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

Abstract

Objective Posttraumatic Stress Disorder (PTSD) has been linked to problematic alcohol use. Those with PTSD have greater difficulty regulating emotions, which may help to explain the PTSD-drinking co-occurrence. However, emotion regulation as a mediator of PTSD-alcohol associations has been limited. In the present study, we examined this association. Method College students (N = 466, Mage = 19.5, 53% female) were assessed for PTSD by structured clinical interview, and were categorized into three groups: those who had not experienced a significant trauma (No Trauma, n = 182), those who had experienced a significant trauma but did not have current PTSD symptoms (Trauma Only, n = 171), and those with significant trauma and with current PTSD (partial or full; PTSD, n = 113). Alcohol use over the past six months and emotion regulation were assessed via self-report (DDQ; Collins, Parks, & Marlatt, 1985; DERS; Gratz & Roemer, 2004). Results Findings revealed that those with trauma and clinically significant PTSD reported greater difficulty with emotion regulation than those who had not been exposed to trauma, which in turn significantly predicted alcohol use. This mediating effect was not found in those with trauma exposure alone, suggesting an important role for PTSD in this pathway. Findings also indicated that the ability to control emotion-based impulses is a particularly relevant mediating facet of emotion regulation. Conclusion These results implicate emotion regulation as a potential explanatory link between PTSD and alcohol use, lending further support to the inclusion of emotion regulation training in PTSD treatment.

Trauma Exposure and Problem Drinking in Late Adolescence: A Latent Profile Analysis

“…This may suggest that PTSD symptoms and emotion dysregulation, rather than the number of trauma exposures per se, may serve as an important risk factor for alcohol misuse. These findings are consistent with a strong body of evidence supporting the self‐medication hypothesis (Khantzian, 1997), suggesting that PTSD symptoms may mediate the association between trauma exposure and problematic drinking behaviors (Haller & Chassin, 2014), and this may be particularly true for individuals who display symptoms of emotional dysregulation (Radomski & Read, 2016). Therefore, trauma exposure alone does not necessarily lead to problematic drinking in late adolescence.…”

“…Studies of PTSD symptoms among young adults have shown that drinking alcohol may serve as a means to cope with PTSD symptoms (Haller & Chassin, 2014; Woolman et al., 2015). Thus, the ability to regulate negative emotions may play a crucial role in the association between PTSD and alcohol use (Radomski & Read, 2016). Emotion regulation is defined as “the ability to manage the internal experience of emotions and the external expression of emotions” (McLean & Foa, 2017, p. 74).…”

Multi‐voxel pattern analysis of amygdala functional connectivity at rest predicts variability in posttraumatic stress severity

“…Posttraumatic stress disorder (PTSD) is a debilitating disorder, associated with reduced physical (El‐Gabalawy, Blaney, Tsai, Sumner, & Pietrzak, 2018; Richardson, Long, Pedlar, & Elhai, 2008), occupational (Smith, Schnurr, & Rosenheck, 2005), social (Freedman, Gilad, Ankri, Roziner, & Shalev, 2015), and emotional (Radomski & Read, 2016) health and well‐being. Despite the negative impact of PTSD on overall quality of life (Vogt et al., 2017), the neurophysiology of this disorder is still not well understood.…”

The impact of sleep and psychiatric symptoms on alcohol consequences among young adults

“…Symptoms of psychiatric disorders, in particular, typically emerge between 14 and 24 years (Kessler et al, 2005) and may impact the course and duration of both substance use and sleep disorders. In regards to the association between psychiatric symptoms and alcohol use among college students, symptoms of PTSD have been associated with increased alcohol use (Radomski & Read, 2016), and those with alcohol use disorders have increased odds of mood and anxiety disorders (Dawson, Grant, Stinson, & Chou, 2005). Complex associations also exist between psychiatric symptoms and sleep: while sleep disturbance is often a symptom of psychiatric disorders, changes in sleep may also impact symptom severity and response to treatment (Krystal, 2012).…”

“… 1 Because anxiety, mood, and trauma-related disorders have been associated with alcohol use among college students (Dawson et al, 2005; Radomski & Read, 2016), we conducted exploratory analyses including only those participants who screened positive for anxiety-, mood-, or trauma-related disorders (at the exclusion of somatization disorder, eating disorders, hypochondriasis, and psychosis). The pattern of results was consistent, in that those who reported both poor sleep quality and a positive psychiatric screen ( M = 6.30, SE = 0.38) reported more alcohol-related consequences than those reporting poor sleep quality/negative screen ( M = 4.50, SE = 0.60), good sleep quality/positive screen ( M = 4.36, SE = 0.31), or good sleep quality/negative screen ( M = 3.92, SE = 0.26).…”