Comorbid Alcohol Research Articles

Trauma-related guilt and posttraumatic stress disorder symptoms in military veterans: The role of psychological inflexibility

A growing body of evidence has shown consistent support for the association between trauma-related guilt and posttraumatic stress disorder (PTSD). However, factors that account for this association are not well understood. The present study examined psychological inflexibility as a potential mediator between trauma-related guilt and PTSD symptoms in a sample of U.S. military veterans. Secondary data analyses from a larger randomized control trial were conducted. Specifically, three separate mediation models were used to test if psychological inflexibility mediated the association between trauma-related guilt (guilt cognitions, guilt distress, overall guilt) and PTSD symptoms in 85 treatment-seeking veterans diagnosed with PTSD and alcohol use disorder. All three components of trauma-related guilt were positively associated with both psychological inflexibility and PTSD symptoms; psychological inflexibility was also positively associated with PTSD symptoms. Furthermore, psychological inflexibility partially mediated the association between all facets of trauma-related guilt and PTSD severity. These findings provide further support for the association between trauma-related guilt and PTSD and also provide insight into one mechanism linking trauma-related guilt to PTSD symptoms. Thus, psychological inflexibility may serve as an important intervention target for veterans with comorbid PTSD and alcohol use disorder struggling with trauma-related guilt.

Within-treatment clinical markers of dropout risk in integrated treatments for comorbid PTSD and alcohol use disorder

BackgroundIntegrated interventions for comorbid posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) are effective, but many patients prematurely drop out from treatment. Little is known about within-treatment risk factors for dropout, limiting the ability during therapy to identify patients at risk for attrition. MethodsWe examined measures assessing PTSD (PTSD Checklist for DSM-5; PCL-5), alcohol use (Substance Use Inventory; SUI), and patient satisfaction (Client Satisfaction Questionnaire; CSQ-8) as potential within-treatment markers of dropout risk, administered to 110 veterans in a randomized clinical trial of integrated exposure therapy versus integrated coping skills therapy for comorbid PTSD + AUD. Hierarchical Cox proportional hazard models with dropout status as the endpoint assessed effects of PCL-5, SUI, and CSQ-8 on dropout risk, and whether effects differed by treatment modality. ResultsA significant interaction between treatment and changes in alcohol use was observed (HR = 2.86, p = .007), where between-session alcohol use was positively associated with dropout hazard rate for those receiving integrated exposure therapy (HR = 2.34, p = .004), but not coping skills therapy (HR = 0.73, p = .19). Specifically, an increase of one drink consumed per day in the interval since last assessment (typically 2–3 weeks) was associated with a 5-fold increase in dropout hazard rate. ConclusionsThe findings provide preliminary evidence of detectable within-treatment markers of dropout during integrated treatment for PTSD + AUD. Study of within-treatment indicators proximal to dropout may help identify at-risk patients and inform timely strategies to boost retention.

Substance use predictors of attendance among veterans in integrated PTSD and alcohol use disorder treatment

Comorbid post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) is common, defined by greater severity and impairment than either disorder alone, and associated with poor treatment attendance. Exposure therapies are effective in treating PTSD+AUD, yet substance use is still cited as a potential contraindication for exposure. This study examined substance use–related predictors of session attendance among veterans (N = 119) randomized to receive integrated exposure therapy (Concurrent Treatment of PTSD and Substance Use Disorders using Prolonged Exposure [COPE]; Back et al., 2015) or integrated coping skills therapy (Seeking Safety [SS]; Najavits, 2002) in a clinical trial for comorbid PTSD+AUD (Norman et al., 2019). At baseline, greater percentage of heavy drinking days (β = −0.23, p = .011) and greater AUD severity per structured clinical interview for DSM-IV-TR (β = −0.21, p = .019) predicted fewer sessions across both treatments. Treatment type did not moderate the relationship between predictors and attendance, except for a trend for craving (p = .057), where greater craving predicted fewer sessions in SS (β = −0.31, p = .02) but not COPE (β = 0.14, p = .28). Percentage of abstinence days, AUD duration, and living in a controlled environment (e.g., recovery home) at the start of therapy were not associated with attendance in either treatment condition. Only a subset of substance use characteristics predicted attendance. Findings did not support the notion that alcohol use leads to lower attendance in exposure therapy compared to nonexposure therapy.

Identifying Predictors of Non-Suicidal Self-Injuries in Individuals with Eating Disorders.

