Negative affect and alcohol craving in trauma-exposed young adult drinkers.

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.

Sleep Quality Moderates the Relationship between Anxiety Sensitivity and PTSD Symptoms in Combat-exposed Veterans.

Objective/Background: Posttraumatic stress disorder (PTSD) and related conditions (e.g., depression) are common in Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn (OEF/OIF/OND) veterans. High anxiety sensitivity (AS), defined as fear of anxiety and anxiety-related consequences, is related to greater PTSD and depressive symptoms; however, few studies have identified possible modifiers of these associations. The current study examined the moderating role of sleep quality in the associations between AS and PTSD and depressive symptoms. Participants: Participants were 155 OEF/OIF/OND community veterans ages 21-40 (12.3% women). Methods: Participants completed a semi-structured clinical interview for DSM-IV PTSD symptoms (Clinician Administered PTSD Scale; CAPS) and self-report measures of anxiety sensitivity (Anxiety Sensitivity Index), sleep quality (Pittsburgh Sleep Quality Index global score; PSQI), and depressive symptoms (Beck Depression Inventory-II; BDI-II). Results: Results of hierarchical linear regression models indicated that the main effects of AS and global PSQI score were significantly associated with greater PTSD and depressive symptoms (both with sleep items removed), above and beyond the covariates of trauma load and military rank. Sleep quality moderated the relationship between AS and PTSD symptoms (but not depressive symptoms), such that greater AS was associated with greater PTSD symptoms for individuals with good sleep quality, but not poor sleep quality. Conclusions: Sleep quality and AS account for unique variance in PTSD and depressive symptoms in combat-exposed veterans. AS may be less relevant to understanding risk for PTSD among combat-exposed veterans experiencing poor sleep quality.

The Relation Between Posttraumatic Stress Symptom Severity and Startle Potentiation to Predictable and Unpredictable Threat.

Aberrant threat reactivity has been implicated in the pathophysiology of posttraumatic stress disorder (PTSD); however, the literature on this association is mixed. One factor that may contribute to this inconsistent association is differences in severity of posttraumatic stress symptoms (PTSSs) across studies, but no studies have tested this hypothesis. The relation between PTSD and threat reactivity may also differ between unpredictable threats (U-threats) and predictable threats (P-threats), given burgeoning evidence to support a particular role for aberrant responding to U-threat in PTSD. The present study examined how PTSS severity relates to startle potentiation to U-threat and P-threat in a trauma-exposed community sample (N = 258). There was a negative linear, but not quadratic, relation between PTSS severity and startle potentiation to U-threat, but not P-threat. Blunted defensive responding to U-threat may therefore contribute to higher levels of PTSSs and may represent a novel treatment target for higher levels of PTSSs.

Alcohol Use Problems, Posttraumatic Stress Disorder, and Suicide Risk Among Trauma-Exposed Firefighters.

Alcohol use problems are associated with suicidal desire and may provide an avenue to suicidal ideation and behavior. However, the influence of posttraumatic stress disorder (PTSD) on the nature of the relationship between alcohol use problems and suicide risk is not well understood. In particular, the potential for PTSD to moderate the association between alcohol use problems and suicide risk remains unexplored. The present study investigated the main and interactive effects of alcohol use problems (Alcohol Use Disorders Identification Test) and PTSD symptoms (PTSD Checklist for DSM-5) on suicide risk (Suicide Behaviors Questionnaire-Revised) in a sample of 632 trauma-exposed firefighters (93.5% men; Mage = 38.44 years, SD = 8.59). Hierarchical logistic regression analyses evaluated whether the main and interactive effects of PTSD symptom severity and alcohol use disorders were significantly related to suicide risk, above and beyond age and cumulative trauma. The main effects of PTSD symptom severity (odds ratio, 1.76; p < 0.001) and alcohol use problems (odds ratio, 1.37; p = 0.391) significantly positively predicted suicide risk; however, PTSD symptoms did not moderate an association between alcohol use problems and suicide risk after accounting for these main effects (p > 0.05). A secondary, exploratory aim demonstrated that all PTSD symptom clusters significantly positively predicted suicide risk (p's < 0.001), although none of these clusters interacted with alcohol use problems to predict suicide risk (p's > 0.05). Theoretical and clinical implications are discussed as they relate to the importance of screening for PTSD and alcohol use disorder among firefighter populations.

Time course of panic disorder and posttraumatic stress disorder onsets.

