Problematic Alcohol Use, Trauma History, and PTSD Symptom Level: A Path Analysis

Objective: This study examined associations between multidimensional experiential avoidance, alcohol use motives, alcohol use, and alcohol-related consequences among individuals with a history of trauma and varying levels of posttraumatic stress disorder (PTSD) symptoms. Methods: A total of 459 college students completed measures online, and the analysis sample was limited to the 313 participants who reported a past Criterion A traumatic event. These participants were separated into two groups based on DSM-IV TR diagnostic criteria: those with a high level of PTSD symptomatology (n = 34) and those with a low level of PTSD symptomatology (n = 279). A multi-group path model examined associations between experiential avoidance, drinking motives, alcohol use, and alcohol problems across these two groups. Results: The majority of participants were female (n = 192, 61.3%) and Caucasian (n = 281, 89.8%) and had a mean age of 19.37 (SD = 2.04). Two unique pathways to alcohol-related problems were observed. Among those with a high level of PTSD symptomatology, distress endurance (ability to behave effectively when under distress) was inversely associated with alcohol-related consequences via alcohol motives and use. For those with a low level of PTSD symptomatology, distress aversion (negative attitudes about, or lack of acceptance of, distress) was positively associated with alcohol-related consequences via alcohol motives and use. Conclusions: Results suggest unique pathways to alcohol consequences as a function of trauma symptom severity and may explain some of the comorbidity between PTSD and alcohol use disorders. Multidimensional indices of experiential avoidance may shed light on risk and resilience factors in PTSD.