Alcohol Expectancies, Posttraumatic Stress Disorder, and Alcohol Use in College Students With a History of Childhood Trauma

Abstract

Objective: Prior research has emphasized that the key mediator in the posttraumatic stress disorder (PTSD) symptom-alcohol use relationship is the expectancy of alcohol's tension-reducing properties. This study extends the literature by examining various alcohol outcome expectancies.

Methods: Cross-sectional data were obtained from 198 college students who reported experiencing at least one traumatic event in childhood. Participants answered surveys measuring PTSD symptoms, alcohol outcome expectancies, and three measures of alcohol consumption and related problems.

Results: Participants included 131 males (mean age = 19.65 years, SD = 1.06, range = 18 to 24) and 67 females (mean age = 19.43 years, SD = 0.82, range = 18 to 23), who were predominantly European-American (82%). For males and females, results of the multivariate analyses suggested that self-perception expectancies mediated the effects of PTSD symptoms on alcohol use severity, whereas sociability expectancies mediated the effects of PTSD symptoms on monthly alcohol use. For women, risk and aggression and sexuality expectancies mediated the relationship between PTSD symptoms and alcohol use severity, while risk and aggression expectancies mediated the relationship between PTSD symptoms and alcohol use consequences. For men, sociability expectancies mediated the effects of PTSD symptoms on alcohol use severity. Across genders, tension-reduction expectancies did not mediate the relationship between PTSD symptom and the three alcohol measures.

Conclusions: This study was unable to find support for the self-medication hypothesis via the tension-reduction outcome expectancy pathway. However, other significant findings can be interpreted in light of the self-medication hypothesis. For example, alcohol may aid in coping with social impairments related to PTSD symptoms, particularly in a college sample. This study also highlighted gender differences in the association between PTSD symptoms and alcohol consumption and related problems.

Keywords: Alcohol abuse; alcohol outcome expectancy; gender differences; posttraumatic stress; self-medication hypothesis.