K Salamanca
- The National Center for Sexual Violence Prevention, Mark Chaffin Center for Healthy Development, Georgia State University, Georgia, Atlanta, USA
- Department of Psychology, Georgia State University, Georgia, Atlanta, USA
| | | | - K Nicole Mullican
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Georgia, Atlanta, USA
- The National Center for Sexual Violence Prevention, Mark Chaffin Center for Healthy Development, Georgia State University, Georgia, Atlanta, USA
| | - Kelly Cue Davis
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Lindsay M Orchowski
- Department of Psychiatry and Human Behavior, Brown University, Rhode Island, Providence, USA
| | - Ruschelle M Leone
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Georgia, Atlanta, USA
- The National Center for Sexual Violence Prevention, Mark Chaffin Center for Healthy Development, Georgia State University, Georgia, Atlanta, USA
| | - Debra Kaysen
- Division of Public Mental Health and Population Sciences, Department of Psychiatry, Stanford University School of Medicine, California, Stanford, USA
| | - Amanda K Gilmore
- Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, Georgia, Atlanta, USA
- The National Center for Sexual Violence Prevention, Mark Chaffin Center for Healthy Development, Georgia State University, Georgia, Atlanta, USA
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Ramarushton B, Griffith EL, Messman BA, Contractor AA, Slavish DC, Zamboanga BL, Blumenthal H. Latent profiles of posttraumatic stress disorder symptoms and sleep disturbances in relation to drinking to cope motives among college students. J Psychiatr Res 2023; 167:37-45. [PMID: 37832202 DOI: 10.1016/j.jpsychires.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 08/11/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD), sleep disturbances, and problematic alcohol use are frequently comorbid. Research shows that individuals with more PTSD symptom severity and poorer sleep are highly susceptible to drinking alcohol to cope with negative affect. The current study examined the number and nature of different subgroups of trauma-exposed college students based on endorsed PTSD symptoms and sleep disturbances; and how such subgroups relate to drinking to cope motives. METHOD The sample included 474 trauma-exposed college students (Mage = 20.69 years; 75.50% female) who completed self-report surveys. RESULTS Latent profile analyses revealed three subgroups: High PTSD-Sleep Disturbances (n = 71), Moderate PTSD-Sleep Disturbances (n = 135), and Low PTSD-Sleep Disturbances (n = 268). Results indicated that college students in the Low PTSD-Sleep Disturbances group endorsed the lowest amount of coping-related drinking motives; however, college students in the Moderate PTSD-Sleep Disturbances group did not endorse significantly different levels of coping-related drinking motives than college students in the High PTSD-Sleep Disturbances group. CONCLUSIONS College students with subclinical presentations of psychopathology are at risk for endorsing risky drinking motives. As they adjust to a stressful environment with a culture of heavy drinking, providing context-relevant intervention efforts such as adaptive coping strategies, relaxation skills designed to facilitate restful sleep, and trauma-informed care may be highly beneficial for college students.
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13
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Ware OD, Strickland JC, Smith KE, Blakey SM, Dunn KE. Factors Associated with High-Risk Substance Use in Persons Receiving Psychiatric Treatment for a Primary Trauma- and Stressor-Related Disorder Diagnosis. J Dual Diagn 2023; 19:199-208. [PMID: 37796639 PMCID: PMC10645162 DOI: 10.1080/15504263.2023.2260340] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
OBJECTIVE Although mental health disorders and high-risk substance use frequently co-occur, they are typically investigated independently. Clinical trials focused on treatment for individuals with trauma- and stressor-related disorders often exclude individuals with high-risk substance use. Little is also known about the role of gender in the relationship between trauma- and stressor-related disorders and high-risk substance use. We examined the relationship between trauma- and stressor-related disorders, high-risk substance use, and gender. METHODS Using the Mental Health Client-Level Data dataset, we examined 15,772 adults receiving treatment in psychiatric hospitals in the United States from 2013 to 2019. RESULTS A logistic regression model showed that for men, relative to women, having multiple mental health diagnoses and having a serious mental illness or serious emotional disturbance was associated with greater odds of high-risk substance use. CONCLUSIONS This study underscores the value of comprehensive gender-centered treatment for people with trauma- and stressor-related disorders engaging in high-risk substance use.
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Affiliation(s)
- Orrin D. Ware
- University of North Carolina at Chapel Hill School of Social Work, 325 Pittsboro Street, Chapel Hill, NC 27599
| | - Justin C. Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA
| | - Kirsten E. Smith
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA
| | - Shannon M. Blakey
- RTI International, 3040 E Cornwallis Rd, Research Triangle Park, NC 27709
| | - Kelly E. Dunn
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA
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14
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Beck JG, Bowen ME, Majeed R, Free BL, Brown TA, Brown B, Farchione T. Alcohol Use and Mental Health Symptoms in Nurses during the Early Months of COVID-19. J Dual Diagn 2023; 19:240-247. [PMID: 37813696 DOI: 10.1080/15504263.2023.2260346] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
OBJECTIVE The current study examined associations of symptoms of posttraumatic stress disorder [PTSD], depression, and generalized anxiety disorder [GAD] with alcohol consumption and drinking to cope in a sample of 310 nurses during the first six months of the COVID-19 pandemic. METHOD Using a cross-sectional design, nurses completed online surveys. RESULTS Over 50% of the sample reported alcohol misuse and 12.2% reported drinking to cope. Further, 38.7% reported elevated symptoms of PTSD, 29.7% moderate-to-high symptoms of depression, and 56.8% elevated symptoms of GAD symptoms. Hierarchical regression analyses were conducted to examine how mental health symptoms were associated with alcohol outcomes, controlling for age, gender pronouns, education, and race. No significant predictors emerged for alcohol consumption. Significant associations of symptoms of PTSD and depression were found for drinking to cope, such that higher levels of mental health symptoms were associated with greater endorsement of drinking to cope. CONCLUSION Results are discussed in light of increasing prevention and support services for nurses.
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Affiliation(s)
- J Gayle Beck
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Mya E Bowen
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Rimsha Majeed
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Bre'Anna L Free
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Timothy A Brown
- Center for Anxiety & Related Disorders, Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Bonnie Brown
- Center for Anxiety & Related Disorders, Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Todd Farchione
- Center for Anxiety & Related Disorders, Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
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15
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Ferrie ML, Lheureux A, Vujanovic AA, Zvolensky MJ, Raines AM. Co-Occurring Posttraumatic Stress Disorder Symptoms and Alcohol Use Behaviors: The Mediating Role of Drinking to Cope with PTSD Symptoms. J Dual Diagn 2023; 19:221-230. [PMID: 37851919 PMCID: PMC10753988 DOI: 10.1080/15504263.2023.2260326] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
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.
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Affiliation(s)
- Mara L. Ferrie
- Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Abby Lheureux
- Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA
- School of Medicine, Tulane University, New Orleans, LA, USA
| | | | - Michael J. Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA
- Department of Behavioral Science, the University of Texas MD Anderson Cancer Center, Houston, TX, USA
- HEALTH Institute, University of Houston, Houston, TX, USA
| | - Amanda M. Raines
- Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA
- South Central Mental Illness Research, Education and Clinical Center, New Orleans, LA, USA
- School of Medicine, Louisiana State University, New Orleans, LA, USA
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16
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Johnson VE, Chng K, Courtney K. Racial trauma as a risk factor for risky alcohol use in diverse college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-8. [PMID: 37289971 DOI: 10.1080/07448481.2023.2214247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 04/24/2023] [Accepted: 05/03/2023] [Indexed: 06/10/2023]
Abstract
Exposure to potentially traumatic race-based experiences poses a risk factor for risky drinking among college students from historically marginalized racial/ethnic backgrounds. Objective: The current study examined the relationship between both the level (severity) and pattern of race-based traumatic stress (RBTS) reactions and risky drinking. Participants: The current study sample was made up of 62 male (23.5%) and 202 female (76.5%) Latino/a/x, Black, and Asian college students attending a minority-serving institution. Methods: Study participants were asked to participate in an anonymous online survey. Results: A criterion profile analysis revealed that higher scores on RBTS reactions overall, and elevated scores on RBTS - avoidance, low self-esteem, and anger, specifically, were indicative of more risky drinking. Conclusions: These findings highlight a distinct pattern of RBTS scores that may predict a vulnerability to risky drinking and underscore the importance of racial trauma healing in alcohol use prevention and intervention efforts.
