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

项目摘要 研究人员已经确定，酒精使用是经历过 性暴力（SV），具有重要的公共卫生影响。创伤后应激障碍 性受害后的症状可能是导致酗酒率上升的原因。的 对这些关联的主要理论解释是自我药疗假说，该假说认为， 性暴力幸存者使用酒精，以科普与急性 PTSD的经历。尽管这一理论的时间性和内在性， 急性创伤后应激障碍症状、与创伤有关的饮酒和随之而来的酒精之间的日常联系 SV幸存者使用。此外，很少有研究将睡眠时间作为一个可能影响睡眠质量的因素。 尽管新兴的理论表明睡眠不足对情感的影响至关重要， 可能会加剧日常PTSD症状。根据这些发现， 目前研究表明，比平常睡眠时间短可能对增加睡眠质量有近端影响， 第二天出现PTSD症状，并且认为大于平时的PTSD症状会反过来预测增加 通过增加与创伤有关的饮酒来科普动机。此外，我们预计， 急性创伤后应激障碍症状和与创伤有关的饮酒可能是一系列间接途径， 比平时睡眠时间短的睡眠时间导致女性SV第二天饮酒量增加 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， 有问题的饮酒者会每天重复测量睡眠时间，创伤后应激障碍症状，创伤- 相关的饮酒，以科普，和酒精使用超过三个星期，使用生态瞬时评估（EMA）。 每晚的睡眠时间将使用体动记录和自我报告的综合测量进行评估;自我报告 报告的创伤后应激障碍症状，与创伤有关的饮酒，以科普动机和酒精使用将通过细胞评估 每天上午、下午和晚上三次向参与者发送提示。这些创新 方法学方法将允许对动态症状变化进行前瞻性检查， 每日饮酒量增加的预测因素。这项研究的结果有望阐明关键的近端 这一过程促进了经历过性暴力的妇女的急性饮酒行为。结果 可能有助于制定有效的干预策略，以减少饮酒来科普性行为 这有助于帮助暴力幸存者，反过来，有助于防止这一人群的酒精使用和相关的健康后果。

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.