Depressive symptoms, avoidant coping, and alcohol use: differences based on gender and posttraumatic stress disorder in emerging adults.

Trauma exposure and alcohol use often co-occur. Unveiling predictors of drinking behavior, including among those with varying levels of trauma exposure, can inform behavioral health prevention and treatment efforts in at-risk populations. The current study examined associations between depressive symptoms, avoidant coping, gender, and alcohol use among emerging adults with and without trauma exposure and posttraumatic stress disorder (PTSD). Participants were 238 emerging adults between the ages of 21 and 30 years (M = 24.75; SD = 2.61) in one of three groups: trauma-exposed with PTSD (n = 70); trauma-exposed with no PTSD (n = 83); or a no trauma (control) group (n = 85). Demographics, parental alcohol problems, depressive symptoms, and avoidant coping were examined as predictors of drinks per drinking day. Chi-square, t-test, bivariate, and group path analysis were conducted. Among participants, men consumed greater amounts of alcohol than women across all three groups. Group assignment based on trauma history and PTSD significantly moderated the association between avoidant coping and alcohol use such that avoidant coping had a significant effect on alcohol use among participants in the trauma-exposed and PTSD groups. There was also a significant group × gender × avoidant coping interaction such that, among participants in the control group, men had attenuated alcohol use at low levels of avoidant coping and increased at high levels of avoidant coping. No effects of race were observed. Results highlight the importance of avoidant coping as a risk factor for problematic drinking, unveiling a specific intervention target for reducing co-occurring PTSD and problematic alcohol use.

Childhood Maltreatment and Use of Aggression among Veterans with Co-occurring PTSD and Alcohol Use Disorder: The Mediating Role of Hostile Cognitions.

History of childhood maltreatment is common among military veterans, particularly those with posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Childhood maltreatment is associated with negative psychosocial outcomes, including use of aggression during adulthood. Prior research has identified maladaptive cognitions as a key mediating variable in the association between early life trauma and aggression. Given the high rates of comorbid PTSD and AUD among veterans and the increased risk of aggression when these conditions co-occur, it is critical to examine malleable intervention targets, such as maladaptive cognitions, for this population. The current secondary analyses examined the mediating role of hostile cognitions on the associations between childhood maltreatment and adulthood aggression in a sample of dually diagnosed veterans. Participants were veterans with co-occurring PTSD and AUD (N = 73) who were enrolled in a larger randomized controlled laboratory trial. Participants completed self-report measures of childhood maltreatment, hostile cognitions, and aggressive behavior. Three models were tested to examine the mediating effect of hostility on the associations between childhood maltreatment, abuse, and neglect on aggression. Results indicated that hostility fully mediated the effect of maltreatment on aggression and partially mediated the effect of childhood abuse on aggression. The effect of childhood neglect on aggression was nonsignificant. Hostile cognitions may be a critical intervention target for veterans with co-occurring PTSD and AUD and history of childhood maltreatment, particularly for those who have experienced higher levels of childhood abuse.

A randomized controlled trial examining the effects of intranasal oxytocin on alcohol craving and intimate partner aggression among couples.

BACKGROUND: While alcohol use disorder (AUD) is a well-established risk factor for intimate partner aggression (IPA), effective treatments for co-occurring AUD and IPA (AUD/IPA) are lacking. Oxytocin is one promising pharmacological candidate for AUD/IPA given its potential to modulate social behavior and attenuate alcohol use. However, emerging data suggests that oxytocin's prosocial effects are inconsistent, and a small number of studies have also found that oxytocin might have the potential to be aggressogenic. No studies have directly examined the impact of oxytocin on alcohol- or IPA-related outcomes in a dyadic context. METHODS: The goal of this double-blind, randomized, and placebo-controlled trial was to examine the effects of a single dose of intranasal oxytocin (40 international units) on cue-induced alcohol craving, subjective aggression, laboratory task-based IPA, and cortisol reactivity in a sample of 100 couples (N = 200 individuals) with AUD and physical IPA in their current relationship. RESULTS: There were no statistically significant differences between the oxytocin and placebo conditions for any of the primary outcomes. CONCLUSIONS: Findings suggest that a single dose of intranasal oxytocin was not efficacious in mitigating alcohol craving or aggression in this sample. Although hypotheses were not supported, the findings provide important evidence that oxytocin was not aggressogenic in this high-risk sample. Future research investigating dispositional and contextual moderators of oxytocin response in addition to the therapeutic effects of more intensive oxytocin dosing or administration strategies on alcohol craving and aggression is warranted.