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Affiliation(s)
- Veronica E Johnson
- John Jay College of Criminal Justice, City University of New York, New York, New York, USA
| | - Kobi Chng
- John Jay College of Criminal Justice, City University of New York, New York, New York, USA
| | - Kellie Courtney
- John Jay College of Criminal Justice, City University of New York, New York, New York, USA
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17
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Scheer JR, Helminen EC, Cascalheira CJ, Jaipuriyar V, Shaw TJ, Zabelski S, Behari K, Pirog S, Batchelder AW, Possemato K, Hughes TL, Sullivan TP. Probable PTSD, PTSD symptom severity, and comorbid PTSD and hazardous drinking among sexual minority women compared to heterosexual women: A meta-analysis. Clin Psychol Rev 2023; 102:102283. [PMID: 37150043 PMCID: PMC10205673 DOI: 10.1016/j.cpr.2023.102283] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 01/24/2023] [Accepted: 04/20/2023] [Indexed: 05/09/2023]
Abstract
Posttraumatic stress disorder (PTSD) is more prevalent among sexual minority women (SMW) than among heterosexual women. PTSD risk varies among SMW, but no meta-analysis has clarified sexual identity-related disparities in probable PTSD among women or SMW's heterogeneity in PTSD risk. SMW are also at pronounced risk of comorbid PTSD and hazardous drinking (HD). However, the difference in comorbid PTSD/HD between SMW and heterosexual women is understudied. This meta-analysis aimed to provide a comprehensive understanding of differences between SMW and heterosexual women and among SMW across demographic characteristics. Peer-reviewed publications that were written in English and reported quantitative data on PTSD specific to SMW were included. Eligible publications (n = 45) were identified through a systematic search of 11 electronic databases, supplemented by a search of reference lists of relevant papers. We found that probable PTSD, PTSD symptom severity, and probable comorbid PTSD/HD are highly prevalent among SMW, with SMW of color, transgender and gender diverse people, and bi+ women (e.g., bisexual, pansexual, queer) being at greatest risk. These results emphasize the need to improve accurate assessment of trauma-related sequelae among SMW and to develop, disseminate, and implement culturally sensitive treatments to reduce PTSD and comorbid PTSD/HD among at-risk SMW.
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Affiliation(s)
- Jillian R Scheer
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY 13244, USA.
| | - Emily C Helminen
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY 13244, USA; College of Health Science and Technology, Rochester Institute of Technology, USA
| | - Cory J Cascalheira
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY 13244, USA; Department of Counseling & Educational Psychology, New Mexico State University, Las Cruces, NM, USA
| | - Virinca Jaipuriyar
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY 13244, USA
| | - Thomas J Shaw
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Sasha Zabelski
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Kriti Behari
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY 13244, USA
| | - Sophia Pirog
- Department of Psychology, Syracuse University, 414 Huntington Hall, Syracuse, NY 13244, USA
| | - Abigail W Batchelder
- Harvard Medical School, Harvard University, Boston, MA, USA; Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; The Fenway Institute, Fenway Health, Boston, MA, USA
| | - Kyle Possemato
- VA Center for Integrated Healthcare, Syracuse Veterans Affairs Medical Center, Syracuse, NY, USA
| | - Tonda L Hughes
- School of Nursing and Department of Psychiatry, Columbia University, New York, NY, USA; Columbia University School of Nursing Center for Sexual and Gender Minority Research, New York, NY, USA
| | - Tami P Sullivan
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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18
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Sherwood J, Phuengsamran D, Janyam S, Murray SM, Holliday CN, Darawuttimaprakorn N, Decker MR. Violence Victimization and Alcohol Use Among Venue-Based Female Sex Workers in Pattaya, Thailand: Unpacking the Temporal Relationship. Violence Against Women 2023:10778012231177997. [PMID: 37259530 DOI: 10.1177/10778012231177997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Female sex workers (FSWs) face prevalent violence victimization and alcohol consumption at work, yet the bidirectional pathways between these factors are not well defined. Using cohort data from 232 venue-based FSWs in Pattaya, associations of violence and alcohol use were examined within a time period and prospectively via structural equation models. Within the time period, violence victimization and alcohol use were consistently associated; by contrast, violence was not prospectively associated with FSW alcohol use. Findings define alcohol as an important risk factor for violence in sex work environments. Alcohol safety interventions should be explored as a vital component of FSW violence prevention.
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Affiliation(s)
- Jennifer Sherwood
- Public Policy Office, amfAR, Foundation for AIDS Research, Washington, DC, USA
| | - Dusita Phuengsamran
- Institute for Population and Social Research, Mahidol University, Bangkok, Thailand
| | - Surang Janyam
- Service Workers in Group Foundation, Bangkok, Thailand
| | - Sarah M Murray
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Charvonne N Holliday
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | | | - Michele R Decker
- Department of Population Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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19
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Dworkin ER, Schallert M, Lee CM, Kaysen D. Pilot randomized clinical trial of an app-based early intervention to reduce PTSD and alcohol use following sexual assault. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023:2023-60287-001. [PMID: 37011153 PMCID: PMC10545809 DOI: 10.1037/tra0001460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
OBJECTIVE Sexual assault is associated with high risk for posttraumatic stress disorder (PTSD), and PTSD often co-occurs with alcohol misuse. Most sexual assault survivors do not access early preventative interventions for such conditions. App-based interventions are a promising means to extend the reach of early interventions and thereby reduce risk of chronic PTSD and alcohol misuse. METHOD This study was a pilot randomized clinical trial of an app-based early intervention with phone coaching (THRIVE) for survivors of past-10-week sexual assault (NCT#: NCT03703258). Intended active components of the THRIVE app are daily cognitive restructuring, daily activity scheduling, and as-needed relationally focused exercises, supported by coaching calls. Forty-one adult female survivors of recent sexual assault with elevated posttraumatic stress and drinking were randomized to intervention or control (symptom-monitoring app with phone coaching). Participants in both conditions were encouraged to use their respective app for 21 days and completed self-report symptom assessments at baseline, postintervention, and 3-month follow-up. RESULTS At 3-month follow-up, the between-group effect size favored intervention for posttraumatic stress (d = -0.70), intoxication frequency (d = -0.62), and drinking hours per week (d = -0.39). More participants evidenced reliable change in intervention versus control for posttraumatic stress (OR = 2.67) and alcohol problems (OR = 3.05) at 3 months. CONCLUSIONS The general direction of effects indicates that THRIVE, coupled with coaching, reduces risk for PTSD and alcohol outcomes beyond coached monitoring. These findings suggest that apps like THRIVE may provide an option for early intervention for sexual assault survivors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Emily R Dworkin
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine
| | - Macey Schallert
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine
| | - Christine M Lee
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine
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20
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Huikko E, Aalto-Setälä T, Santalahti P, Lämsä R, Ahlgrén-Rimpiläinen A. Lifelong mental health service use among 15-22 years old offenders: a document-based, mixed-methods descriptive study. BMJ Open 2023; 13:e065593. [PMID: 36927590 PMCID: PMC10030486 DOI: 10.1136/bmjopen-2022-065593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
OBJECTIVES Among young offenders, psychiatric morbidity and comorbidity are common, but our knowledge about their use of mental health services during childhood and adolescence is scarce. We aimed to describe the lifelong use of mental health services of young offenders who have committed serious crimes. DESIGN AND STUDY SETTING Using data on forensic psychiatric examinations of 42 Finnish offenders aged 15-22 years, we analysed the timing and typical patterns of their prior mental health service use with qualitative and quantitative content analysis and typification. RESULTS Young offenders appeared in this study as children with plenty of perinatal and developmental risks, and risks related to their family situation and peer relations. Most subjects were described as having had emotional or behavioural symptoms, or both, since childhood. Involvement in mental health services was rare before the age of 7 years but increased markedly after that, staying on the same level during adolescence. Five categories of mental health service users were identified: (1) continuing service use around a decade (14.3%), (2) one brief fixed treatment (11.9%), (3) involuntary use of services (31.0%), (4) evasive use of services (21.4%) and (5) no mental health service use (21.4%). CONCLUSIONS Young offenders had symptoms from early ages, but during childhood and adolescence, involvement in mental health services appeared for most as relatively short, repetitive or lacking. To help children at risk of criminal development, a multiprofessional approach, an early evidence-based intervention for behavioural symptoms and screening for learning problems, traumatic experiences and substance use are necessary. Results can help identify children and adolescents with a risk of criminal development, to develop mental health services and to plan further research.