PURPOSE: Posttraumatic stress disorder (PTSD) often co-occurs with panic disorder (PD), with some etiological models positing a causal role of panic reactivity in PTSD onset; however, data addressing the temporal ordering of these conditions are lacking. The aim of this study was to examine the bi-directional associations between PD and PTSD in a nationally representative, epidemiologic sample of trauma-exposed adults. METHODS: Participants were community-dwelling adults (62.6% women; Mage = 48.9, SD 16.3) with lifetime DSM-IV PTSD criterion A trauma exposure drawn from the 2001/2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and re-interviewed in 2004/5 (N = 12,467). Cox discrete-time proportional hazards models with time-varying covariates were used to investigate the bi-directional associations between lifetime PD and PTSD, accounting for demographic characteristics, trauma load, and lifetime history of major depression, generalized anxiety disorder, and social anxiety disorder. RESULTS: PD was significantly associated with subsequent onset of PTSD (HR 1.210, 95%CI = 1.207-1.214, p < .001), and PTSD was significantly associated with onset of PD (HR 1.601, 95% CI 1.597-1.604, p < .001). The association between PTSD and subsequent PD was stronger in magnitude than that between PD and subsequent PTSD (Z = - 275.21, p < .01). Men evidenced stronger associations between PD and PTSD compared to women. CONCLUSIONS: Results were consistent with a bidirectional pathway of risk, whereby PD significantly increased risk for the development of PTSD, and PTSD significantly increased risk for PD. Given the association between PTSD and subsequent PD, particularly among men, clinicians may consider supplementing PTSD treatment with panic-specific interventions, such as interoceptive exposure, to prevent or treat this disabling comorbidity.

Associations Between Personality and Distress Tolerance Among Trauma-Exposed Young Adults.

Low distress tolerance (DT) is related to negative mental health outcomes, particularly among trauma-exposed populations, who are at greater risk for mental health problems. However, little is known about potential etiological factors underlying the development of perceived (i.e., self-report) or behaviorally assessed DT. The present study examined associations between Big Five personality factors (i.e., openness, conscientiousness, extraversion, agreeableness, & neuroticism) and multiple measures of DT. Participants were 440 college students (71.4% women) endorsing a history of one or more potentially traumatic events. Participants completed the abbreviated Big Five Inventory (BFI), Distress Tolerance Scale (DTS), Discomfort Intolerance Scale (DIS), breath-holding task, and Paced Auditory Serial Addition Test (PASAT). Results of a series of hierarchical linear regressions indicated that higher levels of neuroticism and lower levels of conscientiousness were significantly associated with lower DTS scores, but no other DT measures. Greater extraversion was significantly associated with greater DT on the DIS and the PASAT. Lower levels of openness were associated with lower DT on the breath-holding task. Individual differences in normal personality traits account for significant variation in multiple measures of DT and may provide insight into the etiology of various forms of DT.

Emotional Clarity, Anxiety Sensitivity, and PTSD Symptoms Among Trauma-Exposed Inpatient Adolescents.

Although several investigations-on primarily adult samples-demonstrate a potential role of emotion dysregulation in the etiology and maintenance of posttraumatic stress disorder (PTSD), investigations into the mechanisms that may underlie these associations in general and among adolescents in particular are lacking. The present study examined associations among emotional clarity (i.e., the extent to which individuals are confused about the specific emotions they are experiencing), (Gratz, Journal of Psychopathology Behavioral Assessment 26(1):41-54, 2004) anxiety sensitivity, and DSM-IV PTSD symptom cluster severity (i.e., re-experiencing, avoidance, and hyperarousal symptoms) in a diverse sample of trauma-exposed inpatient adolescents. It was hypothesized that anxiety sensitivity would underlie association between emotional clarity and PTSD symptoms. Participants (N = 50; 52.0% female; M age = 15.1 years, SD = 0.51; 44% White) completed measures of emotion dysregulation, anxiety sensitivity, and PTSD. Lower emotional clarity was significantly associated with greater total PTSD symptoms, as well as re-experiencing, avoidance, and arousal symptoms. Additionally, there were indirect effects for lack of emotional clarity via anxiety sensitivity in relation to total PTSD symptoms [B = 0.17, SE = 0.08, BC 95% CI (0.04, 0.35)], re-experiencing symptoms [B = 0.15, SE = 0.08, BC 95% CI (0.03, 0.36)], avoidance symptoms [B = 0.12, SE = 0.07, BC 95% CI (0.02, 0.29)], and hyperarousal symptoms [B = 0.17, SE = 0.08, BC 95% CI (0.04, 0.36)]. Reversed models were violated, supporting the direction of hypothesized effects. Difficulties recognizing and accurately understanding emotions may increase risk for PTSD symptoms among trauma-exposed youth. Furthermore, anxiety sensitivity may be a promising intervention target among youth at risk for PTSD, especially among those demonstrating poorer emotional clarity.