PurposeNearly one third of all patients with an eating disorder (ED) present with non-suicidal self-injury (NSSI). Although it is necessary to pay attention clinically to NSSI in ED patients due to an increased suicidal risk, there are limited data on potential predictors of NSSI in ED. We conducted this study to uncover predictors of NSSI in ED.Materials and MethodsA total of 1355 ED patients who visited an ED clinic was evaluated through structured interviews by psychiatrists. The demographic and clinical characteristics of ED patients with NSSI (NSSI group) and ED patients without NSSI (non-NSSI group) were analyzed to identify potential predictors of NSSI in ED.ResultsAmong all ED individuals, 242 (17.9%) reported a history of NSSI. Compared to the non-NSSI group, the NSSI group reported more severe eating symptomatology, more comorbid psychiatric disease, and more suicidal risk. Comorbid alcohol use disorder, depressive disorder, purging behavior, history of suicide attempt, and rumination symptoms were uncovered as predictors of NSSI in ED.ConclusionThe findings of the study are meaningful in that they highlight predictors of NSSI in ED in a large clinical sample. Understanding risk factors of NSSI and offering appropriate interventions are important to preventing suicidality in ED.

Personality trait and cognitive function in subjects with bipolar disorder and comorbid alcohol intake

Background: Bipolar disorder is a life-threatening and complex condition leading to cognitive and personality impairment, imparting difficult short and long-term management, and affects approximately 1% of the population globallyAims: The present trial was carried out to assess the clinical features of subjects with comorbid alcohol use with bipolar disorder and to assess the cognitive functions and personality traits in these subjects. Materials and Methods: The subjects were screened and assessed for 3 months to assess the presence of bipolar disorder as per ICD 10 criteria using SCAN and were divided into controls and cases (n=40). After assessing subjects on various evaluation tools, the data were subjected to the statistical evaluation for both, case and controls, using t-test, and SPSS version 21.0, and a value of p

Features of cognitive impairment in individuals with paranoid schizophrenia combined with alcohol dependence syndrome

To compare the cognitive functioning of patients with paranoid schizophrenia with alcohol dependence syndrome and patients with this disease without comorbid alcohol pathology. The study included 34 patients with a diagnosis of schizophrenia, paranoid form, aged 24 to 39 years (22 men and 12 women). The experimental group included 17 patients with paranoid schizophrenia combined with alcohol dependence syndrome with diagnosed symptomatic alcoholism. The comparison group included 17 patients with a similar diagnosis without a comorbid disorder. The duration of the disease in both groups was 5-10 years. The main research tool was a neuropsychological examination, which included the Benton test, the pathway test, the Mini-Mental State Examination (MMSE), and the constructive praxis test. Moderate cognitive impairments were found in patients with schizophrenia in combination with comorbid pathology, combined with disorders of intellectual flexibility and cognitive control. Also, in the experimental group, marked disorders of constructive praxis and visual memory were noted, which indicates a lesion of the occipital-parietal parts of the brain. Thus, in the course of the study, cognitive disorders were identified in patients with schizophrenia in combination with alcohol addiction: disturbances of perceptual organization, cognitive flexibility and attention switching, visual memory. Concomitant alcohol dependence is a significant factor for changing cognitive functions in patients with schizophrenia: control functions suffer, visual memory is disturbed and constructive apraxia is noted.

Leveraging a health information exchange to examine the accuracy of self-report emergency department utilization data among hospitalized injury survivors

BackgroundAccurate acute care medical utilization history is an important outcome for clinicians and investigators concerned with improving trauma center care. The objective of this study was to examine the accuracy...

Racial Differences in the Association Between Alcohol Drinking and Cigarette Smoking: Preliminary Findings From an Alcohol Research Program.

