Emotion dysregulation facets as mediators of the relationship between PTSD and alcohol misuse

Abstract

Introduction Posttraumatic stress disorder (PTSD) and alcohol misuse, which frequently co-occur among combat veterans, have been linked to emotion dysregulation. Emotion dysregulation may explain the link between PTSD and alcohol misuse, and this investigation tested emotion dysregulation as a mediator of that relationship. Method Correlations between PTSD symptoms and cluster symptoms, emotion dysregulation full and subscales, and alcohol misuse were examined in a sample of 139 combat Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn veterans (45% African American; 89% men). Emotion dysregulation full scale and subscales were examined as mediators of the relationship between PTSD symptoms and alcohol misuse for the full sample and men only. Results PTSD symptoms and symptom clusters, emotion dysregulation, and alcohol misuse showed positive correlations for the full sample and men only. Neither the full scale of emotion dysregulation nor the facets of emotion dysregulation mediated the relationship between PTSD symptoms and alcohol misuse for the full sample; among men, the Impulse Control Difficulties when Upset and Lack of Emotional Clarity subscales were mediators of that relationship. Conclusions Impulse control difficulties and lack of emotional clarity may play an important role in the link between PTSD and alcohol misuse for male veterans and should be an important target in treatment for individuals with both disorders disorders. Addressing impulse control difficulties and lack of emotional clarity in those with PTSD and alcohol misuse may improve outcomes by helping individuals identify and describe upsetting emotions and develop healthy coping alternatives to alcohol misuse.

Mechanistic role of emotion regulation in the PTSD and alcohol association.

“…Of the facets of emotion regulation tested in our models, difficulty controlling impulse behavior when emotionally distressed (i.e., the IMPULSE subscale) mediated the pathway from PTSD to alcohol consumption. This result was consistent with our hypothesis and previous findings (Tripp et al, 2015), and may speak to Koole’s (2009) conceptualization of need-oriented emotion regulation, in which reducing negative affect is prioritized, even at the cost of negative consequences. In short, according to Koole’s model, a person's drinking may be driven by a perceived need for immediate relief from negative affect.…”

“…Yet, there have been a number of limitations to this work. For example, studies have varied in the alcohol outcome variables examined (e.g., alcohol-related consequences or coping motives for drinking is being predicted rather than drinking behavior itself, or impulsive behaviors broadly, rather than alcohol use specifically; Tripp, McDevitt-Murphy, Avery, & Bracken, 2015; Vujanovic, Bonn-Miller, & Marlatt, 2011; Weiss, Tull, Viana, Anestis, & Gratz, 2012). Critically, studies have varied substantially in their measurement and conceptualization of emotion regulation.…”

The Role of Emotion‐Driven Impulse Control Difficulties in the Relation Between Social Anxiety and Aggression

“…This is a particularly relevant population in which to examine the relations of interest, given their elevated levels of social anxiety (Schneier et al, 2010), emotion-driven impulse control difficulties (Fox, Axelrod, Paliwal, Sleeper, & Sinha, 2007;Fox, Hong, & Sinha, 2008), and aggression (Brady, Myrick, & McElroy, 1998). Indeed, emotion-driven impulse control difficulties have been proposed to underlie the link between other anxiety disorders and relevant maladaptive outcomes, including aggression and substance use, in this population (Tripp & McDevitt-Murphy, 2015;Wahlstrom, Scott, Tuliao, DiLillo, & McChargue, 2015).…”

Development and Validation of the Volitional Components Inventory for Drug Rehabilitation

“…Volition competences could be protective factors of individualization and socialization, supporting the feasibility of recovery treatment in compulsory drug rehabilitation centers to help drug addiction patients abstain from drugs. Notably, social and environmental factors exert more powerful influence than do individual factors (Tripp & McDevitt-Murphy, 2015). Volition as a solely individual factor may not suffice to successfully treat drug addiction.…”