Does insomnia mediate the link between childhood trauma and impaired control over drinking, alcohol use, and related problems?

INTRODUCTION: Hyperarousal theory states that stressful negative events can result in a physiological response in the body leading to poor sleep quality. Childhood trauma is associated with many negative health consequences persisting into adulthood such as insomnia. Insomnia itself is a driver of poor physical and psychological health including excessive alcohol use. We examined the direct and indirect relationships between trauma (i.e., physical-neglect, physical, emotional, and sexual abuse) as well as emotionally supportive families on insomnia, impaired control over drinking, alcohol use, and alcohol-related problems. METHODS: We studied a sample of 941 college students (467 women, 474 men). For our data analysis, we used a structural equation model with model indirect commands and 20,000 iteration bootstrapping with asymmetric confidence intervals in Mplus to obtain our mediated effects. RESULTS: Higher levels of emotional abuse were directly associated with more insomnia. Further, higher levels of physical neglect were directly associated with more impaired control over drinking. We found several mediational pathways from this investigation as well. Higher levels of emotional abuse were indirectly linked to both more alcohol use and alcohol-related problems through increased insomnia and impaired control over drinking. CONCLUSIONS: Our results were consistent with Hyperarousability Theory. We suggest that insomnia may contribute to dysregulated drinking and that combating emotional abuse could be a promising therapeutic target of intervention among college student social drinkers.

Dimensions of childhood trauma and their direct and indirect links to PTSD, impaired control over drinking, and alcohol-related-problems.

INTRODUCTION: Post-Traumatic Stress Disorder (PTSD) develops after experiencing events that evoke fear, helplessness, or horror. The Hyperarousablity Hypothesis suggests that those with PTSD may drink more to dampen physiological reactivity. We examined the direct and indirect relationships between childhood trauma (e.g., physical-neglect, emotional-abuse, physical-abuse, sexual-abuse) versus an emotionally-supportive-family on PTSD, impaired control over drinking (IC), alcohol-use, and alcohol-related-problems. IC reflects consuming more alcohol than one originally intended. METHODS: We fit a multiple-group SEM to data on 835 participants. Mediational analyses were conducted by using the (K = 20,000) bootstrap technique with confidence intervals. RESULTS: Physical-neglect was directly linked to more IC among both genders. Emotional abuse was also found to be directly linked to more PTSD among both genders. Furthermore, PTSD was directly linked to more impaired control over alcohol use (IC) among both genders. Mediational analyses showed that physical-neglect was indirectly linked to more alcohol-related-problems through increased IC. Having an emotionally supportive family was directly linked to fewer PTSD symptoms among women. For both genders, emotional abuse was indirectly linked to more alcohol-related-problems through more PTSD symptoms, impaired control over alcohol use difficulties, and in turn, more alcohol-use. Sexual abuse was indirectly linked to increased alcohol-related- problems through increased PTSD symptoms and more IC, and in turn, more alcohol-use among men. CONCLUSIONS: Recalled childhood trauma (sexual and emotional abuse) may contribute to PTSD symptoms and dysregulated drinking. In conclusion, our data suggest that reducing PTSD symptoms may assist individuals in regaining control over their drinking.

Novel Associations Among Trauma, Mindfulness, and Impaired Control Over Alcohol Use.

Objective: Two thirds of adults experience at least one lifetime traumatic incident. Specifically, childhood traumas (physical neglect, emotional neglect, physical abuse, emotional abuse, and sexual abuse) are associated with increased alcohol use. According to the self-medication hypothesis, alcohol is used to alleviate upsetting thoughts and memories. This may lead to greater impaired control over alcohol use (i.e., a breakdown of an intention to limit drinking). Utilizing mindfulness reduces maladaptive responses to trauma. Trauma and difficulties maintaining control (generally) have been examined with mindfulness as a mediator; however, control over alcohol use specifically, has not. Methods: We analyzed data from a cross-sectional, student survey (N = 847, 49% female) utilizing path modeling. We examined mindfulness and impaired control over alcohol use as potential mediators between trauma and alcohol outcomes (i.e., drinks per drinking day [DPDD] and alcohol-related problems). Results: Emotional neglect (EN) was the strongest predictor among five facets of trauma. Higher EN related to lower mindfulness (ß = - 0.22; SE = 0.05; p ≤ 0.001) and greater impaired control over alcohol (ß = 0.11; SE = 0.06; p = 0.05). Finally, EN was related to higher DPDD, mediated by mindfulness and impaired control over alcohol use (standardized indirect effect = 0.006; 95% CI, 0.002, 0.012). Conclusion: These findings suggest potential mediating pathways from childhood trauma to alcohol-related outcomes via mindfulness and greater impaired control over alcohol use. Current research informs efforts to promote mindfulness interventions to reduce alcohol use and related problems among college students, especially those who have experienced childhood traumas and may experience elevated impaired control over alcohol use.