• Kirsten J Langdon, Annie B Fox, Lynda A King, Daniel W King, Susan Eisen, and Dawne Vogt.
• National Center for PTSD, Women's Health Sciences Division, VA Boston Healthcare System, United States; Department of Psychiatry, Boston University School of Medicine, United States. Electronic address: kirstenjlangdon@gmail.com.
• J Affect Disord. 2016 May 15; 196: 234-42.

BackgroundAlthough alcohol misuse co-occurs with PTSD symptoms at a strikingly high rate (i.e., nearly 52% of men and 28% of women with PTSD also meet diagnostic criteria for an Alcohol Use Disorder), the functional associations between these symptom types remain unclear.MethodsThe current study sought to clarify the nature of posttraumatic stress-alcohol misuse relations by employing a prospective longitudinal methodology-the latent difference score approach-to examine dynamic change in posttraumatic stress symptoms and alcohol misuse among 478 combat-exposed Veterans completing a longitudinal survey of post-deployment mental and physical health. This study builds on the existing literature, as most prior research has been limited to cross-sectional studies and has not explored prospective relations between specific PTSD symptom clusters and alcohol misuse.ResultsConsistent with the self-medication model, results indicated that PTSD symptoms demonstrate a prospective and proximal association with alcohol misuse during the assessment period; however, alcohol misuse did not appear to be a unique contributor to overall PTSD symptom exacerbation over time. Examination of individual PTSD symptom clusters revealed that more severe symptoms of intrusion and numbing, but not avoidance and hyperarousal, predicted greater alcohol misuse at subsequent time intervals.LimitationsThe constructs examined within this investigation relied on self-report data; diagnostic criteria for PTSD and/or Alcohol Use Disorders were not assessed. Future work may benefit from replicating these findings in clinical populations formally diagnosed with PTSD via clinician-administered structured interviews.ConclusionsFindings underscore the importance of addressing PTSD symptoms in the context of alcohol treatment to facilitate improved drinking outcomes.Copyright © 2016 Elsevier B.V. All rights reserved.

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