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Affiliation(s)
- Eeva Huikko
- Mental Health, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Terhi Aalto-Setälä
- Mental Health, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Päivi Santalahti
- Mental Health, Finnish Institute for Health and Welfare, Helsinki, Finland
- Child Psychiatry, University of Turku, Turku, Finland
| | - Riikka Lämsä
- Mental Health, Finnish Institute for Health and Welfare, Helsinki, Finland
- Public health, University of Helsinki, Helsinki, Finland
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21
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Motta-Ochoa R, Incio-Serra N, Brulotte A, Flores-Aranda J. Motives for alcohol use, risky drinking patterns and harm reduction practices among people who experience homelessness and alcohol dependence in Montreal. Harm Reduct J 2023; 20:22. [PMID: 36829166 PMCID: PMC9955533 DOI: 10.1186/s12954-023-00757-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 02/15/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND People experiencing homelessness are disproportionately affected by harms related to alcohol use. Indeed, their alcohol dependence is associated with numerous physical and mental health problems along with strikingly high rates of alcohol-related mortality. Recent research has extensively examined alcohol use patterns among people experiencing homelessness in an effort to develop interventions and treatments for this problem. However, only a few studies have incorporated the perspectives of the individuals under study about their drinking or examined the ways in which they manage the associated harms. To bridge this gap, we conducted a qualitative study exploring the relation between the drinking motives, risky drinking patterns and harm reduction practices of a group of people (n = 34) experiencing homelessness in Montreal, Canada. METHODS The qualitative methods we used consisted of semi-structured interviews (n = 12) and focus groups (n = 2, with a total of 22 participants). The content of the collected data was then analyzed. RESULTS Participants identified their various motives for alcohol use (coping with painful memories, dealing with harsh living conditions, socializing/seeking a sense of belonging, enjoying themselves/having fun); their risky drinking patterns (binge drinking, mixing alcohol with drugs, non-beverage alcohol drinking, failing to keep sufficient alcohol on hand to prevent acute withdrawal, drinking in public settings); their harm reduction practices (planning how much to drink, keeping a supply of alcohol to prevent acute withdrawal, hiding to drink, concealing alcohol, drinking alone, drinking/hanging out with others, drinking non-beverage alcohol, and taking benzodiazepines, cocaine or other stimulant drugs); and the rationales underpinning their alcohol use and harm reduction practices. CONCLUSION Associating the drinking motives of a group of study participants with their risky drinking patterns and harm reduction practices shed light on their rationales for alcohol use, yielding insights that could be used to better tailor policies and interventions to their needs.
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Affiliation(s)
- Rossio Motta-Ochoa
- grid.38678.320000 0001 2181 0211École de travail social, Université du Québec à Montréal, 455 René-Lévesque Blvd. Est Local W-4020, Montreal, QC H2L 4Y2 Canada ,grid.14848.310000 0001 2292 3357École de travail social, Université de Montréal, Pavillon Lionel-Groulx, 3150 Jean-Brillant Street (C-7075), Montreal, QC H3T 1J7 Canada ,Canada Research Chair in Sexually and Gender Diverse Individuals (SGD) and Their Psychoactive Substance Use Trajectories (TRADIS Chair), Montreal, Canada
| | - Natalia Incio-Serra
- grid.14709.3b0000 0004 1936 8649Faculty of Education, McGill University, 3700 McTavish Street, Montreal, QC H3A 1Y2 Canada
| | - Alexandre Brulotte
- grid.38678.320000 0001 2181 0211École de travail social, Université du Québec à Montréal, 455 René-Lévesque Blvd. Est Local W-4020, Montreal, QC H2L 4Y2 Canada ,Canada Research Chair in Sexually and Gender Diverse Individuals (SGD) and Their Psychoactive Substance Use Trajectories (TRADIS Chair), Montreal, Canada
| | - Jorge Flores-Aranda
- École de travail social, Université du Québec à Montréal, 455 René-Lévesque Blvd. Est Local W-4020, Montreal, QC, H2L 4Y2, Canada. .,Canada Research Chair in Sexually and Gender Diverse Individuals (SGD) and Their Psychoactive Substance Use Trajectories (TRADIS Chair), Montreal, Canada.
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Di Tata D, Bianchi D, Pompili S, Laghi F. The Psychological Impact of the COVID-19 Pandemic on Alcohol Abuse and Drunkorexia Behaviors in Young Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3466. [PMID: 36834161 PMCID: PMC9967230 DOI: 10.3390/ijerph20043466] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 outbreak negatively affected young adults' psychological well-being, increasing their stress levels and symptoms of anxiety and depression, and potentially triggering health-risk behaviors. The present study was aimed at investigating the psychological impact of the COVID-19 pandemic on alcohol abuse and drunkorexia behaviors among young adults living in Italy. Participants were 370 emerging adults (63% women, 37% men; Mage = 21.00, SDage = 2.96, range: 18-30) who were recruited through an online survey between November 2021 and March 2022. Participants completed measures of alcohol abuse, drunkorexia behaviors, negative life experiences, and post-traumatic symptoms related to the COVID-19 outbreak. The results showed that the emotional impact and negative life experiences associated with the pandemic predicted both alcohol abuse and drunkorexia behaviors, albeit in different ways. Specifically, the number of negative life experiences during the pandemic and the tendency to avoid COVID-19-related negative thoughts positively predicted alcohol abuse; and the presence of intrusive thoughts associated with the pandemic significantly predicted the frequency of drunkorexia behaviors. Implications for research and clinical practice are discussed.
