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

描述(由申请人提供)：NIAAA R21探索性/发展性申请的总体目标是研究使用经验抽样方法(ESM)在高危人群、女性性虐待和性侵受害者中识别问题饮酒的认知和情感风险因素的可行性。青壮年是性侵犯和高风险饮酒的高危时期。此外，性侵犯是问题饮酒增加的一个风险因素，以及与创伤后应激障碍共存的酒精使用障碍。自我用药假说被提出作为对这种共病的解释，于是，问题饮酒发展为一种试图调节负面情绪和改善创伤后应激障碍症状的尝试。然而，(A)研究没有包括非创伤暴露的对照组，(B)创伤后应激障碍和对问题饮酒的负面影响的综合和独特的贡献没有同时研究，(C)没有使用ESM方法来检查这些关系，以及(D)研究没有检查与日常监测有关的测量反应性。本研究建议使用经验抽样的方法来更好地理解创伤后应激障碍、负面情绪和饮酒之间的时间关系。每天对酒精使用和情绪的多项评估以及多水平建模的应用减少了记忆扭曲，并允许同时检查人内和人之间的问题，即哪些特征会使人们饮酒的风险更大(人与人之间的预测因素)，以及饮酒是否会因创伤后应激障碍症状的增加而增加，而不是负面情绪(人内因素)。150名有儿童性虐待(CSA)或成人性侵犯(SA)病史的女大学生和30名没有创伤病史的女大学生将被要求完成一份关于创伤后应激障碍症状、负面情绪、饮酒和饮酒冲动的电子日记，为期4周，每天2次。将包括一个对照组，以检查重复每日测量的影响。将使用多水平回归分析来解决以下具体目标：(1)如自我用药模型所预测的那样，测试创伤暴露、创伤后应激障碍和负面情绪在人与人之间和人内增加饮酒和冲动中的作用；(2)探索性分析应对动机，作为症状(创伤后应激障碍和负面情绪)与饮酒行为和冲动之间的人内关系的调节因素；(3)检验与日常监测相比，与无监测条件相关的测量反应程度。这些问题的答案将被用来指导未来的预防工作，旨在减少在性侵犯、关系暴力或战斗暴露等创伤事件后出现的问题饮酒模式。

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.