Individuals exposed to interpersonal trauma or accidental trauma can suffer from anxiety and stress-related mental disorders following the event. Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder, which affects nearly 7.8-9.2% of the American population (Hruska & Delahanty, 2012). Substance use disorder (SUD) is the most common mental health disorder associated with individuals suffering from PTSD. Alcohol-use disorder (AUD) is particularly apparent among 52% men and 28% of females suffering from PTSD. The self-meditation hypothesis explains the relationship between alcohol use and PTSD (Hruska & Delahanty, 2012). According to this hypothesis, individuals suffering from PTSD consume alcohol in order to relieve the psychological distress associated with PSTD. Research suggests that co-occurring PTSD symptoms with substance misuse are particularly significant in college students as compared to adults and adolescents (Valenstein-Mah, et al., 2019). This suggests that college students are more vulnerable to PTSD and AUD as compared to the general population. The relationship between alcoholism, stress, and PTSD in post-secondary students can be identified through assessment and treatment of PTSD symptoms and anxiety sensitivity as a result of trauma exposure.
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In order to understand the relationship between alcoholism, stress, and PTSD, it is important to identify the kinds of stressful events which cause stress and PTSD. PTSD is particularly apparent in college students as compared to the general population due to greater exposure to traumatic events (Borsari, Yalch, Pedrelli, Radomski, & L., 2018). Likewise, it is important to identify the symptoms of PTSD and comprehend the establishment of alcohol abuse through PTSD. Furthermore, this phenomenon impacts male and females differently, therefore, it is necessary to distinguish their effects, influences, and treatments. The treatment of alcohol abuse in college students is associated with the assessment and treatment of stress-related mental disorders and PTSD.
History of interpersonal and accidental trauma events can act as an impetus towards the development of stress-related mental health disorders. Research indicates that college students consume a greater amount of alcohol as compared to the general public (Kaysen, et al., 2014). This drinking pattern is heavily associated with negative consequences, such as sexual assault, rape, re-victimization of past abuse. Although, the literature of PTSD has not yet clarified the definition of a traumatic event, however, it is essential in identification of PTSD symptoms (Read, Ouimette, White, Colder, & Farrow, 2011). An interpersonal traumatic experience may include sexual assault, child abuse, or rape. Approximately 25% of college students report a history of childhood physical and sexual abuse (Kaysen, et al., 2014). Furthermore, nearly 25% of the female college students report having experienced rape or attempted rape (Kaysen, et al., 2014). There exists a strong relationship between trauma exposure, stress, and alcohol misuse in post-secondary students. Student veterans are at higher risk of developing PSTD due to serious physical, emotional, and psychological issues (Rudd, Goulding, & Craig J, 2011). Research suggests that nearly 70%-80% of college students are categorized as ‘moderately stressed’, while 10%-15% are identified as ‘severely stressed’ (Russell, Almeida, & Maggs, 2017). College students consume alcohol as a means to relieve stress increasing their risks to traumatic events, which can lead to PTSD.
A research study, conducted at Virginia Commonwealth University, identified the relationship between mental health, PTSD symptoms, and alcohol abuse through a sample of 295 undergraduate students. The participants were assessed through the Traumatic Life Events Questionnaire, PTSD Checklist for DSM-5, and Anxiety Sensitivity Index-3 to identify potentially traumatic events (PTE), PTSD symptoms, and anxiety sensitivity. The study concluded that individuals with interpersonal trauma experienced clinical and sub-clinical symptoms of PTSD (Erin C. Berenz, et al., 2016). Furthermore, PTSD symptoms increase motivation for alcohol use as coping mechanisms.
In western society, the transition from adolescent to adult life is significantly stressful, particularly for college students. Post-secondary students struggle to develop their individual identity through the accomplishment of salient and emerging development tasks (Russell, Almeida, & Maggs, 2017). Social responsibilities, such as friendship, romantic relationships, academic, and occupational lives create diverse and stressful challenges for college students. College students are expected to balance academic and career lives along with social relationships and family demands (Russell, Almeida, & Maggs, 2017). Achieving balance along with these conflicting priorities can create stressful conditions.
