Heavy Drinking, PTSD in College Students Linked

Megan Brooks

January 23, 2014

Heavy drinking may worsen symptoms of posttraumatic stress disorder (PTSD), and PTSD symptoms may contribute to heavy drinking in college students, new research shows.

"Each affects the other. As such, both PTSD and heavy drinking are risk factors for one another, each with implications for the other over the course of college. This information is useful and perhaps imperative for those who assist students dealing with these problems," principal investigator Jennifer Read, PhD, associate professor of psychology at the University of Buffalo, New York, told Medscape Medical News.

Dr. Read added that this finding has clear clinical implications.

"If [health providers] observe evidence of posttraumatic stress symptoms, they should also assess for heavy drinking and alcohol problems. The reverse also is true. Intervening on both PTSD and alcohol symptoms at the same time may be beneficial," she said.

The study was published in the latest issue of the Journal of Abnormal Psychology.

Transitioning to college can be traumatic, the researchers note. It is estimated that 9% of college students have symptoms of PTSD. Heavy drinking is also common on college campuses, and although there has been an assumption that PTSD and heavy drinking are linked, until now, the nature of the relationship was unclear.

The researchers examined relationships between PTSD and heavy drinking (assessed by Web survey) in 486 students as they transitioned into college and at 11 additional time points during the following 3 years.

They used the trait-state-error modeling analytic approach, which allowed them to examine prospective and reciprocal associations among these constructs while taking into account intraindividual stability, they explain.

They found that alcohol involvement (both alcohol use and problems) was linked over time to an exacerbation in PTSD symptoms and that PTSD symptoms showed a similar effect on alcohol consumption.

"Enormous" Clinical Implications

Commenting on the study for Medscape Medical News, Amanda Divin, PhD, assistant professor, Department of Health Sciences, Western Illinois University in Macomb, who was not involved in the research, said that alcohol use is always a "hot topic and problem in college students worthy of further investigation."

"The PTSD association is a unique addition to the literature, in particular exploring the temporal aspect of this relationship," she added.

The study has several strengths, said Dr. Divin, including the fact that it was a "3-year longitudinal study with low attrition (drop out) and high response rate." Also, the investigators used a "sophisticated statistical method designed to determine temporal sequence, which answers the question which came first: alcohol use/problems or PTSD."

"The potential implications of this study are enormous," Dr. Divin said.

"While the findings make sense and are intuitive, the implications for AOD [alcohol and other drug] counselors as well as mental health counselors on a college campus and how they deal with students coping with such issues could be far reaching," Dr. Divin said.

She noted that the self-medication hypothesis for alcohol use has been around for quite some time and that counselors are aware of it.

"However, this study makes a distinct contribution by differentiating between alcohol use and alcohol problems. The finding that PTSD was associated with alcohol use but not necessarily problems is interesting. It suggests that while students may be initially somewhat self-medicating with alcohol, in the long run, they may not be continuing to self-medicate (at least with alcohol), as evidenced by not experiencing alcohol-related problems," she said.

The study was supported by the National Institute on Drug Abuse. The authors and Dr. Divin have reported no relevant financial relationships.

J Abnorm Psychol. 2013;122:984-997. Abstract

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