Daily Predictors of Alcohol Use among Sexual Violence Survivors: The Role of Intraindividual Changes in Sleep Duration and PTSD Symptoms

项目摘要 研究人员发现，饮酒是经历过以下情况的女性的共同担忧 性暴力(SV)，具有重要的公共卫生影响。创伤后应激障碍(PTSD) 性侵害后的症状可能是酒精使用率增加的原因之一。这个 对这些关联的主要理论解释是自我药物假说，该假说假设 性暴力幸存者使用酒精来应对与急性暴力相关的心理痛苦 创伤后应激障碍的经历。尽管这一理论具有时间上的、人与人之间的性质，但很少受到关注 急性创伤后应激障碍症状、与创伤相关的饮酒应对和随后饮酒之间的日常联系 供SV幸存者使用。此外，很少有研究将睡眠时间作为可能影响睡眠质量的一个因素。 在这一过程中发挥着重要作用，尽管新出现的理论表明，睡眠不足对情绪有至关重要的影响 并可能加重日常的创伤后应激障碍症状。根据这些发现，本文的中心假设 目前研究表明，比平时更短的睡眠时间可能会对增加的睡眠时间产生直接影响 第二天出现创伤后应激障碍症状，而比平时更严重的创伤后应激障碍症状将反过来预示着增加 当天晚些时候通过增加与创伤相关的饮酒来应对饮酒动机。此外，我们预计 急性PTSD症状和与创伤相关的饮酒应对可能是一系列间接途径，通过 睡眠时间比平时短会导致女性SV次日饮酒量增加 幸存者。为了验证这些假设，对80名有性暴力史的社区妇女进行了抽样调查 有问题的饮酒者是否会每天重复测量睡眠时间、创伤后应激障碍症状、创伤-- 与饮酒相关的应对措施，以及使用生态瞬时评估(EMA)超过三周的饮酒情况。 每晚的睡眠时间将使用活动记录和自我报告的综合衡量标准进行评估；自我报告 已报告的创伤后应激障碍症状、与创伤相关的饮酒以应对动机和饮酒将通过cell进行评估 每天向参与者发送三次提示，时间分别为上午、下午和晚上。这些创新之处 方法论方法将允许对动态症状变化进行前瞻性检查以捕获 每日酒精使用量增加的预测因素。这项研究的发现有望阐明关键的近端 在经历过性暴力的妇女中促进急性饮酒行为的过程。结果 可能有助于制定有效的干预策略，减少饮酒，以应对性行为 攻击幸存者，并反过来帮助防止酒精使用和相关的健康后果在这些人口。

Project Summary Researchers have identified alcohol use as a common concern among women who have experienced sexual violence (SV), with important public health implications. Posttraumatic stress disorder (PTSD) symptoms following sexual victimization may contribute to these increased rates of alcohol use. The predominant theoretical explanation for these associations is the self-medication hypothesis, which posits that sexual violence survivors use alcohol in order to cope with the psychological distress associated with acute experiences of PTSD. Despite the temporal, within-person nature of this theory, little attention has been given to daily associations between acute PTSD symptoms, trauma-related drinking to cope, and ensuing alcohol use by SV survivors. Moreover, little research has examined sleep duration as a factor that may play an important role in this process, despite emerging theory suggesting that sleep loss has crucial effects on affective functioning and may exacerbate daily PTSD symptoms. Drawing on these findings, the central hypotheses in the present study are that shorter than usual sleep duration is likely to have a proximal effect on increased PTSD symptoms the next day, and that greater than usual PTSD symptoms will in turn predict increased alcohol use later that day through increased trauma-related drinking to cope motives. In addition, we expect that acute PTSD symptoms and trauma-related drinking to cope may be a serial indirect pathway through which shorter than usual sleep duration leads to increased next-day alcohol consumption among female SV survivors. To test these hypotheses, a sample of 80 community women with a history of sexual violence who are problematic drinkers will complete repeated daily measures of sleep duration, PTSD symptoms, trauma- related drinking to cope, and alcohol use over three weeks using ecological momentary assessment (EMA). Sleep duration each night will be assessed using an integrated measure of actigraphy and self-report; self- reported PTSD symptoms, trauma-related drinking to cope motives and alcohol use will be assessed via cell prompts sent to participants three times a day in the morning, afternoon, and evening. These innovative methodological approaches will permit a prospective examination of dynamic symptom changes to capture daily predictors of increased alcohol use. Findings from this study are expected to clarify key proximal processes that promote acute drinking behaviors among women who have experienced sexual violence. Results may inform the development of effective intervention strategies to reduce drinking to cope among sexual assault survivors and, in turn, help prevent alcohol use and related health consequences in this population.