Posttraumatic Stress Disorder Symptoms Mediate the Relationship Between Traumatic Experiences and Drinking Behavior Among Women Attending Alcohol Serving Venues in a South African Township
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OBJECTIVE: South Africa has high rates of traumatic experiences and alcohol abuse or dependence, especially among women. Traumatic experiences often result in symptoms of posttraumatic stress disorder (PTSD), and PTSD has been associated with hazardous drinking. This article examines the relationship between traumatic events and hazardous drinking among women who patronized alcohol-serving venues in South Africa and examines PTSD as a mediator of this relationship. METHOD: A total of 560 women were recruited from a Cape Town township. They completed a computerized assessment that included alcohol consumption, history of traumatic events, and PTSD symptoms. Mediation analysis examined whether PTSD symptoms mediated the relationship between the number of traumatic event categories experienced (range: 0-7) and drinking behavior. RESULTS: The mean Alcohol Use Disorders Identification Test score in the sample was 12.15 (range: 0-34, SD = 7.3), with 70.9% reaching criteria for hazardous drinking (AUDIT > 8). The mean PTSD score was 36.32 (range: 17-85, SD = 16.3),with 20.9% meeting symptom criteria for PTSD (PTSD Checklist with 20.9% meeting symptom criteria for PTSD (PTSD Checklist-Civilian Version ≥ 50). Endorsement of traumatic experiences was high, including adult emotional (51.8%), physical (49.6%), and sexual (26.3%) abuse; childhood physical (35.0%) and sexual (25.9%) abuse; and other types of trauma (83%). All categories of traumatic experiences, except the "other" category, were associated with hazardous drinking. PTSD symptoms mediated 46% of the relationship between the number of traumatic categories experienced and drinking behavior. CONCLUSIONS: Women reported high rates of hazardous drinking and high levels of PTSD symptoms, and most had some history of traumatic events. There was a strong relationship between traumatic exposure and drinking levels, which was largely mediated by PTSD symptoms. Substance use interventions should address histories of trauma in this population, where alcohol may be used in part to cope with past traumas.
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PTSS have been found to mediate the effects of violence exposure on substance abuse.
“PTSS have been found to mediate the effects of violence exposure on aggression (Allwood & Bell, 2008), violence (Jones et al., 2020), delinquent behaviors (Ruchkin et al., 2002), and substance abuse (Watt et al., 2012).”
From Childhood Physical Abuse and Antisocial Traits: Mediating Role of Posttraumatic Stress Symptom Clusters (2022) · cites this paper as Watt et al., 2012
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References 66 · Cited by 37
- Authors
- Watt, M. H., Ranby, K. W., Meade, C. S., Sikkema, K. J., MacFarlane, J. C., Skinner, D., Pieterse, D., & Kalichman, S. C.
- Affiliations
- Duke University (US)
- Stellenbosch University (ZA)
- Research on Health and Society, University of Stellenbosch, South Africa
- University of Connecticut (US)
- ORCID
- Venue
- Journal of Studies on Alcohol and Drugs
- Publisher
- Alcohol Research Documentation, Inc.
- Published
- 2012-07
- Volume
- 73
- Issue
- 4
- Pages
- 549-558
- ISSN
- 1937-1888 (ISSN-L)
- 1938-4114
- PMC
- PMC3364321
- OpenAlex
- W1975164527
- Cited by
- 37
- References
- 66
- Citations by year
- 2026: 1 · 2025: 1 · 2023: 3 · 2022: 1 · 2021: 3 · 2020: 2 · 2019: 1 · 2018: 4 · 2017: 1 · 2016: 4 · 2015: 2 · 2014: 10 · 2013: 4
- FWCI
- 5.80
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of Studies on Alcohol and Drugs (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- SUNScholar (Stellenbosch University) (submittedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01AA018074)
- National Institute on Drug Abuse (K23DA028660)
- National Institute of Allergy and Infectious Diseases (P30AI064518)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Keywords
- post-traumatic stress disorder, traumatic events, hazardous drinking, women, mediation, childhood abuse, sexual abuse, physical abuse, township population, coping with trauma
- MeSH terms
- Adolescent, Adult, Aged, Alcohol Drinking, Alcoholic Beverages, Alcoholism, Cross-Sectional Studies, Female, Food Services, Humans, Middle Aged, Severity of Illness Index, Sex Offenses, South Africa, Stress Disorders, Post-Traumatic, Stress, Psychological, Violence, Wounds and Injuries, Cohort Studies, Prevalence, Suburban Health, Young Adult
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