Abstract
The objective of the present study was to examine how symptoms of posttraumatic stress disorder (PTSD) may confer drinking risk as students with trauma histories complete college and move toward independent adulthood. Students (N = 283) completed assessments of trauma, posttraumatic stress, and alcohol use and consequences at four time points during the year following their fourth year of college. Some students had transitioned out of the college environment, whereas others had not. We examined how transition status moderated within-person associations between changes in PTSD and corresponding changes in alcohol outcomes over time. Using multilevel modeling, we examined differences in within-person PTSD-alcohol associations comparing students who were (1) continuing as fifth-year seniors, (2) graduated and pursuing graduate education, and (3) graduated and left the university setting. Alcohol use and consequences tended to decline on average from the fourth to fifth year post-matriculation. Yet, within-person increases in posttraumatic stress symptomatology across the fifth year were associated with greater alcohol consequences, but only for those students who had left the university setting. These data suggest that the transition out of college may be an important developmental context that is associated with increased vulnerability for negative consequences from stress-related drinking. Findings may have important implications for campus-based prevention efforts geared toward the facilitation of a successful transition into independent adulthood.
Similar content being viewed by others
References
Aiken, L. S., West, S. G., & Reno, R. R. (1991). Multiple regression: Testing and interpreting interactions. Sage Publications.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., Text Revised). Washington: Author.
Armour, C., Tsai, J., Durham, T. A., Charak, R., Biehn, T. L., Elhai, J. D., & Pietrzak, R. H. (2015). Dimensional structure of DSM-5 posttraumatic stress symptoms: Support for a hybrid Anhedonia and Externalizing Behaviors model. Journal of Psychiatric Research, 61, 106–113.
Arnett, J. J. (2000). Emerging adulthood: A theory of development from the late teens through the twenties. American Psychologist, 55, 469–480.
Arnett, J. J. (2005). The developmental context of substance use in emerging adulthood. Journal of Drug Issues, 42, 235–253.
Bailey, K. M., & Stewart, S. H. (2014). Relations among trauma, PTSD, and substance misuse: The scope of the problem. In P. Ouimette & J. P. Read (Eds.), Trauma and substance abuse: Causes, consequences, and treatment of comorbid disorders (2nd ed., pp. 11–34). Washington: American Psychological Association.
Barnett, N. P., Clerkin, E. M., Wood, M., Monti, P. M., Tevyaw, T. O. L., Corriveau, D., et al. (2014). Description and predictors of positive and negative alcohol-related consequences in the first year of college. Journal of Studies on Alcohol and Drugs, 75, 103–114.
Beiter, R., Nash, R., McCrady, M., Rhoades, D., Linscomb, M., Clarahan, M., & Sammut, S. (2015). The prevalence and correlates of depression, anxiety, and stress in a sample of college students. Journal of Affective Disorders, 173, 90–96.
Bisby, J. A., Brewin, C. R., Leitz, J. R., & Curran, H. V. (2009). Acute effects of alcohol on the development of intrusive memories. Psychopharmacology, 204(4), 655–666.
Blanchard, E. B., Buckley, T. C., Hickling, E. J., & Taylor, A. E. (1998). Posttraumatic stress disorder and comorbid major depression: is the correlation an illusion? Journal of Anxiety Disorders, 12(1), 21–37.
Blanco, C., Okuda, M., Wright, C., Hasin, D. S., Grant, B. F., Liu, S. M., & Olfson, M. (2008). Mental health of college students and their non–college-attending peers: results from the national epidemiologic study on alcohol and related conditions. Archives of general psychiatry, 65(12), 1429–1437.
Borsari, B., Murphy, J. G., & Barnett, N. P. (2007). Predictors of alcohol use during the first year of college: Implications for prevention. Addictive Behaviors, 32, 2062–2086.
Bremner, J. D., Southwick, S. M., Darnell, A., & Charney, D. S. (1996). Chronic PTSD in Vietnam combat veterans: course of illness and substance abuse. American Journal of Psychiatry, 153(3), 369–375.
Breslau, N., & Schultz, L. (2013). Neuroticism and post-traumatic stress disorder: a prospective investigation. Psychological medicine, 43(08), 1697–1702.
Briere, J., & Runtz, M. (1987). Post sexual abuse trauma data and implications for clinical practice. Journal of Interpersonal Violence, 2, 367–379.