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Affiliation(s)
- Daniele Di Tata
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Rome, Italy
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23
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DeLaney EN, Williams CD, Jones SCT, Hood KB, Cage J, Coston BE, Hawn SE, Santana A, Dick DM. Sexual Victimization and Mental Health Among LGBQ + College Students: Examining Social Support and Trauma-Related Drinking as Mediators. Int J Ment Health Addict 2023. [DOI: 10.1007/s11469-022-00997-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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Stappenbeck CA, Jaffe AE, Blayney JA, Kirwan M, George WH, Davis KC. An event-level evaluation of women's self-medicated drinking: The role of sexual assault severity, affect, and drinking motives. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023; 15:110-120. [PMID: 35617256 PMCID: PMC10914019 DOI: 10.1037/tra0001278] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Women with sexual assault (SA) histories report heavier and more frequent drinking. Consistent with the motivational model of alcohol use, women with SA histories may consume alcohol to both downregulate negative emotions and upregulate positive ones. The present event-level study used a Bayesian multilevel moderated mediation approach to examine the extent to which women's alcohol use and intoxication was influenced by coping and enhancement drinking motives to downregulate or upregulate affect, respectively. METHOD Women ages 21-30 were recruited from the community to participate in a larger study that included a 32-day daily diary assessment of affect, drinking motives, and alcohol use. RESULTS We found consistent support for women's tendencies to be motivated to drink to cope or enhance negative or positive affect, respectively, and those drinking motives were associated with indicators of increased drinking. Becoming intoxicated to downregulate negative emotion was common and this pathway was particularly strong for women who reported more severe SA histories. Although women with more severe SA histories were generally more likely to drink more, they were not likely to do so as a way to enhance positive experiences. CONCLUSIONS Alcohol interventions that provide adaptive regulatory strategies are needed for women who experience increased negative or positive affect, with a particular focus on self-medication for young women with more severe SA histories. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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25
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Vest BM, Weiss-Laxer NS, Homish DL, Homish GG. Lifetime trauma exposure profiles and alcohol use over time among U.S. Reserve and National Guard soldiers. J Trauma Stress 2022; 35:1642-1655. [PMID: 35901312 PMCID: PMC10440733 DOI: 10.1002/jts.22867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/26/2022] [Accepted: 06/02/2022] [Indexed: 12/24/2022]
Abstract
Although trauma exposure is a recognized risk factor for alcohol use, research on military populations has emphasized combat exposure, with minimal consideration of exposure to other potentially traumatic events (PTEs). We aimed to (a) identify, characterize, and quantify subgroups of service members based on PTE patterns; (b) examine associations between trauma exposure subgroups and alcohol use; and (c) examine these associations longitudinally. Data were drawn from Operation: SAFETY, a longitudinal study of health and well-being among U.S. Army Reserve/National Guard soldiers (N = 478). Exposure to 15 PTEs, including childhood maltreatment, noninterpersonal events (e.g., natural disasters, accidents), interpersonal trauma, and military-related exposures, was assessed at baseline. Latent profile analysis was conducted to characterize mutually exclusive trauma profiles; profile membership was used to longitudinally predict alcohol use in generalized estimating equation models. Four exposure profiles were identified: intimate partner violence (IPV)/combat trauma (8.4%, n = 40), combat trauma (24.7%, n = 118), childhood trauma (8.4%, n = 40), and low trauma (58.6%, n = 280). In adjusted models, compared to the low trauma profile, IPV/combat profile membership was longitudinally associated with alcohol problems, OR = 2.44, p =.005. Membership in other trauma profiles was not associated with alcohol use. Within the IPV/combat profile, men had a higher risk of frequent heavy drinking than women. Results suggest a need to comprehensively screen for lifetime PTE exposure, particularly IPV, in military populations. Given the high prevalence of nonmilitary PTEs, an inclusive, trauma-informed approach to health care and service provision is warranted.
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Affiliation(s)
| | | | - D. Lynn Homish
- Department of Community Health and Health Behavior, University at Buffalo
| | - Gregory G. Homish
- Department of Community Health and Health Behavior, University at Buffalo
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Savage JE, Peterson RE, Aliev F, Dick DM. Genetic and environmental etiology of drinking motives in college students. Alcohol Clin Exp Res 2022; 46:1783-1796. [PMID: 36256465 PMCID: PMC9828131 DOI: 10.1111/acer.14930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/16/2022] [Accepted: 08/18/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Drinking motives are robust proximal predictors of alcohol use behaviors and may mediate distinct etiological pathways in the development of alcohol misuse. However, little is known about the genetic and environmental etiology of drinking motives themselves and their potential utility as endophenotypes. METHODS Here, we leverage a longitudinal study of college students from diverse racial/ethnic backgrounds (phenotypic N = 9889, genotypic N = 4855) to investigate the temporal stability and demographic and environmental predictors of four types of drinking motives (enhancement, social, coping, and conformity). Using genome-wide association study (GWAS) and in silico tools, we characterize their associated genes and genetic variants (single nucleotide polymorphisms or SNPs). RESULTS Drinking motives were stable across four years of college (ICC >0.74). Some robust environmental predictors of alcohol misuse (parental autonomy granting and peer deviance) were broadly associated with multiple types of drinking motives, while others (e.g., trauma exposure) were type specific. Genome-wide analyses indicated modest SNP-based heritability (14-22%, n.s.) and several suggestive genomic loci that corroborate findings from previous molecular genetic studies (e.g., PECR and SIRT4 genes), indicating possible differences in the genetic etiology of positive versus negative reinforcement drinking motives that align with an internalizing/externalizing typology of alcohol misuse. Coping motives were significantly genetically correlated with alcohol use disorder diagnoses (rg = 0.71, p = 0.001). However, results from the genetic analyses were largely underpowered to detect significant associations. CONCLUSIONS Drinking motives show promise as endophenotypes but require further investigation in larger samples to further our understanding of the etiology of alcohol misuse.
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Affiliation(s)
- Jeanne E. Savage
- Virginia Institute for Psychiatric and Behavioral GeneticsVirginia Commonwealth UniversityRichmondVirginiaUSA,Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive ResearchVrije UniversiteitAmsterdamNetherlands
| | - Roseann E. Peterson
- Virginia Institute for Psychiatric and Behavioral GeneticsVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Fazil Aliev
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUSA,Faculty of BusinessKarabuk UniversityKarabukTurkey,Department of Psychiatry, Robert Wood Johnson Medical SchoolRutgers – The State University of New JerseyPiscatawayNew JerseyUSA
| | | | - Danielle M. Dick
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUSA,Department of Psychiatry, Robert Wood Johnson Medical SchoolRutgers – The State University of New JerseyPiscatawayNew JerseyUSA,Department of Human and Molecular GeneticsVirginia Commonwealth UniversityRichmondVirginiaUSA,College Behavioral and Emotional Health InstituteVirginia Commonwealth UniversityRichmondVirginiaUSA
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Itzhaki-Braun Y, Gavriel-Fried B. "They didn't have any idea what drugs were": Pathways to substance use disorders among ultraorthodox Jewish males. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 109:103851. [PMID: 36116337 DOI: 10.1016/j.drugpo.2022.103851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/31/2022] [Accepted: 09/04/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Substance use disorders (SUDs) are a worldwide phenomenon with very negative consequences, and belonging to a religious community is considered to be a protective factor against them. The pathways to SUDs have been investigated in many studies with the aim of helping us better understand this phenomenon and promoting effective intervention programs to prevent and manage it. However, there is a lack of knowledge regarding SUDs in closed religious communities such as the Ultraorthodox Jewish community. METHOD To fill this gap, in the current study we investigated the pathways to SUDs among 14 young men from the Ultraorthodox Jewish community in Israel who were diagnosed as having an SUD in the past and who had been in sustained remission for at least a year. Semi-structured, in-depth interviews consisting of open-ended questions were conducted. RESULTS The findings highlighted two main themes: (a) A lack of support and attention from various systems, where participants reported sense of otherness or lack of belonging to family, educational institutions and community; a lack of responsiveness from those systems; a sense of rejection or exclusion; and a longing for belonging, and (b) A light in the darkness - someone who cares, in which the interviewees received some assistance, either in the period before or during drug use. CONCLUSION Findings point to the unique experience of Ultraorthodox young men in their addiction process and shed light on the failure of the abovementioned systems to help these young men cope. Findings are discussed in the context of the theoretical perspectives of social capital theory and exclusion. Implications for intervention and policy are outlined.