Posttraumatic Stress Disorder Symptoms Among Trauma-Exposed Inpatient Adolescents: The Role of Emotional Nonacceptance and Anxiety Symptom Severity.

The present investigation examined the role of anxiety symptom severity in the relation between emotional nonacceptance and posttraumatic stress disorder (PTSD) symptoms in a diverse sample of trauma-exposed adolescents admitted for acute psychiatric care at an inpatient state hospital (N = 50; 52.0% women; 44% white; mean [SD] age, 15.1 [0.51] years; range, 12-17 years). Anxiety symptom severity partially accounted for the association between emotional nonacceptance and PTSD total symptoms, and fully accounted for the association between emotional nonacceptance and PTSD symptom cluster severity, even after controlling for covariates. Reverse model testing provided confidence in the direction of hypothesized effects. These findings add to a body of literature underscoring the detrimental effect of nonaccepting reactions to negative emotions in the context of PTSD and provide preliminary support for a possible underlying role of anxiety symptom severity in the association between emotional nonacceptance and PTSD symptoms.

Pretyphoon panic attack history moderates the relationship between degree of typhoon exposure and posttyphoon PTSD and depression in a Vietnamese sample.

BACKGROUND: Predisaster risk factors are related to postdisaster psychopathology even at relatively low levels of disaster exposure. A history of panic attacks (PA) may convey risk for postdisaster psychopathology and has been linked to a wide range of psychiatric disorders in Western and non-Western samples. The present study examined the main and interactive effects of pretyphoon PA and level of typhoon exposure in the onset of posttyphoon posttraumatic stress disorder (PTSD), major depression (MDD), and generalized anxiety disorder (GAD) in a Vietnamese sample of typhoon survivors. METHODS: Typhoon Xangsane interrupted a Vietnamese epidemiological mental health needs assessment, providing a rare opportunity for preand posttyphoon assessments. Hierarchical logistic regression analyses evaluated whether the main and interactive effects of typhoon exposure severity and PA history were significantly related to posttyphoon diagnoses, above and beyond age, health status, pretyphoon psychiatric screening results, and history of potentially traumatic events. RESULTS: PA history moderated the relationship between severity of typhoon exposure and posttyphoon PTSD and MDD, but not GAD. Specifically, greater degree of exposure to the typhoon was significantly related to increased likelihood of postdisaster PTSD and MDD among individuals without a history of PA, above and beyond variance accounted for by pretyphoon psychiatric screening results. Individuals with a history of PA evidenced greater risk for postdisaster PTSD and MDD regardless of severity of typhoon exposure. CONCLUSIONS: Preexisting PA may affect the nature of the relationship between disaster characteristics and prevalence of postdisaster PTSD and MDD within Vietnamese samples.

Pre-typhoon socioeconomic status factors predict post-typhoon psychiatric symptoms in a Vietnamese sample.

PURPOSE: Exposure to natural disasters has been associated with increased risk for various forms of psychopathology. Evidence indicates that socioeconomic status (SES) may be important for understanding post-disaster psychiatric distress; however, studies of SES-relevant factors in non-Western, disaster-exposed samples are lacking. The primary aim of the current study was to examine the role of pre-typhoon SES-relevant factors in relation to post-typhoon psychiatric symptoms among Vietnamese individuals exposed to Typhoon Xangsane. METHODS: In 2006, Typhoon Xangsane disrupted a mental health needs assessment in Vietnam in which the Self Reporting Questionnaire-20 (SRQ-20), and the Demographic and Health Surveys Wealth Index, a measure of SES created for use in low-income countries, were administered pre-typhoon. The SRQ-20 was re-administered post-typhoon. RESULTS: Results of a linear mixed model indicated that the covariates of older age, female sex, and higher levels of pre-typhoon psychiatric symptoms were associated with higher levels of post-typhoon psychiatric symptoms. Analysis of SES indicators revealed that owning fewer consumer goods, having lower quality of household services, and having attained less education were associated with higher levels of post-typhoon symptoms, above and beyond the covariates, whereas quality of the household build, employment status, and insurance status were not related to post-typhoon psychiatric symptoms. CONCLUSION: Even after controlling for demographic characteristics and pre-typhoon psychiatric symptoms, certain SES factors uniquely predicted post-typhoon psychiatric distress. These SES characteristics may be useful for identifying individuals in developing countries who are in need of early intervention following disaster exposure.