College students consume alcohol as a means to cope with or respond to stressful conditions. According to tension-reduction theory, alcohol reduces stress in most situations intriguing individuals to increase drinking in stressful situations (Russell, Almeida, & Maggs, 2017). This leads to the development of alcohol problems, which results in additional stress, potentially fostering a psychological dependence on alcohol. It is evident that individuals with a history of traumatic events are more inclined towards developing an alcohol problem due to increased mental stress.
A research study was conducted at Kent State University to understand the correlation between PTSD symptoms and alcohol abuse problems in undergraduate students. For the purpose of this study, the stressor vulnerability model was utilized. The study was based on self-report instruments assessing the extent of PTSD symptoms, alcohol misuse, and avoidance coping in undergraduate students (Hruska & Delahanty, 2012). According to the research, individuals who have experienced a recent interpersonal traumatic event are more likely to develop alcohol problems. Furthermore, it indicated that men with PTSD symptoms were more inclined towards AUD (Hruska & Delahanty, 2012). Therefore, the relationship between PTSD symptoms and alcohol misuse was stronger for males as compared to females.
Every student is not at equal risk to trauma exposure and the development of PTSD. Various studies indicate that although men at considerable risks to trauma exposure, however, women consistently report more sexual assault and interpersonal violence as compared to men (Read, Ouimette, White, Colder, & Farrow, 2011). Another research study was conducted at the University of Washington with 172 female undergraduate students to analyze the impact of daily stress factors on PTSD symptoms and alcohol problems. The study was based on premonitory and daily monitoring assessment of the measures of PTSD, alcohol consumption, trauma exposure, and affect. According to the study, mere trauma exposure and PTSD symptoms are not predicting factors of alcohol abuse in female students (Kaysen, et al., 2014). However, the study identified a significant impact of daily fluctuation in PTSD symptoms on alcohol misuse. The study identified the need for mental health practitioners to identify daily fluctuations in the PTSD symptoms and behaviours to establish effective treatment plans.
Since PTSD symptoms and AUD impact male and female individuals differently, different interventions are needed to tackle the problem. A college campus-based study identified the impact of group interventions on the reduction of alcohol misuse among male individuals (LaBrie, Pedersen, Lamb, & Quinlan, 2007). The study suggested that group intervention benefitted the students more as compared to individual treatment strategies (LaBrie, Pedersen, Lamb, & Quinlan, 2007). Furthermore, individuals who participated in group interventions were less likely to commit alcohol-based violation on campus. Another study conducted at a large metropolitan university in the southern United States including ethnically and racially diverse samples of male and female individuals (Monahan, et al., 2013). The study was based on self-report questionnaires and motivational interviewing (MI) intervention model. The study identified the role of gender, age, ethnicity, and trauma exposure screening in the development of effective group interventions (Monahan, et al., 2013). Furthermore, the study indicated that individuals showed better response in MI interventions as compared to computerized interventions.
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The existing literature has indicated a strong relationship between trauma exposure and drinking problems. However, the correlation between PTSD and drinking is mixed and conflicting (Kaysen, et al., 2014). Despite the lack of significant research, the majority of the studies indicated an obvious relationship between PTSD symptoms and drinking problems. However, the extent of PTSD symptoms in drinking behaviour is unknown (Kaysen, et al., 2014). Future research is required to identify the exact relationship and extent of the impact of PTSD symptoms on alcohol misuse.
Significant limitations were identified in the existing literature data. Although the available literature identified an evident relationship between PTSD symptoms and alcohol misuse in college students, however, it does not analyze the variables responsible for stimulating alcohol misuse (Hruska & Delahanty, 2012). The study recognizes the use of alcohol as a means to cope with the negative symptoms of alcohol. However, it may be noted that not every individual with PTSD has alcohol drinking problems. Therefore, further research is required to recognize factors which lead individuals with PTSD to develop drinking problems. Furthermore, a comparative analysis between the impact of PTSD on the drinking behaviour of male and females is required to recognize their differences. Lastly, vulnerability factors need to be identified which influences AUD among individuals suffering from PTSD.
The researches include a diverse and heterogeneous sample of college students, which can be elevated to constitute data for the general population. Majority of the researches used self-report data methodology. For this reason, it is impossible to indicate whether accurate levels of alcohol consumptions and PTSD symptoms were provided by the participants (LaBrie, Pedersen, Lamb, & Quinlan, 2007). Lastly, further research is required to establish effective intervention, awareness programs, and treatment policies to inspect and treat individuals with PTSD and AUD. For this purpose, specific motivation variables for coping-oriented alcohol use in individuals with PTSD need to be identified in future studies.
