Role of Momentary Alcohol Cognitions in Event-Level Relations Between PTSD Symptoms and Alcohol Outcomes: Le rôle des cognitions momentanées liées à l'alcool au niveau de l'événement entre les symptômes du TSPT et la consommation d'alcool.

Abstract

Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) commonly co-occur. Momentary alcohol cognitions may represent in-the-moment, modifiable risk factors to target in interventions for comorbid PTSD and AUD. However, the role of such cognitions in risk for problematic drinking as it emerges in response to individuals' fluctuating PTSD symptoms across their daily lives remains unknown. The present study aimed to test whether state-level PTSD-alcohol expectancies and/or drinking motives modulate in-the-moment associations between PTSD symptoms and alcohol outcomes. Frequent drinking adults with current PTSD (n = 54) reported on their posttraumatic symptoms and alcohol cognitions, craving, and consumption during four momentary surveys each day for 14 days (3,024 observations) in an ecological momentary assessment design. Multilevel moderation analyses tested whether in-the-moment PTSD-alcohol expectancies and/or drinking motives moderated relations of PTSD symptoms with alcohol craving and consumption. Findings demonstrated a significant interaction between PTSD symptoms and coping drinking motives on in-the-moment alcohol craving. Specifically, greater experience of PTSD symptoms related more strongly to craving for alcohol during events in which drinkers endorsed higher levels of coping drinking motives. There were no additional interaction effects for drinking motives or PTSD-alcohol expectancies on either alcohol craving or consumption. Coping drinking motives appear to convey strong in-the-moment risk for PTSD-related alcohol craving yet not subsequent alcohol consumption. Future research should delineate concurrent alcohol risk and possible protective processes active in the presence of PTSD symptoms to help identify targets for interventions tailored to the unique risk processes maintaining comorbid PTSD and AUD.