Posttraumatic stress hyperarousal symptoms mediate the relationship between childhood exposure to violence and subsequent alcohol misuse in Mi'kmaq youth

Abstract

This study was part of a school-based collaborative research project with a Canadian Mi'kmaq community that examined the potential role of posttraumatic stress (PTS) symptom clusters in mediating the relationship between childhood exposure to violence (EV) and alcohol misuse in a sample of Mi'kmaq adolescents (N = 166). The study employed a cross-sectional design and used several well-validated self-report questionnaires. Path analytic results showed that when each PTS symptom cluster was independently investigated for mediating effects while controlling for depressive symptoms, age, and gender, only the PTS hyperarousal symptom cluster fully mediated the EV-alcohol misuse relationship. Results are discussed within the context of previous theory and research on the topic of PTS as a mediator between EV and alcohol misuse.

Posttraumatic Stress Symptoms and Coping Motives Mediate the Association Between Childhood Maltreatment and Alcohol Problems

“…Contrary to previous research, neither PTSS nor coping motives mediated the association between childhood trauma and alcohol problems as single mediators (Hannan et al, 2017;Goldstein et al, 2010;Grayson & Nolen-Hoeksema, 2005;White & Widom, 2008;Zahradnik et al, 2011). Our findings point to the importance of considering both PTSS and coping motives, in sequence, in understanding the link between childhood maltreatment and alcohol misuse, at least in this population.…”

“…Our study used a broad measure of childhood maltreatment, whereas previous studies have examined specific facets of childhood maltreatment, such as exposure to violence or sexual abuse (Grayson & Nolen-Hoeksema, 2005;Hannan et al, 2017;Zahradnik et al, 2011). Similarly, previous research has shown that specific PTSS clusters, such as hyperarousal, avoidance and numbing, and/or reexperiencing symptoms may be most strongly associated with alcohol misuse (Scott et al, 2003;Sullivan & Holt, 2008;Zahradnik et al, 2011). Future research should thus explore our serial mediation model in relation to different forms of child maltreatment and different PTSS clusters.…”

“…The self-medication hypothesis (SMH) proposes that individuals who experience distressing symptoms of an emotional disorder, such as PTSS, may use the effects of substances like alcohol to reduce and manage their distressing symptoms (Khantzian, 1997). Individuals with a history of traumatic experiences may use the arousal-dampening effect of alcohol to relieve hyperarousal symptoms (Read et al, 2012;Sullivan & Holt, 2008;Zahradnik, Stewart, Sherry, Stevens, & Wekerle, 2011), the affective numbing properties of alcohol to avoid distressing feelings (McDevitt-Murphy, Murphy, Monohan, Flood, & Weathers, 2010;Scott et al, 2013), or the impairing effect alcohol can have on memory retrieval to avoid reexperiencing trauma through intrusive memories (Stewart, Mitchell, Wright, & Loba, 2004;Sullivan & Holt, 2008).…”

Direct and Indirect Effects of Cumulative Trauma, PTSD, and Substance Use Disorder on Probability of Arrest Among Lower Income African American and Latina Women

“…In this sample, exposure to increasing numbers of traumas contributed to greater odds of arrest, as much as 62% for each additional trauma exposure. Cumulative trauma exposure is associated with a wide range of psychological reactions including PTSD (Breslau, 2009), SUD (Khantzian, 1997; Mills et al, 2006; Stewart et al, 1998), depression (Breslau, 2009), and a multitude of associated deficits in emotional and interpersonal regulation (Barrett et al, 2014; Calhoun et al, 2005; Weiss et al, 2012; Zahradnik et al, 2011), which collectively may contribute to behaviors that confer greater risk for criminal justice involvement. Agnew and colleagues proposed that traumas are strain inducing because of their high intensity and the perceived injustice of the acts (Agnew, 2006, 2012; Hay & Evans, 2006).…”

“…Indeed, PTSD is often seen as a disorder of chronic emotion dysregulation in which the individual fluctuates between intense hyperaroused states and emotional numbing/dissociation (Frewen & Lanius, 2006). Symptoms of hyperarousal may contribute to increased anger, hostility, violent or aggressive behaviors toward self and others (Barrett, Teesson, & Mills, 2014), and substance abuse (Zahradnik, Stewart, Sherry, Stevens, & Wekerle, 2011), all of which may increase one’s risk for contact with the criminal justice system. In a compounding manner, acute substance use may exacerbate psychological symptoms and disinhibit behavioral controls, leading to an increased likelihood of antisocial behavior and violence (Ogloff, Talevski, Lemphers, Wood, & Simmons, 2015).…”