Negative affect and alcohol craving in trauma‐exposed young adult drinkers

Abstract

Background: Clinical research indicates that successful posttraumatic stress disorder (PTSD) treatment does not lead to improvements in alcohol use outcomes in comorbid PTSD and alcohol use disorder (AUD). Emerging theory suggests that treating PTSD may not disrupt an association between negative affect and alcohol craving, which underlies negative reinforcement drinking. The goal of the current study was to determine the respective influences of PTSD symptoms, coping motives, and negative affect on trauma and alcohol cue reactivity to inform theoretical models of co-occurring PTSD and AUD. Methods:The sample consisted of 189 young adults (50.3% women; 49.2% current PTSD; 84.0% current AUD) who endorsed interpersonal trauma (e.g., sexual/physical assault) and current weekly alcohol use. Participants completed a trauma and alcohol cue reactivity assessment, in which subjective (e.g., craving, affect) and physiological (i.e., salivation) measures were recorded in response to 4 narrative (i.e., personalized trauma or standard neutral) and in vivo beverage (i.e., personalized alcohol or water) cue combinations.Results: Forward-fitted linear mixed-effects (LME) models confirmed that trauma cue-elicited craving was elevated among those high but not low in PTSD symptoms, consistent with prior research and theory. Trauma cue-elicited craving was fully explained by increases in negative affect, with no evidence of a direct effect of trauma cue on craving. PTSD symptoms moderated an association between trauma cue and negative affect (but not negative affect and craving), and coping motives for alcohol moderated an association between negative affect and craving (but not trauma cue and negative affect). Conclusions:This study provides novel laboratory evidence for the respective contributions of negative affect, PTSD symptoms, and coping motives on alcohol craving in trauma-exposed drinkers. It offers a methodological framework in which to evaluate novel strategies that aim to disrupt negative reinforcement drinking in individuals with co-occurring PTSD and AUD.

Negative urgency, PTSD symptoms, and alcohol risk in college students

“…The CAPS has been found to be a highly reliable and valid measure of PTSD symptom severity ( Blake et al, 1995 , Weathers et al, 2001 ), and has successfully been used in studies of college students ( Borsari et al, 2018 ). CAPS has also demonstrated excellent psychometrics properties; excellent inter-rater reliability (alpha for symptom severity score = 0.99; range of alphas for subscales scores = 0.96 – 0.98; kappa for diagnostic status = 0.89) among college students in a primary sample from this study with 189 participants ( Berenz et al, 2021 ).…”

“…Zero individuals met criteria for psychosis. Comprehensive data on trauma characteristics of this sample are published elsewhere ( Berenz et al, 2021 ).…”

“…This study utilized secondary data from a laboratory investigation of trauma and alcohol cue reactivity ( Berenz et al, 2021 ). Participants were college students, ages 18–25, who responded to advertisements for a study on stressful life experiences and alcohol use.…”

“…Of these, n = 10 were excluded due to missing values on negative urgency measure. Participants completed a series of assessments and self-report questionnaires, that are described in greater detail in previous paper ( Berenz et al, 2021 ). Only data collected as part of the assessment session were used for the present study.…”

“…Although the rates of posttraumatic stress disorder (PTSD) among college students are equivalent to the general population (8 % to 9 %) ( Mccauley et al, 2012 , Read et al, 2011 ), college students who self-report symptoms of PTSD or have been diagnosed with higher levels of PTSD symptoms also manifest higher levels of alcohol consumption compared to college students who do not have PTSD ( Read et al, 2015 , Simpson et al, 2014 ). This finding has been attributed primarily to negative coping in response to trauma and symptoms of PTSD ( Berenz et al, 2021 ).…”