The proposed project aims to prepare the P.I. for a career as a clinical scientist in an academic medical setting with a program of research focused on the development and evaluation of interventions targeting comorbid alcohol use disorders and posttraumatic stress disorder (PTSD). Accordingly, the proposed training plan systematically targets training in 1) PTSD and alcohol use disorders (AUDs), with an emphasis on related comorbidity, 2) social functioning (with an emphasis on social conflict), 3) conducting and employing translational research to inform treatment development, and 4) treatment evaluation. These training goals were designed to be addressable via the feasible combination of intensive on-site mentoring from a primary and secondary sponsor, focused coursework, targeted clinical activities, off-site training opportunities, and dissemination activities describd throughout the application. Collectively, these activities will serve as a critical springboard for the P.I. in her pursuit of the above-stated career goal by yielding training in the use of advanced laboratory-based methods to understand possible maintaining mechanisms common to both PTSD and alcohol use disorders. The proposed research project will enhance training for the above-stated career targeted by the P.I. by providing valuable experience in the administration of a methodologically-advanced, controlled, laboratory- based study of social conflict among 70 adult hazardous drinkers with at least subthreshold PTSD. The primary aim of the study is to investigate the effects of social conflict on both state posttraumatic stress symptoms and alcohol approach bias. Posttraumatic stress symptom reactions will be measured via self-report of symptoms and facial electromyography-measured responses;alcohol approach bias will be measured via self-reported craving levels and the alcohol-related Approach-Avoidance Task. Participants will be randomly assigned (stratified by participant sex) to either a neutral social script or a social conflict script condition. It is predicted that participants in the social conflct condition, compared to those in the neutral social condition, will evidence greater posttraumatic stress symptom reactions and alcohol approach bias in response to script administration. It is further predicted that these effects will be greater for women than men. Importantly, this study will address a clinically significant gap in existing research, which has not examined social conflict as a possible common maintaining mechanism in PTSD/hazardous alcohol use comorbidity. The proposed project is demonstrably significant in light of research suggesting individuals with comorbid PTSD/AUD experience many particularly severe problems, including but not limited to, poorer quality of life and worse treatment outcomes compared to those who are diagnosed with only one of the aforementioned disorders. Accordingly, the proposed program of training and research has considerable potential to ultimately impact the significant public health burden posed by comorbid PTSD/AUDs.
Both hazardous alcohol use and posttraumatic stress disorder (PTSD) represent major public health problems. In addition, people suffering from both of these problems at the same time experience especially poor health and treatments do not work particularly well for them. In order to improve treatments for this population, we need to develop a better understanding of factors that maintain both of these problems and use that information to systematically improve treatment approaches. Social conflict is one factor that may maintain both problems. As such, this study is designed to understand the effects of social conflict on posttraumatic stress symptoms and biases toward approaching alcohol. The associated training plan is designed to advance my expertise in clinical science to prepare me for a career aimed at improving treatments for this population. As such, the proposed program has significant potential to impact the public health burden and suffering those results from co-occurring hazardous alcohol use and PTSD.
