The 7-factor hybrid model of DSM-5 PTSD symptoms and alcohol consumption and consequences in a national sample of trauma-exposed veterans

J Anxiety Disord. 2017 Oct:51:14-21. doi: 10.1016/j.janxdis.2017.08.001. Epub 2017 Aug 6.

Abstract

The purpose of the present study was to investigate associations between the 7-factor hybrid model of DSM-5 posttraumatic stress disorder (PTSD) symptoms, which includes intrusions, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal symptoms, and alcohol consumption and consequences. A nationally representative sample of 916 trauma-exposed U.S. military veterans were administered the Trauma History Screen, PTSD Checklist-5, and Alcohol Use Disorders Identification Test. Confirmatory factor analyses were conducted to determine associations between the 7-factor hybrid model of PTSD symptoms, and alcohol consumption and consequences. Results revealed that lifetime dysphoric arousal (r=0.31), negative affect (r=0.30), and anhedonia (r=0.29) symptom clusters were most strongly associated with past-year alcohol consequences. No significant associations were observed for alcohol consumption. While the cross-sectional study design does not allow one to ascertain causative associations between PTSD factors and alcohol consumption and consequences, results generally align with the self-medication hypothesis, as PTSD factors reflecting internalizing were most strongly related to alcohol-related consequences. These results underscore the importance of assessing for alcohol use problems in veterans who score highly on PTSD symptoms reflecting internalizing symptomatology.

Keywords: Alcohol use; Comorbidity; Confirmatory factor analysis; Posttraumatic stress disorder.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alcohol Drinking*
  • Anhedonia
  • Checklist
  • Cross-Sectional Studies
  • Databases, Factual
  • Diagnostic and Statistical Manual of Mental Disorders
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Male
  • Middle Aged
  • Models, Psychological*
  • Stress Disorders, Post-Traumatic / diagnosis*
  • Veterans / psychology*
  • Young Adult