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

Theoretical models of trauma and alcohol use suggest that trauma-exposed individuals with higher levels of PTSD symptoms are at increased risk of problematic and coping-oriented alcohol use to alleviate unwanted internal states. The goal of the current study was to evaluate whether these associations are enhanced among young adults who report engaging in impulsive behavior in the context of negative affect (i.e., high negative urgency). It was hypothesized that (a) higher negative urgency would be associated with problematic alcohol use; and that (b) negative urgency would moderate the association between PTSD symptoms and problematic alcohol use. Methods: This study used a cross-sectional, secondary data analysis design run on 213 participants: college students, ages 18-25, who endorsed both having an interpersonal traumatic event and current weekly alcohol use. Participants completed a series of assessments and self-report questionnaires. Results: Results of hierarchical linear regression models indicated that greater negative urgency was significantly associated with greater negative alcohol-related consequences and greater coping motives for alcohol, but not past 30-day binge frequency or past 30-day alcohol quantity. Negative urgency did not moderate associations between PTSD symptoms and alcohol outcomes. Conclusions: PTSD symptoms and negative urgency are uniquely associated with indices of alcohol risk in college students with a history of trauma exposure. However, individuals high in negative urgency are not necessarily consuming more alcohol, nor does negative urgency increase the association between PTSD symptoms and drinking outcomes in this population.

Actigraphic Wake after Sleep Onset and Symptom Severity Correspond with Rumination in Trauma-Exposed Individuals.

Rumination and worry are forms of repetitive negative thinking (RNT) commonly associated with internalizing psychopathologies, although less is known about RNT in trauma-exposed individuals with internalizing psychopathologies. Separate lines of research show RNT also plays a role in problematic sleep, which is frequently experienced after trauma exposure. To address gaps in the literature, the current study examines the impact of sleep and symptoms on RNT in trauma-exposed participants. A transdiagnostic sample of 46 unmedicated treatment-seeking trauma-exposed participants completed standard measures of rumination and worry, as well as clinical measures that assessed posttraumatic stress, depression, and anxiety severity. Actigraphic sleep variables were sleep duration, wake after sleep onset (WASO), and sleep efficiency. Sleep and clinical measures were submitted to multiple regression analyses with rumination and worry as dependent variables. The regression results showed that rumination was significantly explained by WASO and posttraumatic stress symptom (PTSS) severity, and the omnibus test was significant. Depression, anxiety, and other estimates of sleep were not significant. No significant results emerged for worry. Preliminary findings suggest that PTSS and WASO, an index of fragmented sleep, may contribute to rumination, but not worry, in trauma-exposed individuals. Longitudinal studies are needed to determine potential causal relationships.

Treatment of co-occurring posttraumatic stress disorder and substance use disorders.

There is a significant need for advanced understanding of treatment of co-occurring posttraumatic stress disorder (PTSD) and substance use disorders (SUD). Approximately half of individuals seeking SUD treatment meet criteria for current PTSD, and individuals with co-occurring PTSD-SUD tend to have poorer treatment outcomes compared with those without such comorbidity. However, there is not sufficient empirical evidence to determine a best course of treatment for these individuals. This paper provides a review of the literature relevant to the treatment of co-occurring PTSD-SUD. To date, treatment studies have focused primarily on non-exposure-based psychosocial treatments, exposure-based psychosocial treatments, and medication trials. The most promising outcome data thus far are for psychosocial treatments that incorporate an exposure therapy component; however, further research is needed, particularly as related to how best to implement these approaches in real-world treatment settings.

Exploration of a factor mixture-based taxonic-dimensional model of anxiety sensitivity and transdiagnostic psychopathology vulnerability among trauma-exposed adults.

