Alcohol Expectancies, Posttraumatic Stress Disorder, and Alcohol Use in College Students With a History of Childhood Trauma

abstract Objective: Prior research has emphasized that the key mediator in the posttraumatic stress disorder (PTSD) symptom–alcohol use relationship is the expectancy of alcohol's tension-reducing properties. This study extends the literature by examining various alcohol outcome expectancies. Methods: Cross-sectional data were obtained from 198 college students who reported experiencing at least one traumatic event in childhood. Participants answered surveys measuring PTSD symptoms, alcohol outcome expectancies, and three measures of alcohol consumption and related problems. Results: Participants included 131 males (mean age = 19.65 years, SD = 1.06, range = 18 to 24) and 67 females (mean age = 19.43 years, SD = 0.82, range = 18 to 23), who were predominantly European-American (82%). For males and females, results of the multivariate analyses suggested that self-perception expectancies mediated the effects of PTSD symptoms on alcohol use severity, whereas sociability expectancies mediated the effects of PTSD symptoms on monthly alcohol use. For women, risk and aggression and sexuality expectancies mediated the relationship between PTSD symptoms and alcohol use severity, while risk and aggression expectancies mediated the relationship between PTSD symptoms and alcohol use consequences. For men, sociability expectancies mediated the effects of PTSD symptoms on alcohol use severity. Across genders, tension-reduction expectancies did not mediate the relationship between PTSD symptom and the three alcohol measures. Conclusions: This study was unable to find support for the self-medication hypothesis via the tension-reduction outcome expectancy pathway. However, other significant findings can be interpreted in light of the self-medication hypothesis. For example, alcohol may aid in coping with social impairments related to PTSD symptoms, particularly in a college sample. This study also highlighted gender differences in the association between PTSD symptoms and alcohol consumption and related problems.

摘要 目的：先前的研究强调，创伤后应激障碍（PTSD）症状与饮酒关系中的关键中介因素是对酒精缓解紧张特性的预期。本研究通过检验各种酒精结果预期拓展了相关文献。 方法：从198名报告在童年时期至少经历过一次创伤事件的大学生中获取横断面数据。参与者回答了测量PTSD症状、酒精结果预期以及三种饮酒量和相关问题的调查问卷。 结果：参与者包括131名男性（平均年龄 = 19.65岁，标准差 = 1.06，范围 = 18至24岁）和67名女性（平均年龄 = 19.43岁，标准差 = 0.82，范围 = 18至23岁），其中主要是欧裔美国人（82%）。对于男性和女性，多元分析结果表明，自我认知预期介导了PTSD症状对饮酒严重程度的影响，而社交预期介导了PTSD症状对每月饮酒量的影响。对于女性，风险与攻击性以及性方面的预期介导了PTSD症状与饮酒严重程度之间的关系，而风险与攻击性预期介导了PTSD症状与饮酒后果之间的关系。对于男性，社交预期介导了PTSD症状对饮酒严重程度的影响。在不同性别中，缓解紧张的预期并未介导PTSD症状与三种饮酒指标之间的关系。 结论：本研究无法通过缓解紧张的结果预期途径为自我药疗假说提供支持。然而，其他重要发现可以根据自我药疗假说进行解释。例如，酒精可能有助于应对与PTSD症状相关的社交障碍，特别是在大学生样本中。本研究还强调了PTSD症状与饮酒量及相关问题之间关联的性别差异。