Medications at the Emergency Department After Recent Rape.

Rape is associated with myriad negative physical and mental health effects, yet little is known about medical prescribing following rape-related emergency room visits. The goal of this study was to examine factors associated with medications prescribed the same day as a sexual assault medical forensic examination (SAMFE). A total of 939 medical records (93.9% female) of a medical university in the Southeastern United States between July 1, 2014, and May 15, 2019, were paired with Sexual Assault Nurse Exam records. Demographic and assault characteristics were examined as correlates of medications prescribed at the emergency department within the same day of a SAMFE. All individuals were offered medications within the national guidelines. Intimate partner violence (IPV) was negatively associated with antibiotic prescriptions and with emergency contraception prescriptions. Genital injury and male gender of victim were positively associated with antiviral prescriptions. Non-genital injury was positively associated with both over-the-counter and prescription pain medication prescriptions. Report of strangulation was positively associated with accepting over-the-counter but not prescription pain medication. IPV and strangulation were positively associated with psychotropic prescriptions. Although specific medications were offered to individuals during the SAMFE, demographic and assault characteristics were associated with medication acceptability.

A Preliminary Exploration of the Influence of Intimate Partner Violence Victimization on Perceptions of Others' Intimate Partner Violence Experiences.

Purpose: Psychological intimate partner violence (IPV) will impact almost half of US adults throughout the lifespan and as many as 80% of undergraduate college students; however, psychological IPV remains understudied. Examining perceptions of IPV can aid in the identification of potential barriers to treatment seeking and advance intervention efforts. The current study intended to determine how myths and stigmatizing beliefs about IPV affected the minimization (i.e., neutralization) of IPV acts and how history of psychological IPV victimization could moderate the aforementioned associations. Methods: Participants were undergraduate students in the southeastern United States (N = 52) who were currently, or had previously been, in a relationship for at least 1 month. Data were collected regarding IPV victimization and perpetration and perceptions of IPV, including stigmatizing beliefs, myth endorsement, and neutralizing beliefs. Results: Findings indicated that those reporting higher levels of psychological IPV victimization endorsed more neutralizing beliefs about IPV more stigmatizing beliefs about females experiencing IPV victimization, compared to those reporting fewer stigmatizing beliefs towards females experiencing IPV. That is, individuals who have experienced psychological IPV and also stigmatize females experiencing IPV victimization may tend to normalize IPV. Conclusions: Findings illuminate how perceptions and personal experiences of IPV can minimize someone's views of the severity of others' IPV victimization. This research has implications for highlighting barriers to help-seeking behaviors for individuals experiencing IPV and informing future studies about help-seeking in undergraduate populations.

Advancing our understanding of the intersection between emotion regulation and alcohol and drug use problems: Dyadic analysis in couples with intimate partner violence and alcohol use disorder.

BACKGROUND: An extensive body of literature has linked emotion regulation to alcohol and drug use problems, including among populations characterized by intimate partner violence (IPV). Advancing this research, the goal of the current study was to examine cognitive emotion regulation strategies and alcohol and drug use problems within a dyadic framework. Specifically, we examined actor and partner effects of maladaptive and adaptive cognitive emotion regulation strategies on alcohol and drug use problems. METHODS: Eighty-four romantic couples (N = 168 total participants) participating in a randomized controlled trial who reported physical IPV and an alcohol use disorder completed self-reported measures of cognitive emotion regulation as well as alcohol and drug use problems. RESULTS: Regarding actor effects, men's greater use of maladaptive cognitive emotion regulation strategies was positively related to their alcohol use problems (p < .001), whereas both women's (p = .02) and men's (p = .047) greater use of adaptive cognitive emotion regulation strategies was negatively related to their own alcohol use problems. In terms of partner effects, men's greater use of maladaptive cognitive emotion regulation strategies (p = .001) and less use of adaptive cognitive emotion regulation strategies (p = .017) was related to their partners' greater drug use problems. CONCLUSIONS: Findings replicate and extend existing work in this area, showing that men's and women's emotion regulation strategies are related to their own alcohol and drug use problems and that men's cognitive emotion regulation strategies are also related to their partners' drug use problems.