PTSD Symptoms and Alcohol-Related Problems among Veterans: Temporal Associations and Vulnerability

Authors

Jeffrey S. Simons, University of South Dakota and Sioux Falls VA Healthcare SystemFollow
Raluca M. Simons, University of South Dakota and Sioux Falls VA Healthcare SystemFollow
Jessica A. Keith, Bay Pines VA Healthcare System
Kevin J. Grimm, Arizona State UniversityFollow
Carol O'Brien, Bay Pines VA Healthcare System
Scott F. Stoltenberg, University of Nebraska-LincolnFollow
Kate Andal, Sioux Falls VA Healthcare System

Document Type

Article

Date of this Version

2018

Citation

Journal of Abnormal Psychology 127:8 (2018), pp. 733–750.

doi: 10.1037/abn0000376

Comments

Copyright © 2018 American Psychological Association. Used by permission.

Abstract

Posttraumatic stress disorder (PTSD) is associated with elevated risk of both alcohol use disorder (AUD) and related conduct problems, which are associated with behavioral and emotional dysregulation. We conducted an intensive longitudinal burst design study with 10 weeks of experience sampling over the course of 1.5 years with 250 veterans of recent conflicts. We tested time-series models of daily associations between posttraumatic stress symptoms (PTSS), alcohol dependence syndrome, and conduct problems. Exacerbations of PTSS predicted higher dependence syndrome and conduct problems the next day. This effect was significant after controlling for both concurrent (i.e., same-day) associations between drinking and the outcomes as well as the strength of associations between the outcomes from one day to the next (i.e., autoregression). Affect lability and disinhibition were hypothesized vulnerability factors increasing the strength of within-person predictors of dependence syndrome and conduct problems. Lability and disinhibition were associated with greater dependence syndrome symptoms and conduct problems over the follow-up period. Consistent with expectation, lability rather than disinhibition increased the association between drinking and dependence syndrome as well as the strength of association between dependence syndrome symptoms from one day to the next. Moderating effects of disinhibition in the conduct problems model were not significant. Importantly, results indicated reciprocal associations over time. Lability potentiated the association between dependence syndrome symptoms and next-day PTSS, whereas disinhibition potentiated the association between conduct problems and next-day PTSS. Results demonstrate complex dynamic associations between PTSS, AUD symptoms, and conduct problems over time indicative of broad regulatory impairments.