Gender-specific associations between trauma cognitions, alcohol cravings, and alcohol-related consequences in individuals with comorbid PTSD and alcohol dependence.

Abstract

The current study examined gender-specific associations between trauma cognitions, alcohol cravings and alcohol-related consequences in individuals with dually diagnosed PTSD and alcohol dependence (AD). Participants (N = 167) had entered a treatment study for concurrent PTSD and AD; baseline information was collected from participants about PTSD-related cognitions in three areas: negative cognitions about self, negative cognitions about the world, and self-blame; and two aspects of AD, alcohol cravings and consequences of AD. Gender differences were examined while controlling for PTSD severity. The results indicate that negative cognitions about the self are significantly related to alcohol cravings in men but not women, and that interpersonal consequences of AD are significantly related to self-blame in women but not in men. These findings suggest that for individuals with comorbid PTSD and AD, psychotherapeutic interventions that focus on reducing trauma-related cognitions are likely to reduce alcohol cravings in men and relational problems in women.

Childhood trauma, PTSD, and problematic alcohol and substance use in low-income, African-American men and women

“…That gender moderated the indirect effect of PTSD on the relationship between childhood trauma and problematic alcohol use, as well as problematic substance use, is interesting given the findings of Jayawickreme et al (2012) that alcohol cravings were more strongly associated with PTSD-related negative cognitions about the self and the world for men than for women in an outpatient clinical sample, possibly suggesting a greater tendency toward self-medication in men than in women. Chaplin et al (2008) proposed that the relatively greater association between alcohol cravings and stress in men may a result of greater pairing of reward and stress systems in men.…”

“…The reasons for the increased comorbidity in men are several, including that men may be more likely in general to abuse alcohol and substances (Grant et al 2004; Swendsen et al, 2012), to use alcohol and substances to manage negative affect and negative cognitions (Chaplin et al, 2008; Jayawickreme et al, 2012), and to experience more stigma regarding mental health problems (Eisenberg, Downs, Golberstein, & Zivin, 2009). It is also possible that women in this sample experience more disincentives to abuse alcohol or substances.…”

“…Our focus on childhood trauma—rather than other types of trauma—is based on theoretical and empirical models of the impact of early trauma on risk for addiction (De Bellis, 2002; Enoch, 2010). Finally, although Chaplin et al (2008) and Jayawickreme et al’s (2012) findings did not include childhood trauma, we hypothesized, based on the their results showing a stronger relationship in men between both PTSD-related and general negative mood/cognition and alcohol cravings that gender would moderate the effect of PTSD on the relationship between childhood trauma and problematic alcohol and substance use, such that the indirect effect of PTSD would be stronger in men than in women.…”

“…Women are at greater risk of developing PTSD following traumatic exposure (Breslau, 2002; Kessler, Sonnega, Bromet, Hughes, & Nelson, 1995) and are more likely to develop PTSD prior to the onset of substance abuse (Sonne, Back, Zuniga, Randall, & Brady, 2003), which could suggest a greater impact of PTSD on the risk for alcohol and/or substance abuse in women. On the other hand, other studies show that men with PTSD may be more likely than women with PTSD to use alcohol, in particular, to manage negative affect and negative cognitions (Chaplin, Hong, Bergquist, & Sinha, 2008; Jayawickreme, Yasinski, Williams, & Foa, 2012). …”

The impact of elevated posttraumatic stress on the efficacy of brief alcohol interventions for heavy drinking college students

“…College personnel working with heavy drinkers are encouraged to screen for trauma-related symptoms, as the presence of PTSD may impact the type of intervention that is appropriate for these students. As has been shown in previous work examining the relationship between trauma cognitions and symptoms of alcohol misuse (Jayawickreme, Yasinski, Williams, & Foa, 2012), there are many factors such as gender and race that are important to consider when developing interventions targeting co-occurring PTSD and alcohol misuse. The results of the current study suggest that these students may show greater reductions in alcohol consequences when they receive a MI rather than a computerized intervention.…”