Coping, PTSD symptoms, and alcohol involvement in trauma-exposed college students in the first three years of college

Abstract

The objective of the present study was to examine prospective, bidirectional associations among posttraumatic stress disorder (PTSD) symptoms, coping style, and alcohol involvement (use, consequences) in a sample of trauma-exposed students just entering college. We also sought to test the mechanistic role that coping may play in associations between PTSD symptoms and problem alcohol involvement over time. Participants (N = 734) completed measures of trauma exposure, PTSD symptoms, coping, and alcohol use and consequences in September of their first college year and again each September for the next 2 years. We observed reciprocal associations between PTSD and negative coping strategies. In our examination of a mediated pathway through coping, we found an indirect association from alcohol consequences and PTSD symptoms via negative coping, suggesting that alcohol consequences may exacerbate posttraumatic stress over time by promoting negative coping strategies. Trauma characteristics such as type (interpersonal vs. noninterpersonal) and trauma reexposure did not moderate these pathways. Models were also invariant across gender. Findings from the present study point to risk that is conferred by both PTSD and alcohol consequences for using negative coping approaches, and through this, for posttraumatic stress. Interventions designed to decrease negative coping may help to offset this risk, leading to more positive outcomes for those students who enter college with trauma exposure.

Figure 1

Cross-lagged panel model of the prospective associations among PTSD symptoms, coping, and alcohol consequences. Alcohol use at each time point was also included in the model but was omitted from the figure for simplicity due to a lack of statistically significant cross-lagged associations with the other variables in the model. Statistically significant (p < .05; solid arrows) paths are shown. All nonsignificant paths (p > .05) were retained in the final model but were omitted form the figure for clarity. The path from Y1 alcohol consequences to Y2 negative coping (dashed arrow) was not significant but is depicted in the figure to illustrate a significant indirect path from alcohol consequences to PTSD symptoms via negative coping (bolded lines), which was statistically significant (95% CI does not contain zero). The other indirect effects were not significant. **p < .01, *p < .05.