The development and initial validation of the Trauma-Related Alcohol Use Coping Measure (TRAC).

Abstract

Objective: Posttraumatic stress disorder (PTSD) symptoms and alcohol use commonly co-occur and present a prevalent clinical comorbidity. The self-medication/coping model has been applied most consistently to understand the PTSD-alcohol use association. However, there is a relative paucity of self-report measures designed to assess motivations for alcohol use, specifically for coping with PTSD symptoms. The goals of the present study were to develop and validate a measure that assesses the use of alcohol to cope with specific facets of PTSD symptomatology across two independent samples. Method: Two samples were evaluated: a universitybased sample (N = 617; 77.0% women; M age = 22.3; SD = 5.20) composed of racially diverse trauma-exposed students and a nationally representative sample (N = 510; 52.5% women; M age = 39.5; SD = 10.9) of traumaexposed adults who endorsed PTSD symptoms and past-year hazardous drinking. Both samples completed identical online questionnaire batteries. A Trauma-Related Alcohol Use Coping (TRAC) measure was developed and validated across both samples. Results: Confirmatory factor analysis was used to support the latent, hierarchical structure of the TRAC measure (total score; coping with intrusion, avoidance, negative alterations in cognitions and mood, and arousal/reactivity symptoms) and supported an 18-item version of the TRAC measure (university-based sample [N = 617]: RMSEA = 0.047, 90% CI [.04, .05]; SRMR = 0.043; CFI = 0.95; TLI = 0.95; nationally representative sample [N = 510]: RMSEA = 0.045, 90% CI [.04, .05]; SRMR = 0.021; CFI = 0.98; TLI = 0.97). The TRAC measure demonstrated excellent internal consistency, convergent, and discriminant validity with well-established measures of mental health, known-groups validity, and incremental validity relative to non-PTSD coping-motivated drinking. Conclusions: Overall, the TRAC measure can be used to assess the extent to which alcohol use is related to coping with PTSD symptoms. Public Health Significance StatementThis study highlights the development of a measure that assesses the use of alcohol to cope with specific facets of posttraumatic stress disorder symptomatology. The measure evinced strong psychometric properties, including internal consistency, convergent and discriminant validity, known-groups validity, and incremental validity, and provided both research and clinical utility.