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Gepubliceerd in: Cognitive Therapy and Research 3/2014

01-06-2014 | Original Article

Low Distress Tolerance and Hyperarousal Posttraumatic Stress Disorder Symptoms: A Pathway to Alcohol Use?

Auteurs: Sophie Duranceau, Mathew G. Fetzner, R. Nicholas Carleton

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 3/2014

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Abstract

Research on substance use suggests that distress tolerance mediates the relationship between posttraumatic stress disorder (PTSD) symptoms and alcohol use; however, given that distress tolerance may represent vulnerabilities for both PTSD symptoms and alcohol use, it may in fact facilitate PTSD and subsequent alcohol use. The present study investigated the relationship between distress tolerance, and alcohol consumption and alcohol-related consequences, with PTSD hyperarousal, re-experiencing, avoidance, and numbing symptoms as mediating variables. A community based North-American sample (n = 146, 81 % = women) completed measures online as part of a larger ongoing study. Results demonstrated that distress tolerance had an indirect effect on alcohol consumption through hyperarousal symptoms but no other PTSD symptoms. No significant relationships were demonstrated with alcohol-related consequences. Findings suggest interventions promoting distress tolerance following trauma exposure may help decrease hyperarousal symptoms and subsequent risk of alcohol-use disorders. Comprehensive results, implications, and future research are discussed.
Voetnoten
1
Due to inconsistencies between what might be termed “social traumas” and the definition of a traumatic event in the DSM, severity of PTSD symptoms were compared between those who indexed a social trauma versus those who did not. Results indicated no statistically significant differences in PTSD symptoms (all p’s >.26) between groups; furthermore, those who indexed a social trauma were not statistically significantly different (p = .50) than persons indexing other types of trauma in the probability of reporting symptoms consistent with probable PTSD.
 
2
Mediation analyses were also run without individuals who indexed a social trauma due to inconsistencies between social traumas and both the DSM-IV-TR and DSM5 defined traumatic events. Results were consistent with the previous analyses wherein there was a statistically significant indirect effect of DTS total score on AUDIT alcohol consumption score through the PCL-C hyperarousal subscale score (p = .05).
 
