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

描述（由申请人提供）：该NIAAA R21探索性/开发性应用程序的总体目标是检查使用经验抽样方法（ESM）的可行性，以确定风险人群中问题饮酒的认知和情感风险因素，女性性虐待和攻击受害者。青年时期是性侵犯和高风险饮酒的高风险时期。此外，性侵犯是问题饮酒以及合并创伤后应激障碍的酒精使用障碍增加的一个风险因素。自我药疗假说被提出来解释这种合并症，因此问题饮酒的发展是为了调节负面情绪和改善PTSD症状。然而，（a）研究没有包括非创伤暴露的对照组，（B）PTSD和负面影响对问题饮酒的综合和独特贡献没有同时研究，（c）这些关系没有使用ESM方法进行检查，（d）研究没有检查与日常监测相关的测量反应。本研究建议使用经验抽样方法，以更好地完善我们的理解创伤后应激障碍，负面影响和酒精使用之间的时间关系。对酒精使用和情绪的多次日常评估以及多层次建模的应用减少了回忆失真，并允许同时检查人内和人与人之间的问题，即什么特征使人们处于更大的饮酒风险（人与人之间的预测因素）以及饮酒是否会增加对PTSD症状的反应。150名有儿童性虐待（CSA）或成人性侵犯（SA）既往史的女大学生和30名无既往创伤史的女大学生将被告知完成PTSD症状，负面影响，酒精使用和饮酒冲动的电子日记，每天2次，持续4周。将纳入一个对照组，以检查重复每日测量的影响。多水平回归分析将用于解决以下具体目标：（1）测试创伤暴露，PTSD和负面影响在增加饮酒和冲动中的作用，无论是在人与人之间，还是在人与人之间，正如自我药疗模型所预测的那样;（2）探索性分析应对动机作为症状之间的人内关系的调节因子（PTSD和负面影响）和饮酒行为和冲动;（3）与无监测条件相比，检查与日常监测相关的测量反应性程度。这些问题的答案将用于指导未来的预防工作，旨在减少性侵犯，关系暴力或战斗暴露等创伤事件后的问题饮酒模式。

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.