Majority of the reviewed research analyzed the relationship between PTSD and alcohol misuse among college students. Furthermore, the impact of PTSD symptoms on the drinking problems is studied. The research indicated a clear relationship between traumatic events and the development of PTSD symptoms. Furthermore, it indicated that interpersonal traumas were more likely to lead to the development of PTSD among college students. In addition to that, the study recognized a direct relationship between stress and alcohol consumption based on self-meditation theory. Differences in the relationship between stress, alcohol, and PTSD in males and females were identified to order to develop effective treatment and intervention opportunities. The research indicated that PTSD symptoms were directly proportional to drinking problems in college students. Lastly, the impact of group intervention and motivational interviewing on alcohol misuse among college students was studied.
- Borsari, B., Yalch, M. M., Pedrelli, P., Radomski, S., & L., R. (2018). Associations among trauma, depression, and alcohol use profiles and treatment motivation and engagement in college students. Journal of American College Health. doi:https://doi.org/10.1080/07448481.2018.1446438
- Erin C. Berenz, P., Salpi Kevorkian, B., Nadia Chowdhury, B., Ph.D., D. M., Kenneth S. Kendler, M., & Ananda B. Amstadter, P. (2016). Posttraumatic Stress Disorder Symptoms, Anxiety Sensitivity, and Alcohol Use Motives in College Students with a History of Interpersonal Trauma. Psychol Addict Behav, 30(7), 755–763. doi:10.1037/adb0000193
- Hruska, B., & Delahanty, D. L. (2012). Application of the Stressor Vulnerability Model to Understanding Posttraumatic Stress Disorder (PTSD) and Alcohol-Related Problems in an Undergraduate Population. Psychology of Addictive Behaviors, 26(4), 734–746. doi:10.1037/a0027584
- Kaysen, D., Atkins, D. C., Simpson, T. L., Stappenbeck, C. A., Blayney, J. A., Lee, C. M., & Larimer, M. E. (2014). Proximal Relationships Between PTSD Symptoms and Drinking Among Female College Students: Results From a Daily Monitoring Study. Psychology of Addictive Behaviors, 28(1), 62–73. doi:10.1037/a0033588
- LaBrie, J. W., Pedersen, E. R., Lamb, T. F., & Quinlan, T. (2007). A campus-based motivational enhancement group intervention reduces problematic drinking in freshmen male college students. Addictive Behaviors, 32, 889–901. doi:10.1016/j.addbeh.2006.06.030
- Monahan, C. J., McDevitt-Murphy, M. E., Dennhardt, A. A., Skidmore, J. R., Martens, M. P., & Murphy, J. G. (2013). The impact of elevated posttraumatic stress on the efficacy of brief alcohol interventions for heavy drinking college students. Addictive Behaviors, 38, 1719–1725. Retrieved from http://dx.doi.org/10.1016/j.addbeh.2012.09.004
- Read, J. P., Ouimette, P., White, J., Colder, C., & Farrow, S. (2011). Rates of DSM–IV–TR Trauma Exposure and Posttraumatic Stress Disorder Among Newly Matriculated College Students. Psychol Trauma, 3(2), 148–156. doi:10.1037/a0021260
- Rudd, M. D., Goulding, J., & Craig J, B. (2011). Student Veterans: A National Survey Exploring Psychological Symptoms and Suicide Risk. Professional Psychology: Research and Practice, 42(5), 354-360. doi:10.1037/a0025164
- Russell, M. A., Almeida, D. M., & Maggs, J. L. (2017). Stressor-Related Drinking and Future Alcohol Problems among University Students. Psychol Addict Behav, 676–687. doi:10.1037/adb0000303
- Valenstein-Mah, H., Simpson, T. L., Bowen, S., Enkema, M. C., Bird, E. R., Cho, H. I., & Larimer, M. E. (2019). Feasibility Pilot of a Brief Mindfulness Intervention for College Students. Mindfulness, 10, 1255–1268. Retrieved from https://doi.org/10.1007/s12671-018-1077-y
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