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Affiliation(s)
- Yael Itzhaki-Braun
- Bob Shapell School of Social Work, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel.
| | - Belle Gavriel-Fried
- Bob Shapell School of Social Work, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
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28
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Haro B, López-Goñi JJ, Fernández-Montalvo J, Arteaga A. Prevalence and Differential Profile of Patients with Substance Use Disorder Who Have Suffered Physical and/or Sexual Abuse. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP12820-NP12837. [PMID: 33729037 DOI: 10.1177/08862605211001463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Patients with substance use disorder (SUD) who undergo treatment present a high prevalence of lifetime physical and/or sexual abuse. Studies about this phenomenon and the specific needs of patients with a history of abuse must be carried out to tailor treatment programs. The first goal of this article was to determine the prevalence of physical and/or sexual abuse among patients with SUD, and the second goal was to analyze the specific characteristics of these patients. A sample of 418 subjects was assessed to achieve the first goal and 104 subjects (52 with and 52 without a history of physical and/or sexual abuse) were examined to reach the second goal. All patients sought treatment for SUD in two Spanish clinical centers. The results showed that 15.5% of the sample had a history of physical and/or sexual abuse (42.3% of women and 9.9% of men). Patients with a history of abuse presented a higher need for SUD treatment in family and psychiatric areas and more psychopathological symptoms than patients without a history of abuse. According to this more serious profile, a patient-centered intervention considering the history of abuse is recommended. This will allow the specific needs of these patients to be met, thus improving SUD treatment success.
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Affiliation(s)
- Begoña Haro
- Universidad Pública de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - José J López-Goñi
- Universidad Pública de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Javier Fernández-Montalvo
- Universidad Pública de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Alfonso Arteaga
- Universidad Pública de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
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29
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Luciano MT, Acuff SF, Olin CC, Lewin RK, Strickland JC, McDevitt-Murphy ME, Murphy JG. Posttraumatic stress disorder, drinking to cope, and harmful alcohol use: A multivariate meta-analysis of the self-medication hypothesis. JOURNAL OF PSYCHOPATHOLOGY AND CLINICAL SCIENCE 2022; 131:447-456. [PMID: 35587413 PMCID: PMC9233097 DOI: 10.1037/abn0000764] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The association between posttraumatic stress disorder (PTSD) and harmful alcohol use has often been explained through the self-medication hypothesis via coping-related drinking motives. However, the magnitude of the indirect effect of PTSD on harmful alcohol use through coping motives is unclear. This study aggregated this indirect effect using a meta-analytic structural equation modeling approach and explored moderators that influenced the indirect effect. We identified articles from PsycINFO, PubMed/MEDLINE, and PROQUEST (through June 22, 2021) containing measures of (a) PTSD symptoms, (b) coping-related drinking, and (c) harmful alcohol use. Thirty-four studies yielding 69 effect sizes were included (mean N = 387.26 participants; median N = 303.5; range = 42-1,896; aggregate sample n = 15,128). Coping motives mediated the relation between PTSD and harmful alcohol use, accounting for 80% of the variance in the total effect. Moderating variables and evidence of publication bias were also found. Findings suggest that coping-related drinking is a strong mediator in the relation between PTSD and harmful alcohol use and that the strength of the indirect effect is meaningfully influenced by measurement approach, sample characteristics, and study design. Additional longitudinal and multivariate studies are needed to establish directionality and account for additional variance. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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30
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Biweekly Delivery of a Group-Based Adaptation of Written Exposure Therapy (WET) for PTSD in Residential Substance Treatment. COGNITIVE AND BEHAVIORAL PRACTICE 2022. [DOI: 10.1016/j.cbpra.2022.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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31
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Fein‐Schaffer D, Hawn SE, Annunziata AJ, Ryabchenko K, Miller MW, Wolf EJ. Premorbid traumatic stress and veteran responses to the COVID-19 pandemic. J Trauma Stress 2022; 35:559-569. [PMID: 34861065 PMCID: PMC9015518 DOI: 10.1002/jts.22770] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/16/2021] [Accepted: 09/15/2021] [Indexed: 12/20/2022]
Abstract
The COVID-19 pandemic has had unprecedented effects on lifestyle stability and physical and mental health. We examined the impact of preexisting posttraumatic stress disorder (PTSD), alcohol use disorder (AUD), and depression on biopsychosocial responses to the pandemic, including psychiatric symptoms, COVID-19 exposure, and housing/financial stability, among 101 U.S. military veterans enrolled in a longitudinal study of PTSD, a population of particular interest given veterans' trauma histories and defense-readiness training. Participants (83.2% male, 79.2% White, Mage = 59.28 years) completed prepandemic, clinician-administered psychiatric diagnostic interviews and a phone-based assessment between May and September 2020 using a new measure, the Rapid Assessment of COVID-19-Related Experiences (RACE), which was used to assess pandemic responses and its effects on mental and physical health; COVID-19 diagnosis and testing were also extracted from electronic medical records. Multivariate regressions showed that, controlling for demographic characteristics, prepandemic PTSD, β = .332; p = .003, and AUD symptoms, β = .228; p = .028, were associated with increased pandemic-related PTSD symptoms. Prepandemic AUD was associated with increased substance use during the pandemic, β = .391; p < .001, and higher rates of self-reported or medical record-based COVID-19 diagnosis, β = .264; p = .019. Minority race was associated with pandemic-related housing/financial instability, β = -.372; p < .001, raising concerns of population inequities. The results suggest that preexisting PTSD and AUD are markers for adverse pandemic-related psychiatric outcomes and COVID-19 illness. These findings carry implications for the importance of targeting prevention and treatment efforts for the highest-risk individuals.
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Affiliation(s)
- Dana Fein‐Schaffer
- National Center for PTSD at VA Boston Healthcare SystemBostonMassachusettsUSA
| | - Sage E. Hawn
- National Center for PTSD at VA Boston Healthcare SystemBostonMassachusettsUSA,Department of PsychiatryBoston University School of MedicineBostonMassachusettsUSA
| | | | - Karen Ryabchenko
- National Center for PTSD at VA Boston Healthcare SystemBostonMassachusettsUSA,Department of PsychiatryBoston University School of MedicineBostonMassachusettsUSA
| | - Mark W. Miller
- National Center for PTSD at VA Boston Healthcare SystemBostonMassachusettsUSA,Department of PsychiatryBoston University School of MedicineBostonMassachusettsUSA
| | - Erika J. Wolf
- National Center for PTSD at VA Boston Healthcare SystemBostonMassachusettsUSA,Department of PsychiatryBoston University School of MedicineBostonMassachusettsUSA
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32
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Farrelly KN, Romero-Sanchiz P, Mahu T, Barrett SP, Collins P, Rasic D, Stewart SH. Posttraumatic Stress Disorder Symptoms and Coping Motives are Independently Associated with Cannabis Craving Elicited by Trauma Cues. J Trauma Stress 2022; 35:178-185. [PMID: 34288131 DOI: 10.1002/jts.22715] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 04/24/2021] [Accepted: 04/25/2021] [Indexed: 01/03/2023]
Abstract
Cannabis use is common among individuals with posttraumatic stress disorder (PTSD), although its use can ultimately worsen PTSD outcomes. Cannabis-use coping motives may help explain the PTSD-cannabis relationship. Frequent pairing of trauma cues with substance use to cope with negative affect can lead to conditioned substance craving. For the present cue-reactivity study, we examined if PTSD symptoms were associated with cannabis craving elicited by a personalized trauma cue and explored whether coping motives mediated this hypothesized relationship; enhancement motives were included as a comparison mediator. Participants (N = 51) were trauma-exposed cannabis users who completed validated assessments on PTSD symptom severity and cannabis use motives. They were then exposed to a personalized audiovisual cue based on their own traumatic experience after which they responded to questions on a standardized measure regarding their cannabis craving. The results demonstrated that PTSD symptoms were associated with increased cannabis craving following trauma cue exposure, B = 0.43, p = .004, 95% CI [0.14, 0.72]. However, the results did not support our hypothesis of an indirect effect through general coping motives, indirect effect = .03, SE = .08, 95% CI [-.10, .21]. We found an independent main effect of general coping motives on trauma cue-elicited cannabis craving, B = 1.86, p = .002, 95% CI [0.72, 3.01]. These findings have important clinical implications suggesting that clinicians should target both PTSD symptoms and general coping motives to prevent the development of conditioned cannabis craving to trauma reminders in trauma-exposed cannabis users.