Literatuur
go back to reference American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
go back to reference Barbor, T. F., de la Fuente, J. R., Saunders, J., & Grant, M. (1989). AUDIT: The alcohol use disorders identification test: Guidelines for use in primary health care (Report No. 89.4). Geneva, CH: World Health Organization. Barbor, T. F., de la Fuente, J. R., Saunders, J., & Grant, M. (1989). AUDIT: The alcohol use disorders identification test: Guidelines for use in primary health care (Report No. 89.4). Geneva, CH: World Health Organization.
go back to reference Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182. doi:10.1037/0022-3514.51.6.1173.PubMedCrossRef Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182. doi:10.​1037/​0022-3514.​51.​6.​1173.PubMedCrossRef
go back to reference Bollen, K. A., & Stine, R. (1990). Direct and indirect effects: Classical and bootstrap estimates of variability. Sociological Methodology, 20(1), 15–140. Bollen, K. A., & Stine, R. (1990). Direct and indirect effects: Classical and bootstrap estimates of variability. Sociological Methodology, 20(1), 15–140.
go back to reference Carleton, R. N., Brundin, P., Asmundson, G. J. G., & Taylor, S. (2006). Traumatic life events questionnaire. Regina: Department of Psychology, University of Regina. Carleton, R. N., Brundin, P., Asmundson, G. J. G., & Taylor, S. (2006). Traumatic life events questionnaire. Regina: Department of Psychology, University of Regina.
go back to reference Collimore, K. C., Carleton, R. N., Hofmann, S. G., & Asmundson, G. J. G. (2010). Posttraumatic stress and social anxiety: The interaction of traumatic events and interpersonal fears. Depression and Anxiety, 27, 1017–1026. doi:10.1002/da.20728.PubMedCrossRef Collimore, K. C., Carleton, R. N., Hofmann, S. G., & Asmundson, G. J. G. (2010). Posttraumatic stress and social anxiety: The interaction of traumatic events and interpersonal fears. Depression and Anxiety, 27, 1017–1026. doi:10.​1002/​da.​20728.PubMedCrossRef
go back to reference Cummings, J. R., Bornovalova, M. A., Ojanen, T., Hunt, E., MacPherson, L., & Lejuez, C. (2013). Time doesn’t change everything: The longitudinal course of distress tolerance and its relationship with externalizing and internalizing symptoms during adolescence. Journal of Abnormal Child Psychology, 41, 735–748. doi:10.1007/s10802-012-9704-x.PubMedCrossRef Cummings, J. R., Bornovalova, M. A., Ojanen, T., Hunt, E., MacPherson, L., & Lejuez, C. (2013). Time doesn’t change everything: The longitudinal course of distress tolerance and its relationship with externalizing and internalizing symptoms during adolescence. Journal of Abnormal Child Psychology, 41, 735–748. doi:10.​1007/​s10802-012-9704-x.PubMedCrossRef
go back to reference Daughters, S. B., Lejuez, C. W., Kahler, C. W., Strong, D. R., & Brown, R. A. (2005). Psychological distress tolerance and duration of most recent abstinence attempt among residential treatment-seeking substance abusers. Psychology of Addictive Behaviors, 19, 208–211. doi:10.1037/0893-164X.19.2.208.PubMedCrossRef Daughters, S. B., Lejuez, C. W., Kahler, C. W., Strong, D. R., & Brown, R. A. (2005). Psychological distress tolerance and duration of most recent abstinence attempt among residential treatment-seeking substance abusers. Psychology of Addictive Behaviors, 19, 208–211. doi:10.​1037/​0893-164X.​19.​2.​208.PubMedCrossRef
go back to reference Daughters, S. B., Reynolds, E. K., MacPherson, L., Kahler, C. W., Danielson, C. K., Zvolensky, M., et al. (2009). Distress tolerance and early adolescent externalizing and internalizing symptoms: The moderating role of gender and ethnicity. Behaviour Research and Therapy, 47, 198–205. doi:10.1016/j.brat.2008.12.001.PubMedCentralPubMedCrossRef Daughters, S. B., Reynolds, E. K., MacPherson, L., Kahler, C. W., Danielson, C. K., Zvolensky, M., et al. (2009). Distress tolerance and early adolescent externalizing and internalizing symptoms: The moderating role of gender and ethnicity. Behaviour Research and Therapy, 47, 198–205. doi:10.​1016/​j.​brat.​2008.​12.​001.PubMedCentralPubMedCrossRef
go back to reference Fetzner, M. G., Collimore, K. C., Carleton, R. N., & Asmundson, G. J. G. (2011). Clarifying the relationship between AS dimensions and PTSD symptom clusters: Are negative and positive affectivity theoretically relevant constructs? Cognitive Behaviour Therapy, 41, 15–25. doi:10.1080/16506073.2011.621971.PubMedCrossRef Fetzner, M. G., Collimore, K. C., Carleton, R. N., & Asmundson, G. J. G. (2011). Clarifying the relationship between AS dimensions and PTSD symptom clusters: Are negative and positive affectivity theoretically relevant constructs? Cognitive Behaviour Therapy, 41, 15–25. doi:10.​1080/​16506073.​2011.​621971.PubMedCrossRef
