Paper Search Console

Home Search Page Alphabetical List About Contact

Journal Title

Title of Journal: Curr Addict Rep

Search In Journal Title:

Abbravation: Current Addiction Reports

Search In Journal Abbravation:

Publisher

Springer International Publishing

Search In Publisher:

DOI

10.1007/s10639-015-9428-y

Search In DOI:

ISSN

2196-2952

Search In ISSN:
Search In Title Of Papers:

Associations among Trauma, Posttraumatic Stress, and Hazardous Drinking in College Students: Considerations for Intervention

Authors: Jennifer P. Read, Sharon Radomski, Brian Borsari,

Publish Date: 2015/02/03
Volume: 2, Issue:1, Pages: 58-67
PDF Link

Abstract

Students with trauma and posttraumatic stress are disproportionately at risk for heavy drinking and for alcohol-related consequences. Brief motivational interventions (BMIs) have been shown to reduce hazardous drinking in college students, and could serve as a first-line approach to reduce heavy drinking in students with trauma and posttraumatic stress (PTS). Yet the standard BMI format may not adequately address the factors that lead to hazardous drinking in these students. Here, we review the literature on PTS and hazardous drinking in college students, and highlight cognitive (self-efficacy, alcohol expectancies) and behavioral (coping strategies, emotion regulation skills, protective behaviors) factors that may link trauma and PTS to drinking risk. Incorporating these factors into standard BMIs in a collaborative way that enhances their personal relevance may enhance intervention efficacy and acceptability for these at-risk students.College students report rates of trauma and posttraumatic stress (PTS) comparable to those in community samples [1, 2, 3, 4]. Heavy drinking and associated consequences are widespread among college students [5, 6, 7]. Recent research indicates that students with trauma and, in particular, with PTS are at elevated risk for such problematic drinking patterns [8•, 9]. This is true not only for students with a diagnosable posttraumatic stress disorder, but for those experiencing sub-threshold clinical PTS symptoms as well. Interventions to reduce the hazardous drinking that disproportionately affects students with PTS are needed. Brief motivational interventions (BMIs) have strong empirical support for successfully reducing problem drinking in college students [10, 11] and thus may offer promise in targeting drinking risk in students with PTS. Typically, BMIs administered in the college context consist of one to two individual meetings that are approximately 50 min long [10]. These interventions use motivational interviewing as the counseling approach, and often include personalized feedback to promote less risky drinking.Yet, this standard BMI content may not adequately address some of the unique factors that contribute to hazardous drinking in students with trauma and posttraumatic stress. Recent work [12•] has successfully used brief intervention to reduce problem drinking in veterans with posttraumatic stress by targeting factors that may be most relevant to their experiences and symptoms. Similar approaches may be beneficial in college settings. In this article, we review the association between trauma and posttraumatic stress and alcohol involvement in college students. We then suggest several promising, theoretically based modifications that might be incorporated into BMIs designed to reduce risk drinking in this high-risk population.Heavy drinking and its consequences are a widespread and well-known problem on college campuses [5, 6]. Such drinking can lead acutely to a number of significant and deleterious outcomes, including sexually transmitted diseases, vehicular accidents, and even death [5, 7, 13]. Further, those students whose drinking patterns persist are at risk for greater alcohol problems later in adulthood [14]. Not all college students are equally likely to engage in heavy drinking or to experience harmful alcohol consequences. A growing literature indicates that trauma exposure and associated posttraumatic stress are among the factors that may portend risk for problematic alcohol consumption in college students.Approximately two out of three college students report trauma exposure [1, 2], a percentage consistent with rates reported in the general community [15]. The types of traumas that students report are significant by any standard. Sexual victimization is particularly common in this population [16, 17], but other types of traumatic events typically reported include the sudden death of a loved one, non-sexual assault, natural disasters, and motor vehicle accidents [2, 18, 19, 20]. High rates of combat trauma and alcohol use have been reported in student service members/veterans pursuing higher education under the GI-bill [21]. For some, trauma exposure can lead to symptoms of posttraumatic stress disorder (PTSD), a disorder characterized by traumatic intrusions, avoidance of trauma stimuli, alterations in mood and cognition, and hyper-arousal/reactivity [22, 23]. These symptoms are best understood as occurring along a spectrum of severity, rather than as a categorical symptom state [24, 25, 26, 27, 28]. As such, even symptom presentations that fall below conventional diagnostic cutoffs may be associated with significant distress and functional impairment [8•, 29, 30, 31, 32]. Consistent with community prevalence rates [15], an estimated 8–9 % of college students meet the diagnostic criteria for PTSD [2, 3, 33], and an even larger number (15–30 %) show evidence of clinically significant but sub-diagnostic threshold posttraumatic stress symptoms [2]. In the present paper, we consider this broad range of clinically significant symptoms, which we refer to as posttraumatic stress, or PTS.Traumatic life events and the range of stress responses to them long have been linked to problem drinking in clinical samples [34], and an emerging literature has demonstrated this link to occur in college students as well [35]. In just the past few years, data have emerged to show that college students with trauma exposure and PTS drink more and experience worse consequences than those without PTS [8•, 9, 36, 37, 38]. Importantly, the literature points to PTSD symptoms specifically—and not just having been exposed to trauma—as being most clearly associated with hazardous drinking [e.g., 8•]. Below, we review a sampling of this literature.Studies examining concurrent relations between trauma and PTS and alcohol involvement in college samples find that trauma and PTS are associated with greater problematic drinking [8•, 38, 39, 40, 41, 42]. Convergent with these findings are recent data that show students with PTSD place a greater value (demand) on alcohol than students without these symptoms, suggesting that alcohol may be especially salient and appealing to those struggling with PTSD [43]. Work conducted in our own lab also demonstrates significant risk for problem drinking among students with PTS [Radomski and Read, manuscript under review]. Specifically, those categorized through a structured diagnostic interview as having clinically significant PTS (N = 113; M = 6.58) report approximately 25 % more alcohol problems over the 30 days than those with trauma exposure but no PTS (N = 172; M = 9.22), and 50 % more than those with no trauma exposure at all (N = 182; M = 14.38).


Keywords:

References


.
Search In Abstract Of Papers:
Other Papers In This Journal:


Search Result:



Help video to use 'Paper Search Console'