The moderating roles of emotion regulation and coping self-efficacy on the association between PTSD symptom severity and drug use among female sexual assault survivors.

Abstract

Objective: Posttraumatic stress disorder (PTSD) and substance use disorders are a significant comorbid concern among sexual assault survivors. Thus, underlying risk and protective factors are critical to investigate in understanding how to prevent this comorbidity. Method: The current study assessed potential moderating effects of coping self-efficacy (CSE) and emotion dysregulation on the association between sexual assault-related PTSD symptom severity and drug use severity in a sample of college women. In this study, 518 female undergraduate students completed self-report measures of nonconsensual sexual experiences, PTSD symptoms, CSE, emotion dysregulation, and drug use severity. Results: Of these participants, 287 women reported at least 1 incident of attempted or completed rape. We found evidence of a significant moderation effect, suggesting that high levels of CSE and low levels of emotion dysregulation reduce the likelihood of drug use issues for female sexual assault survivors. Conclusions: These findings suggest that assessment tools, interventions, and trauma-related policies should target CSE and emotion dysregulation in attenuating the risk of drug use for women with assault-related PTSD symptoms. Clinical Impact StatementCollege women are at high risk for sexual violence, a public health crisis which is strongly associated with numerous adverse health outcomes. This study is the first evaluation of the conditional effect of PTSD symptom severity on drug use severity contingent upon the influence of both coping self-efficacy and emotion regulation among a sample of women with a history of rape experiences. These findings provide clear clinical implications for informed assessment and intervention practices for mental health providers, including more comprehensive and tailored interventions to reduce the likelihood of drug use issues for women.

Using a transdiagnostic approach to examine the associations among internalizing symptoms, emotion regulation, and distress tolerance

“…The absence of significant interaction effects suggests that contrary to our expectations, one’s ability to regulate emotions did not influence the relationship between these specific internalizing symptoms and trait DT. While previous work has identified ER ability as a moderator between these specific disorders and various associated outcomes (e.g., Kim & Kwon, 2020; Mahoney et al, 2022; Mikonowicz & Tull, 2023), present findings suggest that this interaction may not extend to perceived capacity to tolerate stress as an outcome. It is important to consider that the findings pertaining to OCD and PTSD may have been influenced by the average symptom severity scores falling below the threshold for clinical diagnosis according to the respective scales (see Table 1).…”

A pilot test of Written Exposure Therapy for PTSD in residential substance use treatment

“…Improvements in trauma‐coping self‐efficacy and emotion regulation are consistent with prior findings indicating that these outcomes improve following exposure therapy among individuals with PTSD‐SUD 20,33,34 . Improvements in recovery capital scores suggest that participants felt more positively about SUD recovery post‐WET 35 .…”

“…These findings are consistent with published reports indicating that PTSD can be treated concurrently with SUD and that exposure-based interventions are most effective 6,7,11 Improvements in trauma-coping self-efficacy and emotion regulation are consistent with prior findings indicating that these outcomes improve following exposure therapy among individuals with PTSD-SUD. 20,33,34 Improvements in recovery capital scores suggest that participants felt more positively about SUD recovery post-WET. 35 Overall, results suggest that WET is associated with improvements in mental health indicators important to PTSD-SUD recovery, in addition to PTSD symptom reduction.…”

“…We chose to assess emotion regulation and posttraumatic coping self-efficacy because evidence suggests that these constructs are associated with substance use following traumatic event exposure. 20 The study design and resources precluded the inclusion of a postdischarge follow-up to assess relapse. Therefore, we assessed substance use recovery capital instead, which has been shown to predict substance use remission.…”

“…We assessed (1) the feasibility and acceptability of implementing WET in residential SUD treatment, based on recruitment, retention, and patient attitudes and (2) changes in PTSD symptoms and other mental health indicators (emotion regulation and posttraumatic coping self‐efficacy). We chose to assess emotion regulation and posttraumatic coping self‐efficacy because evidence suggests that these constructs are associated with substance use following traumatic event exposure 20 . The study design and resources precluded the inclusion of a postdischarge follow‐up to assess relapse.…”