go back to reference Gosling, S. D., Vazire, S., Srivastava, S., & John, O. P. (2004). Should we trust web-based studies? A comparative analysis of six preconceptions about internet questionnaires. American Psychologist, 59, 93–104. doi:10.1037/0003-066X.59.2.93. Gosling, S. D., Vazire, S., Srivastava, S., & John, O. P. (2004). Should we trust web-based studies? A comparative analysis of six preconceptions about internet questionnaires. American Psychologist, 59, 93–104. doi:10.​1037/​0003-066X.​59.​2.​93.
go back to reference Howell, A. N., Leyro, T. M., Hogan, J., Buckner, J. D., & Zvolensky, M. J. (2010). Anxiety sensitivity, distress tolerance, and discomfort intolerance in relation to coping and conformity motives for alcohol use and alcohol use problems among young adult drinkers. Addictive Behaviors, 35, 1144–1147. doi:10.1016/j.addbeh.2010.07.003.PubMedCentralPubMedCrossRef Howell, A. N., Leyro, T. M., Hogan, J., Buckner, J. D., & Zvolensky, M. J. (2010). Anxiety sensitivity, distress tolerance, and discomfort intolerance in relation to coping and conformity motives for alcohol use and alcohol use problems among young adult drinkers. Addictive Behaviors, 35, 1144–1147. doi:10.​1016/​j.​addbeh.​2010.​07.​003.PubMedCentralPubMedCrossRef
go back to reference Leeies, M., Pagura, J., Sareen, J., & Bolton, J. M. (2010). The use of alcohol and drugs to self-medicate symptoms of posttraumatic stress disorder. Depression and Anxiety, 27, 731–736. doi:10.1002/da.20677.PubMed Leeies, M., Pagura, J., Sareen, J., & Bolton, J. M. (2010). The use of alcohol and drugs to self-medicate symptoms of posttraumatic stress disorder. Depression and Anxiety, 27, 731–736. doi:10.​1002/​da.​20677.PubMed
go back to reference Marshall-Berenz, E. C., Vujanovic, A. A., Bonn-Miller, M. O., Bernstein, A., & Zvolensky, M. J. (2010). Multimethod study of distress tolerance and PTSD symptom severity in a trauma-exposed community sample. Journal of Traumatic Stress, 23, 623–630. doi:10.1002/jts.20568.PubMedCentralPubMedCrossRef Marshall-Berenz, E. C., Vujanovic, A. A., Bonn-Miller, M. O., Bernstein, A., & Zvolensky, M. J. (2010). Multimethod study of distress tolerance and PTSD symptom severity in a trauma-exposed community sample. Journal of Traumatic Stress, 23, 623–630. doi:10.​1002/​jts.​20568.PubMedCentralPubMedCrossRef
go back to reference Prati, G., & Pietrantoni, L. (2009). Optimism, social support, and coping strategies as factors contributing to posttraumatic growth: A meta-analysis. Journal of Loss and Trauma, 14, 364–388. doi:10.1080/15325020902724271.CrossRef Prati, G., & Pietrantoni, L. (2009). Optimism, social support, and coping strategies as factors contributing to posttraumatic growth: A meta-analysis. Journal of Loss and Trauma, 14, 364–388. doi:10.​1080/​1532502090272427​1.CrossRef
go back to reference Preacher, K. J., & Hayes, A. F. (2008). Contemporary approaches to assessing mediation in communication research. In A. F. Hayes, M. D. Slater, & L. B. Snyder (Eds.), The Sage sourcebook of advanced data analysis methods for communication research (pp. 13–54). Thousand Oaks, CA: Sage.CrossRef Preacher, K. J., & Hayes, A. F. (2008). Contemporary approaches to assessing mediation in communication research. In A. F. Hayes, M. D. Slater, & L. B. Snyder (Eds.), The Sage sourcebook of advanced data analysis methods for communication research (pp. 13–54). Thousand Oaks, CA: Sage.CrossRef
go back to reference Saunders, J. B., Aasland, O. G., Babor, T. F., de la Fuente, J. R., & Grant, M. (1993). Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction, 88, 791–804. doi:10.1111/j.1360-0443.1993.tb02093.x.PubMedCrossRef Saunders, J. B., Aasland, O. G., Babor, T. F., de la Fuente, J. R., & Grant, M. (1993). Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II. Addiction, 88, 791–804. doi:10.​1111/​j.​1360-0443.​1993.​tb02093.​x.PubMedCrossRef
go back to reference Simons, J. S., Gaher, R. M., Jacobs, G. A., Meyer, D., & Johnson-Jimenez, E. (2005). Associations between alcohol use and PTSD symptoms among American Red Cross disaster relief workers responding to the 9/11/2001 attacks. The American Journal of Drug and Alcohol Abuse, 31, 285–304. doi:10.1081/ADA-200047937.PubMedCrossRef Simons, J. S., Gaher, R. M., Jacobs, G. A., Meyer, D., & Johnson-Jimenez, E. (2005). Associations between alcohol use and PTSD symptoms among American Red Cross disaster relief workers responding to the 9/11/2001 attacks. The American Journal of Drug and Alcohol Abuse, 31, 285–304. doi:10.​1081/​ADA-200047937.PubMedCrossRef
