Trauma, Trauma Sequela, and Alcohol Information Processing

ABSTRACT: Trauma, Trauma Sequelae, and Alcohol Information Processing College students are at risk for both trauma and resulting traumatic stress sequelae (TSS). Perhaps not coincidentally, the use of alcohol (ALC) is prevalent on U.S. campuses, and is associated with myriad consequences. TSS and ALC commonly co-occur, and are posited to be causally related to one another. Yet, no research has examined interrelated cognitive mechanisms by which traumatic stress sequelae may affect alcohol use in this at-risk group. The relevance of negative emotion and information processing in understanding TSS-ALC associations is noted in both Self-Medication and Social Learning (SLT) models. Data suggest that trauma and its sequelae may alter information processing mechanisms, such that individuals with TSS demonstrate an attentional bias to relevant cues. This bias appears to be specific to emotionally relevant information. We posit that the co-occurrence of TSS and drinking may be explained by closely associated TSS and ALC information memory networks that are linked by a process of spreading activation. That is, trauma cues may activate both negative emotions and alcohol-related information in sequence, resulting in a bias to process this information in ways that are likely to lead to drinking. We propose that activation of a trauma memory network will impact alcohol information processing in three ways. First, this activation will result in a bias to process positive alcohol expectancies, most specifically, self-medication expectancies. Second, processing alcohol information will interfere with processing other emotionally irrelevant information when a trauma network is activated. Finally, alcohol will be more strongly associated in memory with positively valenced information when a trauma memory network is activated. Implicit cognition has been shown to be important for understanding alcohol use, and has been suggested to be a critical etiological factor in posttraumatic stress. Here, we use multiple tasks (expectancy reaction time; E-TASK, Modified Stroop;M-Stroop, IAT) to assess implicit TSS-ALC cognitive processes. Two experiments will examine causal paths through which trauma cues affect alcohol information processing in college students with and without posttraumatic stress disorder (PTSD). The first will evaluate the impact of trauma cue and PTSD on bias in processing alcohol expectancies (E-TASK) and interference in processing alcohol information (M-Stroop). The second will test the impact of cue exposure and PTSD on the evaluation (positive, negative associations) of alcohol information using the IAT. Findings will inform interventions designed to modify positive beliefs about alcohol in the interest of decreasing heavy drinking on college campuses. PROJECT NARRATIVE The college years represent a transition into adulthood, during which students experience adult freedoms and responsibilities, and when they must learn to negotiate these in an environment where drinking is the norm. This may pose a particular challenge to those already attempting to cope with post- traumatic stress. Knowledge from this study regarding how alcohol beliefs are affected by trauma and posttraumatic disorder (PTSD) will inform interventions designed to decrease heavy and problem drinking on college campuses.