The proposed project aims to prepare the P. I. for a career as a clinical scientist in a research-oriented academic institution with a program of research focused on increasing our understanding of interventions targeting comorbid posttraumatic stress disorder (PTSD) and alcohol misuse. Accordingly, the proposed training plan systematically targets training in 1) PTSD-alcohol misuse comorbidity, 2) alcohol use to regulate affect, 3) affect regulation in the context of PTSD, and 4) intervention development and evaluation. These activities represent crucial steps towards the stated career goals by yielding experience and training in the use of sophisticated laboratory-based methods to understand the maintenance of PTSD and alcohol misuse and translate this knowledge to the development of more efficacious interventions for this comorbidity. The associated research project is related to each of the proposed training goals and provides valuable experience in the administration of a methodologically-sophisticated, controlled, laboratory-based. The proposed sample will consist of 76 adults who meet criteria for at least subthreshold PTSD and endorse hazardous alcohol use. The primary aim of this study is to investigate the effect of an integrated psychoeducation approach focused on risks associated with drinking to reduce negative affect on confidence to refrain from drinking, motivation to quit drinking, and changes in motives for drinking. Participants will be randomly assigned to one of four psychoeducation conditions (i.e., health information control, concurrent PTSD-alcohol, concurrent alcohol-PTSD, and integrated). It is predicted that integrated psychoeducation, compared to all other conditions, will result in each of the following after being presented with ideographic traumatic event and alcohol use-related cues: 1) increased confidence to refrain from alcohol use, 2) increased motivation to quit alcohol use, and 3) greater reductions in self-reported negative affect reduction motives for alcohol use. The study also seeks to empirically test the impact of sex on these hypothesized effects. This will directly address a clinically-significant gap in existing research which has not examined the effect of sex on psychoeducation outcomes despite evidence suggesting sex is likely to impact the effect of psychoeducation. This program of research is demonstrably significant in light of research that suggests individuals suffering from comorbid PTSD and alcohol misuse experience poorer quality of life and poorer prognosis in treatment when compared to individuals with PTSD or alcohol misuse only. Further, existing treatments for comorbid PTSD and alcohol misuse are associated with unsatisfactory improvements in PTSD symptoms and alcohol use, which suggests current approaches may not be addressing the evidence-based mechanisms implicated in this type of comorbidity. The current study, therefore, represents an early attempt to isolate the effects of an intervention component being employed in the treatment of PTSD-alcohol use comorbidity in the controlled environment of the laboratory to develop an evidence base to inform future intervention development.
Leading scientists interested in treating the millions of people suffering from both posttraumatic stress disorder (PTSD) and alcohol use disorders (AUDs) report that treatments are not particularly effective;however, no treatments focus on factors that explain why the two commonly co-occur. Focusing on these factors in treatment may improve our limited ability to help people suffering from this common and complex problem. Controlled research in the laboratory is needed to examine the potential of this approach prior to trying it a a large scale. This study, therefore, is the first controlled laboratory study that tries to understand how to best change drinking to cope, which many scientists believe explains why PTSD and AUDs co-occur so frequently. Findings will provide valuable information critical to improving treatments for people suffering from both PTSD and an AUD.