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Affiliation(s)
- Kyra N Farrelly
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Pablo Romero-Sanchiz
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Tiberiu Mahu
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sean P Barrett
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Pamela Collins
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Daniel Rasic
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sherry H Stewart
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
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Christ NM, Byllesby BM, Elhai JD. The Effect of Cognitive-Affective Factors on PTSD and Alcohol Use Symptoms: An Investigation on Rumination, Suppression, and Reappraisal. Subst Use Misuse 2022; 57:2053-2062. [PMID: 36305851 DOI: 10.1080/10826084.2022.2129997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Background: Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) are mental health conditions that often co-occur. The complexity of this comorbidity is well-documented, though the role of malleable cognitive-affective factors in PTSD/AUD warrants further study. Specifically, attaining a more comprehensive understanding of the role of malleable cognitive-affective factors in individuals with symptoms of PTSD/AUD may have important implications for future research, such as in treatment-seeking individuals. Extant examinations of cognitive-affective factors have demonstrated unique associations of cognitive reappraisal, expressive suppression, and rumination in PTSD symptom severity, though these effects had yet to be explored in subgroups of comorbid PTSD/AUD.Methods: In a sample of trauma-exposed individuals (n = 334) recruited to participate through an internet labor market, we first empirically examined latent subgroups of PTSD/AUD symptoms using latent profile analysis, then included expressive suppression, cognitive reappraisal, and four dimensions in the model to elucidate their role in specific profile patterns of PTSD/AUD symptom typologies.Results: Our results support a four-class model of PTSD/AUD symptoms, with unique predictive effects of expressive suppression, problem-focused thoughts, repetitive thoughts, and anticipatory thoughts on latent profile status.Conclusions: These findings may have important implications for future research focused on examining cognitive-affective patterns as they apply to intervention techniques in treatment-seeking individuals with symptoms of PTSD/AUD.
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Affiliation(s)
- Nicole M Christ
- Department of Psychology, University of Toledo, Toledo, Ohio, USA
| | - Brianna M Byllesby
- Department of Psychology, University of South Dakota, Vermillion, South Dakota, USA
| | - Jon D Elhai
- Department of Psychology, University of Toledo, Toledo, Ohio, USA
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Shaw R, Read JP. The differential effects of verbal sexual coercion and forcible sexual assault on alcohol use and consequence trajectories in the first year of college. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2021; 13:835-846. [PMID: 34591534 PMCID: PMC9164101 DOI: 10.1037/tra0001130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Verbal sexual coercion (VSC) is the most prevalent and pervasive form of sexual victimization that women experience, yet the long-term harmful effects of this type of experience are unknown. The current study examined the effects of verbal sexual coercion versus forcible sexual assault (FSA) on alcohol use and alcohol consequences, two deleterious outcomes that have been linked to sexual victimization. METHOD In a sample of college women (N = 649), lifetime history of VSC and FSA were examined as predictors of trajectories of alcohol outcomes with latent growth models. Participants were assessed at six timepoints over their first year of college, a critical transition period of increased risk for both alcohol use and trauma exposure. We also examined the influence of victimization characteristics, such as relationship to the perpetrator and revictimization experiences in these associations. RESULTS VSC experiences were predictive of higher levels of alcohol use and alcohol-related consequences (i.e., intercept). This risk was sustained throughout the first year of college. VSC experiences did not predict changes (i.e., slope) in alcohol outcomes over this time. In contrast, FSA was not predictive of either initial level or change in alcohol use and consequences over time. CONCLUSION Findings highlight the importance of distinguishing among types of coercive experiences, as they show unique associations with later harmful outcomes. Verbal sexual coercion, common in the lives of young women but often overlooked in the extant literature, is associated with substantial negative impact during the first year of college. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Zegel M, Lebeaut A, Healy N, Tran JK, Vujanovic AA. Mental Health Correlates of Probable Posttraumatic Stress Disorder, Probable Alcohol Use Disorder, and Their Co-Occurrence among Firefighters. Behav Modif 2021; 46:395-421. [PMID: 34323099 DOI: 10.1177/01454455211033517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Firefighters demonstrate high rates of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Research has yet to compare how these diagnoses and their co-occurrence relate to firefighter mental health. This study evaluated trauma load, PTSD, alcohol use, depression, sleep, suicide risk, anger, and occupational stress across four discrete groups of firefighters (N = 660): (1) trauma-exposed only (n = 471), (2) probable PTSD-only (n = 36), (3) probable AUD-only (n = 125), and (4) probable PTSD-AUD (n = 28). Firefighters completed an online survey. Firefighters with probable PTSD-AUD demonstrated higher scores on all criterion variables, except trauma load, compared to firefighters with probable AUD-only or trauma-only. Firefighters with probable PTSD-AUD and probable PTSD-only reported similar levels of all indices, except alcohol use severity and suicide risk, which were higher among the probable PTSD-AUD group. Results provide preliminary empirical evidence of the deleterious impact of PTSD-AUD comorbidity among firefighters.
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Affiliation(s)
| | | | | | - Jana K Tran
- National Aeronautics and Space Administration (NASA), Houston, TX, USA
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Livingston NA, Lee DJ, Mahoney CT, Farmer SL, Cole T, Marx BP, Keane TM. Longitudinal assessment of PTSD and illicit drug use among male and female OEF-OIF veterans. Addict Behav 2021; 118:106870. [PMID: 33667852 DOI: 10.1016/j.addbeh.2021.106870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Posttraumatic stress disorder (PTSD) and substance use share both directional ("self-medication") and mutually-reinforcing associations over time. Research on gender differences regarding the co-occurrence of PTSD and substance use over time remains limited and largely focused on alcohol use; less is known regarding the co-occurrence of PTSD and illicit drug use, especially among veteran men vs. women. As the proportion of women in the military expands, we believe a greater focus on gender differences is warranted. METHOD We conducted a cross-lagged panel analysis of PTSD symptoms and drug use problems using two waves of data from a large, nationwide longitudinal registry of post-9/11 veterans. Participants included 608 men and 635 women (N = 1243; Mage = 42.3; 75.2% White) who completed self-report PTSD and drug use problem questionnaires at T1 and again at T2 15-37 months later. RESULTS Veteran men reported more severe drug use and related problems overall, yet the cross-sectional correlation between PTSD and drug use problems was strongest among drug using veteran women. In our cross-lagged models, we found that PTSD symptoms predicted future drug use problems among veteran men, whereas drug use problems predicted future PTSD symptom severity among women. CONCLUSIONS These results support the self-medication pathway among veteran men but not women, for whom drug use problems might prolong or exacerbate PTSD symptom severity over time. These results are consistent with some emerging evidence but also provide novel insight into functional associations governing the longitudinal course of PTSD and drug use problems for men vs. women.
