Effect of Trauma-Related Stress During Acute Alcohol Intoxication on Driving-Related Risky Decision-Making

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7. Project Summary/Abstract The proposed project aims to prepare the PI for a career as a scientist in an academic setting with a research program focused on etiological mechanisms, deleterious outcomes, and pathways of co-occurrence between trauma exposure, posttraumatic stress, and problematic alcohol use, with the aim of advancing developmentally- and contextually-sensitive models of comorbidity that inform effective prevention, selective intervention, and treatment for those struggling with these debilitating conditions. A comprehensive training plan was therefore constructed to systematically advance the PI’s training in: 1) contextually-relevant risk factors, comorbidity, assessment tools, and sophisticated research related to trauma exposure, posttraumatic stress, and problematic alcohol use and 2) the development, implementation, analysis, and dissemination of prevention programs that target individuals exposed to trauma. Importantly, the proposed study is designed to complement this training program by helping the PI to refine relevant research skills via the feasible combination of intensive mentoring from primary and secondary sponsors, focused coursework, intensive workshops, off-site training opportunities, and dissemination activities described throughout the application. The proposed sample will include 140 trauma-exposed adult drinkers endorsing PTSD symptoms. The primary research goal is to test whether induction of acute trauma-related stress (via script-driven imagery) during alcohol intoxication (.06% BrAC) will influence driving-related risky decision-making – willingness to drive, perceived likelihood of negative consequences, and performance-based risk-tasking (via a game involving stopping a vehicle during a changing yellow traffic light). Participants will be randomly assigned to either an alcohol or placebo condition and to receive either an autobiographical trauma script or neutral script. It is expected that (1) participants in the alcohol + trauma script condition (i.e. intoxicated and stressed) will endorse greater willingness to drive and lesser perceived likelihood of negative consequences than those in the alcohol + neutral script condition (i.e. only intoxicated) and (2) participants in the alcohol + trauma script condition will evidence the greatest increase in driving-related risk-taking compared to all other conditions. The proposed project aligns with the National Institute on Alcohol Abuse and Alcoholism F31 mechanism in three key ways. First, the research project aims to extend our understanding of modulating risk factors for intoxicated driving by examining the influence of “real time” trauma-related stress during intoxication on driving- related risky decision-making. Second, findings will serve to inform educational and prevention efforts, as well as inform “in the moment” (i.e. ecological) intervention, with the ultimate goal of reducing the high prevalence of intoxicated driving among individuals exposed to trauma. Finally, the project will serve as an important training opportunity for the PI through tailored training in the development of his independent research program targeting prevention-oriented trauma and alcohol use work.