ABSTRACT
Stressors and trauma exposures are risk factors for increased alcohol use and alcohol use disorder (AUD), particularly among those with posttraumatic stress disorder (PTSD) symptoms. The COVID- 19 pandemic represents a prolonged, collective stressor;research is needed to determine its impact on alcohol use outcomes and PTSD and their functional relationship (i.e., PTSD symptoms predicting alcohol use outcomes [self-medication pathway], or alcohol use outcomes predicting later PTSD [susceptibility pathway]). Further, research on the interplay of alcohol use and the likelihood of engaging in risky behaviors during the pandemic is needed. We will present on results of a two-part study for which data collection is ongoing. The first aim leverages an existing registry cohort of veterans with data prior to the COVID-19 pandemic, including alcohol consumption, PTSD, and chronic health conditions. We will examine longitudinal data (current n = 33) collected at three time points with latent growth curve modeling to assess trajectories of change in alcohol use outcomes during the pandemic, controlling for pre-COVID alcohol consumption and PTSD symptoms. Results are forthcoming pending completion of all planned longitudinal data collection. The second aim implements ecological momentary assessment (EMA) data collection (current n = 26) including alcohol use, problems, and PTSD symptoms assessed three times per day for 28 days. Linear and nonlinear multilevel models will examine the bidirectional prospective relationships between momentary PTSD symptom severity and binge drinking occasions and momentary manifestations of alcohol use problems. Based on an earlier data freeze, preliminary results suggest that PTSD symptom severity had a limited association with later alcohol problems or binge drinking (although a same-day association was found for alcohol problems;B = .004, SE = .001, p = .008). Momentary alcohol use problems and binge drinking occasions showed trend-level associations with subsequent momentary PTSD symptom severity (and a same-day association was found for alcohol use problems on PTSD symptom severity;B = 2.41, SE = .62, p = .001). Preliminary findings show potentially stronger support for the susceptibility pathway model over the self-medication pathway model of PTSD and alcohol phenotypes co-occurrence. Secondary analyses of the whole sample will examine the association of risky behaviors with alcohol phenotypes. The impact of COVID-19 stressors and physical health covariates on alcohol and PTSD outcomes will also be examined.