Important differences have been shown in alcohol drinking and cigarette smoking prevalence, patterns and consequences among individuals from different racial backgrounds. Alcohol and nicotine are often co-used, and the association between drinking and smoking may differ between racial groups-a question explored in the present study. Data from the NIAAA natural history and screening protocols were utilized; non-Hispanic Black and non-Hispanic White individuals were included in the analyses [N=1692; 65.2% male; 58.3% met criteria for current alcohol use disorder (AUD); 37.8% were current cigarette smokers]. Bivariate associations between assessments related to alcohol drinking and cigarette smoking were examined, and the strength and direction of these associations were compared between the two groups. The sample included 796 Black and 896 White individuals. Black participants had higher frequency (P<0.0001) and severity (P=0.007) of AUD, as well as higher frequency (P<0.0001) of cigarette smoking. Bivariate analyses showed that the expected positive associations between alcohol drinking and cigarette smoking, observed among White individuals, were blunted or absent among Black individuals [age at first cigarette-AUD identification test (AUDIT) score: F(1, 292)=7.60, P=0.006; cigarette pack years-AUDIT score: F(1, 1111)=10.97, P=0.001]. Some decoupling in the association between alcohol drinking and cigarette smoking was found among Black compared to White individuals. The sample was drawn from a specific population enrolled in alcohol research protocols, which is a limitation of the present study. These preliminary findings highlight the importance of considering racial/ethnic background in preventive and therapeutic strategies for comorbid alcohol and nicotine use.

Impact of alcohol abuse on suicide risk in schizophrenic patients

Suicide is one of the main causes of death among patients with mental illnesses. At the same time, alcohol consumption is associated with high risk of autoaggressive and suicidal behavior in population. On the other hand there is an opinion that alcohol may have an illusory-compensatory effect. In that case, alcohol consumption may be an attempt to decrease different symptoms such as depression, anxiety or hallucinations. An analysis of co-occurring schizophrenia and alcohol abuse is presented. Suicide statistics among patients with schizophrenia is studied. Different mechanisms contributing to suicide are highlighted. The correlations of other risk factors with suicide attempts with the assessment of the patient's social resources and environment were studied. The role of alcohol in the presence of other obvious risk factors has been assessed. Possible mechanisms of the protective role of alcohol in relation to suicides among patients with schizophrenia are presented. The authors outline topics of perspective research to clarify the risk of self-destructive behavior in patients with schizophrenia with comorbid alcohol dependence, to search for its predictors and to develop well-grounded complex preventive measures.

Medical Problems In Patients With Alcohol Dependence With Common Schizophrenia And Schizoaffective Disorder

Goal of this study of the relationship between alcohol use, severity of psychiatric symptoms and the number of verified medical diagnoses. The study was that self-reporting of medical history is less accurate in patients with comorbid alcohol dependence and schizophrenia compared with patients with alcohol dependence only or with control. 46 patients with schizophrenia or schizoaffective disorder and concomitant alcohol dependence recruited from the Bukhara Regional Psychoneurological Dispensary. 27 patients suffered from schizophrenia, and 19 patients from schizoaffective disorder.

Associations of alcohol use, mental health and socioeconomic status in England: Findings from a representative population survey

BackgroundAlcohol use and mental health problems often co-occur, however, little is known about how this varies by type of mental health problem and to what extent associations are explained by socioeconomic status (SES). Our study examined the prevalence and associations of non-drinking, hazardous use, and harmful/probable dependence in individuals who do and do not meet criteria for different mental health problems and whether associations remained after adjustment for SES. MethodsA secondary analysis of an English dataset, 2014 Adult Psychiatric Morbidity Survey (N = 7,218), was conducted. The Alcohol Use Disorder Identification Test was used to categorise participants as non-drinking, low risk, hazardous use and harmful/probable dependence. Mental health problems were screened using a range of validated tools. Multinomial logistic regression analyses were used to address study aims. ResultsThe prevalence of non-drinking, hazardous and harmful/probable dependence was higher among those meeting criteria for a mental health problem. After adjustment for SES, non-drinking was most common in those meeting criteria for probable psychotic disorder (MOR = 3.42, 95 %CI = 1.74–6.70), hazardous use in those meeting criteria for anti-social personality disorder (MOR = 2.66, 95 %CI = 1.69–4.20) and harmful/probable dependence in those meeting criteria for borderline personality disorder (MOR = 9.77, 95 % CI = 4.81–19.84). ConclusionsThere were marked increases in the odds of reporting both non-drinking and harmful drinking among those meeting criteria for a mental health problem, particularly more severe problems. Our findings indicate that the relationship between alcohol and mental health is more complex and comorbid alcohol and mental health problems should be treated in parallel with access to both services.

A Prospective Comparison of Bipolar I and II Subjects With and Without Comorbid Alcohol Dependence From the COGA Dataset.