The aim of this study was to evaluate the associations between a factor mixture-based taxonic-dimensional model of anxiety sensitivity (AS) and posttraumatic stress, panic, generalized anxiety, depression, psychiatric multimorbidity, and quality of life among a young adult sample exposed to traumatic stress (N = 103, n (females) = 66, M (age) = 23.68 years, SD (age) = 9.55). Findings showed support for the conceptual and operational utility of the AS taxonic-dimensional model with respect to concurrent transdiagnostic vulnerability among trauma-exposed adults. Specifically, relative to the low-AS group, the high-AS group demonstrated elevated levels of panic, depressive, and posttraumatic stress symptom severity as well as greater psychiatric multimorbidity and poorer quality of life. Furthermore, past-month MDD, GAD, PTSD, and panic attacks occurred nearly exclusively among the high-AS group. Continuous AS physical and psychological concerns scores were found to be significantly related to levels of panic and posttraumatic stress symptom severity, psychiatric multimorbidity as well as panic attack status only among the high-AS group and not among the low-AS group. Findings are discussed with respect to their implications for the conceptual and operational utility of the FMM-based taxonic-dimensional model of AS, related vulnerability for psychopathology in the context of trauma, and the clinical implications of these findings for assessment and intervention.

Evaluation of perseveration in relation to panic-relevant responding: an initial test.

BACKGROUND: Perseveration reflects the tendency to engage in a behavior even when it is no longer rewarding nor produces the expected consequences. METHOD: The current study explored whether (1) individuals endorsing a recent (past 2 years) history of nonclinical panic attacks would report greater levels of perseveration compared to individuals without such a history; (2) whether individuals endorsing higher levels of perseveration would evidence greater panic-relevant responding to a 4-minute 10% carbon dioxide-enriched air challenge. RESULTS: Results indicated that individuals with, compared to without, a positive panic attack history endorsed significantly greater levels of perseveration. Additionally, greater pre-challenge levels of perseveration significantly predicted greater panic attack symptom severity as well as self-reported anxiety; these significant effects were evident above and beyond the variance accounted for by sex, trait-level negative affectivity, panic attack status, and distress tolerance as well as shared variance with the related constructs of persistence and perfectionism. DISCUSSION: Together, the current findings provide initial, albeit preliminary, support for the utility of investigating perseveration in relation to models of panic psychopathology specifically, and offer a further empirical context for perseveration-psychopathology relations in general.

Prolonged Exposure Therapy for PTSD among Individuals in a Residential Substance Use Treatment Program: A Case Series.

Clients with co-occurring posttraumatic stress disorder (PTSD) and substance use disorders present a unique challenge for clinicians in substance use treatment settings. Substance dependent individuals with PTSD tend to improve less during substance use treatment and relapse more quickly following abstinence attempts compared to those without PTSD. Recent scientific efforts have focused on understanding the potential benefit of providing PTSD treatment concurrent with substance use treatment. The current case study describes 4 individuals with PTSD in a residential substance use facility who received prolonged exposure therapy for treatment of PTSD, in addition to the substance use treatment. These individuals completed 9 bi-weekly 60-minute sessions of prolonged exposure, as well as in vivo and imaginal exposure homework between sessions. None of the clients met criteria for PTSD at the end of treatment, with these gains being maintained at 3- and 6-months post-treatment. Additionally, the clients did not relapse in response to undergoing exposure therapy. Implications for delivery of PTSD treatment in substance use treatment facilities are discussed.

The Influences of Posttraumatic Stress Disorder and Distress Tolerance on Trauma and Alcohol Cue Reactivity in a Sample of Trauma-Exposed College Students.

OBJECTIVE: Models of comorbid posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) often emphasize negative reinforcement drinking (i.e., drinking to reduce negative affect) as a key etiological and maintenance factor. However, potential risk factors related to negative reinforcement drinking in PTSD-AUD are less understood. Distress tolerance exhibits theoretical and empirical promise as one possible, malleable, risk factor. The current study used a trauma and alcohol cue reactivity paradigm to elucidate the role of perceived (i.e., self-reported) distress tolerance in trauma-related alcohol risk. METHOD: Participants were 185 university students (50.3% female) endorsing lifetime interpersonal trauma exposure and current weekly alcohol consumption. Subjective craving for alcohol was assessed in response to four combinations of audio narrative (personalized trauma vs. neutral) and beverage (alcohol vs. water) cues. Forward-fitting linear mixed-effects models were used to evaluate study hypotheses. RESULTS: Perceived distress tolerance significantly interacted with beverage cue in relation to craving (ß = -.293, p = .011), such that individuals low, as compared with high, in perceived distress tolerance reported greater craving for alcohol in response to the alcohol, but not water, beverage cue. Although low perceived distress tolerance was associated with greater alcohol coping motives and alcohol use problems at baseline, there were no main effects of perceived distress tolerance in relation to craving, and perceived distress tolerance did not significantly interact with trauma cues to predict craving (ps > .05). CONCLUSIONS: Among trauma-exposed young adult drinkers, low perceived distress tolerance may influence alternative processes of AUD risk, such as susceptibility to conditioned craving responses to alcohol.

