Alcohol Abuse in Subjects Developing or not Developing Posttraumatic Stress Disorder after Trauma Exposure

Abstract

Background and Objectives: The complex relation between trauma and alcohol abuse is still far to be recognized. Traumatic experiences<br /> can prompt and facilitate an excessive use of alcohol. On the other hand, alcohol use may increase the possibility to be involved in traumatic<br /> events or reduce post‑trauma resilience. This study aimed to explore alcohol use and abuse in a sample of traumatized participants, with or<br /> without posttraumatic stress disorder (PTSD). Methods: Thirty‑five outpatients with a Diagnostic and Statistical Manual of Mental Disorders,<br /> Fourth Edition, Text Revision (DSM‑IV‑TR) diagnosis of PTSD and 35 outpatients with trauma exposure who did not develop PTSD were<br /> recruited. The clinical assessment of the participants comprised the following scales: The Structured Clinical Interview for DSM‑IV, the<br /> Clinician‑Administered PTSD Scale, and the Alcohol Use Disorders Identification Test (AUDIT). Results: Correlation analysis conducted<br /> on all participants showed a significant positive correlation between the AUDIT score and trauma load. When considering the two groups<br /> separately, the same correlation reached statistical significance in the PTSD group only. Analysis of beta‑coefficients of regressions confirmed<br /> a significant influence of trauma load on the AUDIT score. Conclusion: A greater use of alcohol significantly correlated with trauma load<br /> only in the PTSD group. This data indicates that trauma itself is not sufficient to determine drinking problems, whereas PTSD symptoms may<br /> lead to alcohol use. A circular relation, rather than a linear one, can therefore be considered when traumatic experiences and alcohol use are<br /> taken into account. Specifically, traumatic experiences could cause the PTSD development, which could, in turn, lead to alcohol use or abuse<br /> as a self‑medication. Such outcome could develop in alcohol use disorder that, circularly, enhances the risk of traumatic experiences. Hence,<br /> in the clinical evaluation of PTSD patients, a deep investigation of drinking patterns is highly recommended.