Objective: Comorbidity of alcohol use disorders in bipolar subjects is high as indicated by epidemiological and clinical studies. Though a more severe course of bipolar disorder in subjects with comorbid alcohol dependence has been reported, fewer studies considered the longitudinal course of alcohol dependence in bipolar subjects and the prospective course of comorbid bipolar II subjects. Beside baseline analysis, longitudinal data of the COGA (Collaborative Study on Genetics in Alcoholism) were used to evaluate the course of bipolar I and II disordered subjects with and without comorbid alcohol dependence over more than 5 years of follow-up.Methods: Characteristics of bipolar disorder, alcohol dependence and comorbid psychiatric disorders were assessed using semi-structured interviews (SSAGA) at baseline and at a 5-year follow-up. Two hundred twenty-eight bipolar I and II patients were subdivided into groups with and without comorbid alcohol dependence.Results: Of the 152 bipolar I and 76 bipolar II patients, 172 (75, 4%) had a comorbid diagnosis of alcohol dependence. Bipolar I patients with alcohol dependence, in particular women, had a more severe course of bipolar disorder, worse social functioning and more suicidal behavior than all other groups of subjects during the 5-year follow-up. In contrast, alcohol dependence improved significantly in both comorbid bipolar I and II individuals during this time.Conclusions: A 5-year prospective evaluation of bipolar patients with and without alcohol dependence confirmed previous investigations suggesting a more severe course of bipolar disorder in comorbid bipolar I individuals, whereas bipolar II individuals were less severely impaired by comorbid alcohol use disorder. While severity of alcohol dependence improved during this time in comorbid alcohol-dependent bipolar I patients, the unfavorable outcome for these individuals might be due to the higher comorbidity with personality and other substance use disorders which, together with alcohol dependence, eventually lead to poorer symptomatic and functional clinical outcomes.

Evaluation of Benign Prostatic Hyperplasia Patients in Regards to Co-Morbid Conditions and Personal Habits

Benign prostatic hyperplasia (BPH) is one of the most common diseases encountered in urology practice which commonly occurs in the ageing man. Similarly, diabetes, hypertension, cardiovascular disease and erectile dysfunction also increases with ageing. This study is an attempt to look at the percentage of patients presenting with any associated illness and then to assess the risk of smoking and alcohol consumption and their socioeconomic status of our group of patients by taking a thorough history of BPH patients. The study was conducted in the urology department saveetha medical college and hospital. This was a prospective cross-sectional study from October 2019 till February 2020. In this study, 150 BPH patients history was taken, and data regarding their co-morbid conditions, smoking habits and alcohol consumption were taken, and results were analyzed. Among the co-morbid conditions in this group of patients, the most typical medical condition found was diabetes (46%) and the second most common cause was erectile dysfunction (32%). Further, public health perspective research with factual data collected through various hospitals to assess future trends in BPH incidence rates and co-morbid conditions must be strongly encouraged to identify risk factors for the Indian population.

Prevalence of Severe Mental Illness Dual Diagnosis Among Inpatients in a Psychiatric Hospital in Malaysia

Objective The aim of this study was to determine the prevalence of alcohol or non-alcohol substance use dual diagnosis among inpatients with severe mental illness in a psychiatric institution in Malaysia. In addition, this study aimed to determine adverse outcomes between dual diagnosis versus single diagnosis. Methods: This was a cross-sectional study conducted in the inpatient ward using the Mini-International Neuropsychiatric Interview (MINI) to establish the diagnosis of severe mental illness and to screen for alcohol or non-alcohol substance use disorder comorbidity. Outcomes and severity of different domains among severe mental illness patients were assessed using the Addiction Severity Index (ASI). Results: Out of 152 patients who participated in this study, 51.3% (n = 78) had comorbid alcohol use disorder, and 29.6% (n = 45) had non-alcohol substance use disorder. Males with Kadazan ethnicity with severe mental illness and alcohol use disorder had a higher risk of having comorbid non-alcohol substance use disorder. Similarly, male Kadazan patients with severe mental illness and non-alcohol substance use disorder had a higher risk of having a comorbid alcohol use disorder. Dual diagnosis patients with alcohol and non-alcohol substance use disorder had higher rates of hospitalizations (p < .001 and p = .001). Family and social relationships were affected among the alcohol use disorder group as shown by the higher composite score for family status (FCOMP; p < .001). This group also showed more severe psychiatric status, as the composite score for psychiatric status (PCOMP) was high (p = .004). Suicidality was higher among patients with alcohol use disorder and severe mental illness (p < .001). Conclusions: The prevalence of severe mental illness dual diagnosis was high in this study with poorer outcomes, higher rates of admissions, and risk of suicidality. This highlights the importance of provisions for a more holistic treatment approach among patients with dual diagnosis.

