Trauma Cue-Elicited Emotional Responding and Emotion Regulation: Examining Momentary Mechanisms of Posttraumatic Stress Disorder and Risky Alcohol Use

Emotional responding to a trauma cue has been proposed as a critical momentary mechanism of drinking risk in individuals with posttraumatic stress disorder (PTSD). Individuals with PTSD experience stronger cue-elicited negative affect compared to those without PTSD, which in turn increases acute urges to drink alcohol. However, there are few tests of these theorized pathways as they unfold in the moment. The present study aimed to replicate prior laboratory-based findings showing PTSD to influence alcohol urge indirectly through emotional responding (Rodriguez & Read, 2020), and to extend this model of drinking risk by examining momentary emotion regulation as a serial mediator. Community participants with trauma exposure and risky alcohol use (N = 159) completed an online survey, which included a focused, expressive writing exercise about their selfidentified worst traumatic experience. This writing exercise served as a virtual personalized trauma cue. Affect and drinking urge were assessed at baseline and immediately posttrauma cue. Participants were grouped by PTSD status (based on the Posttraumatic Stress Disorder Checklist). A parallel mediation model examined the indirect effects of arousal and valence dimensions of emotional responding. A serial mediation model evaluated the contribution of momentary emotion regulation. Our online paradigm replicated the prior laboratorybased findings, indicating that the valence dimension of emotional responding mediated the pathway between PTSD and momentary alcohol urge. However, serial mediation was not supported. Results of this study support virtual administration of trauma cue paradigms and build on prior work suggesting that emotional responding is a relevant momentary mechanism for understanding comorbid PTSD and risky drinking.