Idiographic Examination of Alcohol to Dampen Positive Emotions for Co-morbid Alcohol Use and PTSD

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PROJECT SUMMARY/ABSTRACT Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) co-occur with high frequency (24- 61%). PTSD role have emotions suggest regulation) less via alcohol use. One explanation for these findings is This co-occurrence has considerable clinical significance. Individuals with co-occurring PTSD-AUD (vs. or AUD alone) report more PTSD symptoms and worse alcohol outcomes. Research emphasizes the of emotional processes in the co-occurrence of PTSD and AUD. However, prior investigations in this area been narrow in scope, focusing almost exclusively on negative emotions. The limited research on positive purports a role of alcohol use in up-regulating (eliciting/increasing) positive emotions. Our pilot data that alcohol use among individuals with PTSD symptoms also may be motivated by avoidance (down- of positive emotions . We have found that trauma-exposed individuals with PTSD symptoms are accepting of positive emotions, and more likely to engage in fforts to avoid positive emotions, including that positive emotions elicit physiological e arousal that is linked to trauma-related symptoms and thus evaluated as aversive among individuals with PTSD symptoms. The processes current proposal will leverage intensive l ongitudinal data t o evaluate dynamic and idiographic among positive emotional processes, alcohol use, and PTSD symptoms as they unfold in daily life among trauma-exposed community individuals who regularly drink and experience PTSD symptoms (N=150). Ecological momentary assessment (EMA) will capture momentary processes in real-time & in natural settings, maximizing profiles. ecological validity and generalizability of findings. Idiographic analysis will identify personalized risk These approacheswill provide the necessary data to inform idiographic PTSD-AUD interventions that can be implemented at the microlevel. Aim 1 determines the extent to which PTSD symptoms are related to alcohol use to down-regulate positive emotions at the momentary level. Aim 2 usesidiographic analysis to identifypatterns of alcohol to down-regulate positive emotions in relation to PTSD. An Exploratory Aim assesses whether alcohol use to down-regulate positive emotions is distinct from other motives for alcohol use. The findings of this research have the potential to transform health care practice. General practice is to increase positive emotions in PTSD-AUD intervention. If our pilot work is confirmed, and alcohol use serves to down-regulate positive emotions in those with PTSD symptoms, clinicians may first want to evaluate adverse reactions to positive emotions in PTSD-AUD intervention, and, if indicated, address those concerns. The proposed research utilizes an innovative approach to fill significant gaps regarding mechanisms in co- occurring PTSD-AUD. This work is important, timely, and innovative. Preventing PTSD-AUD among trauma- exposed individuals has important implications for the health and well-being of people in our nation.