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Affiliation(s)
- Nicholas A Livingston
- U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, MA, United States; Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States; National Center for PTSD, Behavioral Science Division, Boston, MA, United States.
| | - Daniel J Lee
- U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, MA, United States; Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States; National Center for PTSD, Behavioral Science Division, Boston, MA, United States
| | - Colin T Mahoney
- Western New England University, Springfield, MA, United States
| | - Stacey L Farmer
- Department of Veteran Affairs, Albany Stratton VA Medical Center, Albany, NY, United States
| | - Travis Cole
- National Center for PTSD, Behavioral Science Division, Boston, MA, United States
| | - Brian P Marx
- U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, MA, United States; Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States; National Center for PTSD, Behavioral Science Division, Boston, MA, United States
| | - Terence M Keane
- U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, MA, United States; Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States; National Center for PTSD, Behavioral Science Division, Boston, MA, United States
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37
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Masculinity and stigma among emerging adult military members and veterans: implications for encouraging help-seeking. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01768-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Alcohol to down-regulate negative and positive emotions: Extending our understanding of the functional role of alcohol in relation to posttraumatic stress disorder. Addict Behav 2021; 115:106777. [PMID: 33359633 DOI: 10.1016/j.addbeh.2020.106777] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Functional models of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) underscore the role of internally-driven negative reinforcement. However, with the focus of these models being on negative emotions broadly, there is limited understanding of the effect of alcohol use to down-regulate specific forms of negative emotions or positive emotions generally. Among populations characterized by PTSD, there is growing evidence that positive emotions may elicit aversive reactions and thus be intentionally reduced, including via alcohol use. OBJECTIVE The current study examined the associations among PTSD symptom severity, alcohol use to down-regulate both negative (i.e., despondency and anger) and positive emotions, and alcohol misuse. METHOD Data were collected from 320 trauma-exposed, substance-using individuals in the community (M age = 35.78, 46.9% women). RESULTS Individuals with greater PTSD symptom severity reported significantly higher alcohol use to down-regulate despondency, anger, and positive emotions, which, in turn, were linked to greater alcohol misuse. CONCLUSIONS Alcohol use may serve to down-regulate both negative (i.e., despondency and anger) and positive emotions, and these functions may help to explain the association of PTSD symptom severity to alcohol misuse. PTSD-AUD models may benefit from specifying a negatively reinforcing function of alcohol use in the context of positive emotions.
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Blakey SM, Tsai J, Elbogen EB. Drinking to Cope with Posttraumatic Stress: A Nationally Representative Study of Men with and without Military Combat Experience. J Dual Diagn 2021; 17:101-112. [PMID: 33730991 DOI: 10.1080/15504263.2021.1891360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Posttraumatic stress disorder (PTSD) and hazardous alcohol use are prevalent among trauma survivors. Despite higher rates of both PTSD and hazardous alcohol use among military combat veterans than civilians, scant research has examined whether military combat experience is associated with drinking alcohol to cope with PTSD symptoms. This study tested the hypothesis that compared to trauma-exposed men without combat experience, men with military combat experience would be more likely to endorse drinking alcohol to cope with their PTSD symptoms. Methods: Interview data from N = 11,474 men who reported at least one lifetime traumatic experience were drawn from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), a face-to-face interview study that recruited a nationally representative sample of adults living in the United States between 2004 and 2005. Results: Among men endorsing lifetime trauma exposure, men with military combat experience (n = 1,386) were more likely than men without combat experience (n = 10,088) to report drinking alcohol to cope (7.22 vs. 2.61% in unweighted analyses, 6.46 vs. 2.37% in weighted analyses). Total number of lifetime trauma types, lifetime PTSD severity, and lifetime alcohol abuse/dependence were significantly associated with drinking to cope in bivariate and multivariate analyses. Military combat experience was significantly associated with drinking to cope in multivariate analyses adjusting for lifetime PTSD diagnosis. Military combat experience was not significantly associated with drinking to cope in multivariate analyses adjusting for lifetime PTSD symptom count. Conclusions: Although military combat experience was significantly associated with drinking to cope in bivariate analyses, multivariate analyses yielded mixed findings: combat experience was significantly associated with drinking to cope in models adjusting for PTSD diagnosis, but not in models adjusting for PTSD symptom count. Findings highlight the importance of assessing and targeting PTSD symptom-related alcohol use, even in the absence of alcohol abuse/dependence. Results from this preliminary study could inform future research on drinking to cope with PTSD symptoms among military combat veterans and other trauma survivors.
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Affiliation(s)
- Shannon M Blakey
- Durham VA Health Care System, Durham, North Carolina, USA.,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, North Carolina, USA
| | - Jack Tsai
- School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA.,VA National Center on Homelessness Among Veterans, Tampa, Florida, USA
| | - Eric B Elbogen
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, North Carolina, USA.,VA National Center on Homelessness Among Veterans, Tampa, Florida, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
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40
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Bourgeois C, Lecomte T, McDuff P, Daigneault I. Mental health disorders as cooccuring and predictive factors of psychotic disorders in sexually abused children. CHILD ABUSE & NEGLECT 2021; 111:104819. [PMID: 33261843 DOI: 10.1016/j.chiabu.2020.104819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/10/2020] [Accepted: 11/09/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Little is known about the factors associated with psychosis in sexually abused children. Many factors have been associated with both sexual abuse and psychosis, and some mental health disorders have been identified as implied in the relationship between childhood trauma and psychosis. OBJECTIVES This study aims to identify factors cooccurring with psychotic disorders in sexually abused youth and to determine which predict the development of psychosis in this population. PARTICIPANTS AND SETTING Children with a corroborated report of sexual abuse (n = 882) at a Child Protection Agency (CPA) between 2000 and 2010 and whose health data could be retrieved from public health databases were selected for this study. METHODS A prospective matched-cohort design was used, with administrative databases from a CPA and a public health system. Logistic regressions were performed to determine which mental health diagnoses were associated with, and which predicted, psychotic disorders. RESULTS Logistic regressions revealed that personality disorders were significantly associated with psychotic disorders whereas substance misuse disorders and intellectual disability significantly predicted psychotic disorders. CONCLUSIONS Psychotic disorders and personality disorders appear concomitantly in sexually abused youth. Having received a substance misuse disorder diagnosis increases the risk of developing a psychotic disorder in sexually abused youth. Health professionals should be aware of those risk factors to help reduce the severity of youth sexual abuse consequences and, ultimately, prevent psychosis.
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Affiliation(s)
- Catherine Bourgeois
- Université de Montréal, Department of Psychology, 90 avenue Vincent d'Indy, Montreal, Quebec, H2V 2S9, Canada.
