Experience-Sampling Study of PTSD and Alcohol-Related Problems

Abstract

Posttraumatic stress disorder (PTSD) represents a debilitating psychiatric condition that is affecting the lives of many returning veterans. PTSD and alcohol use and dependence are highly comorbid. The purpose of this study was to understand the functional mechanisms between PTSD and alcohol use and problems. Specifically, the role of negative urgency and emotional intelligence were investigated as vulnerability and resiliency factors, respectively. This study utilized experience sampling to test associations between PTSD symptoms and alcohol use and related problems in a sample of 90 OIF/OEF veterans. Participants completed eight brief questionnaires daily for two weeks on palmtop computers. Elevations in PTSD symptoms during the day were associated with subsequent increases in alcohol use and associated problems that night. PTSD symptoms were associated with greater problems above and beyond the effect of drinking level at both the within-and between-person level. Emotional intelligence was associated with lower negative urgency, fewer PTSD symptoms, and less alcohol use and associated problems. The effects of emotional intelligence were primarily indirect via negative * The contents of this manuscript do not represent the views of the Department of Veterans Affairs or the United States Government.Correspondence concerning this article should be addressed to Raluca M. Gaher, Department of Psychology, The University of South Dakota, 414 East Clark St. Vermillion, SD 57069. rgaher@usd.edu. NIH Public Access Author ManuscriptPsychol Addict Behav. Author manuscript; available in PMC 2015 December 01. Published in final edited form as:Psychol Addict Behav. 2014 December ; 28(4): 1013-1025. doi:10.1037/a0037257. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript urgency and the effects of negative urgency on alcohol use and problems were indirect via its positive association with PTSD symptoms. Hypothesized cross-level effects of emotional intelligence and negative urgency were not supported. The findings suggest a functional association between PTSD symptoms and alcohol consumption. The association between PTSD symptoms and alcohol consumption is consistent with a self-medication model. However, the significant associations between PTSD symptoms and alcohol problems, after controlling for use level, suggest a broader role of dysregulation.Posttraumatic stress disorder (PTSD) represents a debilitating psychiatric condition that is affecting the lives of many returning veterans. This disorder has significant social and financial implications for society as well as the affected individuals and their families. PTSD is associated with increased rates of a range of problematic behaviors including alcoholrelated problems as well as difficulties in social and occupational functioning (Mills, Teesson, Ross, Darke, & Shanahan, 2005;Mills, Teesson, Ross, & Darke, 2007). PTSD and alcohol dependence are highly comorbid, such that individuals with PTSD also have cooccurring alcohol dependence in ra...

Quantifying alcohol consumption: Self-report, transdermal assessment, and prediction of dependence symptoms

“…Nonetheless, researchers are often interested in not only assessing number of drinks in these studies but also assessing predictors such as affect, which may be more influenced by memory biases or establishing temporal associations within days, in which case experience sampling approaches may be necessary. A combination of experience sampling and daily morning reports (Gaher et al, 2014; Simons et al, 2010, 2014) or use of EMA (Piasecki et al, 2011) may be necessary to accurately assess low intensity drinking events.…”

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

“…Past studies have linked PTSD severity to alexithymia, defined as the inability to identify or describe one's emotions (McCaslin et al, 2006). In a recent study of OEF/OIF veterans, higher emotional intelligence (defined as the ability to understand and regulate emotions) predicted overall fewer symptoms of PTSD, less alcohol use, and alcohol problems (Gaher et al, 2014). Another study of college students found that several emotion dysregulation facets including impulse control difficulties and lack of emotional clarity were associated with the number of negative consequences of alcohol use (Dvorak et al, 2014).…”

Military sexual trauma, combat exposure, and negative urgency as independent predictors of PTSD and subsequent alcohol problems among OEF/OIF veterans.

“…an individual may take in response to intense negative affect (Cyders & Smith, 2008) and has been independently associated with greater rates of PTSD (Weiss et al, 2013) and alcohol-related problems in previous research (Settles, Cyders, & Smith, 2010; Wray, Simons, Dvorak, & Gaher, 2012; Kaiser, Milich, Lynam, & Charnigo, 2012; Shishido et al, 2013). Indeed, prospective research shows that posttraumatic stress symptoms are associated with, and predict, higher rates of future alcohol-related problems (Gaher et al, 2014; Hooper et al, 2008; Ouimette, Read, Wade, & Tirone, 2010). Due to the high comorbidity between PTSD and alcohol-related problems, it is essential to study PTSD and alcohol outcomes together in the same model and identify mechanisms to better understand the high comorbidity.…”