Impulsivity interacts with momentary PTSD symptom worsening to predict alcohol use in male veterans
Open accessAbstract
BACKGROUND: Posttraumatic stress disorder (PTSD) is prevalent among veterans who served post-9/11, and co-occurs with problem alcohol and substance use. Studies using ecological momentary assessment have examined the temporal association between time-varying PTSD symptoms and alcohol use. Results suggest individual differences in these associations. OBJECTIVES: We tested hypotheses that alcohol use measured by momentary assessment would be explained by acute increases in PTSD symptoms, and the PTSD-alcohol association would be moderated by trait impulsivity. METHODS: A sample of 28 male post-9/11-era veterans who reported past-month PTSD symptoms and risky alcohol use were enrolled. On a quasi-random schedule, participants completed three electronic assessments daily for 28 days measuring past 2-h PTSD symptoms, alcohol, and substance use. At baseline, trait impulsivity was measured by the Barratt Impulsiveness Scale. Past-month PTSD symptoms and alcohol use were measured. Using three-level hierarchical models, number of drinks recorded by momentary assessment was modeled as a function of change in PTSD symptoms since last assessment, controlling for lag-1 alcohol and substance use and other covariates. A cross-level interaction tested moderation of the within-time PTSD-alcohol association by impulsivity. RESULTS: A total of 1,522 assessments were completed. A positive within-time association between PTSD symptom change and number of drinks was demonstrated. The association was significantly moderated by impulsivity. CONCLUSION: Results provide preliminary support for a unique temporal relationship between acute PTSD symptom change and alcohol use among veterans with trait impulsiveness. If replicated in a clinical sample, results may have implications for a targeted momentary intervention.
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Increased impulsivity is a significant moderator between PTSD and substance misuse.
“Other research has identified increased impulsivity as a significant moderator between PTSD and substance misuse (85, 86) as well as the role of negative urgency within this relationship (87).”
From A Biopsychosocial Overview of the Opioid Crisis: Considering Nutrition and Gastrointestinal Health (2019) · cites this paper as [85]
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- Authors
- Black, A. C., Cooney, N. L., Sartor, C. E., Arias, A. J., & Rosen, M. I.
- Affiliations
- United States Department of Veterans Affairs (US)
- Yale University (US)
- Corresponding author
- Black, Anne C.
- Venue
- The American Journal of Drug and Alcohol Abuse
- Publisher
- Informa UK Limited
- Published
- 2018-04-11
- Volume
- 44
- Issue
- 5
- Pages
- 524-531
- ISSN
- 0095-2990 (ISSN-L)
- 1097-9891
- PMC
- PMC6172135
- OpenAlex
- W2797123078
- Cited by
- 31
- References
- 29
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 4 · 2023: 6 · 2021: 4 · 2020: 5 · 2019: 3 · 2018: 2
- FWCI
- 4.10
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The American Journal of Drug and Alcohol Abuse (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (R21 DA039038)
- U.S. Department of Veterans Affairs (CIN 13-407, V1CDA2014-27, VISN 1 MIRECC)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- post-traumatic stress disorder, impulsivity, alcohol consumption, veterans, moderation, ecological momentary assessment, hazardous drinking, substance use, post-9/11 veterans, temporal association
- MeSH terms
- Ecological Momentary Assessment, Adult, Alcohol Drinking, Humans, Impulsive Behavior, Male, Models, Theoretical, Pilot Projects, Stress Disorders, Post-Traumatic, Veterans, Substance-Related Disorders, Self Report
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