go back to reference Stewart, S. H., Conrod, P. J., Pihl, R. O., & Dongier, M. (1999). Relations between posttraumatic stress symptom dimensions and substance dependence in a community-recruited sample of substance-abusing women. Psychology of Addictive Behaviors, 13, 78–88. doi:10.1037/0893-164X.13.2.78.CrossRef Stewart, S. H., Conrod, P. J., Pihl, R. O., & Dongier, M. (1999). Relations between posttraumatic stress symptom dimensions and substance dependence in a community-recruited sample of substance-abusing women. Psychology of Addictive Behaviors, 13, 78–88. doi:10.​1037/​0893-164X.​13.​2.​78.CrossRef
go back to reference Stewart, S. H., Mitchell, T. L., Wright, K. D., & Loba, P. (2004). The relations of PTSD symptoms to alcohol use and coping drinking in volunteers who responded to the Swissair Flight 111 airline disaster. Journal of Anxiety Disorders, 18, 51–68. doi:10.1016/j.janxdis.2003.07.006.PubMedCrossRef Stewart, S. H., Mitchell, T. L., Wright, K. D., & Loba, P. (2004). The relations of PTSD symptoms to alcohol use and coping drinking in volunteers who responded to the Swissair Flight 111 airline disaster. Journal of Anxiety Disorders, 18, 51–68. doi:10.​1016/​j.​janxdis.​2003.​07.​006.PubMedCrossRef
go back to reference Stump, M. J., & Smith, J. E. (2008). The relationship between posttraumatic growth and substance use in homeless women with histories of traumatic experiences. The American Journal of Addictions, 17, 478–487. doi:10.1080/10550490802409017.CrossRef Stump, M. J., & Smith, J. E. (2008). The relationship between posttraumatic growth and substance use in homeless women with histories of traumatic experiences. The American Journal of Addictions, 17, 478–487. doi:10.​1080/​1055049080240901​7.CrossRef
go back to reference Tabachnick, B. G., & Fidell, L. S. (2001). Using multivariate statistics (4th ed.). New York, NY: Harper and Row. Tabachnick, B. G., & Fidell, L. S. (2001). Using multivariate statistics (4th ed.). New York, NY: Harper and Row.
go back to reference Vujanovic, A. A., Bonn-Miller, M. O., Potter, C. M., Marshall, E. C., & Zvolensky, M. J. (2011a). An evaluation of the relation between distress tolerance and posttraumatic stress within a trauma-exposed sample. Journal of Psychopathology and Behavioral Assessment, 33, 129–135. doi:10.1007/s10862-010-9209-2.PubMedCentralPubMedCrossRef Vujanovic, A. A., Bonn-Miller, M. O., Potter, C. M., Marshall, E. C., & Zvolensky, M. J. (2011a). An evaluation of the relation between distress tolerance and posttraumatic stress within a trauma-exposed sample. Journal of Psychopathology and Behavioral Assessment, 33, 129–135. doi:10.​1007/​s10862-010-9209-2.PubMedCentralPubMedCrossRef
go back to reference Weathers, F. W., Litz, B. T., Huska, J. A., & Keane, T. M. (1994). PCL-C for DSM-IV. Boston, MA: National Center for PTSD-Behavioral Sciences Division. Weathers, F. W., Litz, B. T., Huska, J. A., & Keane, T. M. (1994). PCL-C for DSM-IV. Boston, MA: National Center for PTSD-Behavioral Sciences Division.
go back to reference Zhao, X., Lynch, J. G, Jr, & Chen, Q. (2010). Reconsidering Baron and Kenny: Myths and truths about mediation analysis. The Journal of Consumer Research, 37, 197–206. doi:10.1086/651257.CrossRef Zhao, X., Lynch, J. G, Jr, & Chen, Q. (2010). Reconsidering Baron and Kenny: Myths and truths about mediation analysis. The Journal of Consumer Research, 37, 197–206. doi:10.​1086/​651257.CrossRef
go back to reference Zvolensky, M. J., Marshall, E. C., Johnson, K., Hogan, J., Bernstein, A., & Bonn-Miller, M. O. (2009). Relations between anxiety sensitivity, distress tolerance, and fear reactivity to bodily sensations to coping and conformity marijuana use motives among young adult marijuana users. Experimental and Clinical Psychopharmacology, 17, 31–42. doi:10.1037/a0014961.PubMedCentralPubMedCrossRef Zvolensky, M. J., Marshall, E. C., Johnson, K., Hogan, J., Bernstein, A., & Bonn-Miller, M. O. (2009). Relations between anxiety sensitivity, distress tolerance, and fear reactivity to bodily sensations to coping and conformity marijuana use motives among young adult marijuana users. Experimental and Clinical Psychopharmacology, 17, 31–42. doi:10.​1037/​a0014961.PubMedCentralPubMedCrossRef
Metagegevens
Titel
Low Distress Tolerance and Hyperarousal Posttraumatic Stress Disorder Symptoms: A Pathway to Alcohol Use?
Auteurs
Sophie Duranceau
Mathew G. Fetzner
R. Nicholas Carleton
Publicatiedatum
01-06-2014
Uitgeverij
Springer US
Gepubliceerd in
Cognitive Therapy and Research / Uitgave 3/2014
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI
https://doi.org/10.1007/s10608-013-9591-7

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