Bronfenbrenner, U. (1979). Contexts of child rearing: Problems and prospects. American Psychologist, 34, 844–850.
Chassin, L., Sher, K. J., Hussong, A., & Curran, P. (2013). The developmental psychopathology of alcohol use and alcohol disorders: Research achievements and future directions. Development and Psychopathology, 25, 1567–1584.
Colder, C. R. (2001). Life stress, physiological and subjective indexes of negative emotionality, and coping reasons for drinking: Is there evidence for a self-medication model of alcohol use? Psychology of Addictive Behaviors, 15, 237–245.
Cooper, M. L., Frone, M. R., Russell, M., & Mudar, P. (1995). Drinking to regulate positive and negative emotions: A motivational model of alcohol use. Journal of Personality and Social Psychology, 69, 990–1005.
Curran, P. J., & Bauer, D. J. (2011). The disaggregation of within-person and between-person effects in longitudinal models of change. Annual Review of Psychology, 62, 583–619.
Eisenberg, D., Nicklett, E. J., Roeder, K., & Kirz, N. E. (2011). Eating disorder symptoms among college students: Prevalence, persistence, correlates, and treatment-seeking. Journal of American College Health, 59, 700–707.
Elder, G. H. (1998). The life course as developmental theory. Child Development, 69, 1–12.
Ford, J. D., Elhai, J. D., Connor, D. F., & Frueh, B. C. (2010). Poly-victimization and risk of posttraumatic, depressive, and substance use disorders and involvement in delinquency in a national sample of adolescents. Journal of Adolescent Health, 46, 545–552.
Fromme, K., Corbin, W. R., & Kruse, M. I. (2008). Behavioral risks during the transition from high school to college. Developmental Psychology, 44, 1497–1504.
Galambos, N. L., Dalton, A. L., & Maggs, J. L. (2009). Losing sleep over it: Daily variation in sleep quantity and quality in Canadian students' first semester of university. Journal of Research on Adolescence, 18(4), 741–761.
Gottfredson, N. C., & Hussong, A. M. (2013). Drinking to dampen affect variability: Findings from a college student sample. Journal of Studies on Alcohol and Drugs, 74, 576–583.
Hussong, A. M., Gould, L. F., & Hersh, M. A. (2008). Conduct problems moderate self-medication and mood-related drinking consequences in adolescents. Journal of Studies on Alcohol and Drugs, 69, 296–307.
IBM Corp. Released. (2012). IBM SPSS Statistics for Windows, Version 21.0. Armonk: IBM Corp.
John, O. P., & Srivastava, S. (1999). The Big Five trait taxonomy: History, measurement, and theoretical perspectives. Handbook of personality: Theory and research, 2(1999), 102–138.
Johnston, L. D., O’Malley, P. M., Bachman, J. G., & Schulenberg, J. E. (2012). Monitoring the Future national survey results on drug use, 1975–2011. Volume II: College students and adults ages 19–50. Ann Arbor: Institute for Social Research, The University of Michigan.
Kaltman, S., Krupnick, J., Stockton, P., Hooper, L., & Green, B. L. (2005). Psychological impact of types of sexual trauma among college women. Journal of Traumatic Stress, 18, 547–555.
Kaysen, D., Atkins, D. C., Simpson, T. L., Stappenbeck, C. A., Blayney, J. A., Lee, C. M., & Larimer, M. E. (2013). Proximal relationships between PTSD symptoms and drinking among female college students: Results from a daily monitoring study. Psychology of Addictive Behaviors, 28, 62–73.
Ketoja, J., Svidkovski, A. S., Heinälä, P., & Seppä, K. (2013). Risky drinking and its detection among medical students. Addictive Behaviors, 38, 2115–2118.
Khantzian, E. J. (2003). The self-medication hypothesis revisited: The dually-diagnosed patient. Primary Psychiatry, 1047, 53–54.
Kubany, E. S., Haynes, S. Y., Leisen, M. B., Owens, J. A., Kaplan, A. S., Watson, S. B., & Burns, K. (2000). Development and preliminary validation of a brief broad-spectrum measure of trauma exposure: The traumatic life events questionnaire. Psychological Assessment, 12, 210–224.
Larimer, M. E., Lee, C. M., Kilmer, J. R., Fabiano, P. M., Stark, C. B., Geisner, I. M., et al. (2007). Personalized mailed feedback for college drinking prevention: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 75, 285–293.
