THE UTILITY OF HAIR CORTISOL CONCENTRATIONS IN THE PREDICTION OF PTSD SYMPTOMS AND ALCOHOL-RELATED DRINKING MOTIVES FOLLOWING TRAUMATIC PHYSICAL INJURY
Psychiatry; Psychology
Pacella M L; Hruska B; Steudte-Schmiedgen S; George R L; Delahanty D
Psychosomatic Medicine
2016
2016-04
Journal Article
n/a
Examining The Relationships Between Posttraumatic Stress Disorder Symptoms, Positive Smoking Outcome Expectancies, And Cigarette Smoking In People With Substance Use Disorders: A Multiple Mediator Model
abuse treatment; anxiety disorders; Cigarette smoking; consequences questionnaire; daily smokers; fagerstrom test; negative affect; nicotine dependence; Positive smoking outcome expectancies; posttraumatic stress disorder (PTSD); psychiatric-disorders; Psychology; scale ces-d; Substance Abuse; Substance use disorder (SUD); tobacco use
Cigarette smoking is highly prevalent in people with substance use disorders (SUDs) and is associated with significant physical health problems. Posttraumatic stress disorder (PTSD) is also highly associated with both SUDs and cigarette smoking and may serve as a barrier to smoking cessation efforts. In addition, people with PTSD are more likely to hold positive smoking outcome expectancies (i.e., beliefs that smoking cigarettes results in positive outcomes); these beliefs may contribute to cigarette smoking in people with SUDs experiencing PTSD symptoms. The present study examined the relationship between PTSD symptoms and typical daily cigarette smoking/cigarette dependence symptoms in a sample of 227 trauma-exposed current smokers with SUDs (59.9% male, 89.4% Caucasian) seeking detoxification treatment services. Additionally, the indirect effects of multiple types of positive smoking outcome expectancies on these relationships were examined. Participants completed questionnaires assessing PTSD symptoms, positive smoking outcome expectancies, cigarette consumption, and cigarette dependence symptoms. Results indicated that PTSD symptoms were not directly related to cigarette consumption or cigarette dependence symptoms. However, negative affect reduction outcome expectancies were shown to have a significant indirect effect between PTSD symptoms and cigarette consumption, while negative affect reduction, boredom reduction, and taste-sensorimotor manipulation outcome expectancies were all found to have significant indirect effects between PTSD symptoms and cigarette dependence symptoms. The indirect effect involving negative affect reduction outcome expectancies was statistically larger than that of taste sensorimotor manipulation outcome expectancies, while negative affect reduction and boredom reduction outcome expectancies were comparable in magnitude. These results suggest that expectancies that smoking can manage negative affective experiences are related to cigarette smoking in people with SUDs experiencing PTSD symptoms and suggest that effective smoking cessation treatments should take into account these expectancies. (C) 2013 Elsevier Ltd. All rights reserved.
Hruska B; Bernier J; Kenner F; Kenne D R; Boros A P; Richardson C J; Delahanty D L
Addictive Behaviors
2014
2014-01
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/j.addbeh.2013.10.002" target="_blank" rel="noreferrer noopener">10.1016/j.addbeh.2013.10.002</a>
Application Of The Stressor Vulnerability Model To Understanding Posttraumatic Stress Disorder (ptsd) And Alcohol-related Problems In An Undergraduate Population
alcohol use disorder; differential role; events; exposed college-students; gender differences; identification test; physical abuse; posttraumatic stress disorder (PTSD); problem drinking; Psychology; refusal self-efficacy; social support; stressor; Substance Abuse; substance use; traumatic; vulnerability model
Research examining the comorbidity of posttraumatic stress disorder (PTSD) and alcohol-use disorder (AUD) suggests that individuals experiencing PTSD symptoms (PTSS) often drink alcohol as a means to self-medicate their trauma symptoms; however, little attention has been given to moderating variables that may make this association more likely. The stressor vulnerability model proposes that being male, relying on maladaptive forms of coping, and holding positive alcohol-outcome expectancies predispose individuals to engage in alcohol use when experiencing psychological distress. In the current study, sex, avoidance coping (AVC), tension-reduction expectancies (TRE), and emotional-relief drinking-refusal self-efficacy. (ERDRSE) were examined as moderators of the relationship between PTSS and alcohol-related problems in a sample of 144 undergraduates. Results indicated that males reporting high levels of TRE exhibited a stronger positive relationship between PTSS and alcohol-related problems than was present for males reporting low levels of TRE and for females reporting either high or low levels of TRE. In addition, a significant positive relationship between PTSS and alcohol-related problems was observed for individuals reporting high levels of TRE and low levels of ERDRSE, but not for individuals reporting high levels of TRE and high levels of ERDRSE, low TRE-low ERDRSE, or low TRE-high ERDRSE. Assessment of these vulnerability factors in traumatized youth and young adults may serve as a useful means of identifying individuals at risk for the development of alcohol-related problems.
