Associations of Subjective and Objective Stress Responses With Interpersonal Trauma, PTSD, Stress-Induced Drinking, and Drinking to Cope in Young Adults

Objective: To understand how interpersonal trauma (IPT), stress response, and drinking to cope converge to predict stress-induced drinking, a risk factor for alcohol use disorder. Method: Young adults with no substance use disorder were classified into three trauma history groups: (a) IPT with PTSD (n = 27), (b) IPT without PTSD (n = 35), and (c) Control (no trauma-history/no PTSD; n = 36). Participants completed a baseline assessment, including a structured clinical interview, to confirm PTSD diagnosis, followed by the Trier Social Stressor Task (TSST) and an alcohol use task. Subjective units of distress and blood serum cortisol were collected at standardized timepoints throughout the tasks. Results: In all three groups (PTSD, IPT, control), males consumed more alcohol in the lab than females. Participants in the PTSD group had significantly higher drinking to cope motives, which were associated with greater subjective reactivity; however, neither drinking to cope motives nor subjective reactivity to the TSST predicted post-stressor alcohol consumption for those with PTSD. Conclusions: The interplay among trauma history, stress, and drinking among young adults is nuanced; additional lab-based studies are needed to further clarify the nuanced connection between trauma history, acute stress reactions, and alcohol use. Public Health Significance Statement People with varying trauma history may have differing levels of vulnerability to stress-induced drinking. Although it was expected that young adults with PTSD would be at the highest risk for engaging in stress-induced drinking, results suggest a more nuanced relation. For example, young adults with PTSD who report higher drinking to cope motives report higher subjective reactivity following an acute stressor; however, the relation between subjective distress, drinking motives, and drinking behavior in this population warrants more research. The nuances of trauma-specific stress response (e.g., trauma cues) should be carefully considered in future directions in this line of lab-based research with young adults with interpersonal trauma history with and without PTSD.