Lee, M. R., Chassin, L., & Villalta, I. K. (2013). Maturing out of alcohol involvement: Transitions in latent drinking statuses from late adolescence to adulthood. Development and Psychopathology, 25, 1137–1153.
Lerner, R. M. (1982). Children and adolescents as producers of their development. Developmental Review, 2, 342–370.
Littlefield, A. K., Sher, K. J., & Wood, P. K. (2009). Is “maturing out” of problematic alcohol involvement related to personality change? Journal of Abnormal Psychology, 118(2), 360–374.
Martens, M. P., Cimini, M. D., Barr, A. R., Rivero, E. M., Vellis, P. A., Desemone, G. A., & Horner, K. J. (2007). Implementing a screening and brief intervention for high-risk drinking in university-based health and mental health care settings: Reductions in alcohol use and correlates of success. Addictive Behaviors, 32, 2563–2572.
Martens, M. P., Neighbors, C., Lewis, M. A., Lee, C. M., Oster-Aaland, L., & Larimer, M. E. (2008). The roles of negative affect and coping motives in the relationship between alcohol use and alcohol-related problems among college students. Journal of Studies on Alcohol and Drugs, 69, 412–419.
McDevitt-Murphy, M. E., Weathers, F. W., Flood, A. M., Eakin, D. E., & Benson, T. A. (2007). The utility of the PAI and the MMPI-2 for discriminating PTSD, depression, and social phobia in trauma-exposed college students. Assessment, 14, 181–195.
Menary, K. R., Corbin, W. R., Leeman, R. F., Fucito, L. M., Toll, B. A., DeMartini, K., & O’Malley, S. S. (2015). Interactive and indirect effects of anxiety and negative urgency on alcohol-related problems. Alcoholism: Clinical and Experimental Research, 39, 1267–1274.
Najdowski, C. J., & Ullman, S. E. (2009). Prospective effects of sexual victimization on PTSD and problem drinking. Addictive Behaviors, 43, 965–968.
Osgood, D. W. (2005). On your own without a net: The transition to adulthood for vulnerable populations. University of Chicago Press.
Read, J. P., Brown, P. J., & Kahler, C. W. (2004). Substance use and posttraumatic stress disorders: Symptom interplay and effects on outcome. Addictive Behaviors, 29(8), 1665–1672.
Read, J. P., Kahler, C. W., Strong, D., & Colder, C. R. (2006). Development and preliminary validation of the Young Adult Alcohol Consequences Questionnaire. Journal of Studies on Alcohol, 67, 169–178.
Read, J. P., Ouimette, P., White, J., Colder, C., & Farrow, S. (2011). Rates of DSM IV-TR trauma exposure and posttraumatic stress disorder among newly matriculated college students. Trauma: Theory, Research, and Practice, 3, 148–156.
Read, J. P., Colder, C. R., Merrill, J. E., Ouimette, P., White, J., & Swartout, A. (2012). Trauma and posttraumatic stress symptoms predict alcohol and other drug consequence trajectories in the first year of college. Journal of Consulting and Clinical Psychology, 80, 426–439.
Read, J. P., Wardell, J. D., & Colder, C. R. (2013). Reciprocal associations between PTSD and alcohol involvement in college: A three-year trait-state-error analysis. Journal of Abnormal Psychology, 122, 984–997.
Read, J. P., Merrill, J. E., Griffin, M. J., Bachrach, R. L., & Khan, S. N. (2014). Posttraumatic stress symptoms and alcohol problems: Self-medication or trait vulnerability? The American Journal on Addictions, 23, 108–116.
Roodman, A. A., & Clum, G. A. (2001). Revictimization rates and method variance: A meta-analysis. Clinical Psychology Review, 21, 183–204.
Schulenberg, J. E., Bryant, A. L., & O’Malley, P. M. (2004). Taking hold of some kind of life: How developmental tasks relate to trajectories of well-being during the transition to adulthood. Development and Psychopathology, 16, 1119–1140.
Settersten Jr., R. A. (2007). The new landscape of adult life: Road maps, signposts, and speed lines. Research in Human Development, 4, 239–252.
Shah, A. A., Bazargan-Hejazi, S., Lindstrom, R. W., & Wolf, K. E. (2009). Prevalence of at-risk drinking among a national sample of medical students. Substance Abuse, 30(2), 141–149.