Treatment Goals and Alcohol Use Outcomes in Veterans With Comorbid Alcohol Dependence and Posttraumatic Stress Disorder.

Previous research demonstrates the utility of goals in attaining improved drinking outcomes. Considerably less is known about the association between substance use goals and outcomes among persons with comorbid substance use disorder (SUD) and posttraumatic stress disorder (PTSD). This secondary analysis examined the association between alcohol use outcomes and participants' treatment entry substance use goals to either abstain or reduce substance use in the context of treatment for comorbid SUD/PTSD. Participants (N = 39) were treatment-seeking veterans with current alcohol dependence and PTSD. Participants completed self-report and clinician-rated measures of substance use and PTSD as part of a larger randomized controlled trial. Participants in both goal groups (abstain; reduce) achieved significant reductions in the likelihood of drinking and the likelihood of exceeding low-risk drinking levels. The primary analysis did not identify significant differences in outcome between goal groups; however, the exploratory analysis revealed that participants with reduced use goals were more likely to drink and more likely to exceed low-risk drinking levels. The findings suggest a moderately strong association between substance use goal and drinking outcome in the current study. Although the findings did not unequivocally support abstinence as a superior treatment goal, they offer a preliminary indication that abstinence may be an overall lower-risk option. These findings expand consideration of the utility of substance use goals and suggest that clinicians should invite consideration of abstinence but may need not limit integrated treatment for SUD/PTSD based on strict adherence to abstinence, particularly if low-risk use goals are targeted. (Am J Addict 2021;30:131-137).

Age-Related Changes in the Association Between Traumatic Brain Injury and Dementia in Older Men and Women.

To investigate age-related changes in the association between traumatic brain injury (TBI) and dementia in older men and women separately. A total of 243 general practices in the UK. This study included 4760 patients who received a first TBI diagnosis between 1995 and 2010 (index date), and 4760 patients without TBI who were matched to those with TBI by age, sex, index year, Charlson Comorbidity Index, alcohol dependence, and physician (index date: a randomly selected visit date). Retrospective cohort study. Incidence of dementia in the decade following index date. Within 10 years of index date, 8.8% of men with TBI and 4.8% of those without TBI were diagnosed with dementia, while the respective figures were 9.0% and 6.7% in women (P values < .01). There was a significant association between TBI and dementia in men (hazard ratio [HR] = 2.29, 95% confidence interval [CI]: 1.64-3.19) and in women (HR = 1.33, 95% CI: 1.07-1.64). Furthermore, the association between TBI and dementia was significant in men aged 60 to 70 (HR = 2.51, 95% CI: 1.27-4.96) and 71 to 80 years (HR = 3.00, 95% CI: 1.82-4.93), whereas the relationship was only significant and potentially unreliable in women aged 81 to 90 years (HR = 1.49, 95% CI: 1.03-2.14). The age-related relationship between TBI and dementia differed between men and women. More research of a prospective nature and including behavioral data is needed to better understand these differences.

The neural, behavioral, and epidemiological underpinnings of comorbid alcohol use disorder and post-traumatic stress disorder.

Alcohol use disorder (AUD) and (PTSD) frequently co-occur and individuals suffering from this dual diagnosis often exhibit increased symptom severity and poorer treatment outcomes than those with only one of these diseases. Although there have been significant advances in our understanding of the neurobiological mechanisms underlying each of these disorders, the neural underpinnings of the comorbid condition remain poorly understood. This chapter summarizes recent epidemiological findings on comorbid AUD and PTSD, with a focus on vulnerable populations, the temporal relationship between these disorders, and the clinical consequences associated with the dual diagnosis. We then review animal models of the comorbid condition and emerging human and non-human animal research that is beginning to identify maladaptive neural changes common to both disorders, primarily involving functional changes in brain reward and stress networks. We end by proposing a neural framework, based on the emerging field of affective valence encoding, that may better explain the epidemiological and neural findings on AUD and PTSD.

Dual Substance Use of Electronic Cigarettes and Alcohol.

