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Examining the Relationship Between PTSD Symptom Clusters and Drinking to Cope Motives on Drinking Outcomes

Fatima Tariq, Dept. of Psychology, with Dr. Christina Sheerin, Dept. of Psychology and Virginia Institute for Psychiatric and Behavioral Genetics

Posttraumatic stress disorder (PTSD) is prevalent among combat veterans, and its symptoms are categorized (in DSM-IV) in clusters of: reexperiencing, avoidance, and hyperarousal. Alcohol use disorder (AUD), often preceded by risky drinking behaviors such as binge drinking, and PTSD comorbidity is especially common in veteran populations. One theory underlying this comorbidity is that individuals use alcohol to self-medicatePTSD symptoms. Extant literature more often examines the relation on PTSD symptom severity as a unitary construct rather than on individual symptom clusters,a gap the present study attempts to fill.The aims of this study were to examine whether PTSD total symptom severity and each symptom cluster had significant main effects on a range of alcohol use outcomes (total frequency, binge drinking, and risky drinking) and determine whether self-reported drinking to cope motives moderate the relationship between PTSD symptoms and alcohol use outcomes. It was hypothesized that a) the hyperarousal symptom cluster would most strongly predict alcohol outcomes, as compared to other clusters, and b) drinking to cope would moderate the relationship between PTSD symptoms on alcohol use outcomes, such that those who reported greater drinking to cope motives would endorse higher severity of alcohol use. The present sample (N = 211) consists of a combat trauma-exposed subsample of individuals from a larger study of OIF/OEF veterans (90.5% male, 70.1% white, 70.1%) assessed for PTSD, determined through clinical interview with the Clinician-Administered PTSD Scale for DSM-IV. Participants also completed the drinking to cope subscale from the Drinking Motives Questionnaire (DMQ-Cope) and the Timeline Folllowback measure (TLFB; with outcome measures including total number of drinks per month, risky drinking status, and total number of binge days). Analyses consisted of a series of separate hierarchical regression models, with PTSD severity scores (total and symptom cluster) entered in Step 1, DMQ-Cope entered in Step 2, and their interaction entered in Step 3. Linear regressions were conducted for the continuous number of drinks per month, a logistic regression was conducted for risky drinker status, and a negative binomial regression was conducted for number of binge drinking days. In the linear regressions examining whether total PTSD symptom severity and each symptom clusters had significant main effects on total number of drinks per month, while all PTSD severity scores were initially associated in Step 1 with total alcohol use (all ps <0.02), when DMQ-Cope was added to the model (Step 2), they were no longer significant. In the final step (Step 3), DMQ-Cope showed main effects (all ps < 0.001), but there were no significant interaction effects found (all ps > 0.15). The pattern for both risky drinking status and number of binge drinking days was the same. PTSD total and cluster scores were not associated with either outcome in any of the Steps (all ps > 0.35), DMQ-Cope showed a main effect in all models (all ps < 0.003), and no interaction effects were found (all ps > 0.107). The current findings show that across all alcohol use outcomes, drinking to cope is a strong predictor of alcohol use outcomes, over and above the impact of PTSD symptoms in this sample. Drinking to cope has been independently associated with both PTSD and alcohol misuse and the current study’s findings add to the existing literature. Contrary to hypotheses, however, hyperarousal symptoms were not associated with alcohol use outcomes and no moderations were found. Limitations include limited diversity within the sample and future research would benefit from examination in civilian populations, extension to different types of traumas, and examination of other alcohol use outcomes, such as risky drinking behaviors and problems.

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Faculty Advisor/Mentor

Christina Sheerin, Ph.D.


Virginia Commonwealth University. Undergraduate Research Opportunities Program

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VCU Undergraduate Research Posters


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Examining the Relationship Between PTSD Symptom Clusters and Drinking to Cope Motives on Drinking Outcomes