A Daily Process Examination of Alcohol Use and PTSD in Female College Students

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DESCRIPTION (provided by applicant): The overall objective of this NIAAA R21 Exploratory/Developmental application is to examine the feasibility of using experience sampling methodologies (ESM) to identify cognitive and emotional risk factors for problem drinking in an at-risk population, female sexual abuse and assault victims. Young adulthood is a period of high risk for both sexual assault and high risk drinking. Moreover, sexual assault is a risk factor for increases in problem drinking as well as alcohol use disorders comorbid with PTSD. The self-medication hypothesis has been proposed as an explanation for this comorbidity, whereupon problem drinking develops as an attempt to modulate negative affect and ameliorate PTSD symptoms. However, (a) studies have not included non-trauma exposed comparison groups, (b) the combined and unique contributions of PTSD and negative affect on problem drinking have not been studied concurrently, (c) these relationships have not been examined using ESM methodologies, and (d) studies have not examined measurement reactivity associated with daily monitoring. This study proposes using the experience sampling method to better refine our understanding of the temporal relations between PTSD, negative affect, and alcohol use. Multiple daily assessments of alcohol use and mood and the application of multilevel modeling reduces recall distortion and allows for simultaneous examination of both within- and between-person questions regarding what characteristics place people at greater risk for drinking (between-person predictors) and whether drinking increases in response to PTSD symptoms over and above negative mood (within-person factors). 150 female college students with a past history of child sexual abuse (CSA) or adult sexual assault (SA), and 30 female college students with no past trauma history, will be signaled to complete an electronic diary of PTSD symptoms, negative affect, alcohol use, and urges to drink, 2 times daily for 4 weeks. A comparison group will be included to examine the impact of repeated daily measurement. Multilevel regression analyses will be used to address the following specific aims: (1) To test the role of trauma exposure, PTSD, and negative affect in increasing drinking and urges, both between- and within-persons, as predicted by the self-medication model; (2) conduct exploratory analyses of coping motives as a moderator of the within-person relationship between symptoms (PTSD and negative affect) and drinking behavior and urges; (3) Examine degree of measurement reactivity associated with daily monitoring compared to a no-monitoring condition. Answers to these questions will be used to guide future prevention efforts aimed at reducing problematic drinking patterns following traumatic events like sexual assault, relationship violence or combat exposure.