PTSD, Alcohol Dependence, and Conduct Problems: Distinct Pathways via Lability and Disinhibition

Authors

Jeffrey S. Simons, University of South Dakota and Sioux Falls VA Medical CenterFollow
Raluca M. Simons, University of South Dakota and Sioux Falls VA Medical CenterFollow
Carol O'Brien, Bay Pines VA Health Care System
Scott F. Stoltenberg, University of Nebraska-LincolnFollow
Jessica A. Keith, Bay Pines VA Health Care System
Jaime A. Hudson, Sioux Falls VA Medical Center

Document Type

Article

Date of this Version

1-2017

Citation

Addictive Behaviors 64 (January 2017), pp. 185–193.

doi: 10.1016/j.addbeh.2016.08.044

Comments

Copyright © 2016 Elsevier Ltd. Used by permission.

Abstract

This study tested the role of affect lability and disinhibition in mediating associations between PTSD symptoms and two forms of alcohol-related problems, dependence syndrome symptoms (e.g., impaired control over consumption) and conduct problems (e.g., assault, risk behaviors). Genotype at the serotonin transporter linked polymorphic region (5-HTTLPR) was hypothesized to moderate associations between traumatic stress and PTSD symptoms. In addition, the study tested whether childhood traumatic stress moderated associations between combat trauma and PTSD symptoms. Participants were 270 OIF/OEF/OND veterans. The hypothesized model was largely supported. Participants with the low expression alleles of 5-HTTLPR (S or L_G) exhibited stronger associations between childhood (but not combat) traumatic stress and PTSD symptoms. Affect lability mediated the associations between PTSD symptoms and alcohol dependence symptoms. Behavioral disinhibition mediated associations between PTSD symptoms and conduct related problems. Conditional indirect effects indicated stronger associations between childhood traumatic stress and lability, behavioral disinhibition, alcohol consumption, AUD symptoms, and associated conduct problems via PTSD symptoms among those with the low expression 5-HTTLPR alleles. However, interactions between combat trauma and either childhood trauma or genotype were not significant. The results support the hypothesis that affect lability and behavioral disinhibition are potential intermediate traits with distinct associations with AUD and associated externalizing problems.