Hruska B; Delahanty D L
Psychology of Addictive Behaviors
2012
2012-12
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1037/a0027584" target="_blank" rel="noreferrer noopener">10.1037/a0027584</a>
Alcohol Use Disorder History Moderates The Relationship Between Avoidance Coping And Posttraumatic Stress Symptoms
accident survivors; administered ptsd scale; alcohol use disorder; avoidance coping; cue reactivity; drug-use; follow-up; major depression; patients; posttraumatic stress disorder (PTSD); Psychology; sexual assault survivors; social support; structured clinical interview; Substance Abuse; substance use disorder; Substance Abuse
Avoidance coping (AVC) is common in individuals with posttraumatic stress disorder (PTSD) and in individuals with alcohol use disorder (AUD). Given that PTSD and AUD commonly co-occur, AVC may represent a risk factor for the development of comorbid posttraumatic stress and alcohol use. In this study, the relationship between AVC and PTSD symptoms (PTSS) was examined in individuals with versus without AUDs. Motor vehicle accident (MVA) victims were assessed 6 weeks postaccident for AUD history (i.e. diagnoses of current or past alcohol abuse or dependence) and AVC. PTSS were assessed 6 weeks and 6 months post-MVA. All analyses were conducted on the full sample of MVA victims as well as on the subset of participants who were legally intoxicated (blood alcohol concentration >= 0.08) during the accident. It was hypothesized that the relationship between AVC and PTSS would be stronger in those individuals with an AUD history and especially strong in the subset of individuals who were legally intoxicated during the MVA. Results were largely supportive of this hypothesis, even after controlling for in-hospital PTSS, gender, and current major depression. Early assessment of AUD history and avoidance coping may aid in detecting those at elevated risk for PTSD, and intervening to reduce AVC soon after trauma may help buffer the development of PTSD + AUD comorbidity.
Hruska B; Fallon W; Spoonster E; Sledjeski E M; Delahanty D L
Psychology of Addictive Behaviors
2011
2011-09
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1037/a0022439" target="_blank" rel="noreferrer noopener">10.1037/a0022439</a>
The Association Between Daily Ptsd Symptom Severity And Alcohol-related Outcomes In Recent Traumatic Injury Victims
alcohol; college-students; combat veterans; dependence; drinking; experience sampling; functional outcomes; hospitalization; interventions; posttraumatic stress disorder (PTSD); posttraumatic stress disorder (PTSD); prolonged exposure; Psychology; Substance Abuse; traumatic injury; us
The self-medication hypothesis proposes that individuals experiencing posttraumatic stress disorder (PTSD) symptoms may use alcohol (or other substances) to self-medicate distress, while the mutual maintenance hypothesis proposes that alcohol use also exacerbates or maintains distress. Existing research largely supports the self-medication hypothesis. However, findings are often based upon retrospective reporting of problems and assessment of symptoms anchored to a trauma occurring in the remote past. To improve on these retrospective designs, the current study examined the relationship between daily PTSD symptom severity and alcohol-related outcomes during the early phase of recovery following a traumatic physical injury. Specifically, 36 injury victims reported on PTSD symptom severity, alcohol craving, alcohol consumption, and negative drinking consequences thrice daily (morning, afternoon, night) over 7 days beginning 6 weeks postinjury. Results indicated relationships between PTSD symptom severity and alcohol craving/negative consequences when these experiences were assessed concurrently within the same signal (particularly during the nighttime assessments). Prospective models found that nighttime PTSD symptom severity was related to negative drinking consequences occurring the following morning, even after controlling for consumption level, suggesting a more general behavioral regulation problem. Results were less supportive of the mutual maintenance hypothesis. Collectively, these results suggest that health interventions targeting PTSD symptom severity in recent injury victims-particularly when delivered at night-may be able to prevent problematic alcohol use.
Hruska B; Pacella M L; George R L; Delahanty D L
Psychology of Addictive Behaviors
2017
2017-05
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1037/adb0000262" target="_blank" rel="noreferrer noopener">10.1037/adb0000262</a>
Trajectories Of Daily Ptsd Symptoms In Recent Traumatic Injury Victims
assessment; care; checklist pcl; ecological momentary; growth analysis; latent class; posttraumatic stress disorder (PTSD); posttraumatic stress disorder (PTSD); Psychiatry; Psychology; PTSD symptom trajectories; resilience; scale; survivors; traumatic injury
Objective: Prior research has identified different PTSD symptom (PTSS)trajectories over months and years posttrauma that warrant different levels of clinical attention. Earlier identification of at-risk trauma victims can facilitate efficient and appropriate intervention efforts. Method: Using latent class growth analysis, we examined daily PTSS trajectories beginning 6 weeks postinjury in 68 injury victims. Resulting classes were compared on key characteristics at 6 and 21 weeks postinjury. Results: Three trajectories were identified: a nonreactive class (67.8%) with low initial symptom levels that remained low, a moderate-stable class (27.9%) with elevated symptom levels that remained constant, and a severe-increasing class (4.4%) with high symptom levels that increased. Conclusions: High-risk injury victims can be identified by their daily PTSS, allowing for early identification of those at risk for elevated distress and in greater need for intervention.
Hruska B; Pacella M L; George R L; Delahanty D L
Psychological Trauma-Theory Research Practice and Policy
2016
2016-11
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1037/tra0000145" target="_blank" rel="noreferrer noopener">10.1037/tra0000145</a>