Simms, L. J., Watson, D., & Doebbelling, B. N. (2002). Confirmatory factor analyses of posttraumatic stress symptoms in deployed and nondeployed veterans of the Gulf War. Journal of Abnormal Psychology, 111(4), 637–647.
Simons, J. S., Gaher, R. M., Oliver, M. N., Bush, J. A., & Palmer, M. A. (2005). An experience sampling study of associations between affect and alcohol use and problems among college students. Journal of Studies on Alcohol, 66, 459–469.
Simpson, T. L., Stappenbeck, C. A., Luterek, J., Lehavot, K., & Kaysen, D. (2014). Drinking motives moderate daily relationships between PTSD symptoms and alcohol use. Journal of Abnormal Psychology, 123, 237–247.
Smyth, J. M., Hockemeyer, J. R., Heron, K. E., Wonderlich, S. A., & Pennebaker, J. W. (2008). Prevalence, type, disclosure, and severity of adverse life events in college students. Journal of American College Health, 57, 69–76.
U.S. Department of Education National Center for Education Statistics. (2015). Digest of Education Statistics, 2013.
Valdez, C. E., Bailey, B. E., Santuzzi, A. M., & Lilly, M. M. (2014). Trajectories of depressive symptoms in foster youth transitioning into adulthood the roles of emotion dysregulation and PTSD. Child Maltreatment, 19, 209–218.
Wardell, J. D., Read, J. P., & Colder, C. R. (2013). The role of behavioral inhibition and behavioral approach systems in the associations between mood and alcohol consequences in college: A longitudinal multilevel analysis. Addictive Behaviors, 38, 2772–2781.
Weathers, F. W., Litz, B. T., Herman, D. S., Huska, J. A., & Keane, T. M. (1993). The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. In annual convention of the international society for traumatic stress studies, San Antonio (Vol. 462).
Weiss, N. H., Tull, M. T., Anestis, M. D., & Gratz, K. L. (2013). The relative and unique contributions of emotion dysregulation and impulsivity to posttraumatic stress disorder among substance dependent inpatients. Drug and Alcohol Dependence, 128, 45–51.
Wood, M. D., Read, J. P., Palfai, T. P., & Stevenson, J. F. (2001). Social influence processes and college student drinking: the mediational role of alcohol outcome expectancies. Journal of studies on alcohol, 62(1), 32–43.
Zayfert, C. (2012). Cognitive behavioral conceptualization of retraumatization. Retraumatization: Assessment, Treatment, and Prevention, 1, 9–31.
Zlotnick, C., Warshaw, M., Shea, M. T., Allsworth, J., Pearlstein, T., & Keller, M. B. (1999). Chronicity in posttraumatic stress disorder (PTSD) and predictors of course of comorbid PTSD in patients with anxiety disorders. Journal of Traumatic Stress, 12, 89–100.
Acknowledgements
This work was supported by a grant from the National Institute on Drug Abuse (R01DA018993) to Dr. Jennifer P. Read.
We would like to thank Drs. Jackie White, Paige Ouimette, Craig Colder, Ashlyn Swartout, Sherry Farrow, and Jennifer Merrill for their myriad contributions to this project. We also thank the members of the UB Alcohol Research Lab for their many efforts to support data collection for this study and the participants for sharing their experiences.
The TLEQ was used with permission from WPS. Copyright © 2004 by Western Psychological Services. WPS, 12031 Wilshire Boulevard, Los Angeles, California 90025, U.S.A, Format adapted by J. Read, SUNY at Buffalo.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest. This includes those pertaining to academic, personal, or political relationships; employment; consultancies or honoraria, or financial connections.
Funding
This paper is an original empirical study, funded by the National Institute on Drug Abuse (R01DA018993: Read, PI).
Ethical Approval
As noted, this study was approved by the University at Buffalo, SUNY IRB. Participants’ right to privacy was not infringed. The manuscript contains no identifying participant information. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
Informed Consent
As noted in the “Method” section, in collecting data for this paper, we followed APA ethical guidelines. Informed consent was obtained from all participants included in the study.
Rights and permissions
About this article
Cite this article
Read, J.P., Radomski, S. & Wardell, J.D. Posttraumatic Stress and Problem Drinking at the Transition Out of College. Prev Sci 18, 440–449 (2017). https://doi.org/10.1007/s11121-017-0778-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11121-017-0778-0