Posttraumatic stress disorder (PTSD) and alcohol dependence (AD) frequently co-occur, although results of both cross-sectional and longitudinal studies evaluating the nature of their relationship have been mixed. There has been varied support for competing models explaining how these conditions influence one another. To assess both the self-medication and mutual maintenance models, as well as examine the potential moderating role of drinking motives, the current study used Generalized Estimating Equations to evaluate daily associations for an average of 7.3 days between PTSD symptoms and alcohol use in a mixed-gender sample of individuals who met criteria for both PTSD and AD. Results generally supported a self-medication model with elevated PTSD symptoms predictive of greater alcohol use on that same day and on the following day. Contrary to a mutual maintenance model prediction, drinking did not predict next-day PTSD symptoms. Results also indicated that both coping and enhancement drinking motives were significant moderators of the PTSD and drinking relationships, suggesting that these relationships may be more or less salient depending on an individual’s particular drinking motivations. For example, among those higher on coping drinking motives, a 1-unit increase in PTSD symptom severity was associated with a 37% increase in amount of alcohol consumed the same day, while among those low on coping drinking motives, a 1-unit PTSD increase was associated with only a 10% increase in alcohol consumption. We discuss implications of these findings for the larger literature on the associations between PTSD and alcohol use as well as for clinical interventions.

Objective Although assessments of sexual assault victimization and perpetration have greatly improved, current scoring methods do not fully utilize the wealth of information they provide. The present studies assessed new methods for scoring sexual assault severity using the Sexual Experiences Survey (SES; Koss et al., 2007). Method In two studies of female (n = 436) and male (n = 313) non-problem drinkers who had engaged in unprotected sex within the past year, we compared three severity ranking schemes as well as three scoring methods per severity scheme for a total of nine scoring methods. New severity ranking schemes considered tactic types separately, varied combinations of assault outcomes, and accounted for multiple types and frequencies of assaults. Measures assessing convergent validity were also administered. Results Seventy-eight percent (n = 340) of the women reported victimization, and 58% (n = 180) of the men reported perpetration. All severity scoring methods were strongly associated with convergent measures. Conclusions Each scoring method is viable; however especially among samples with greater victimization/perpetration rates, there can be advantages to incorporating multiple types and frequencies of assault experiences into SES scores. Recent refinements of the SES necessitate commensurate improvements in its scoring methods in order to significantly advance the field of sexual assault assessment.

Suicidal ideation (SI) and aggression are common correlates of Posttraumatic Stress Disorder (PTSD) among Iraq and Afghanistan War veterans. The existing literature has established a strong link between these factors, but a more nuanced understanding of how PTSD influences them is needed. The current study examined the direct and indirect relationships between PTSD symptom clusters and SI and general aggression (without a specified target) via depression, alcohol misuse, and trait anger. Participants were 359 (92% male) Iraq/Afghanistan War veterans. Path analysis results suggest that the PTSD numbing cluster was directly (β=.28, p<.01.) and indirectly (β=.17, p=.001) related to SI through depression and the PTSD hyperarousal cluster was indirectly related to SI through depression (β=.13, p<.001). The PTSD re-experiencing cluster was directly related to aggression (β=.17, p<.05), whereas the PTSD numbing and hyperarousal clusters were indirectly related to aggression through trait anger (β=.05, p<.05; β=.20, p<.001). These findings suggest that adjunct treatments aimed at stabilizing anger, depression, and alcohol misuse may help clinicians ameliorate the maladaptive patterns often observed in returning Veterans. These results also point to specific manifestations of PTSD and co-occurring conditions that may inform clinicians in their attempts to identify at-risk veterans and facilitate preventative interventions.

The self-medication hypothesis has been proposed to explain comorbidity between PTSD and drinking, whereupon problem drinking develops as an attempt to modulate negative affect and ameliorate PTSD symptoms. Studies have begun utilizing daily monitoring methodologies to refine our understanding of proximal relations between PTSD, affect, and alcohol use. 136 female college drinkers with a past history of sexual victimization and 38 female college drinkers with no past trauma history, completed electronic monitoring of PTSD symptoms, affect, alcohol use, and alcohol cravings, daily for 4 weeks. A two-part mixed hurdle model was used to examine likelihood of drinking and amount of alcohol consumed on drinking days. We did find significant relationships between daily PTSD symptoms, affect, and drinking. On days women experienced more intrusive and behavioral avoidance symptoms of PTSD they experienced stronger urges to drink and were more likely to drink on that day. On days where women experienced more negative affect than their average, they experienced stronger urges to drink whereas on days where women experienced more of the dysphoric symptoms associated with PTSD than their average, they drank less. On days with higher positive affect women reported stronger urges to drink and were more likely to drink. Results suggest the need to examine both aspects of affect and specific PTSD symptoms as they may differentially predict drinking behavior. Differences in the ways in which PTSD symptoms and affect influence drinking suggest that interventions more specifically address the function of drinking behaviors in reducing alcohol use among college women.

Research suggests that many men have used a variety of tactics to avoid using a condom when having sex with a woman. Guided by previous work demonstrating that men’s use of coercive condom resistance tactics was predicted by negative attitudes toward women, inconsistent condom use, multiple partners, and sexual sensation seeking, the current study used latent profile analysis (LPA) to determine whether similar constructs were associated with a variety of resistance tactics. A community sample of 313 moderate drinking men participated, of whom 80% reported employing at least one condom use resistance tactic since adolescence. The LPA revealed three classes of men. In general, men with the least negative beliefs about women, low levels of sexual sensation seeking and impulsivity, and positive beliefs about condoms (Condom Positive/Low Hostility) reported less use of resistance tactics than men with moderate sexual sensation seeking and impulsivity, negative beliefs about condoms, and moderate (Condom Negative/Moderate Hostility) or high (Condom Negative/High Hostility) negative attitudes about women. The classes also differed in terms of their sexual behaviors. This study demonstrated that sexual risk behavior interventions should not only address the tactics through which men resist using condoms but also tailor these efforts to men’s individual characteristics.