Trauma Cue-Elicited Alcohol Craving as a Function of Adult Versus Childhood-Onset Interpersonal Traumatic Events in Young Adult Drinkers.

OBJECTIVE: Childhood trauma may influence risk for alcohol use disorder and posttraumatic stress disorder through negative and positive reinforcement drinking. Laboratory studies evaluating childhood trauma in relation to these phenotypes are limited. METHOD: This study examined the influence of childhood index traumas on responses to trauma and alcohol cues among 184 college students (50.0% female) endorsing lifetime interpersonal trauma and current weekly alcohol use. Participants' subjective alcohol craving and distress were measured in response to four narrative (trauma vs. neutral) and beverage (alcohol vs. water) cue combinations. RESULTS: Forward-fitted linear mixed-effects models indicated main effects of childhood index traumas on distress (ß= 6.151, p = .001) and craving (ß = 0.656, p = .023), wherein individuals with childhood index traumas showed evidence of elevated levels of distress and craving. Childhood index trauma interacted with the narrative cue to predict distress (ß = -10.764, p = .002), wherein individuals with childhood index traumas showed greater levels of distress to the neutral cue, and individuals with adult index traumas showed greater levels of distress to the trauma cue. Childhood index trauma interacted with the beverage cue to predict craving (ß = -0.599, p = .011), wherein childhood index traumas were associated with greater levels of craving to neutral cues. Childhood index trauma did not significantly interact with the beverage cue to predict distress or the narrative cue to predict craving (ps > .05). CONCLUSIONS: Childhood trauma may be more relevant to positive rather than negative reinforcement aspects of alcohol use disorder during young adulthood.

Lifetime trauma endorsement, posttraumatic stress disorder, and alcohol dependence as a function of sexual minority status.

OBJECTIVE: Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) frequently co-occur, with elevated rates of both disorders in lesbian, gay, or bisexual (LGB) samples. Few studies have compared the strength of PTSD-AUD associations between LGB and heterosexual individuals or evaluated the role of nontraumatic LGB discrimination in these relationships among sexual minorities. METHOD: The current study utilized nationally representative epidemiological data (N = 29,646) to (a) examine whether associations between lifetime trauma endorsement/PTSD and lifetime alcohol dependence (AD) differ as a function of sexual minority status and (b) evaluate the role of LGB-specific discrimination in trauma/PTSD and AD associations among LGB individuals. RESULTS: Logistic regression analyses showed the association between lifetime trauma endorsement and lifetime AD was significantly greater in magnitude for LGB individuals (odds ratio [OR] = 2.17) compared to heterosexual individuals (OR = 1.32; Z = 2.51, p < .05). The magnitude of the association between lifetime PTSD and lifetime AD was not greater in the LGB subsample (OR = 2.11) than the heterosexual subsample (OR = 1.71; Z = 0.63, p > .05), after controlling for trauma endorsement. Among the LGB subsample, logistic regression analyses did not support a significant main effect for LGB discrimination nor an interaction between trauma endorsement and nontraumatic LGB discrimination, nor between PTSD and nontraumatic LGB discrimination, on lifetime AD (ps > .05). CONCLUSIONS: LGB individuals demonstrate stronger associations between lifetime trauma endorsement and AD, relative to heterosexual counterparts; however, this association may not be accounted for or moderated by nontraumatic LGB discrimination. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Trauma and alcohol characteristics related to high intensity binge drinking during college.

High intensity (HI) binge drinking has emerged as a high-risk drinking phenotype in young adult drinkers, yet few studies have evaluated clinically meaningful correlates of HI binge drinking among young adults at risk for co-occurring psychopathologies, such as interpersonal trauma-exposed drinkers. The present study compared three groups (i.e., HI binge, standard binge, non-binge drinkers) of interpersonal trauma-exposed college student drinkers (N = 221) on alcohol and interpersonal trauma characteristics. Results of one-way ANOVAs indicated that the HI binge group endorsed significantly greater negative alcohol-related consequences relative to the other two groups. The HI binge group endorsed significantly greater enhancement motives compared to the non-binge group, and no group differences were detected for PTSD and interpersonal trauma characteristics. Individuals who engage in HI binge drinking may experience greater alcohol problems due to their use of alcohol to enhance positive mood. HI binge drinking does not differentiate individuals on the basis of interpersonal trauma experiences or related psychopathology.