Event level associations between posttraumatic stress disorder and alcohol behavior in college students
Bachrach, Rachel Lauren
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Self-medication theory (SMT) posits that individuals exposed to trauma and resulting posttraumatic stress symptoms (PTSD) are at risk for heavy drinking and associated negative consequences. Estimates of PTSD among college students are comparable to rates in the general adult population, and recent research has linked PTSD and negative alcohol-related consequences in college individuals. The social environment (e.g., perceived peer norms, active peer influences) is a critical predictor of alcohol involvement in college. Research also shows that emotionally supportive peers are critical to the diminution and resolution of PTSD symptoms. As such, drinking behaviors of supportive peers may have an effect on drinking outcomes for students struggling with posttraumatic distress. The present project aimed to assess the dynamic relationship between PTSD, alcohol behavior, and the influence of emotionally supportive peers at the daily level. Specifically, the study investigated: (1) whether higher daily levels of PTSD symptoms were associated with increased within-subject levels of daily alcohol use and consequences; (2) whether daily PTSD symptom expression and alcohol behavior was moderated by the typical drinking patterns in one's emotional support group; and (3) whether the relationship between daily PTSD symptoms and daily alcohol behavior was moderated by the daily drinking behavior of emotionally support peers. In addition, multilevel modeling (MLM) analyses were used to test the relationship between weekly PTSD symptom severity and weekend alcohol behavior to delineate temporal associations posited by SMT. Exploratory MLM analyses also assessed how participants' other friends/acquaintances moderated the daily and week to weekend PTSD-alcohol relationship. Trauma-exposed heavy drinking college students (N=128) completed a baseline assessment and subsequent 30 days of daily web-based surveys assessing alcohol use and related consequences, PTSD symptoms, emotionally supportive and other friend/acquaintance alcohol behavior. Results directly testing SMT were not supported. However, both supportive peer and other friend/acquaintance alcohol behavior moderated the relationship between daily PTSD and daily alcohol behavior, as well as weekday PTSD and weekend alcohol behavior. Overall, supportive peer drinking behaviors were not as harmful to those experiencing more daily/weekly PTSD symptoms relative to other friends/acquaintances' alcohol behaviors. These findings highlight the importance of social support as a buffer against problematic drinking and provide useful information for interventions aimed at high-risk drinkers.