Electronic cigarettes (ECs) are a modern nicotine delivery system that rapidly grew in widespread use, particularly in younger populations. Given the long history of the comorbidity of alcohol and nicotine use, the rising prevalence of ECs raises the question as to their role in the consumption of alcohol. Of the numerous models of ECs available, JUUL is the most popular. This narrative review aims to determine current trends in literature regarding the relationship between EC and alcohol dual use, as well as hypothesize potential pathogenic tissue damage and summarize areas for future study, including second-hand vapor exposure and calling for standardization among studies. In summary, EC users are more likely to participate in hazardous drinking and are at higher risk for alcohol use disorder (AUD). We surmise the pathogenic damage of dual use may exhibit an additive effect, particularly in pathogen clearance from the lungs, increased inflammation and decreased immune response, physical damage to epithelial cells, and exacerbation of chronic obstructive pulmonary disease (COPD)-like illnesses. A better understanding of pathogenic damages is critical to understand the risks placed on dual users when exposed to respiratory pathogens, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Synchronous primary neoplasia in patients with oropharyngeal cancer: Impact of tumor HPV status. A GETTEC multicentric study.

Patients with oropharyngeal squamous cell carcinoma (OPSCC) display a significant risk of synchronous primary neoplasia (SPN) which could impact their management. The aims of this study were to evaluate the risk and distribution of SPN in OPSCC patients according to their HPV (p16) status, the predictive factors of SPN and the impact of SPN on therapeutic strategy and oncologic outcomes. All OPSCC patients treated from 2009 to 2014 were included in this multicentric retrospective study. Univariate analyses were conducted using Chi-2 and Fisher exact tests. For multivariate analyses, all variables associated with a p≤0.10 in univariate analysis were included in logistic regression models. Among the 1291 patients included in this study, 75 (5.8%) displayed a SPN which was preferentially located in the upper aerodigestive tract, lung and esophagus. Comorbidity level (p=0.03), alcohol (p=0.005) and tobacco (p=0.01) consumptions, and p16 tumor status (p<0.0001) were significant predictors of SPN. In multivariate analysis, p16+status was significantly associated with a lower risk of SPN (OR=0.251, IC95% [0.133;0.474]). Patients with a SPN were more frequently referred for non-curative treatment (p=0.02). In patients treated with curative intent, there was no impact of SPN on the therapeutic strategy (surgical vs. non-surgical treatment). We observed no overall survival differences between patients with or without SPN. P16 tumor status is the main predictive factor of SPN in OPSCC patients. This study provides crucial results which should help adapt the initial work-up and the global management of OPSCC patients.

Importance of sex and trauma context on circulating cytokines and amygdalar GABAergic signaling in a comorbid model of posttraumatic stress and alcohol use disorders.

Alcohol use disorder (AUD) and anxiety disorders are frequently comorbid and share mechanisms that could be therapeutic targets. To facilitate mechanistic studies, we adapted an inhibitory avoidance-based “2-hit” rat model of posttraumatic stress disorder (PTSD) and identified predictors and biomarkers of comorbid alcohol (ethanol)/PTSD-like symptoms in these animals. Stressed Wistar rats received a single footshock on two occasions. The first footshock occurred when rats crossed into the dark chamber of a shuttle box. Forty-eight hours later, rats received the second footshock in a familiar (FAM) or novel context (NOV). Rats then received 4 weeks of two-bottle choice (2BC) ethanol access. During subsequent abstinence, PTSD-like behavior responses, GABAergic synaptic transmission in the central amygdala (CeA), and circulating cytokine levels were measured. FAM and NOV stress more effectively increased 2BC drinking in males and females, respectively. Stressed male rats, especially drinking-Vulnerable individuals (≥0.8g/kg average 2-hr ethanol intake with >50% ethanol preference), showed higher fear overgeneralization in novel contexts, increased GABAergic transmission in the CeA, and a profile of increased G-CSF, GM-CSF, IL-13, IL-6, IL-17a, leptin and IL-4 that discriminated between stress context (NOV>FAM>Control). However, drinking-resilient males showed the highest G-CSF, IL-13, and leptin levels. Stressed females showed increased acoustic startle and decreased sleep maintenance, indicative of hyperarousal, with increased CeA GABAergic transmission in NOV females. This paradigm promotes key features of PTSD, including hyperarousal, fear generalization, avoidance, and sleep disturbance, with comorbid ethanol intake, in a sex-specific fashion that approximates clinical comorbidities better than existing models, and identifies increased CeA GABAergic signaling and a distinct pro-hematopoietic, proinflammatory, and pro-atopic cytokine profile that may aid in treatment.