How Do Alcohol Expectations Affect Drinking in People With PTSD?


People affected by post-traumatic stress disorder (PTSD) are unusually likely to develop problems with alcohol use disorder (alcoholism and/or alcohol abuse). In addition, when a person with PTSD drinks excessively, he or she commonly experiences a worsening of PTSD symptoms. In a study scheduled for publication in February 2015 in the journal Addictive Behaviors, a team of American researchers looked at the role that expectancies about the effects of alcohol have on the drinking behaviors of people with PTSD. These researchers also examined the connected role of impulsive behavior.

PTSD and Alcohol Problems

Post-traumatic stress disorder occurs in a substantial minority of people who witness or participate in an event that either produces life-threatening circumstances or appears to produce life-threatening circumstances. Women who live through traumatic events develop the condition somewhat more often than men who live through such events. Compared to other people from similar demographic backgrounds (i.e., age, gender, racial/ethnic ancestry, etc.), people who develop PTSD are more likely to consume alcohol in excessive amounts and develop diagnosable alcohol problems, the National Center for PTSD reports. Conversely, people with diagnosable alcohol problems have higher chances of developing PTSD in the aftermath of traumatic situations. Specific sources of trauma most often associated with problematic alcohol use include physical abuse and sexual abuse during childhood and physical or sexual assault during adulthood. Other sources of trauma sometimes associated with problematic alcohol use include natural disasters, life-threatening illnesses and major accidents.

People with PTSD may turn to alcohol for several reasons, including hopes of easing the intensity of their symptoms. However, alcohol intake in general and drunkenness in particular can increase the severity of several common symptoms of post-traumatic stress disorder. Specifically, alcohol intake and drunkenness can increase the social isolation of a PTSD-affected person, intensify the impact of PTSD-related mood disturbances, increase PTSD-related emotional detachment and worsen a PTSD-related inability to shut down the body’s “fight-or-flight” reflex.

Alcohol Expectancies

Positive expectations of alcohol consumption commonly include things such as increased pleasure levels and increased ease of social interaction. Negative drinking expectations include such things as the chance of developing a hangover and increasing risks for participation in unsafe driving.

Drinking Expectancies and PTSD

In the study scheduled for publication in Addictive Behaviors, researchers from the University of Mississippi and the Department of Veterans Affairs used the help of 63 adults to explore the connection between alcohol expectations, the presence of PTSD and any given individual’s typical level of alcohol intake. The researchers also explored the connection between these issues and an age-inappropriate level of involvement in impulsive or reckless behavior. All 63 of the study participants had a diagnosis for PTSD, as well as a diagnosis for some form of substance use disorder (substance addiction/substance abuse). In addition, all of the participants were in residential treatment for their substance-related issues.

The researchers concluded that highly impulsive, PTSD-affected adults are unusually likely to consume alcohol in excessive amounts that contribute significantly to the risks for developing alcohol use disorder. The researchers also concluded that positive alcohol expectancies help explain the connection between impulsive behavior and hazardous drinking. Specifically, when an impulsive person with PTSD has a low or moderate expectation that alcohol use will produce positive outcomes, he or she has a greater chance of drinking in excessive amounts. However, the researchers found that PTSD-affected individuals with high expectations for alcohol’s positive effects will increase the amount they drink whether or not they have an unusual tendency toward impulsive behavior. In addition, they found that impulsive behavior and negative expectations for alcohol use do not have an impact on the amount of alcohol people with PTSD consume.

The study’s authors believe their findings show that impulsive behavior and positive alcohol expectancies work together to help determine how much alcohol a person simultaneously impacted by PTSD and any form of substance use disorder typically drinks.

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