Posttraumatic Stress Disorder and Conduct Problems: The Role of Self‐Control Demands

Abstract

We tested within‐ and between‐person effects of posttraumatic stress disorder (PTSD) symptoms on conduct problems and alcohol intoxication via self‐control demands using multilevel structural equation modeling in a longitudinal burst‐design study of 251 U.S. veterans who participated in the recent wars in Iraq and Afghanistan. We theorized that experiencing PTSD symptoms engenders efforts to regulate mood, control thoughts, and inhibit or control behavior that is taxing to the individual (i.e., it places demands on self‐control) and hypothesized that this process results in subsequent deficits in regulatory control that manifest in heightened intoxication and conduct problems associated with PTSD. At the within‐person level, daytime PTSD symptoms, IRR = 1.09, and self‐control demands, IRR = 1.12, exhibited within‐person associations with nighttime conduct problems over and above nighttime intoxication. Consistent with our hypothesis, daytime increases in self‐control demands mediated the associations between daytime PTSD symptoms and subsequent nighttime conduct problems. The indirect effect between daytime PTSD symptoms and nighttime intoxication via self‐control demands was nonsignificant. At the between‐person level, self‐control demands mediated the associations between PTSD symptoms and conduct problems; however, the expected between‐person associations with intoxication were nonsignificant. Drinking behavior is related to but cannot fully account for various difficulties in psychosocial functioning associated with PTSD. The present results suggest that dysregulated behavior may, ironically, stem from individuals’ concerted efforts to control and manage overwhelming symptoms. Self‐control demands may be a common factor that accounts for a broad range of functional impairments associated with PTSD.

External validity of analogue sexual risk laboratory data.

“…Perceived intoxication from the morning assessments provides an overall subjective estimate of the previous night's level of intoxication accounting for individual differences in tolerance, food intake, etc. Validity of the approach is supported by expected associations with criterion variables in previous research (Maisto, Simons, Palfai, Moskal, & Luehring-Jones, 2021;Simons et al, 2016Simons et al, , 2021. There were two substantial outliers on the subject mean and these were recoded to one unit greater than the nearest outlying value (Tabachnik & Fidell, 2001).…”

Affective dependence, self-regulation, and alcohol problems: Between- and within-person associations.

“…Alcohol problems assessments included alcohol use disorder symptoms (American Psychiatric Association, 2013), high-risk drinking outcomes (J. S. Simons et al, 2014), and interpersonal and conduct problems (R. M. Simons et al, 2021).…”