| | - Tania Lecomte
- Université de Montréal, Department of Psychology, 90 avenue Vincent d'Indy, Montreal, Quebec, H2V 2S9, Canada
| | - Pierre McDuff
- Université de Montréal, Department of Psychology, 90 avenue Vincent d'Indy, Montreal, Quebec, H2V 2S9, Canada
| | - Isabelle Daigneault
- Université de Montréal, Department of Psychology, 90 avenue Vincent d'Indy, Montreal, Quebec, H2V 2S9, Canada
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41
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Witte TH, Weymouth BB, Gajos JM, Penunuri A, Levy S. Trauma Exposure and Problem Drinking in Late Adolescence: A Latent Profile Analysis. J Trauma Stress 2020; 33:1048-1059. [PMID: 33038904 DOI: 10.1002/jts.22599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 07/13/2020] [Accepted: 07/17/2020] [Indexed: 11/06/2022]
Abstract
Exposure to early traumatic events has been implicated in problem drinking during late adolescence, and this association may be stronger among youth with emotion regulation deficits. The purpose of this study was to identify subgroups of late adolescents based on trauma type, including loss, posttraumatic stress disorder (PTSD) symptoms; and emotion regulation deficits that confer the risk for problematic drinking behaviors. A sample of 946 participants (M age = 18.84 years, SD = 1.06) was analyzed with mixed-indicator latent profile analysis to identify subgroups and explore whether these subgroups displayed significant differences regarding elevated drinking frequency, alcohol quantity, and problematic alcohol use. A four-profile model yielded the best fit to the data, and four groups were identified and labeled "high functioning" (29.4%), "loss regulated" (32.3%), "loss dysregulated" (28.1%), and "multiple trauma dysregulated" (10.1%). Individuals in the high functioning group reported the lowest rates on all three measures of alcohol misuse (14.6-24.9%), whereas those in the multiple trauma dysregulated group reported the highest rates on all three measures (31.6-71.5%). Individuals in the multiple trauma dysregulated group (M = 0.25) differed significantly from those in the other three groups (Ms = 0.42-0.72) on the measure of problematic alcohol use but scored similarly to those in the loss dysregulated group on measures of drinking frequency (M = 0.32 and 0.24, respectively) and quantity (M = 0.43 and 0.39, respectively). These findings have implications for prevention programs targeted for alcohol use disorders among older adolescents.
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Affiliation(s)
- Tricia H Witte
- Department of Human Development and Family Studies, The University of Alabama, Tuscaloosa, Tuscaloosa, Alabama, USA
| | - Bridget B Weymouth
- Department of Human Development and Family Studies, The University of Alabama, Tuscaloosa, Tuscaloosa, Alabama, USA
| | - Jamie M Gajos
- Department of Human Development and Family Studies, The University of Alabama, Tuscaloosa, Tuscaloosa, Alabama, USA
| | - Andrew Penunuri
- Department of Management, The University of Alabama, Tuscaloosa, Tuscaloosa, Alabama, USA
| | - Sera Levy
- Department of Psychology, The University of Alabama, Tuscaloosa, Tuscaloosa, Alabama, USA
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42
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McPhee MD, Keough MT, Rundle S, Heath LM, Wardell JD, Hendershot CS. Depression, Environmental Reward, Coping Motives and Alcohol Consumption During the COVID-19 Pandemic. Front Psychiatry 2020; 11:574676. [PMID: 33192708 PMCID: PMC7661794 DOI: 10.3389/fpsyt.2020.574676] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 09/28/2020] [Indexed: 12/21/2022] Open
Abstract
Background: Increases in the incidence of psychological distress and alcohol use during the COVID-19 pandemic have been predicted. Behavioral theories of depression and alcohol self-medication theories suggest that greater social/environmental constraints and increased psychological distress during COVID-19 could result in increases in depression and drinking to cope with negative affect. The current study had two goals: (1) to examine self-reported changes in alcohol use and related outcomes after the introduction of COVID-19 social distancing requirements, and; (2) to test hypothesized mediation models to explain individual differences in self-reported changes in depression and alcohol use during the early weeks of the COVID-19 pandemic. Methods: Participants (n = 833) were U.S. residents recruited for participation in a single online survey. The cross-sectional survey included questions assessing environmental reward, depression, COVID-19-related distress, drinking motives, and alcohol use outcomes. Outcomes were assessed via retrospective self-report for two timeframes in the single survey: the 30 days prior to state-mandated social distancing ("pre-social-distancing"), and the 30 days after the start of state-mandated social distancing ("post-social-distancing"). Results: Depression severity, coping motives, and some indices of alcohol consumption (e.g., frequency of binge drinking, and frequency of solitary drinking) were significantly greater post-social-distancing relative to pre-social-distancing. Conversely, environmental reward and other drinking motives (social, enhancement, and conformity) were significantly lower post-social distancing compared to pre-social-distancing. Behavioral economic indices (alcohol demand) were variable with regard to change. Mediation analyses suggested a significant indirect effect of reduced environmental reward with drinking quantity/frequency via increased depressive symptoms and coping motives, and a significant indirect effect of COVID-related distress with alcohol quantity/frequency via coping motives for drinking. Discussion: Results provide early cross-sectional evidence regarding the relation of environmental reward, depression, and COVID-19-related psychological distress with alcohol consumption and coping motives during the early weeks of the COVID-19 pandemic. Results are largely consistent with predictions from behavioral theories of depression and alcohol self-medication frameworks. Future research is needed to study prospective associations among these outcomes.
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Affiliation(s)
- Matthew D. McPhee
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | | | - Samantha Rundle
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Laura M. Heath
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Jeffrey D. Wardell
- Department of Psychology, York University, Toronto, ON, Canada
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Christian S. Hendershot
- Department of Psychology, University of Toronto, Toronto, ON, Canada
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
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43
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Hawn SE, Cusack SE, Amstadter AB. A Systematic Review of the Self-Medication Hypothesis in the Context of Posttraumatic Stress Disorder and Comorbid Problematic Alcohol Use. J Trauma Stress 2020; 33:699-708. [PMID: 32516487 PMCID: PMC7572615 DOI: 10.1002/jts.22521] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/10/2019] [Accepted: 12/10/2019] [Indexed: 11/12/2022]
Abstract
Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) commonly co-occur and are associated with many negative public health outcomes. There are several etiological models that explain the overlap between PTSD and AUD, including shared genetic risk and phenotypic causality, but the predominant model of etiologic association is the drinking-to-cope self-medication model. Although the self-medication model is conceptually appealing and has been widely accepted within the literature examining alcohol use and anxiety (e.g., PTSD) phenotypes, the findings are inconsistent and there is a lack of rigorous empirical evidence in support of this model. This review, which was, to our knowledge, the first systematic review of the self-medication model in relation to PTSD to date, aimed to synthesize the current literature on the association between PTSD and problematic alcohol use within the context of the self-medication model. In total, 24 studies met the inclusion criteria for the review and assessed the self-medication hypothesis using a variety of measurement instruments and data analytic approaches, such as mediation, moderation, and regression. Overall, the included studies provide evidence for the self-medication hypothesis but are limited in rigor due to methodological limitations. These limitations, which include issues with the operationalization (or lack thereof) of trauma-related drinking to cope, are discussed, and directions for future research are presented.
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Affiliation(s)
- Sage E Hawn
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Shannon E Cusack
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
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44
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Hawn SE, Aggen SH, Cusack SE, Dick D, Amstadter AB. Examination of a novel measure of trauma-related drinking to cope. J Clin Psychol 2020; 76:1938-1964. [PMID: 32478444 DOI: 10.1002/jclp.22972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/19/2020] [Accepted: 04/25/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVES The present study sought to fill a gap in the current literature by developing a concise self-report questionnaire assessing drinking motives specific to coping with symptoms of posttraumatic stress disorder (PTSD). This new four-item questionnaire is called the Trauma Related Drinking questionnaire (TRD). METHOD Using structural equation modeling, the latent structure of the TRD items and how they relate to other variables of interest were explored among a sample of 1,896 college undergraduates from a large public university. RESULTS Broadly, we found evidence to suggest that TRD is a more specific measure of drinking to cope motives compared to the commonly used Drinking Motives Questionnaire coping subscale. Additionally, findings demonstrate support for the external validation of TRD, both with regard to PTSD and alcohol consumption and related problems. CONCLUSIONS Results support the use of TRD in future self-medication research and as a clinically useful screening tool.
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Affiliation(s)
- Sage E Hawn
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia.,Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Steven H Aggen
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Shannon E Cusack
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia.,Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | | | - Danielle Dick
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia.,Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia
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