Posttraumatic stress symptoms and alcohol problems: Self-medication or trait vulnerability?

Background and Objectives Posttraumatic stress symptoms (PTSD) and problem alcohol use (ALC) commonly co-occur, but the nature of this co-occurrence is unclear. Self-medication explanations have been forwarded, yet traits such as tendency toward negative emotionality and behavioral disconstraint also have been implicated. In this study we test three competing models (Self-Medication, Trait Vulnerability, Combined Dual Pathway) of PTSD-ALC prospectively in a college sample. Method Participants (N = 659; 73% female, M age = 18) provided data at college matriculation (Time 1) and 1 year later (Time 2). Results Structural equation models showed disconstraint to meditate the path from PTSD symptoms to alcohol problems, supporting a trait vulnerability conceptualization. Findings regarding negative emotionality and self-medication were more mixed. Negative emotionality played a stronger role in cross-sectional than in prospective analyses, suggesting the importance of temporal proximity. Conclusions and Scientific Significance Self-regulation skills may be an important focus for clinicians treating PTSD symptoms and alcohol misuse disorders concurrently. (Am J Addict 2014;23:108-116)